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Zheng G, Zhou B, Fang Z, Chen X, Liu M, He F, Zhang H, Zhu H, Dong Y, Hao G. Long-Term Visit-to-Visit Blood Pressure Variability and Cognitive Decline Among Patients With Hypertension: A Pooled Analysis of 3 National Prospective Cohorts. J Am Heart Assoc 2024; 13:e035504. [PMID: 38934858 DOI: 10.1161/jaha.124.035504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND A limited number of studies investigated the association between blood pressure variability (BPV) and cognitive impairment in patients with hypertension. This study aimed to identify the longitudinal association between BPV and cognitive decline and the role of blood pressure (BP) control in this association. METHODS AND RESULTS Participants with hypertension from the HRS (Health and Retirement Study), the ELSA (English Longitudinal Study of Ageing), and the CHARLS (China Health and Retirement Longitudinal Study) were included. Variation independent of the mean (VIM) was adopted to measure BPV. Cognitive function was measured by standard questionnaires, and a standardized Z score was calculated. Linear mixed-model and restricted cubic splines were adopted to explore the association between BPV and cognitive decline. The study included 4853, 1616, and 1432 eligible patients with hypertension from the HRS, ELSA, and CHARLS, respectively. After adjusting for covariates, per-SD increment of VIM of BP was significantly associated with global cognitive function decline in Z scores in both systolic BP (pooled β, -0.045 [95% CI, -0.065 to -0.029]) and diastolic BP (pooled β, -0.022 [95% CI, -0.040 to -0.004]) among hypertensive patients. Similar inverse associations were observed in patients with hypertension taking antihypertensive drugs and in patients with hypertension with well-controlled BP. CONCLUSIONS High BPV was independently associated with a faster cognitive decline among patients with hypertension, even those with antihypertensive medications or well-controlled BP. Further studies are needed to confirm our results and determine whether reducing BPV can prevent or delay cognitive decline.
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Affiliation(s)
- Guangjun Zheng
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
| | - Biying Zhou
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
| | - Zhenger Fang
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
| | - Xia Chen
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
| | - Mingliang Liu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
| | - Fudong He
- School of Public Health Guangdong Pharmaceutical University Guangzhou China
| | - Haofeng Zhang
- School of Public Health Guangdong Pharmaceutical University Guangzhou China
| | - Haidong Zhu
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia Augusta University Augusta GA USA
| | - Yanbin Dong
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia Augusta University Augusta GA USA
| | - Guang Hao
- School of Public Health Guangdong Pharmaceutical University Guangzhou China
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Chen X, Dong X, Liu J, Liu X, Deng M, Yang Y. Rural-Urban Differences in Mild Cognitive Impairment Among Patients with Chronic Obstructive Pulmonary Disease in ChengDu, China. Int J Chron Obstruct Pulmon Dis 2023; 18:2497-2508. [PMID: 37965079 PMCID: PMC10642570 DOI: 10.2147/copd.s434743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023] Open
Abstract
Purpose The rural-urban gap in sociodemographic, lifestyle, and disease-related characteristics among COPD patients is prevalent. These differences may influence the prevalence of mild cognitive impairment (MCI). This study aimed to compare the prevalence and determinants of MCI between rural and urban areas among COPD patients. Patients and Methods The cross-sectional study sample comprised 372 COPD patients from China. We evaluated the cognitive function and lung function, collected sociodemographic, lifestyle, and disease-related information, to compare the prevalence of MCI in rural and urban areas. Using multivariate regression analysis to examine the effects of variables to MCI. Results The prevalence of MCI in rural areas was higher than that in urban areas (65.4% vs 47.9%, P=0.001). The prevalence in farm laborers was almost twice as high as that of non-farm laborers in urban areas (82.6% vs 43.1%), but no significant difference in rural areas (P=0.066). However, the data were lower in subjects who insisted on long-term home oxygen therapy (39.7%, CI:27.8-51.6, P<0.001), and who with higher monthly household income (49.6%, CI:40.2-58.9) in rural areas, but no significant difference in urban areas (P=0.985 and 0.502). Multivariate logistic regression analysis indicated that participants aged 71 years and above, former smokers were at a high risk of MCI in both urban and rural areas. However, participants who slept for 6-8 hours a day, shopping frequently, or exercised for more than 2 hours a day had a lower risk of MCI in urban areas. But rural participants who insisted on long-term home oxygen therapy had a lower probability of developing MCI. Conclusion This study revealed that there were significant differences in MCI among COPD patients in rural and urban areas, especially in exercise, sleeping, shopping, and long-term home oxygen therapy. Medical staff should give health guidance according to the actual situation of patients with COPD.
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Affiliation(s)
- Xiaomei Chen
- School of Nursing, Army Medical University, Chongqing, People’s Republic of China
- Nursing Department, Qionglai Medical Center Hospital, Qionglai, Chengdu, People’s Republic of China
| | - Xunhu Dong
- School of Military Preventive Medicine, Army Medical University, Chongqing, People’s Republic of China
| | - Jia Liu
- School of Nursing, Army Medical University, Chongqing, People’s Republic of China
| | - Xiao Liu
- School of Nursing, Army Medical University, Chongqing, People’s Republic of China
| | - Menghui Deng
- School of Nursing, Army Medical University, Chongqing, People’s Republic of China
| | - Yanni Yang
- School of Nursing, Army Medical University, Chongqing, People’s Republic of China
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3
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Huang CS, Yan YJ, Lin R, Sun WQ, Ye Y, Wang NF, Li H. Effect of self-determination theory-based integrated creative art (SDTICA) program on older adults with mild cognitive impairment in nursing homes: Study protocol for a cluster randomised controlled trial. BMC Geriatr 2023; 23:238. [PMID: 37081387 PMCID: PMC10120181 DOI: 10.1186/s12877-023-03896-0] [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: 10/26/2022] [Accepted: 03/15/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The cognitive benefits of early non-pharmacological approaches have been demonstrated in older adults with mild cognitive impairment (MCI). However, older adults living in nursing homes have more severe cognitive impairment problems and lower initiative and compliance to participate in complex interventions. Hence, it important to investigate more attractive and sustainable methods to prevent or delay cognitive decline. The present study adopts the self-determination theory (SDT) as a theoretical framework to innovatively develop an integrated art-based intervention for older adults with MCI in nursing homes in China and aims to evaluate its effects on cognitive function, mental health, and other health-related outcomes. METHODS The study is a nursing home-based, cluster randomised controlled trial (RCT) that targets older adults (aged ≥ 60 years) with MCI in Fuzhou City, China. All nursing homes in the area covered by Fuzhou City are invited to participate. Eligible nursing homes are randomised to one of two groups: intervention group (receive a 14-week, 27-session intervention) and waitlist control group (receive the usual care). The SDT-based integrated creative art (SDTICA) program reasonably adopts the SDT as a theoretical framework to innovatively develop an integrated art-based intervention for older adults with MCI in nursing homes. The primary (global cognitive function and psychological indicator) and secondary (daily activity function, social function, and specific domains of cognitive function) outcomes will be measured at baseline, after the intervention, and during follow-up. DISCUSSION This study aims to evaluate the effects of SDTICA program on neuropsychological outcomes in older adults with MCI and provide scientific evidence for art-based non-pharmacologic interventions in nursing homes, which may reduce dementia risk in older adults with MCI. TRIAL REGISTRATION The trial was prospectively registered at the Chinese Clinical Trials Registry with the registration number ChiCTR2200061681 on 30 June 2022.
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Affiliation(s)
- Chen-Shan Huang
- The School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, Fujian Province, 350122, China
| | - Yuan-Jiao Yan
- The School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, Fujian Province, 350122, China
- Shengli Clinical Medical College, Fujian Provincial Hospital & Fujian Medical University, No. 134 Dongjie Street, Gulou District, Fuzhou City, Fujian Province, 350001, China
| | - Rong Lin
- The School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, Fujian Province, 350122, China
- Shengli Clinical Medical College, Fujian Provincial Hospital & Fujian Medical University, No. 134 Dongjie Street, Gulou District, Fuzhou City, Fujian Province, 350001, China
| | - Wen-Qian Sun
- The School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, Fujian Province, 350122, China
| | - Yu Ye
- The School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, Fujian Province, 350122, China
| | - Na-Fang Wang
- The School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, Fujian Province, 350122, China
| | - Hong Li
- The School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, Fujian Province, 350122, China.
- Shengli Clinical Medical College, Fujian Provincial Hospital & Fujian Medical University, No. 134 Dongjie Street, Gulou District, Fuzhou City, Fujian Province, 350001, China.
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Gong N, Yang D, Zou J, He Q, Hu L, Chen W, Liao J. Exploring barriers to dementia screening and management services by general practitioners in China: a qualitative study using the COM-B model. BMC Geriatr 2023; 23:55. [PMID: 36717818 PMCID: PMC9886538 DOI: 10.1186/s12877-023-03756-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Dementia has become a global public health problem, and general practitioners (GPs) play a key role in diagnosing and managing dementia. However, in Chinese primary care settings, dementia is underdiagnosed and inefficiently managed, and dementia screening and management services provided by GPs are suboptimal. The reasons underlying this gap are poorly understood. This study aimed to determine the barriers that hinder GPs from actively promoting dementia screening and management, and thereby provide insights for the successful promotion of dementia screening and management services in primary care. METHODS Purposive sampling was used. And focus groups and in-depth interviews were conducted face-to-face among GPs from community health service centers (CHSCs) in South China. Thematic analysis was used to identify barriers to screening and managing dementia and map them to the Capability/Opportunity/Motivation-Behavior model (COM-B model). RESULTS Fifty-two GPs were included. The COM-B model found nine barriers to implementing dementia screening and management services in primary healthcare: (1) poor capability: lack of systematic knowledge of dementia and inadequate dementia screening skills; (2) little opportunity: unclear pathways for referral, insufficient time for dementia screening and management, lack of dementia-specific leaders, and no guarantee of services continuity; (3) low motivation: outside of GP scope, worries associated with dementia stigma rooted in culture beliefs, and insufficient financial incentives. CONCLUSIONS Our study concluded that GPs were not yet ready to provide dementia screening and management services due to poor capability related to knowledge and skills of dementia, little opportunity associated with an unsupportive working environment, and low motivation due to unclear duty and social pressure. Accordingly, systematic implementation strategies should be taken, including standardized dementia training programs, standardized community-based dementia guidelines, expansion of primary care workforces, development of dedicated leaders, and the eradication of stigma attached to dementia to promote dementia screening and management services in primary care.
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Affiliation(s)
- Ni Gong
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, Guangdong, 510632 China
| | - Dan Yang
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, Guangdong, 510632 China
| | - Jianfeng Zou
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou
, Guangdong, 510080 China ,Longhua District Chronic Disease Control Center, Longhua District, Shenzhen
, Guangdong, 518110 China
| | - Qianyu He
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou
, Guangdong, 510080 China ,grid.12981.330000 0001 2360 039XSun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, Guangdong China
| | - Lei Hu
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, Guangdong, 510632 China
| | - Weiju Chen
- grid.258164.c0000 0004 1790 3548School of Nursing, Jinan University, Guangzhou, Guangdong, 510632 China
| | - Jing Liao
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou
, Guangdong, 510080 China ,grid.12981.330000 0001 2360 039XSun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, Guangdong China
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5
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Wei C, Zhu Z, Zheng JN, Lu Y, Cao C, Qu S, Liu M, Meng XE, Lou Q, Wang Q, Duan JA, Shang EX, Han Z, Zhu Y. Chinese Medicine, Succinum, Ameliorates Cognitive Impairment of Carotid Artery Ligation Rats and Inhibits Apoptosis of HT22 Hippocampal Cells via Regulation of the GSK3β/β-Catenin Pathway. Front Pharmacol 2022; 13:867477. [PMID: 35784758 PMCID: PMC9240707 DOI: 10.3389/fphar.2022.867477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/06/2022] [Indexed: 12/23/2022] Open
Abstract
Succinum is an organic mineral formed from the resin of ancient coniferous and leguminous plants, which is applied for tranquilizing mood, promoting blood circulation, and removing blood stasis in Chinese medicine. For quite a long time, the modern research of succinum mainly focuses on the study of physical and chemical properties and authenticity identification while few reports on its medicinal mechanism. In current study, we evaluated different solvent extracts of succinum on carotid artery ligation rats mimicking vascular dementia. It was found that ethyl acetate extracts of succinum significantly improved the learning and memory abilities of model rats and inhibited neuronal apoptosis in the hippocampus. On a mice hippocampal neuronal cell line (HT22), ethyl acetate extracts of succinum also exerted better action trend in inhibiting cell apoptosis induced by oxygen glucose deprivation (OGD). By using XAV-939 on both in vivo and in vitro studies, it was found that ethyl acetate extracts of succinum might exert these functions by regulating the GSK3β/β-catenin pathway. These studies revealed the neuronal function of succinum, which explained the traditional effects of succinum and provided more modern scientific basis for its clinical application.
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Affiliation(s)
- Chongqi Wei
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Ziqiang Zhu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Jia-ni Zheng
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Yunqing Lu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Cheng Cao
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Suchen Qu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Mengqiu Liu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Xue-er Meng
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Qianyin Lou
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Qingqing Wang
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Jin-ao Duan
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Er-xin Shang
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
- *Correspondence: Yue Zhu, ; Zhenxiang Han, ; Er-xin Shang,
| | - Zhenxiang Han
- Department of Neurology and Rehabilitation, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Yue Zhu, ; Zhenxiang Han, ; Er-xin Shang,
| | - Yue Zhu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
- *Correspondence: Yue Zhu, ; Zhenxiang Han, ; Er-xin Shang,
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6
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Dong X, Zhao L, Kong X, Xu T, Sun T. Development of a Psychometric Test: A Care Risk Scale for Homebound Older People With Dementia. Front Psychol 2022; 13:876173. [PMID: 35645944 PMCID: PMC9136282 DOI: 10.3389/fpsyg.2022.876173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background Homebound older people with dementia (OPWD) face a series of care risks due to disease characteristics, care issues, and the family environment. However, China lacks a quantitative assessment tool for care risk. Thus, we attempted to develop a care risk scale for homebound OPWD. Methods A care risk scale, with initially 18 items, was designed based on a systematic literature review, expert consultation, and a pilot study with 20 OPWD. The initial scale was validated among 1,045 homebound OPWD in Ningbo, China from November 1, 2020 to July 30, 2021. After removing three items that lacked discrimination power, the reliability and validity of the remaining 15 items was evaluated. Factor extraction was performed via principal axis factoring and Cattell's scree plot analysis, with the resulting factors then being subjected to a varimax rotation. Results The final scale consisted of 15 items assessed on a 5-point Likert scale that loaded on to three different factors, including dementia symptoms (four items), family support (four items), and home environment (seven items). These three factors were found to explain 72.9% of the cumulative variance. The overall Cronbach's alpha for the final scale was 0.907. The correlation coefficients in the item-to-total analysis ranged from 0.511 to 0.662. Conclusion The validation analysis indicated satisfactory reliability and validity of the 15-item scale for assessing care risk of homebound OPWD. This scale can help long-term care professionals and family caregivers identify care risks and help them take targeted measures to enhance safety of care for OPWD.
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Affiliation(s)
- Xiaoxin Dong
- Ningbo College of Health Sciences, Ningbo, China
| | - Lingbo Zhao
- Ningbo College of Health Sciences, Ningbo, China
| | | | - Ting Xu
- Ningbo Kangning Hospital, Ningbo, China
| | - Tongda Sun
- Ningbo College of Health Sciences, Ningbo, China
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7
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Zhu K, Zhang Q, He B, Huang M, Lin R, Li H. Immersive Virtual Reality-Based Cognitive Intervention for the Improvement of Cognitive Function, Depression, and Perceived Stress in Older Adults With Mild Cognitive Impairment and Mild Dementia: Pilot Pre-Post Study. JMIR Serious Games 2022; 10:e32117. [PMID: 35188466 PMCID: PMC8902670 DOI: 10.2196/32117] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/05/2021] [Accepted: 12/06/2021] [Indexed: 01/19/2023] Open
Abstract
Background The incidence of dementia is increasing annually, resulting in varying degrees of adverse effects for individuals, families, and society. With the continuous development of computer information technology, cognitive interventions are constantly evolving. The use of immersive virtual reality (IVR) as a cognitive intervention for older adults with mild cognitive impairment (MCI) and mild dementia (MD) is promising, although only few studies have focused on its use. Objective The Chinese virtual supermarket (CVSM) IVR system was developed to provide a comprehensive and individual cognitive intervention program for older patients with MCI and MD. The aim of this study was to explore the feasibility and clinical effectiveness of this 5-week IVR-based cognitive intervention. Methods A pretest-posttest study design was conducted with 31 older adults with MCI and MD from August 2020 to January 2021. All participants participated in a 5-week immersive virtual cognitive training program using the CVSM system. Feasibility was assessed as the incidence and severity of cybersickness symptoms and participant satisfaction based on questionnaires conducted after the intervention. Clinical effectiveness was evaluated using neuropsychological assessments, including several commonly used measures of cognitive function, depression, perceived stress, and activities of daily living. Measurements were obtained at baseline and after the intervention period. Results A total of 18 patients with MCI (mean age 82.94 [SD 5.44] years; 12 females) and 13 patients with MD (mean age 85.7 [SD 4.67] years, 10 females) participated in this pilot study. Both groups showed significant improvements in all cognitive function measurements (P<.001). The MD group had a significantly greater improvement in general cognitive function compared to the MCI group in Montreal Cognitive Assessment Scale, Symbol Digit Modalities Test, Shape Trail Test, and Auditory Verbal Learning Test. Furthermore, an intervention effect was observed in the improvement of perceived stress (P=.048 for MD group, P=.03 for MCI group ). Conclusions The use of the CVSM system may be effective in enhancing the cognitive function of patients with MCI and MD, including general cognitive function, memory, executive function, and attention. IVR technology enriches cognitive intervention approaches and provides acceptable, professional, personalized, and interesting cognitive training for older adults with cognitive impairment. Trial Registration ClinicalTrials ChiCTR2100043753; https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2100043753
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Affiliation(s)
- KaiYan Zhu
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - QiongYao Zhang
- Information Management Center, Fujian Provincial Hospital, Fuzhou, China
| | - BingWei He
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, China
| | - MeiZhen Huang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Rong Lin
- The School of Nursing, Fujian Medical University, Fuzhou, China.,Research Center for Nursing Theory and Practice, Department of Nursing, Fujian Provincial Hospital, Fuzhou, China
| | - Hong Li
- The School of Nursing, Fujian Medical University, Fuzhou, China.,Research Center for Nursing Theory and Practice, Department of Nursing, Fujian Provincial Hospital, Fuzhou, China
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8
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Teng G, Zhang F, Li Z, Zhang C, Zhang L, Chen L, Zhou T, Yue L, Zhang J. Quantitative Electrophysiological Evaluation of the Analgesic Efficacy of Two Lappaconitine Derivatives: A Window into Antinociceptive Drug Mechanisms. Neurosci Bull 2021; 37:1555-1569. [PMID: 34550562 DOI: 10.1007/s12264-021-00774-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/16/2021] [Indexed: 10/20/2022] Open
Abstract
Quantitative evaluation of analgesic efficacy improves understanding of the antinociceptive mechanisms of new analgesics and provides important guidance for their development. Lappaconitine (LA), a potent analgesic drug extracted from the root of natural Aconitum species, has been clinically used for years because of its effective analgesic and non-addictive properties. However, being limited to ethological experiments, previous studies have mainly investigated the analgesic effect of LA at the behavioral level, and the associated antinociceptive mechanisms are still unclear. In this study, electrocorticogram (ECoG) technology was used to investigate the analgesic effects of two homologous derivatives of LA, Lappaconitine hydrobromide (LAH) and Lappaconitine trifluoroacetate (LAF), on Sprague-Dawley rats subjected to nociceptive laser stimuli, and to further explore their antinociceptive mechanisms. We found that both LAH and LAF were effective in reducing pain, as manifested in the remarkable reduction of nocifensive behaviors and laser-evoked potentials (LEPs) amplitudes (N2 and P2 waves, and gamma-band oscillations), and significantly prolonged latencies of the LEP-N2/P2. These changes in LEPs reflect the similar antinociceptive mechanism of LAF and LAH, i.e., inhibition of the fast signaling pathways. In addition, there were no changes in the auditory-evoked potential (AEP-N1 component) before and after LAF or LAH treatment, suggesting that neither drug had a central anesthetic effect. Importantly, compared with LAH, LAF was superior in its effects on the magnitudes of gamma-band oscillations and the resting-state spectra, which may be associated with their differences in the octanol/water partition coefficient, degree of dissociation, toxicity, and glycine receptor regulation. Altogether, jointly applying nociceptive laser stimuli and ECoG recordings in rats, we provide solid neural evidence for the analgesic efficacy and antinociceptive mechanisms of derivatives of LA.
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Affiliation(s)
- Guixiang Teng
- College of Life Science, Northwest Normal University, Lanzhou, 730070, China.,The Rural Development Academy, Northwest Normal University, Lanzhou, 730070, China
| | - Fengrui Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.,Department of Psychology, University of the Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhenjiang Li
- School of Psychology, Jiangxi Normal University, Nanchang, 330022, China
| | - Chun Zhang
- School of Chemical and Biological Engineering, Lanzhou Jiaotong University, Lanzhou, 730070, China
| | - Libo Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.,Department of Psychology, University of the Chinese Academy of Sciences, Beijing, 100049, China
| | - Lele Chen
- College of Life Science, Northwest Normal University, Lanzhou, 730070, China.,The Rural Development Academy, Northwest Normal University, Lanzhou, 730070, China
| | - Tao Zhou
- College of Life Science, Northwest Normal University, Lanzhou, 730070, China.,The Rural Development Academy, Northwest Normal University, Lanzhou, 730070, China
| | - Lupeng Yue
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China. .,Department of Psychology, University of the Chinese Academy of Sciences, Beijing, 100049, China.
| | - Ji Zhang
- College of Life Science, Northwest Normal University, Lanzhou, 730070, China. .,The Rural Development Academy, Northwest Normal University, Lanzhou, 730070, China.
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9
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Jia J, Xu J, Liu J, Wang Y, Wang Y, Cao Y, Guo Q, Qu Q, Wei C, Wei W, Zhang J, Yu E. Comprehensive Management of Daily Living Activities, behavioral and Psychological Symptoms, and Cognitive Function in Patients with Alzheimer's Disease: A Chinese Consensus on the Comprehensive Management of Alzheimer's Disease. Neurosci Bull 2021; 37:1025-1038. [PMID: 34050523 PMCID: PMC8275730 DOI: 10.1007/s12264-021-00701-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/06/2021] [Indexed: 01/05/2023] Open
Abstract
Alzheimer's disease (AD) is the most common cognitive disorder in the elderly. Its main clinical manifestations are cognitive decline (C), behavioral and psychological symptoms (B), and a decline in the activities of daily living (A), also known as ABC symptoms. Early identification and evaluation of ABC symptoms are helpful for establishing the accurate diagnosis, comprehensive treatment, and prognosis of AD. To guide Chinese clinical practice for optimization of the comprehensive management of AD, in 2018, The Academy of Cognitive Disorder of China gathered 22 neurologists and gerontologists in China to build a consensus on the comprehensive management of AD. Based on a review of the evidence, the consensus summarizes the pathogenesis, pathological changes, clinical manifestations, evaluation, diagnosis, drug and non-drug treatment, and patient care for AD. Focus group discussion was used to establish a flowchart of comprehensive ABC management for AD patients. The new consensus provides a feasible AD management process for clinicians.
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Affiliation(s)
- Jianjun Jia
- Department of Neurology, The Second Medical Center, People's Liberation Army General Hospital, Beijing, 100853, China.
| | - Jun Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
| | - Jun Liu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Yongjun Wang
- Cognitive Impairment Department, Shenzhen Kangning Hospital, Shenzhen, 518118, China
| | - Yanjiang Wang
- Department of Neurology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Yunpeng Cao
- Department of Neurology, The First Hospital of China Medical University, Shenyang, 210112, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Qiuming Qu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Cuibai Wei
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Wenshi Wei
- Department of Neurology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Junjian Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Enyan Yu
- Department of Psychology, Chinese Academy of Sciences Cancer Hospital of the University of the Chinese Academy of Sciences, Hangzhou, 310022, China
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10
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Lin R, Yan YJ, Zhou Y, Luo YT, Cai ZZ, Zhu KY, Li H. Effects of Creative Expressive Arts-based Storytelling (CrEAS) programme on older adults with mild cognitive impairment: protocol for a randomised, controlled three-arm trial. BMJ Open 2020; 10:e036915. [PMID: 33177133 PMCID: PMC7661382 DOI: 10.1136/bmjopen-2020-036915] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Early non-pharmacological interventions can prevent cognitive decline in older adults with mild cognitive impairment (MCI). Creative expression (CrExp) can potentially mitigate cognitive decline and enhance the physical and mental health of older people. However, it is unclear whether activities involving CrExp can improve cognitive function and other health-related outcomes in older adults with MCI. The aim of the present study is to develop a Creative Expressive Arts-based Storytelling (CrEAS) programme that integrates verbal and non-verbal expressive activities and evaluate its effectiveness in improving cognitive function and other outcome indicators so as to explore its possible mechanism from the perspective of neuroimaging. METHODS AND ANALYSIS This parallel randomised controlled trial with three arms (one intervention and two control arms) will be conducted over a 24-week period. A total of 111 participants will be enrolled and randomised to the CrEAS, recreation and usual activity groups. The CrEAS programme combines visual arts therapy and storytelling (TimeSlips) under the Expressive Therapy Continuum theoretical framework and provides an opportunity for people with MCI to actively engage in activities to improve cognitive function through verbal and nonverbal CrExp. Global cognitive function, specific domains of cognition (memory, executive function, language and attention) and other health-related outcomes (anxiety, depression and quality of life) will be measured at baseline, at the end of the intervention, and at the 24-week follow-up. Structural/functional brain MRI data will be collected at baseline and immediately after the intervention. ETHICS AND DISSEMINATION Ethics approval was obtained from the Ethics Committee of Fujian Provincial Hospital (K2018-03-061). The study results will be disseminated through peer-reviewed journals and at academic conferences. TRIAL REGISTRATION NUMBER ChiCTR1900021526.
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Affiliation(s)
- Rong Lin
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Yuan-Jiao Yan
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Yi Zhou
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Yu-Ting Luo
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Zhen-Zhen Cai
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Kai-Yan Zhu
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Hong Li
- The School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
- Department of Nursing, Fujian Provincial Hospital, Fuzhou, Fujian, China
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11
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Wei L, Chai Q, Chen J, Wang Q, Bao Y, Xu W, Ma E. The impact of Tai Chi on cognitive rehabilitation of elder adults with mild cognitive impairment: a systematic review and meta-analysis. Disabil Rehabil 2020; 44:2197-2206. [PMID: 33043709 DOI: 10.1080/09638288.2020.1830311] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Li Wei
- Tianjin Medical University General Hospital, Tianjin, China
| | - Qianwen Chai
- Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Jin Chen
- Tianjin Medical University General Hospital, Tianjin, China
| | - Qin Wang
- Tianjin Medical University General Hospital, Tianjin, China
| | - Yuting Bao
- Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Weiwei Xu
- Tianjin Medical University General Hospital, Tianjin, China
| | - Enting Ma
- Tianjin Medical University General Hospital, Tianjin, China
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12
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Impact of Chronic Stress on Attention Control: Evidence from Behavioral and Event-Related Potential Analyses. Neurosci Bull 2020; 36:1395-1410. [PMID: 32929635 DOI: 10.1007/s12264-020-00549-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/08/2020] [Indexed: 01/01/2023] Open
Abstract
Chronic stress affects brain function, so assessing its hazards is important for mental health. To overcome the limitations of behavioral data, we combined behavioral and event-related potentials (ERPs) in an attention network task. This task allowed us to differentiate between three specific aspects of attention: alerting, orienting, and execution. Forty-one participants under chronic stress and 31 non-stressed participants were enrolled. On the performance level, the chronically stressed group showed a significantly slower task response and lower accuracy. Concerning ERP measures, smaller cue-N1, cue-N2, and larger cue-P3 amplitudes were found in the stressed group, indicating that this group was less able to assign attention to effective information, i.e., they made inefficient use of cues and had difficulty in maintaining alerting. In addition, the stressed group showed larger target-N2 amplitudes, indicating that this group needed to allocate more cognitive resources to deal with the conflict targets task. Subgroup analysis revealed lower target-P3 amplitudes in the stressed than in the non-stressed group. Group differences associated with the attention networks were found at the ERP level. In the stressed group, excessive depletion of resources led to changes in attention control. In this study, we examined the effects of chronic stress on individual executive function from a neurological perspective. The results may benefit the development of interventions to improve executive function in chronically stressed individuals.
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13
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Jin D, Wang P, Zalesky A, Liu B, Song C, Wang D, Xu K, Yang H, Zhang Z, Yao H, Zhou B, Han T, Zuo N, Han Y, Lu J, Wang Q, Yu C, Zhang X, Zhang X, Jiang T, Zhou Y, Liu Y. Grab-AD: Generalizability and reproducibility of altered brain activity and diagnostic classification in Alzheimer's Disease. Hum Brain Mapp 2020; 41:3379-3391. [PMID: 32364666 PMCID: PMC7375114 DOI: 10.1002/hbm.25023] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/26/2020] [Accepted: 04/14/2020] [Indexed: 02/06/2023] Open
Abstract
Alzheimer's disease (AD) is associated with disruptions in brain activity and networks. However, there is substantial inconsistency among studies that have investigated functional brain alterations in AD; such contradictions have hindered efforts to elucidate the core disease mechanisms. In this study, we aim to comprehensively characterize AD-associated functional brain alterations using one of the world's largest resting-state functional MRI (fMRI) biobank for the disorder. The biobank includes fMRI data from six neuroimaging centers, with a total of 252 AD patients, 221 mild cognitive impairment (MCI) patients and 215 healthy comparison individuals. Meta-analytic techniques were used to unveil reliable differences in brain function among the three groups. Relative to the healthy comparison group, AD was associated with significantly reduced functional connectivity and local activity in the default-mode network, basal ganglia and cingulate gyrus, along with increased connectivity or local activity in the prefrontal lobe and hippocampus (p < .05, Bonferroni corrected). Moreover, these functional alterations were significantly correlated with the degree of cognitive impairment (AD and MCI groups) and amyloid-β burden. Machine learning models were trained to recognize key fMRI features to predict individual diagnostic status and clinical score. Leave-one-site-out cross-validation established that diagnostic status (mean area under the receiver operating characteristic curve: 0.85) and clinical score (mean correlation coefficient between predicted and actual Mini-Mental State Examination scores: 0.56, p < .0001) could be predicted with high accuracy. Collectively, our findings highlight the potential for a reproducible and generalizable functional brain imaging biomarker to aid the early diagnosis of AD and track its progression.
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Affiliation(s)
- Dan Jin
- Brainnetome Center & National Laboratory of Pattern RecognitionInstitute of Automation, Chinese Academy of SciencesBeijingChina
- School of Artificial IntelligenceUniversity of Chinese Academy of SciencesBeijingChina
| | - Pan Wang
- Department of NeurologyTianjin Huanhu Hospital, Tianjin UniversityTianjinChina
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of PsychiatryUniversity of Melbourne and Melbourne HealthMelbourneVictoriaAustralia
- Department of Biomedical EngineeringUniversity of MelbourneMelbourneVictoriaAustralia
| | - Bing Liu
- Brainnetome Center & National Laboratory of Pattern RecognitionInstitute of Automation, Chinese Academy of SciencesBeijingChina
- School of Artificial IntelligenceUniversity of Chinese Academy of SciencesBeijingChina
- Center for Excellence in Brain Science and Intelligence TechnologyInstitute of Automation, Chinese Academy of SciencesBeijingChina
| | - Chengyuan Song
- Department of NeurologyQilu Hospital of Shandong UniversityJi'nanChina
| | - Dawei Wang
- Department of RadiologyQilu Hospital of Shandong UniversityJi'nanChina
| | - Kaibin Xu
- Brainnetome Center & National Laboratory of Pattern RecognitionInstitute of Automation, Chinese Academy of SciencesBeijingChina
| | - Hongwei Yang
- Department of RadiologyXuanwu Hospital of Capital Medical UniversityBeijingChina
| | | | - Hongxiang Yao
- Department of Radiology, the Second Medical Centre, National Clinical Research Centre for Geriatric DiseasesChinese PLA General HospitalBeijingChina
| | - Bo Zhou
- Department of Neurology, the Second Medical Centre, National Clinical Research Centre for Geriatric DiseasesChinese PLA General HospitalBeijingChina
| | - Tong Han
- Department of RadiologyTianjin Huanhu HospitalTianjinChina
| | - Nianming Zuo
- Brainnetome Center & National Laboratory of Pattern RecognitionInstitute of Automation, Chinese Academy of SciencesBeijingChina
- School of Artificial IntelligenceUniversity of Chinese Academy of SciencesBeijingChina
| | - Ying Han
- Department of NeurologyXuanwu Hospital of Capital Medical UniversityBeijingChina
- Beijing Institute of GeriatricsBeijingChina
- National Clinical Research Center for Geriatric DisordersBeijingChina
- Center of Alzheimer's DiseaseBeijing Institute for Brain DisordersBeijingChina
| | - Jie Lu
- Department of RadiologyXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Qing Wang
- Department of RadiologyQilu Hospital of Shandong UniversityJi'nanChina
| | - Chunshui Yu
- Department of RadiologyTianjin Medical University General HospitalTianjinChina
| | - Xinqing Zhang
- Department of NeurologyXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Xi Zhang
- Department of Neurology, the Second Medical Centre, National Clinical Research Centre for Geriatric DiseasesChinese PLA General HospitalBeijingChina
| | - Tianzi Jiang
- Brainnetome Center & National Laboratory of Pattern RecognitionInstitute of Automation, Chinese Academy of SciencesBeijingChina
- School of Artificial IntelligenceUniversity of Chinese Academy of SciencesBeijingChina
- Center for Excellence in Brain Science and Intelligence TechnologyInstitute of Automation, Chinese Academy of SciencesBeijingChina
| | - Yuying Zhou
- Department of NeurologyTianjin Huanhu Hospital, Tianjin UniversityTianjinChina
| | - Yong Liu
- Brainnetome Center & National Laboratory of Pattern RecognitionInstitute of Automation, Chinese Academy of SciencesBeijingChina
- School of Artificial IntelligenceUniversity of Chinese Academy of SciencesBeijingChina
- Center for Excellence in Brain Science and Intelligence TechnologyInstitute of Automation, Chinese Academy of SciencesBeijingChina
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14
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Dou X, Yao H, Feng F, Wang P, Zhou B, Jin D, Yang Z, Li J, Zhao C, Wang L, An N, Liu B, Zhang X, Liu Y. Characterizing white matter connectivity in Alzheimer's disease and mild cognitive impairment: An automated fiber quantification analysis with two independent datasets. Cortex 2020; 129:390-405. [PMID: 32574842 DOI: 10.1016/j.cortex.2020.03.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 12/13/2019] [Accepted: 03/31/2020] [Indexed: 12/28/2022]
Abstract
Alzheimer's disease (AD) is a chronic neurodegenerative disease characterized by progressive dementia. Diffusion tensor imaging (DTI) has been widely used to show structural integrity and delineate white matter (WM) degeneration in AD. The automated fiber quantification (AFQ) method is a fully automated approach that can rapidly and reliably identify major WM fiber tracts and evaluate WM properties. The main aim of this study was to assess WM integrity and abnormities in a cohort of patients with amnestic mild cognitive impairment (aMCI) and AD as well as normal controls (NCs). For this purpose, we first used AFQ to identify 20 major WM tracts and assessed WM integrity and abnormalities in a cohort of 120 subjects (39 NCs, 34 aMCI patients and 47 AD patients) in a discovery dataset and 122 subjects (43 NCs, 37 aMCI patients and 42 AD patients) in a replicated dataset. Pointwise differences along WM tracts were identified in the discovery dataset and simultaneously confirmed in the replicated dataset. Next, we investigated the utility of DTI measures along WM tracts as features to distinguish patients with AD from NCs via multilevel cross validation using a support vector machine. Correlation analysis revealed the identified microstructural WM alterations and classification output to be highly associated with cognitive ability in the patient groups, suggesting that they may be a robust biomarker of AD. This systematic study provides a pipeline to examine WM integrity and its potential clinical application in AD and may be useful for studying other neurological and psychiatric disorders.
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Affiliation(s)
- Xuejiao Dou
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, China
| | - Hongxiang Yao
- Department of Radiology, The Second Medical Centre, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, China
| | - Feng Feng
- Department of Neurology, The Second Medical Centre, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, China
| | - Pan Wang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300350, China; Department of Neurology, Nankai University Huanhu Hospital, Tianjin, China
| | - Bo Zhou
- Department of Neurology, The Second Medical Centre, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, China
| | - Dan Jin
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, China
| | - Zhengyi Yang
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Jin Li
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Cui Zhao
- Department of Neurology, The Second Medical Centre, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, China
| | - Luning Wang
- Department of Neurology, The Second Medical Centre, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, China
| | - Ningyu An
- Department of Radiology, The Second Medical Centre, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, China
| | - Bing Liu
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Xi Zhang
- Department of Neurology, The Second Medical Centre, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, China.
| | - Yong Liu
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
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