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Ouyang F, Chen X, Liang J, Li J, Jiang Z, Chen Y, Yan Z, Zeng J, Xing S. Population-Average Brain Templates and Application to Automated Voxel-Wise Analysis Pipelines for Cynomolgus Macaque. Neuroinformatics 2022; 20:613-626. [PMID: 34523062 DOI: 10.1007/s12021-021-09545-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 12/31/2022]
Abstract
The growing number of neuroimaging studies of cynomolgus macaques require extending existing templates to facilitate species-specific application of voxel-wise neuroimaging methodologies. This study aimed to create population-averaged structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) templates for the cynomolgus macaques and apply the templates in fully automated voxel-wise analyses. We presented the development of symmetric and asymmetric MRI and DTI templates from a sample of 63 young male cynomolgus monkeys with the use of optimized template creation approaches. We also generated the associated average tissue probability maps and Diffeomorphic Anatomical Registration using Exponentiated Lie Algebra templates for use with the Statistical Parametric Mapping (SPM), as well as the average fractional anisotropy/skeleton targets for incorporation into tract-based spatial statistics (TBSS) framework. Both asymmetric and symmetric templates in a standardized coordinate space demonstrated low bias and high contrast. Fully automated processing using SPM was accomplished for all native MRI datasets and demonstrated outstanding performance regarding skull-stripping, segmentation, and normalization when using the MRI templates. Automated normalization to the DTI template was excellently achieved for all native DTI images using the TBSS pipeline. The cynomolgus MRI and DTI templates are anticipated to provide a common platform for precise single-subject data analysis and facilitate comparison of neuroimaging findings in cynomolgus monkeys across studies and sites. It is also hoped that the procedures of template creation and fully-automated voxel-wise frameworks will provide a straightforward avenue for investigating brain function, development, and neuro-psychopathological disorders in non-human primate models.
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Affiliation(s)
- Fubing Ouyang
- Department of Neurology and Stroke Center, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, The First Affiliated Hospital, Sun Yat-Sen University, National Key Clinical Department and Key Discipline of Neurology, No. 58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Xinran Chen
- Department of Neurology and Stroke Center, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, The First Affiliated Hospital, Sun Yat-Sen University, National Key Clinical Department and Key Discipline of Neurology, No. 58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Jiahui Liang
- Department of Neurology and Stroke Center, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, The First Affiliated Hospital, Sun Yat-Sen University, National Key Clinical Department and Key Discipline of Neurology, No. 58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Jianle Li
- Department of Neurology and Stroke Center, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, The First Affiliated Hospital, Sun Yat-Sen University, National Key Clinical Department and Key Discipline of Neurology, No. 58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Zimu Jiang
- Department of Neurology and Stroke Center, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, The First Affiliated Hospital, Sun Yat-Sen University, National Key Clinical Department and Key Discipline of Neurology, No. 58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Yicong Chen
- Department of Neurology and Stroke Center, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, The First Affiliated Hospital, Sun Yat-Sen University, National Key Clinical Department and Key Discipline of Neurology, No. 58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Zhicong Yan
- Department of Neurology and Stroke Center, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, The First Affiliated Hospital, Sun Yat-Sen University, National Key Clinical Department and Key Discipline of Neurology, No. 58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Jinsheng Zeng
- Department of Neurology and Stroke Center, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, The First Affiliated Hospital, Sun Yat-Sen University, National Key Clinical Department and Key Discipline of Neurology, No. 58 Zhongshan Road 2, Guangzhou, 510080, China.
| | - Shihui Xing
- Department of Neurology and Stroke Center, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, The First Affiliated Hospital, Sun Yat-Sen University, National Key Clinical Department and Key Discipline of Neurology, No. 58 Zhongshan Road 2, Guangzhou, 510080, China.
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Kumar A, Kim S, Su Y, Sharma M, Kumar P, Singh S, Lee J, Furdui CM, Singh R, Hsu FC, Kim J, Whitlow CT, Nader MA, Deep G. Brain cell-derived exosomes in plasma serve as neurodegeneration biomarkers in male cynomolgus monkeys self-administrating oxycodone. EBioMedicine 2021; 63:103192. [PMID: 33418508 PMCID: PMC7804975 DOI: 10.1016/j.ebiom.2020.103192] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/16/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023] Open
Abstract
Background The United States is currently facing an opioid crisis. Novel tools to better comprehend dynamic molecular changes in the brain associated with the opioid abuse are limited. Recent studies have suggested the usefulness of plasma exosomes in better understanding CNS disorders. However, no study has ever characterized exosomes (small extracellular vesicles of endocytic origin) secreted by brain cells to understand the potential neurodegenerative effects of long-term oxycodone self-administration (SA). Methods MRI of Cynomolgus monkeys (Macaca fascicularis) was performed to assess alterations in gray matter volumes with oxycodone SA. We isolated total exosomes (TE) from the plasma of these monkeys; from TE, we pulled-out neuron-derived exosomes (NDE), astrocytes-derived exosomes (ADE), and microglia-derived exosomes (MDE) using surface biomarkers L1CAM (L1 cell adhesion molecule), GLAST (Glutamate aspartate transporter) and TMEM119 (transmembrane protein119), respectively. Findings We observed a significantly lower gray matter volume of specific lobes of the brain (frontal and parietal lobes, and right putamen) in monkeys with ∼3 years of oxycodone SA compared to controls. Higher expression of neurodegenerative biomarkers (NFL and α-synuclein) correlates well with the change in brain lobe volumes in control and oxycodone SA monkeys. We also identified a strong effect of oxycodone SA on the loading of specific miRNAs and proteins associated with neuro-cognitive disorders. Finally, exosomes subpopulation from oxycodone SA group activated NF-κB activity in THP1- cells. Interpretation These results provide evidence for the utility of brain cells-derived exosomes from plasma in better understanding and predicting the pro-inflammatory and neurodegenerative consequence of oxycodone SA. Funding NIH
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Affiliation(s)
- Ashish Kumar
- Department of Cancer Biology, Wake Forest Baptist Medical Center, United States
| | - Susy Kim
- Department of Cancer Biology, Wake Forest Baptist Medical Center, United States
| | - Yixin Su
- Department of Cancer Biology, Wake Forest Baptist Medical Center, United States
| | - Mitu Sharma
- Department of Cancer Biology, Wake Forest Baptist Medical Center, United States
| | - Pawan Kumar
- Department of Cancer Biology, Wake Forest Baptist Medical Center, United States
| | - Sangeeta Singh
- Department of Cancer Biology, Wake Forest Baptist Medical Center, United States
| | - Jingyun Lee
- Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, United States; Proteomics and Metabolomics Shared Resource, Wake Forest Baptist Health, United States
| | - Cristina M Furdui
- Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, United States; Proteomics and Metabolomics Shared Resource, Wake Forest Baptist Health, United States; Comprehensive Cancer Center, Wake Forest Baptist Health, United States
| | - Ravi Singh
- Department of Cancer Biology, Wake Forest Baptist Medical Center, United States; Comprehensive Cancer Center, Wake Forest Baptist Health, United States
| | - Fang-Chi Hsu
- Comprehensive Cancer Center, Wake Forest Baptist Health, United States; Biostatistics and Data Science, Wake Forest Baptist Health, United States
| | - Jeongchul Kim
- Radiology Informatics and Image Processing Laboratory, Wake Forest School of Medicine, United States; Department of Radiology, Section of Neuroradiology, Wake Forest School of Medicine, United States
| | - Christopher T Whitlow
- Comprehensive Cancer Center, Wake Forest Baptist Health, United States; Biostatistics and Data Science, Wake Forest Baptist Health, United States; Radiology Informatics and Image Processing Laboratory, Wake Forest School of Medicine, United States; Department of Radiology, Section of Neuroradiology, Wake Forest School of Medicine, United States; Department of Biomedical Engineering, Wake Forest School of Medicine, United States; Center for Research on Substance Use and Addiction, Wake Forest School of Medicine, United States
| | - Michael A Nader
- Center for Research on Substance Use and Addiction, Wake Forest School of Medicine, United States; Department of Physiology and Pharmacology, Wake Forest School of Medicine, Medical Center Boulevard, NRC 546, Winston-Salem, NC 27157, United States.
| | - Gagan Deep
- Department of Cancer Biology, Wake Forest Baptist Medical Center, United States; Comprehensive Cancer Center, Wake Forest Baptist Health, United States; Center for Research on Substance Use and Addiction, Wake Forest School of Medicine, United States; Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC, United States.
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Al Harrach M, Rousseau F, Groeschel S, Chabrier S, Hertz-Pannier L, Lefevre J, Dinomais M. Is the Blood Oxygenation Level-Dependent fMRI Response to Motor Tasks Altered in Children After Neonatal Stroke? Front Hum Neurosci 2020; 14:154. [PMID: 32410976 PMCID: PMC7202247 DOI: 10.3389/fnhum.2020.00154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/07/2020] [Indexed: 12/13/2022] Open
Abstract
Functional MRI is increasingly being used in the assessment of brain activation and connectivity following stroke. Many of these studies rely on the Blood Oxygenation Level Dependent (BOLD) contrast. However, the stability, as well as the accuracy of the BOLD response to motor task in the ipsilesional hemisphere, remains ambiguous. In this work, the BOLD signal acquired from both healthy and affected hemispheres was analyzed in 7-year-old children who sustained a Neonatal Arterial Ischemic Stroke (NAIS). Accordingly, a repetitive motor task of the contralesional and the ipsilesional hands was performed by 33 patients with unilateral lesions. These patients were divided into two groups: those without cerebral palsy (NAIS), and those with cerebral palsy (CP). The BOLD signal time course was obtained from distinctly defined regions of interest (ROIs) extracted from the functional activation maps of 30 healthy controls with similar age and demographic characteristics as the patients. An ROI covering both the primary motor cortex (M1) and the primary somatosensory cortex (S1) was also tested. Compared with controls, NAIS patients without CP had similar BOLD amplitude variation for both the contralesional and the ipsilesional hand movements. However, in the case of NAIS patients with CP, a significant difference in the averaged BOLD amplitude was found between the healthy and affected hemisphere. In both cases, no progressive attenuation of the BOLD signal amplitude was observed throughout the task epochs. Besides, results also showed a correlation between the BOLD signal percentage variation of the lesioned hemisphere and the dexterity level. These findings suggest that for patients who sustained a NAIS with no extensive permanent motor impairment, BOLD signal-based data analysis can be a valuable tool for the evaluation of functional brain networks.
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Affiliation(s)
- Mariam Al Harrach
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS) EA7315, Université d'Angers, Polytech Angers, Angers, France
| | | | - Samuel Groeschel
- Department of Child Neurology, Paediatric Neuroimaging, University Hospital, Tübingen, Germany
| | - Stéphane Chabrier
- INSERM UMR1059 Sainbiose, Univ Saint-Étienne, Univ Lyon, Saint-Étienne, France.,INSERM, CIC 1408, CHU Saint-Étienne, French Centre for Paediatric Stroke, Paediatric Physical and Rehabilitation Medicine Department, Saint-Étienne, France
| | - Lucie Hertz-Pannier
- INSERM U114 Neurospin, UNIACT, Institut Joliot, Université de Paris, CEA-Paris Saclay, Gif sur Yvette, France
| | - Julien Lefevre
- UMR CNRS 7289, Aix Marseille Université, Institut de Neurosciences de la Timone, Marseille, France
| | - Mickael Dinomais
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS) EA7315, Université d'Angers, Polytech Angers, Angers, France.,CHU Angers, Département de Médecine Physique et de Réadaptions and LUNAM, Angers, France
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He B, Yang Z, Fan L, Gao B, Li H, Ye C, You B, Jiang T. MonkeyCBP: A Toolbox for Connectivity-Based Parcellation of Monkey Brain. Front Neuroinform 2020; 14:14. [PMID: 32410977 PMCID: PMC7198896 DOI: 10.3389/fninf.2020.00014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/10/2020] [Indexed: 01/24/2023] Open
Abstract
Non-human primate models are widely used in studying the brain mechanism underlying brain development, cognitive functions, and psychiatric disorders. Neuroimaging techniques, such as magnetic resonance imaging, play an important role in the examinations of brain structure and functions. As an indispensable tool for brain imaging data analysis, brain atlases have been extensively investigated, and a variety of versions constructed. These atlases diverge in the criteria based on which they are plotted. The criteria range from cytoarchitectonic features, neurotransmitter receptor distributions, myelination fingerprints, and transcriptomic patterns to structural and functional connectomic profiles. Among them, brainnetome atlas is tightly related to brain connectome information and built by parcellating the brain on the basis of the anatomical connectivity profiles derived from structural neuroimaging data. The pipeline for building the brainnetome atlas has been published as a toolbox named ATPP (A Pipeline for Automatic Tractography-Based Brain Parcellation). In this paper, we present a variation of ATPP, which is dedicated to monkey brain parcellation, to address the significant differences in the process between the two species. The new toolbox, MonkeyCBP, has major alterations in three aspects: brain extraction, image registration, and validity indices. By parcellating two different brain regions (posterior cingulate cortex) and (frontal pole) of the rhesus monkey, we demonstrate the efficacy of these alterations. The toolbox has been made public (https://github.com/bheAI/MonkeyCBP_CLI, https://github.com/bheAI/MonkeyCBP_GUI). It is expected that the toolbox can benefit the non-human primate neuroimaging community with high-throughput computation and low labor involvement.
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Affiliation(s)
- Bin He
- School of Mechanical and Power Engineering, Harbin University of Science and Technology, Harbin, China
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Zhengyi Yang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Lingzhong Fan
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Bin Gao
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Hai Li
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Chuyang Ye
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Bo You
- School of Mechanical and Power Engineering, Harbin University of Science and Technology, Harbin, China
| | - Tianzi Jiang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Chinese Institute for Brain Research, Beijing, China
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A nonhuman primate model of early Alzheimer's disease pathologic change: Implications for disease pathogenesis. Alzheimers Dement 2018; 15:93-105. [PMID: 30467082 PMCID: PMC6383152 DOI: 10.1016/j.jalz.2018.06.3057] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/18/2018] [Accepted: 06/28/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Nonhuman primates may serve as excellent models of sporadic age-associated brain β-amyloid deposition and Alzheimer's disease pathologic changes. We examined whether a vervet nonhuman primate model recapitulated pathologic, physiologic, and behavioral features of early Alzheimer's disease. METHODS Nine middle-aged (mean = 11.2 years) and nine aged (mean = 21.7 years) female vervet/African green monkeys underwent cerebrospinal fluid collection, gait speed measurement, and neuroimaging before neuropathologic assessment. RESULTS β-amyloid plaques were identified in all aged vervets and paired helical filament tau immunoreactivity was observed in all animals. Cerebrospinal fluid β-amyloid42 and gait speed correlated negatively with age and plaque density. Greater plaque and paired helical filament tau burden predicted reduced volumes and CMRg in several brain regions. DISCUSSION We observed a coordinated set of relationships among neuropathologic, cerebrospinal fluid, imaging, and behavioral modalities consistent with early Alzheimer's disease. Our results support future use of the vervet model to explore disease mechanisms, biomarkers, and novel therapeutic strategies.
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Morphometric analysis and neuroanatomical mapping of the zebrafish brain. Methods 2018; 150:49-62. [PMID: 29936090 DOI: 10.1016/j.ymeth.2018.06.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/14/2018] [Indexed: 12/21/2022] Open
Abstract
Large-scale genomic studies have recently identified genetic variants causative for major neurodevelopmental disorders, such as intellectual disability and autism. However, determining how underlying developmental processes are affected by these mutations remains a significant challenge in the field. Zebrafish is an established model system in developmental neurogenetics that may be useful in uncovering the mechanisms of these mutations. Here we describe the use of voxel-intensity, deformation field, and volume-based morphometric techniques for the systematic and unbiased analysis of gene knock-down and environmental exposure-induced phenotypes in zebrafish. We first present a computational method for brain segmentation based on transgene expression patterns to create a comprehensive neuroanatomical map. This map allowed us to disclose statistically significant changes in brain microstructure and composition in neurodevelopmental models. We demonstrate the effectiveness of morphometric techniques in measuring changes in the relative size of neuroanatomical subdivisions in atoh7 morphant larvae and in identifying phenotypes in larvae treated with valproic acid, a chemical demonstrated to increase the risk of autism in humans. These tools enable rigorous evaluation of the effects of gene mutations and environmental exposures on neural development, providing an entry point for cellular and molecular analysis of basic developmental processes as well as neurodevelopmental and neurodegenerative disorders.
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Tyrrell DJ, Bharadwaj MS, Jorgensen MJ, Register TC, Shively C, Andrews RN, Neth B, Keene CD, Mintz A, Craft S, Molina AJA. Blood-Based Bioenergetic Profiling Reflects Differences in Brain Bioenergetics and Metabolism. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:7317251. [PMID: 29098063 PMCID: PMC5643153 DOI: 10.1155/2017/7317251] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/09/2017] [Accepted: 07/20/2017] [Indexed: 11/18/2022]
Abstract
Blood-based bioenergetic profiling provides a minimally invasive assessment of mitochondrial health shown to be related to key features of aging. Previous studies show that blood cells recapitulate mitochondrial alterations in the central nervous system under pathological conditions, including the development of Alzheimer's disease. In this study of nonhuman primates, we focus on mitochondrial function and bioenergetic capacity assessed by the respirometric profiling of monocytes, platelets, and frontal cortex mitochondria. Our data indicate that differences in the maximal respiratory capacity of brain mitochondria are reflected by CD14+ monocyte maximal respiratory capacity and platelet and monocyte bioenergetic health index. A subset of nonhuman primates also underwent [18F] fluorodeoxyglucose positron emission tomography (FDG-PET) imaging to assess brain glucose metabolism. Our results indicate that platelet respiratory capacity positively correlates to measures of glucose metabolism in multiple brain regions. Altogether, the results of this study provide early evidence that blood-based bioenergetic profiling is related to brain mitochondrial metabolism. While these measures cannot substitute for direct measures of brain metabolism, provided by measures such as FDG-PET, they may have utility as a metabolic biomarker and screening tool to identify individuals exhibiting systemic bioenergetic decline who may therefore be at risk for the development of neurodegenerative diseases.
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Affiliation(s)
- Daniel J. Tyrrell
- Frankel Cardiovascular Center, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Manish S. Bharadwaj
- Section on Comparative Medicine, Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Matthew J. Jorgensen
- Section on Comparative Medicine, Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Thomas C. Register
- Section on Comparative Medicine, Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Carol Shively
- Section on Comparative Medicine, Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Rachel N. Andrews
- Section on Comparative Medicine, Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Bryan Neth
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer's Prevention & Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - C. Dirk Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Akiva Mintz
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Suzanne Craft
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer's Prevention & Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Anthony J. A. Molina
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer's Prevention & Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
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