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Hadad R, Mandelli ML, Rankin KP, Toohey C, Sturm VE, Javandel S, Milicic A, Knudtson M, Allen IE, Hoffmann N, Friedberg A, Possin K, Valcour V, Miller BL. Itching Frequency and Neuroanatomic Correlates in Frontotemporal Lobar Degeneration. JAMA Neurol 2024; 81:977-984. [PMID: 39037825 PMCID: PMC11264090 DOI: 10.1001/jamaneurol.2024.2213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 05/24/2024] [Indexed: 07/24/2024]
Abstract
Importance Itching is common in geriatric populations and is frequently linked to dermatological or systemic conditions. Itching engages specific brain regions that are implicated in the pathogenesis of frontotemporal lobar degeneration spectrum disorders (FTLD-SD). Thus, itching of undetermined origin (IUO) may indicate the presence of a neurodegenerative process. Objective To compare the frequency of itching in FTLD-SD and Alzheimer disease (AD) and to determine the neuroanatomical underpinnings of IUO. Design, Setting, and Participants This case-control study evaluated data and brain magnetic resonance images (MRIs) for participants with FTLD-SD or AD. Participants of a research study on FTLD-SD at the University of California, San Francisco, Memory and Aging Center were evaluated from May 1, 2002, to December 31, 2021. The exposure group underwent structural brain MRI within 6 months of initial diagnosis. Research visit summaries were reviewed to validate qualitative details and accurately identify itching with undetermined origin (IUO). Exposures Symptoms suggestive of FTLD-SD or AD. Main Outcomes and Measures Frequency of itching in FTLD-SD and AD and neuroanatomic correlates. Results A total of 2091 research visit summaries were reviewed for 1112 patients exhibiting symptoms indicative of FTLD-SD or AD. From 795 records where itching or a related phrase was endorsed, 137 had IUO. A total of 454 participants were included in the study: 137 in the itching group (mean [SD] age, 62.7 [9.9] years; 74 [54%] females and 63 males [46%]) and 317 in the nonitching group (mean [SD] age, 60.7 [10.8] years; 154 [49%] females and 163 males [51%]). Groups were similar in age, sex, and disease severity. More frequent itching was found in FTLD-SD (95/248 patients [38%], of which 44 [46%] had behavioral variant frontotemporal dementia [bvFTD]) compared with the AD group (14/77 patients [18%]; P = .001). The odds of itching were 2.4 (95% CI, 1.48-3.97) times higher for FTLD-SD compared with all other cases of dementia. Compared with healthy controls, the group with IUO exhibited greater gray matter atrophy bilaterally in the amygdala, insula, precentral gyrus, and cingulum, as well as in the right frontal superior gyrus and thalamus. Among patients with bvFTD and itching vs bvFTD without itching, itching was associated with right-lateralized gray matter atrophy affecting the insula, thalamus, superior frontal gyrus, and cingulum. Conclusions and Relevance Among individuals with IUO, FTLD-SD was disproportionately represented compared with AD. In FTLD-SD, dysfunction in the right anterior insula and its connected regions, including the right precentral gyrus, cingulum, and bilateral amygdala, contribute to dysregulation of the itching-scratching networks, resulting in uncontrollable itching or skin picking. Awareness among physicians about the relationship between neurodegeneration and itching may help in the management of itch in older individuals. Further studies are needed to determine the best treatments for these symptoms in patients with neurodegenerative disorders.
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Affiliation(s)
- Rafi Hadad
- Stroke and Cognition Institute, Department of Neurology, Rambam Health Care Campus, Haifa, Israel
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
| | - Maria Luisa Mandelli
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Katherine P. Rankin
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Charlie Toohey
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Virginia E. Sturm
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
- Department of Psychiatry and Behavioral Sciences University of California, San Francisco
| | - Shireen Javandel
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Andjelika Milicic
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Marguerite Knudtson
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Isabel Elaine Allen
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Nathalia Hoffmann
- Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Adit Friedberg
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Katherine Possin
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Victor Valcour
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Bruce L. Miller
- Global Brain Health Institute, Department of Neurology, University of California, San Francisco
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
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Alateeq K, Walsh EI, Ambikairajah A, Cherbuin N. Association between dietary magnesium intake, inflammation, and neurodegeneration. Eur J Nutr 2024; 63:1807-1818. [PMID: 38597977 PMCID: PMC11329609 DOI: 10.1007/s00394-024-03383-1] [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: 06/08/2023] [Accepted: 03/29/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Consistent evidence shows that magnesium (Mg) intake is associated with lower blood pressure (BP), and that lower BP is associated with improved cerebral health. However, recent findings indicate that the positive effect of dietary Mg intake on cerebral health is not mediated by a decrease in BP. As Mg's anti-inflammatory action is a plausible alternative mechanism, the objective of this study was to investigate the associations between Mg intake and inflammation to determine whether it mediates any neuroprotective effect. METHODS Participants from the UK Biobank (n = 5775, aged 40-73 years, 54.7% female) were assessed for dietary magnesium using an online food questionnaire, brain and white matter lesion (WML) volumes were segmented with FreeSurfer software, and inflammation markers including high-sensitivity C-reactive protein (hs-CRP), leukocyte, erythrocyte count, and Glycoprotein acetylation (GlycA) were measured using specific laboratory techniques such as immunoturbidimetry, automated cell counting, and nuclear magnetic resonance. Hierarchical linear regression models were performed to investigate the association between dietary Mg, and inflammatory markers and between dietary Mg, brain and WMLs volumes. Mediation analysis was performed to test a possible mediation role of inflammation on the association between dietary Mg and brain and WMLs volumes. RESULTS Higher dietary Mg intake was associated with lower inflammation: hs-CRP level (- 0.0497%; 95% confidence interval [CI] - 0.0497%, - 0.0199%) leukocytes count (- 0.0015%; 95%CI - 0.00151%, - 0.0011%), and GlycA (- 0.0519%; 95%CI - 0.1298%, - 0.0129%). Moreover, higher dietary Mg intake was associated with larger grey matter volume (0.010%; 95%CI 0.004%, 0.017%), white matter volume (0.012%; 95%CI 0.003, 0.022) and right hippocampal volume (0.002%; 95%CI 0.0007, -0.0025%). Lower hs-CRP levels mediated the positive association between higher dietary Mg intake and larger grey matter volume. CONCLUSIONS The anti-inflammatory effects of dietary Mg intake in the general population, appears to mediate its neuroprotective effect.
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Affiliation(s)
- Khawlah Alateeq
- National Centre for Epidemiology and Population Health, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia.
- Radiological Science, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia.
| | - Erin I Walsh
- National Centre for Epidemiology and Population Health, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia
| | - Ananthan Ambikairajah
- National Centre for Epidemiology and Population Health, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia
- Discipline of Psychology, Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia
- Centre for Ageing Research and Translation, Faculty of Health, University of Canberra, Canberra, 2617, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia
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Bao Y, Chen X, Li Y, Yuan S, Han L, Deng X, Ran J. Chronic Low-Grade Inflammation and Brain Structure in the Middle-Aged and Elderly Adults. Nutrients 2024; 16:2313. [PMID: 39064755 PMCID: PMC11280392 DOI: 10.3390/nu16142313] [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: 06/20/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Low-grade inflammation (LGI) mainly acted as the mediator of the association of obesity and inflammatory diet with numerous chronic diseases, including neuropsychiatric diseases. However, the evidence about the effect of LGI on brain structure is limited but important, especially in the context of accelerating aging. This study was then designed to close the gap, and we leveraged a total of 37,699 participants from the UK Biobank and utilized inflammation score (INFLA-score) to measure LGI. We built the longitudinal relationships of INFLA-score with brain imaging phenotypes using multiple linear regression models. We further analyzed the interactive effects of specific covariates. The results showed high level inflammation reduced the volumes of the subcortex and cortex, especially the globus pallidus (β [95% confidence interval] = -0.062 [-0.083, -0.041]), thalamus (-0.053 [-0.073, -0.033]), insula (-0.052 [-0.072, -0.032]), superior temporal gyrus (-0.049 [-0.069, -0.028]), lateral orbitofrontal cortex (-0.047 [-0.068, -0.027]), and others. Most significant effects were observed among urban residents. Furthermore, males and individuals with physical frailty were susceptive to the associations. The study provided potential insights into pathological changes during disease progression and might aid in the development of preventive and control targets in an age-friendly city to promote great health and well-being for sustainable development goals.
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Affiliation(s)
- Yujia Bao
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.B.); (X.C.); (Y.L.); (S.Y.)
| | - Xixi Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.B.); (X.C.); (Y.L.); (S.Y.)
| | - Yongxuan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.B.); (X.C.); (Y.L.); (S.Y.)
| | - Shenghao Yuan
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.B.); (X.C.); (Y.L.); (S.Y.)
| | - Lefei Han
- School of Global Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
| | - Xiaobei Deng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.B.); (X.C.); (Y.L.); (S.Y.)
| | - Jinjun Ran
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
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Chen Y, Spina S, Callahan P, Grinberg LT, Seeley WW, Rosen HJ, Kramer JH, Miller BL, Rankin KP. Pathology-specific patterns of cerebellar atrophy in neurodegenerative disorders. Alzheimers Dement 2024; 20:1771-1783. [PMID: 38109286 PMCID: PMC10984510 DOI: 10.1002/alz.13551] [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: 06/27/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION Associations of cerebellar atrophy with specific neuropathologies in Alzheimer's disease and related dementias (ADRD) have not been systematically analyzed. This study examined cerebellar gray matter volume across major pathological subtypes of ADRD. METHODS Cerebellar gray matter volume was examined using voxel-based morphometry in 309 autopsy-proven ADRD cases and 80 healthy controls. ADRD subtypes included AD, mixed Lewy body disease and AD (LBD-AD), and frontotemporal lobar degeneration (FTLD). Clinical function was assessed using the Clinical Dementia Rating (CDR) scale. RESULTS Distinct patterns of cerebellar atrophy were observed in all ADRD subtypes. Significant cerebellar gray matter changes appeared in the early stages of most subtypes and the very early stages of AD, LBD-AD, FTLD-TDP type A, and progressive supranuclear palsy. Cortical atrophy positively predicted cerebellar atrophy across all subtypes. DISCUSSION Our findings establish pathology-specific profiles of cerebellar atrophy in ADRD and propose cerebellar neuroimaging as a non-invasive biomarker for differential diagnosis and disease monitoring. HIGHLIGHTS Cerebellar atrophy was examined in 309 patients with autopsy-proven neurodegeneration. Distinct patterns of cerebellar atrophy are found in all pathological subtypes of Alzheimer's disease and related dementias (ADRD). Cerebellar atrophy is seen in early-stage (Clinical Dementia Rating [CDR] ≤1) AD, Lewy body dementia (LBD), frontotemporal lobar degeneration with tau-positive inclusion (FTLD-tau), and FTLD-transactive response DNA binding protein (FTLD-TDP). Cortical atrophy positively predicts cerebellar atrophy across all neuropathologies.
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Affiliation(s)
- Yu Chen
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Salvatore Spina
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Patrick Callahan
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Lea T. Grinberg
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of PathologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - William W. Seeley
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of PathologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Howard J. Rosen
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Joel H. Kramer
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Bruce L. Miller
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Katherine P. Rankin
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
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Broce IJ, Sirkis DW, Nillo RM, Bonham LW, Lee SE, Miller BL, Castruita PA, Sturm VE, Sugrue LS, Desikan RS, Yokoyama JS. C9orf72 gene networks in the human brain correlate with cortical thickness in C9-FTD and implicate vulnerable cell types. Front Neurosci 2024; 18:1258996. [PMID: 38469573 PMCID: PMC10925697 DOI: 10.3389/fnins.2024.1258996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/15/2024] [Indexed: 03/13/2024] Open
Abstract
Introduction A hexanucleotide repeat expansion (HRE) intronic to chromosome 9 open reading frame 72 (C9orf72) is recognized as the most common genetic cause of amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and ALS-FTD. Identifying genes that show similar regional co-expression patterns to C9orf72 may help identify novel gene targets and biological mechanisms that mediate selective vulnerability to ALS and FTD pathogenesis. Methods We leveraged mRNA expression data in healthy brain from the Allen Human Brain Atlas to evaluate C9orf72 co-expression patterns. To do this, we correlated average C9orf72 expression values in 51 regions across different anatomical divisions (cortex, subcortex, and cerebellum) with average gene expression values for 15,633 protein-coding genes, including 54 genes known to be associated with ALS, FTD, or ALS-FTD. We then performed imaging transcriptomic analyses to evaluate whether the identified C9orf72 co-expressed genes correlated with patterns of cortical thickness in symptomatic C9orf72 pathogenic HRE carriers (n = 19) compared to controls (n = 23). Lastly, we explored whether genes with significant C9orf72 imaging transcriptomic correlations (i.e., "C9orf72 imaging transcriptomic network") were enriched in specific cell populations in the brain and enriched for specific biological and molecular pathways. Results A total of 2,120 genes showed an anatomical distribution of gene expression in the brain similar to C9orf72 and significantly correlated with patterns of cortical thickness in C9orf72 HRE carriers. This C9orf72 imaging transcriptomic network was differentially expressed in cell populations previously implicated in ALS and FTD, including layer 5b cells, cholinergic neurons in the spinal cord and brainstem and medium spiny neurons of the striatum, and was enriched for biological and molecular pathways associated with protein ubiquitination, autophagy, cellular response to DNA damage, endoplasmic reticulum to Golgi vesicle-mediated transport, among others. Conclusion Considered together, we identified a network of C9orf72 associated genes that may influence selective regional and cell-type-specific vulnerabilities in ALS/FTD.
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Affiliation(s)
- Iris J. Broce
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
- Department of Neurosciences, University of California San Diego, San Diego, CA, United States
| | - Daniel W. Sirkis
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Ryan M. Nillo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Luke W. Bonham
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Suzee E. Lee
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Patricia A. Castruita
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Virginia E. Sturm
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, United States
| | - Leo S. Sugrue
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Rahul S. Desikan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Jennifer S. Yokoyama
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, United States
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Parker N, Cheng W, Hindley GFL, O'Connell KS, Karthikeyan S, Holen B, Shadrin AA, Rahman Z, Karadag N, Bahrami S, Lin A, Steen NE, Ueland T, Aukrust P, Djurovic S, Dale AM, Smeland OB, Frei O, Andreassen OA. Genetic Overlap Between Global Cortical Brain Structure, C-Reactive Protein, and White Blood Cell Counts. Biol Psychiatry 2024; 95:62-71. [PMID: 37348803 DOI: 10.1016/j.biopsych.2023.06.008] [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: 01/19/2023] [Revised: 06/02/2023] [Accepted: 06/11/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND For many brain disorders, a subset of patients jointly exhibit alterations in cortical brain structure and elevated levels of circulating immune markers. This may be driven in part by shared genetic architecture. Therefore, we investigated the phenotypic and genetic associations linking global cortical surface area and thickness with blood immune markers (i.e., white blood cell counts and plasma C-reactive protein levels). METHODS Linear regression was used to assess phenotypic associations in 30,823 UK Biobank participants. Genome-wide and local genetic correlations were assessed using linkage disequilibrium score regression and local analysis of covariance annotation. The number of shared trait-influencing genetic variants was estimated using MiXeR. Shared genetic architecture was assessed using a conjunctional false discovery rate framework, and mapped genes were included in gene-set enrichment analyses. RESULTS Cortical structure and blood immune markers exhibited predominantly inverse phenotypic associations. There were modest genome-wide genetic correlations, the strongest of which were for C-reactive protein levels (rg_surface_area = -0.13, false discovery rate-corrected p = 4.17 × 10-3; rg_thickness = -0.13, false discovery rate-corrected p = 4.00 × 10-2). Meanwhile, local genetic correlations showed a mosaic of positive and negative associations. White blood cells shared on average 46.24% and 38.64% of trait-influencing genetic variants with surface area and thickness, respectively. Additionally, surface area shared 55 unique loci with the blood immune markers while thickness shared 15. Overall, monocyte count exhibited the largest genetic overlap with cortical brain structure. A series of gene enrichment analyses implicated neuronal-, astrocytic-, and schizophrenia-associated genes. CONCLUSIONS The findings indicate shared genetic underpinnings for cortical brain structure and blood immune markers, with implications for neurodevelopment and understanding the etiology of brain-related disorders.
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Affiliation(s)
- Nadine Parker
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Weiqiu Cheng
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Guy F L Hindley
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Kevin S O'Connell
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sandeep Karthikeyan
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Børge Holen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Alexey A Shadrin
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Zillur Rahman
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Naz Karadag
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Shahram Bahrami
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Aihua Lin
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nils Eiel Steen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thor Ueland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway; KG Jebsen Thrombosis Research and Expertise Centre, University of Tromsø, Tromsø, Norway
| | - Pål Aukrust
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway; Section of Clinical Immunology and Infectious Disease, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; Norwegian Centre for Mental Disorders Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Anders M Dale
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California; Department of Psychiatry, University of California, San Diego, La Jolla, California; Department of Neurosciences, University of California San Diego, La Jolla, California; Department of Radiology, University of California San Diego, La Jolla, California
| | - Olav B Smeland
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Oleksandr Frei
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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Ma DR, Li SJ, Shi JJ, Liang YY, Hu ZW, Hao XY, Li MJ, Guo MN, Zuo CY, Yu WK, Mao CY, Tang MB, Zhang C, Xu YM, Wu J, Sun SL, Shi CH. Shared Genetic Architecture between Parkinson's Disease and Brain Structural Phenotypes. Mov Disord 2023; 38:2258-2268. [PMID: 37990409 DOI: 10.1002/mds.29598] [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: 05/10/2023] [Revised: 08/02/2023] [Accepted: 08/21/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Patients with Parkinson's disease (PD) have consistently demonstrated brain structure abnormalities, indicating the presence of shared etiological and pathological processes between PD and brain structures; however, the genetic relationship remains poorly understood. OBJECTIVE The aim of this study was to investigate the extent of shared genetic architecture between PD and brain structural phenotypes (BSPs) and to identify shared genomic loci. METHODS We used the summary statistics from genome-wide association studies to conduct MiXeR and conditional/conjunctional false discovery rate analyses to investigate the shared genetic signatures between PD and BSPs. Subsequent expression quantitative trait loci mapping in the human brain and enrichment analyses were also performed. RESULTS MiXeR analysis identified genetic overlap between PD and various BSPs, including total cortical surface area, average cortical thickness, and specific brain volumetric structures. Further analysis using conditional false discovery rate (FDR) identified 21 novel PD risk loci on associations with BSPs at conditional FDR < 0.01, and the conjunctional FDR analysis demonstrated that PD shared several genomic loci with certain BSPs at conjunctional FDR < 0.05. Among the shared loci, 16 credible mapped genes showed high expression in the brain tissues and were primarily associated with immune function-related biological processes. CONCLUSIONS We confirmed the polygenic overlap with mixed directions of allelic effects between PD and BSPs and identified multiple shared genomic loci and risk genes, which are likely related to immune-related biological processes. These findings provide insight into the complex genetic architecture associated with PD. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Dong-Rui Ma
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Shuang-Jie Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Jing-Jing Shi
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Yuan-Yuan Liang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Zheng-Wei Hu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Xiao-Yan Hao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Meng-Jie Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Meng-Nan Guo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Chun-Yan Zuo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Wen-Kai Yu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Cheng-Yuan Mao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Mi-Bo Tang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Chan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Yu-Ming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, China
| | - Jun Wu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, China
| | - Shi-Lei Sun
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, China
| | - Chang-He Shi
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, China
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8
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Sokołowski A, Roy ARK, Goh SM, Hardy EG, Datta S, Cobigo Y, Brown JA, Spina S, Grinberg L, Kramer J, Rankin KP, Seeley WW, Sturm VE, Rosen HJ, Miller BL, Perry DC. Neuropsychiatric symptoms and imbalance of atrophy in behavioral variant frontotemporal dementia. Hum Brain Mapp 2023; 44:5013-5029. [PMID: 37471695 PMCID: PMC10502637 DOI: 10.1002/hbm.26428] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/25/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
Behavioral variant frontotemporal dementia is characterized by heterogeneous frontal, insular, and anterior temporal atrophy patterns that vary along left-right and dorso-ventral axes. Little is known about how these structural imbalances impact clinical symptomatology. The goal of this study was to assess the frequency of frontotemporal asymmetry (right- or left-lateralization) and dorsality (ventral or dorsal predominance of atrophy) and to investigate their clinical correlates. Neuropsychiatric symptoms and structural images were analyzed for 250 patients with behavioral variant frontotemporal dementia. Frontotemporal atrophy was most often symmetric while left-lateralized (9%) and right-lateralized (17%) atrophy were present in a minority of patients. Atrophy was more often ventral (32%) than dorsal (3%) predominant. Patients with right-lateralized atrophy were characterized by higher severity of abnormal eating behavior and hallucinations compared to those with left-lateralized atrophy. Subsequent analyses clarified that eating behavior was associated with right atrophy to a greater extent than a lack of left atrophy, and hallucinations were driven mainly by right atrophy. Dorsality analyses showed that anxiety, euphoria, and disinhibition correlated with ventral-predominant atrophy. Agitation, irritability, and depression showed greater severity with a lack of regional atrophy, including in dorsal regions. Aberrant motor behavior and apathy were not explained by asymmetry or dorsality. This study provides additional insight into how anatomical heterogeneity influences the clinical presentation of patients with behavioral variant frontotemporal dementia. Behavioral symptoms can be associated not only with the presence or absence of focal atrophy, but also with right/left or dorsal/ventral imbalance of gray matter volume.
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Affiliation(s)
- Andrzej Sokołowski
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Ashlin R. K. Roy
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Sheng‐Yang M. Goh
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Emily G. Hardy
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Samir Datta
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Jesse A. Brown
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Salvatore Spina
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Lea Grinberg
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Joel Kramer
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - William W. Seeley
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of PathologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Virginia E. Sturm
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - David C. Perry
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
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9
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Gouilly D, Rafiq M, Nogueira L, Salabert AS, Payoux P, Péran P, Pariente J. Beyond the amyloid cascade: An update of Alzheimer's disease pathophysiology. Rev Neurol (Paris) 2023; 179:812-830. [PMID: 36906457 DOI: 10.1016/j.neurol.2022.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 10/02/2022] [Accepted: 12/02/2022] [Indexed: 03/13/2023]
Abstract
Alzheimer's disease (AD) is a multi-etiology disease. The biological system of AD is associated with multidomain genetic, molecular, cellular, and network brain dysfunctions, interacting with central and peripheral immunity. These dysfunctions have been primarily conceptualized according to the assumption that amyloid deposition in the brain, whether from a stochastic or a genetic accident, is the upstream pathological change. However, the arborescence of AD pathological changes suggests that a single amyloid pathway might be too restrictive or inconsistent with a cascading effect. In this review, we discuss the recent human studies of late-onset AD pathophysiology in an attempt to establish a general updated view focusing on the early stages. Several factors highlight heterogenous multi-cellular pathological changes in AD, which seem to work in a self-amplifying manner with amyloid and tau pathologies. Neuroinflammation has an increasing importance as a major pathological driver, and perhaps as a convergent biological basis of aging, genetic, lifestyle and environmental risk factors.
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Affiliation(s)
- D Gouilly
- Toulouse Neuroimaging Center, Toulouse, France.
| | - M Rafiq
- Toulouse Neuroimaging Center, Toulouse, France; Department of Cognitive Neurology, Epilepsy and Movement Disorders, CHU Toulouse Purpan, France
| | - L Nogueira
- Department of Cell Biology and Cytology, CHU Toulouse Purpan, France
| | - A-S Salabert
- Toulouse Neuroimaging Center, Toulouse, France; Department of Nuclear Medicine, CHU Toulouse Purpan, France
| | - P Payoux
- Toulouse Neuroimaging Center, Toulouse, France; Department of Nuclear Medicine, CHU Toulouse Purpan, France; Center of Clinical Investigation, CHU Toulouse Purpan (CIC1436), France
| | - P Péran
- Toulouse Neuroimaging Center, Toulouse, France
| | - J Pariente
- Toulouse Neuroimaging Center, Toulouse, France; Department of Cognitive Neurology, Epilepsy and Movement Disorders, CHU Toulouse Purpan, France; Center of Clinical Investigation, CHU Toulouse Purpan (CIC1436), France
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10
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Thaker AA, McConnell BV, Rogers DM, Carlson NE, Coughlan C, Jensen AM, Lopez-Paniagua D, Holden SK, Pressman PS, Pelak VS, Filley CM, Potter H, Solano DA, Heffernan KS, Bettcher BM. Astrogliosis, neuritic microstructure, and sex effects: GFAP is an indicator of neuritic orientation in women. Brain Behav Immun 2023; 113:124-135. [PMID: 37394144 PMCID: PMC10584366 DOI: 10.1016/j.bbi.2023.06.026] [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: 12/08/2022] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Data from human studies suggest that immune dysregulation is associated with Alzheimer's disease (AD) pathology and cognitive decline and that neurites may be affected early in the disease trajectory. Data from animal studies further indicate that dysfunction in astrocytes and inflammation may have a pivotal role in facilitating dendritic damage, which has been linked with negative cognitive outcomes. To elucidate these relationships further, we have examined the relationship between astrocyte and immune dysregulation, AD-related pathology, and neuritic microstructure in AD-vulnerable regions in late life. METHODS We evaluated panels of immune, vascular, and AD-related protein markers in blood and conducted in vivo multi-shell neuroimaging using Neurite Orientation Dispersion and Density Imaging (NODDI) to assess indices of neuritic density (NDI) and dispersion (ODI) in brain regions vulnerable to AD in a cohort of older adults (n = 109). RESULTS When examining all markers in tandem, higher plasma GFAP levels were strongly related to lower neurite dispersion (ODI) in grey matter. No biomarker associations were found with higher neuritic density. Associations between GFAP and neuritic microstructure were not significantly impacted by symptom status, APOE status, or plasma Aβ42/40 ratio; however, there was a large sex effect observed for neurite dispersion, wherein negative associations between GFAP and ODI were only observed in females. DISCUSSION This study provides a comprehensive, concurrent appraisal of immune, vascular, and AD-related biomarkers in the context of advanced grey matter neurite orientation and dispersion methodology. Sex may be an important modifier of the complex associations between astrogliosis, immune dysregulation, and brain microstructure in older adults.
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Affiliation(s)
- Ashesh A Thaker
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Brice V McConnell
- Department of Neurology, Behavioral Neurology Section, University of Colorado Alzheimer's & Cognition Center, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Dustin M Rogers
- Department of Biostatistics and Informatics, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Nichole E Carlson
- Department of Biostatistics and Informatics, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Christina Coughlan
- Department of Neurology, University of Colorado Alzheimer's & Cognition Center, Linda Crnic Institute for Down Syndrome, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alexandria M Jensen
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Dan Lopez-Paniagua
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Samantha K Holden
- Department of Neurology, Behavioral Neurology Section, University of Colorado Alzheimer's & Cognition Center, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Peter S Pressman
- Department of Neurology, Behavioral Neurology Section, University of Colorado Alzheimer's & Cognition Center, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Victoria S Pelak
- Department of Neurology, Behavioral Neurology Section, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; Department of Ophthalmology, Sue Anschutz-Rodgers University of Colorado Eye Center, University of Colorado School of Medicine, Aurora, CO, USA
| | - Christopher M Filley
- Behavioral Neurology Section, Departments of Neurology and Psychiatry, University of Colorado Alzheimer's & Cognition Center, Marcus Institute for Brain Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Huntington Potter
- Department of Neurology, University of Colorado Alzheimer's & Cognition Center, Linda Crnic Institute for Down Syndrome, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - D Adriana Solano
- Department of Neurology, University of Colorado Alzheimer's & Cognition Center, Linda Crnic Institute for Down Syndrome, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kate S Heffernan
- Division of Neuropharmacology and Neurological Disorders, Emory National Primate Research Center, Emory University, Atlanta, GA, USA
| | - Brianne M Bettcher
- Department of Neurology, Behavioral Neurology Section, University of Colorado Alzheimer's & Cognition Center, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
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11
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Broce IJ, Sirkis DW, Nillo RM, Bonham LW, Lee SE, Miller B, Castruita P, Sturm VE, Sugrue LS, Desikan RS, Yokoyama JS. C9orf72 gene networks in the human brain correlate with cortical thickness in C9-FTD and implicate vulnerable cell types. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.17.549377. [PMID: 37503230 PMCID: PMC10370095 DOI: 10.1101/2023.07.17.549377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Introduction A hexanucleotide repeat expansion (HRE) intronic to chromosome 9 open reading frame 72 (C9orf72) is recognized as the most common genetic cause of amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and ALS-FTD. Identifying genes that show similar regional co-expression patterns to C9orf72 may help identify novel gene targets and biological mechanisms that mediate selective vulnerability to ALS and FTD pathogenesis. Methods We leveraged mRNA expression data in healthy brain from the Allen Human Brain Atlas to evaluate C9orf72 co-expression patterns. To do this, we correlated average C9orf72 expression values in 51 regions across different anatomical divisions (cortex, subcortex, cerebellum) with average gene expression values for 15,633 protein-coding genes, including 50 genes known to be associated with ALS, FTD, or ALS-FTD. We then evaluated whether the identified C9orf72 co-expressed genes correlated with patterns of cortical thickness in symptomatic C9orf72 pathogenic HRE carriers (n=19). Lastly, we explored whether genes with significant C9orf72 radiogenomic correlations (i.e., 'C9orf72 gene network') were enriched in specific cell populations in the brain and enriched for specific biological and molecular pathways. Results A total of 1,748 genes showed an anatomical distribution of gene expression in the brain similar to C9orf72 and significantly correlated with patterns of cortical thickness in C9orf72 HRE carriers. This C9orf72 gene network was differentially expressed in cell populations previously implicated in ALS and FTD, including layer 5b cells, cholinergic motor neurons in the spinal cord, and medium spiny neurons of the striatum, and was enriched for biological and molecular pathways associated with multiple neurotransmitter systems, protein ubiquitination, autophagy, and MAPK signaling, among others. Conclusions Considered together, we identified a network of C9orf72-associated genes that may influence selective regional and cell-type-specific vulnerabilities in ALS/FTD.
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Affiliation(s)
- Iris J. Broce
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurosciences, University of California, San Diego, San Diego, CA, United States
| | - Daniel W. Sirkis
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Ryan M. Nillo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Luke W. Bonham
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Suzee E. Lee
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Bruce Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Patricia Castruita
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Virginia E. Sturm
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, and Trinity College Dublin, Dublin, Ireland
| | - Leo S. Sugrue
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Rahul S. Desikan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Jennifer S. Yokoyama
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, and Trinity College Dublin, Dublin, Ireland
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12
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Packer A, Corbett A, Arathimos R, Ballard C, Aarsland D, Hampshire A, Dima D, Creese B, Malanchini M, Powell TR. Limited evidence of a shared genetic relationship between C-reactive protein levels and cognitive function in older UK adults of European ancestry. FRONTIERS IN DEMENTIA 2023; 2:1093223. [PMID: 39081969 PMCID: PMC11285585 DOI: 10.3389/frdem.2023.1093223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/10/2023] [Indexed: 08/02/2024]
Abstract
Introduction Previous studies have shown associations between cognitive function and C-reactive protein (CRP) levels in older adults. Few studies have considered the extent to which a genetic predisposition for higher CRP levels contributes to this association. Methods Data was analyzed from 7,817 UK participants aged >50 years as part of the PROTECT study, within which adults without dementia completed a comprehensive neuropsychological battery. We constructed a polygenic risk score (PRS-CRP) that explained 9.61% of the variance in serum CRP levels (p = 2.362 × 10-7) in an independent cohort. Regressions were used to explore the relationship between PRS-CRP and cognitive outcomes. Results We found no significant associations between PRS-CRP and any cognitive measures in the sample overall. In older participants (>62 years), we observed a significant positive association between PRS-CRP and self-ordered search score (i.e., spatial working memory). Conclusion Whilst our results indicate a weak positive relationship between PRS-CRP and spatial working memory that is specific to older adults, overall, there appears to be no strong effects of PRS-CRP on cognitive function.
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Affiliation(s)
- Amy Packer
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Anne Corbett
- College of Medicine & Health, St Luke's, University of Exeter, Exeter, United Kingdom
| | - Ryan Arathimos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Clive Ballard
- College of Medicine & Health, St Luke's, University of Exeter, Exeter, United Kingdom
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Adam Hampshire
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Danai Dima
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychology, School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Byron Creese
- Department of Clinical and Biomedical Sciences, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Margherita Malanchini
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
- Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, London, United Kingdom
| | - Timothy R. Powell
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
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13
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Mendelson D, Mizrahi R, Lepage M, Lavigne KM. C-Reactive protein and cognition: Mediation analyses with brain morphology in the UK Biobank. Brain Behav Immun Health 2023; 31:100664. [PMID: 37484195 PMCID: PMC10362544 DOI: 10.1016/j.bbih.2023.100664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 05/26/2023] [Accepted: 06/28/2023] [Indexed: 07/25/2023] Open
Abstract
Cognitive impairments and abnormal immune activity are both associated with various clinical disorders. The association between C-Reactive protein (CRP), a marker associated with inflammation, and cognitive performance remains unclear. Further, mechanisms potentially linking CRP to cognition are not yet established. Brain structure may well mediate this relationship: immune processes play crucial roles in shaping and maintaining brain structure, with brain structure and function driving cognition. The United Kingdom Biobank (UKBB) is a large cohort study with extensive assessments, including high-sensitivity serum CRP levels, brain imaging, and various cognitive tasks. With data from 39,200 UKBB participants, we aimed first to determine the relationship between CRP and cognitive performance, and second, to assess metrics of brain morphology as potential mediators in this relationship. Participants were aged 40 to 70 at initial assessment and were mostly Caucasian. After accounting for potential covariates (e.g., age, sex, medical diagnoses, use of selective-serotonin reuptake inhibitors), we found CRP levels to have small, negative associations with fluid intelligence (b = -0.03, 95%CI[-0.05,-0.02], t(14381) = -3.62, pcor = .004), and numeric memory (b = -0.03, 95%CI[-0.05,-0.01], t(14366) = -3.31, pcor = .007). We found no evidence of brain morphology mediating these relationships (all |ab| < 0.001, all pcor > .55). Our findings from this large sample suggest that serum-assessed CRP is of marginal importance for cognitive performance in mid-to-late aged Caucasians; the small effect sizes of statistically significant associations provide context to previous inconsistent results. The seeming lack of involvement of brain morphology suggests that other brain metrics (e.g., connectivity, functional activation) may be more pertinent to this relationship. Future work should also consider CRP levels measured in the central nervous system and/or other cytokines that may better predict cognitive performance in this population.
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Affiliation(s)
- Daniel Mendelson
- Douglas Research Centre, 6875 Blvd. LaSalle, Verdun, Québec, H4H 1R3, Canada
- Department of Psychology, McGill University, 2001 McGill College Ave., Montréal, Québec, H3A 1G1, Canada
| | - Romina Mizrahi
- Douglas Research Centre, 6875 Blvd. LaSalle, Verdun, Québec, H4H 1R3, Canada
- Department of Psychiatry, McGill University, 1033 Pine Ave. West, Montréal, Québec, H3A 1A1, Canada
| | - Martin Lepage
- Douglas Research Centre, 6875 Blvd. LaSalle, Verdun, Québec, H4H 1R3, Canada
- Department of Psychiatry, McGill University, 1033 Pine Ave. West, Montréal, Québec, H3A 1A1, Canada
| | - Katie M. Lavigne
- Douglas Research Centre, 6875 Blvd. LaSalle, Verdun, Québec, H4H 1R3, Canada
- Department of Psychiatry, McGill University, 1033 Pine Ave. West, Montréal, Québec, H3A 1A1, Canada
- Montreal Neurological Institute-Hospital, 3801 University St., Montréal, Québec, H3A 2B4, Canada
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14
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Zhang Y, Tatewaki Y, Nakase T, Liu Y, Tomita N, Thyreau B, Zheng H, Muranaka M, Takano Y, Nagasaka T, Taki Y. Impact of hs-CRP concentration on brain structure alterations and cognitive trajectory in Alzheimer's disease. Front Aging Neurosci 2023; 15:1227325. [PMID: 37593375 PMCID: PMC10427872 DOI: 10.3389/fnagi.2023.1227325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/13/2023] [Indexed: 08/19/2023] Open
Abstract
Introduction Present study was to investigate hs-CRP concentration, brain structural alterations, and cognitive function in the context of AD [Subjective cognitive decline (SCD), mild cognitive impairment (MCI), and AD]. Methods We retrospectively included 313 patients (Mean age = 76.40 years, 59 SCD, 101 MCI, 153 AD) in a cross-sectional analysis and 91 patients (Mean age = 75.83 years, 12 SCD, 43 MCI, 36 AD) in a longitudinal analysis. Multivariable linear regression was conducted to investigate the relationship between hs-CRP concentration and brain structural alterations, and cognitive function, respectively. Results Hs-CRP was positively associated with gray matter volume in the left fusiform (β = 0.16, pFDR = 0.023) and the left parahippocampal gyrus (β = 0.16, pFDR = 0.029). Post hoc analysis revealed that these associations were mainly driven by patients with MCI and AD. The interaction of diagnosis and CRP was significantly associated with annual cognitive changes (β = 0.43, p = 0.008). Among these patients with AD, lower baseline CRP was correlated with greater future cognitive decline (r = -0.41, p = 0.013). Conclusion Our study suggests that increased hs-CRP level may exert protective effect on brain structure alterations and future cognitive changes among patients already with cognitive impairment.
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Affiliation(s)
- Ye Zhang
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yasuko Tatewaki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Japan
| | - Taizen Nakase
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Japan
| | - Yingxu Liu
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Naoki Tomita
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Japan
| | | | - Haixia Zheng
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Michiho Muranaka
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Japan
| | - Yumi Takano
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Japan
| | - Tatsuo Nagasaka
- Division of Radiology, Tohoku University Hospital, Sendai, Japan
| | - Yasuyuki Taki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Japan
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
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15
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Roy ARK, Datta S, Hardy E, Sturm VE, Kramer JH, Seeley WW, Rankin KP, Rosen HJ, Miller BL, Perry DC. Behavioural subphenotypes and their anatomic correlates in neurodegenerative disease. Brain Commun 2023; 5:fcad038. [PMID: 36910420 PMCID: PMC9999361 DOI: 10.1093/braincomms/fcad038] [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: 07/01/2022] [Revised: 11/11/2022] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Patients with neurodegenerative disorders experience a range of neuropsychiatric symptoms. The neural correlates have been explored for many individual symptoms, such as apathy and disinhibition. Atrophy patterns have also been associated with broadly recognized syndromes that bring together multiple symptoms, such as the behavioural variant of frontotemporal dementia. There is substantial heterogeneity of symptoms, with partial overlap of behaviour and affected neuroanatomy across and within dementia subtypes. It is not well established if there are anatomically distinct behavioural subphenotypes in neurodegenerative disease. The objective of this study was to identify shared behavioural profiles in frontotemporal dementia-spectrum and Alzheimer's disease-related syndromes. Additionally, we sought to determine the underlying neural correlates of these symptom clusters. Two hundred and eighty-one patients diagnosed with one of seven different dementia syndromes, in addition to healthy controls and individuals with mild cognitive impairment, completed a 109-item assessment capturing the severity of a range of clinical behaviours. A principal component analysis captured distinct clusters of related behaviours. Voxel-based morphometry analyses were used to identify regions of volume loss associated with each component. Seven components were identified and interpreted as capturing the following behaviours: Component 1-emotional bluntness, 2-emotional lability and disinhibition, 3-neuroticism, 4-rigidity and impatience, 5-indiscriminate consumption, 6-psychosis and 7-Geschwind syndrome-related behaviours. Correlations with structural brain volume revealed distinct neuroanatomical patterns associated with each component, including after controlling for diagnosis, suggesting that localized neurodegeneration can lead to the development of behavioural symptom clusters across various dementia syndromes.
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Affiliation(s)
- Ashlin R K Roy
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Samir Datta
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Emily Hardy
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Virginia E Sturm
- Department of Neurology, University of California, San Francisco 94158, USA
- Department of Psychiatry, University of California, San Francisco 94143, USA
| | - Joel H Kramer
- Department of Neurology, University of California, San Francisco 94158, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Katherine P Rankin
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Howard J Rosen
- Department of Neurology, University of California, San Francisco 94158, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco 94158, USA
| | - David C Perry
- Department of Neurology, University of California, San Francisco 94158, USA
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16
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Pipingas A, Murphy KJ, Davis CR, Itsiopoulos C, Kingsley M, Scholey A, Macpherson H, Segal L, Breckon J, Minihane AM, Meyer D, Ogden E, Dyer KA, Eversteyn E, Hardman RJ, Poorun K, Justice K, Hana M, Buckley JD, White D, Davison K, Clark JS, Bracci EL, Kennedy G. A Mediterranean Diet and Walking Intervention to Reduce Cognitive Decline and Dementia Risk in Independently Living Older Australians: The MedWalk Randomized Controlled Trial Experimental Protocol, Including COVID-19 Related Modifications and Baseline Characteristics. J Alzheimers Dis 2023; 96:409-427. [PMID: 37781806 PMCID: PMC10657681 DOI: 10.3233/jad-230641] [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] [Received: 08/10/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Several clinical trials have examined diet and physical activity lifestyle changes as mitigation strategies for risk factors linked to cognitive decline and dementias such as Alzheimer's disease. However, the ability to modify these behaviors longer term, to impact cognitive health has remained elusive. OBJECTIVE The MedWalk trial's primary aim is to investigate whether longer-term adherence to a Mediterranean-style diet and regular walking, delivered through motivational interviewing and cognitive-behavioral therapy (MI-CBT), can reduce age-associated cognitive decline and other dementia risk factors in older, independently living individuals without cognitive impairment. METHODS MedWalk, a one-year cluster-randomized controlled trial across two Australian states, recruited 60-90-year-old people from independent living retirement villages and the wider community. Participants were assigned to either the MedWalk intervention or a control group (maintaining their usual diet and physical activity). The primary outcome is 12-month change in visual memory and learning assessed from errors on the Paired Associates Learning Task of the Cambridge Neuropsychological Test Automated Battery. Secondary outcomes include cognition, mood, cardiovascular function, biomarkers related to nutrient status and cognitive decline, MI-CBT effectiveness, Mediterranean diet adherence, physical activity, quality of life, cost-effectiveness, and health economic evaluation.Progress and Discussion:Although COVID-19 impacts over two years necessitated a reduced timeline and sample size, MedWalk retains sufficient power to address its aims and hypotheses. Baseline testing has been completed with 157 participants, who will be followed over 12 months. If successful, MedWalk will inform interventions that could substantially reduce dementia incidence and ameliorate cognitive decline in the community. TRIAL REGISTRATION Registered on the Australia New Zealand Clinical Trials Registry ANZCTR 12620000978965 (https://www.anzctr.org.au).
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Affiliation(s)
- Andrew Pipingas
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Karen J. Murphy
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Courtney R. Davis
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | | | - Michael Kingsley
- Department of Exercise Sciences, The University of Auckland, Newmarket, New Zealand
- Holsworth Research Initiative, La Trobe University, Bendigo, VIC, Australia
| | - Andrew Scholey
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- Nutrition Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, VIC, Australia
| | - Helen Macpherson
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
| | - Leonie Segal
- Economics and Social Policy Group, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Jeff Breckon
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | | | - Denny Meyer
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Edward Ogden
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Kathryn A. Dyer
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Emily Eversteyn
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Roy J. Hardman
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Kaylass Poorun
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Keri Justice
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Maher Hana
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jonathan D. Buckley
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - David White
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Kade Davison
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Jessie S. Clark
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Ella L. Bracci
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Greg Kennedy
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - on behalf of MedWalk collaborative team
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance & UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
- Department of Exercise Sciences, The University of Auckland, Newmarket, New Zealand
- Holsworth Research Initiative, La Trobe University, Bendigo, VIC, Australia
- Nutrition Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, VIC, Australia
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
- Economics and Social Policy Group, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
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17
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Scholl JL, King ZR, Pearson K, Kallsen NA, Ehli EA, Fercho KA, Brown-Rice KA, Forster GL, Baugh LA. Methylation of genes and regulation of inflammatory processes on emotional response in young adults with alcoholic parents. Brain Behav Immun Health 2022; 25:100505. [PMID: 36110145 PMCID: PMC9468507 DOI: 10.1016/j.bbih.2022.100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 10/31/2022] Open
Abstract
Many Americans are adult children of an alcoholic parent (ACoA), which can confer an increased risk of trauma and hazardous alcohol use, as well as heritable and environmental genetic influence. Psychological health and related neural activity can be influenced by inflammation responses, but it is not clear how these factors interact regarding risk or resilience to hazardous alcohol use. The goals of this study were to better understand the relationships between current alcohol use and inflammation, how these are modified by single nucleotide polymorphisms (SNPs) and/or epigenetic modifications of inflammation-associated genes; and how these alter neural reactivity to emotionally-salient stimuli. To do so, ACoA participants were dichotomized as resilient (not engaged in hazardous alcohol use) or vulnerable (currently engaged in hazardous alcohol use). Measures of blood-oxygen-level-dependent (BOLD) activity within regions of interest (ROIs), SNPs and DNA methylation of specific inflammation regulatory genes, and biological markers of inflammation were compared between these groups. Vulnerable ACoAs exhibited higher plasma C-reactive protein (CRP) and greater BOLD activity in the right hippocampus and ventral anterior cingulate cortex in response to emotional cues as well as reduced methylation of CRP and glucocorticoid-related genes. Path analysis revealed significant relationships between alcohol use, SNPs, DNA methylation of inflammatory-related genes, CRP levels, and BOLD activity to emotional stimuli. Taken together, these findings suggest a complex association related to hazardous alcohol use in ACoAs that may predict current inflammation and neural reactivity to emotional stimuli. A better understanding of these associations could direct the future of individual treatment options.
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Affiliation(s)
- Jamie L. Scholl
- Basic Biomedical Sciences & Center for Brain and Behavior Research, Sanford School of Medicine, University of South Dakota, USA
| | - Zach R. King
- Basic Biomedical Sciences & Center for Brain and Behavior Research, Sanford School of Medicine, University of South Dakota, USA
| | - Kami Pearson
- Basic Biomedical Sciences & Center for Brain and Behavior Research, Sanford School of Medicine, University of South Dakota, USA
| | | | - Erik A. Ehli
- Avera Institute for Human Genetics, Sioux Falls, SD, USA
| | | | - Kathleen A. Brown-Rice
- Department of Counselor Education, College of Education, Sam Houston State University, Huntsville, TX, USA
| | - Gina L. Forster
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Lee A. Baugh
- Basic Biomedical Sciences & Center for Brain and Behavior Research, Sanford School of Medicine, University of South Dakota, USA
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18
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Fard MT, Savage KM, Stough CK. Peripheral inflammation marker relationships to cognition in healthy older adults - A systematic review. Psychoneuroendocrinology 2022; 144:105870. [PMID: 35908534 DOI: 10.1016/j.psyneuen.2022.105870] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
Several cognitive domains show decline with increasing age, which is associated with poorer work performance and reduced quality of life. As many nations show a rise in the number of citizens aged over 60 years, the study of the mechanisms underlying age-related cognitive functional reductions, such as inflammation, is important. Inflammaging has been implicated in progressive minor decline through to dementia typologies, with peripheral cytokine patterns investigated for their potential role in cognitive function. Assessing the relationship between these markers and cognitive performance could elucidate mechanisms with aging beyond neuropathologies. The research literature suggests peripheral cytokines/chemokines such as interleukin-6 and c-reactive protein are associated with cognitive processing. In this systematic review, we examine the evidence for a relationship between a range of peripheral inflammatory markers and domains of cognitive function in healthy older adults. To do this, a literature search was conducted using the following databases: SCOPUS, PubMed, Web of Science, and PsycINFO. Risk of bias was assessed using the Cochrane Risk of Bias Tool. Twenty-nine studies met our inclusion criteria. Although a wide range of systemic inflammatory biomarkers were examined, IL-6 and CRP were the most studied. The evidence suggests an inverse inflammatory biomarker-cognitive function relationship whereby elevations in most cytokines were associated with poorer performance across cognitive domains. The findings contribute to our understanding of peripheral inflammation and domains of cognitive function, offering insight into inflammaging processes.
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Affiliation(s)
- Masoumeh Tangestani Fard
- Centre for Human Psychopharmacology, School of Health Sciences, Swinburne University of Technology, Burwood Road, Hawthorn, Australia, 3122
| | - Karen M Savage
- Centre for Human Psychopharmacology, School of Health Sciences, Swinburne University of Technology, Burwood Road, Hawthorn, Australia, 3122.
| | - Con K Stough
- Centre for Human Psychopharmacology, School of Health Sciences, Swinburne University of Technology, Burwood Road, Hawthorn, Australia, 3122
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19
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Klaus F, Nguyen TT, Thomas ML, Liou SC, Soontornniyomkij B, Mitchell K, Daly R, Sutherland AN, Jeste DV, Eyler LT. Peripheral inflammation levels associated with degree of advanced brain aging in schizophrenia. Front Psychiatry 2022; 13:966439. [PMID: 36032250 PMCID: PMC9412908 DOI: 10.3389/fpsyt.2022.966439] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Brain structural abnormalities have been demonstrated in schizophrenia (SZ); these resemble those seen in typical aging, but are seen at younger ages. Furthermore, SZ is associated with accelerated global brain aging, as measured by brain structure-based brain predicted age difference (Brain-PAD). High heterogeneity exists in the degree of brain abnormalities in SZ, and individual differences may be related to levels of peripheral inflammation and may relate to cognitive deficits and negative symptoms. The goal of our study was to investigate the relationship between brain aging, peripheral inflammation, and symptoms of SZ. We hypothesized older brain-PAD in SZ vs. healthy comparison (HC) participants, as well as positive relationships of brain-PAD with peripheral inflammation markers and symptoms in SZ. We analyzed data from two cross-sectional studies in SZ (n = 26; M/F: 21/5) and HC (n = 28; 20/8) (22-64 years). Brain-PAD was calculated using a previously validated Gaussian process regression model applied to raw T1-weighted MRI data. Plasma levels of inflammatory biomarkers (CRP, Eotaxin, Fractalkine, IP10, IL6, IL10, ICAM1, IFNγ, MCP1, MIP1β, SAA, TNFα, VEGF, VCAM1) and cognitive and negative symptoms were assessed. We observed a higher brain-PAD in SZ vs. HC, and advanced brain age relative to chronological age was related to higher peripheral levels of TNFα in the overall group and in the SZ group; other inflammatory markers were not related to brain-PAD. Within the SZ group, we observed no association between cognitive or negative symptoms and brain-PAD. These results support our hypothesis of advanced brain aging in SZ. Furthermore, our findings on the relationship of the pro-inflammatory cytokine TNFα with higher brain-PAD of SZ are relevant to explain heterogeneity of brain ages in SZ, but we did not find strong evidence for cognitive or negative symptom relationships with brain-PAD.
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Affiliation(s)
- Federica Klaus
- Department of Psychiatry, UC San Diego, La Jolla, CA, United States
- VA San Diego Healthcare System, La Jolla, CA, United States
| | - Tanya T. Nguyen
- Department of Psychiatry, UC San Diego, La Jolla, CA, United States
- VA San Diego Healthcare System, La Jolla, CA, United States
| | - Michael L. Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | - Sharon C. Liou
- Department of Psychiatry, UC San Diego, La Jolla, CA, United States
| | | | - Kyle Mitchell
- VA San Diego Healthcare System, La Jolla, CA, United States
| | - Rebecca Daly
- Department of Psychiatry, UC San Diego, La Jolla, CA, United States
- Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, La Jolla, CA, United States
| | - Ashley N. Sutherland
- Department of Psychiatry, UC San Diego, La Jolla, CA, United States
- VA San Diego Healthcare System, La Jolla, CA, United States
| | - Dilip V. Jeste
- Department of Psychiatry, UC San Diego, La Jolla, CA, United States
- Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, La Jolla, CA, United States
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - Lisa T. Eyler
- Department of Psychiatry, UC San Diego, La Jolla, CA, United States
- VA San Diego Healthcare System, La Jolla, CA, United States
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20
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Shen B, Hernandez DG, Chitrala KN, Fanelli-Kuczmarski MT, Noren Hooten N, Pacheco NL, Mode NA, Zonderman AB, Ezike N, Evans MK. APOE gene region methylation is associated with cognitive performance in middle-aged urban adults. Neurobiol Aging 2022; 116:41-48. [PMID: 35561457 PMCID: PMC10878469 DOI: 10.1016/j.neurobiolaging.2022.03.010] [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: 05/28/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022]
Abstract
Apolipoprotein (APOE) ε4 allele is a strong risk factor for Alzheimer's disease (AD) and cognitive decline. Epigenetic modifications such as DNA methylation (DNAm) play a central role in cognition. This study sought to identify DNAm sites in the APOE genomic region associated with cognitive performance in a racially diverse middle-aged cohort (n = 411). Cognitive performance was measured by 11 standard neuropsychological tests. Two CpG sites were associated with the Card Rotation and Benton Visual Retention cognitive tests. The methylation level of the CpG site cg00397545 was associated with Card Rotation Test score (p = 0.000177) and a novel CpG site cg10178308 was associated with Benton Visual Retention Test score (p = 0.000084). Significant associations were observed among the dietary inflammatory index, which reflects the inflammatory potential of the diet, cognitive performance and the methylation level of several CpG sites. Our results indicate that DNAm in the APOE genomic area is correlated with cognitive performance and may presage cognitive decline.
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Affiliation(s)
- Botong Shen
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Dena G Hernandez
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Kumaraswamy Naidu Chitrala
- Fels Institute for Personalized Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Marie T Fanelli-Kuczmarski
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Natasha L Pacheco
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Nicolle A Mode
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Ngozi Ezike
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.
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21
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Boots EA, Feinstein DL, Leurgans S, Aiken-Morgan AT, Fleischman DA, Lamar M, Barnes LL. Acute versus chronic inflammatory markers and cognition in older black adults: Results from the Minority Aging Research Study. Brain Behav Immun 2022; 103:163-170. [PMID: 35439553 PMCID: PMC9704497 DOI: 10.1016/j.bbi.2022.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/16/2022] [Accepted: 04/14/2022] [Indexed: 10/18/2022] Open
Abstract
Peripheral inflammation is elevated in older Black adults, an elevation which prior work has suggested may be due to chronic stress associated with systemic racism and related adverse cardiovascular health conditions. Inflammation is also involved in the pathogenic processes of dementia; however, limited (and mixed) results exist concerning inflammation and cognitive decline in Black adults. We characterized patterns of inflammation and their role in cognitive decline in 280 older Black adults (age = 72.99 ± 6.00 years; 69.6% female) from the Minority Aging Research Study (MARS) who were without dementia at baseline and followed between 2 and 15 years (mean = 9 years). Participants completed a blood draw at baseline and annual cognitive evaluations. Serum was assayed for 9 peripheral inflammatory markers; 19 neuropsychological test scores were used to create indices of global cognition and five cognitive domains. Principal component analysis with varimax rotation characterized patterns of inflammation with factor loadings > 0.6 per component contributing to two composite scores representing acute/upstream and chronic/downstream inflammation. These composites were used as separate predictors in linear mixed regression models to determine associations with level and change in cognition adjusting for relevant covariates. Higher baseline upstream/acute inflammation associated with lower baseline semantic memory (p = .040) and perceptual speed (p = .046); it was not related to cognitive decline. By contrast, higher baseline downstream/chronic inflammation associated with faster declines in global cognition (p = .010), episodic (p = .027) and working memory (p = .006); it was not related to baseline cognition. For older Black adults, chronic, but not acute, inflammation may be a risk factor for changes in cognition.
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Affiliation(s)
- Elizabeth A Boots
- Department of Psychology, University of Illinois at Chicago, Chicago, IL 60607, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - Douglas L Feinstein
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL 60612, USA; Jesse Brown VA Medical Center, Chicago, IL 60612, USA
| | - Sue Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA
| | - Adrienne T Aiken-Morgan
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill NC 27516, USA
| | - Debra A Fleischman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
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22
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Chen X, Yao T, Cai J, Fu X, Li H, Wu J. Systemic inflammatory regulators and 7 major psychiatric disorders: A two-sample Mendelian randomization study. Prog Neuropsychopharmacol Biol Psychiatry 2022; 116:110534. [PMID: 35150783 DOI: 10.1016/j.pnpbp.2022.110534] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/19/2022] [Accepted: 02/06/2022] [Indexed: 11/27/2022]
Abstract
Systemic inflammation has been thought to play a considerable part in psychiatric disorders. However, the causal relationships between systemic inflammation and psychiatric disorders and the directions of the causal effects remain elusive and need further investigation. By leveraging the summary statistics of genome-wide association studies, the standard inverse variance weighted method was applied to assess the causal associations among 41 systemic inflammatory regulators and 7 major psychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD), anorexia nervosa (AN), autism spectrum disorder (ASD), bipolar disorder (BIP), major depression disorder (MDD), obsessive-compulsive disorder (OCD), and schizophrenia (SCZ), within a two-sample bidirectional Mendelian randomization analysis. Additionally, the weighted median test and the Mendelian randomization pleiotropy residual sum and outlier test were conducted for sensitivity analyses. The results suggested a total of 15 unique systemic inflammatory regulators might be causally associated with disease risk, including 2 for ADHD, 4 for AN, 2 for ASD, 2 for MDD, 2 for OCD, and 5 for SCZ. Among them, the genetically predicted concentration of basic fibroblast growth factor was significantly related to AN at the Bonferroni-corrected threshold (Odds ratio = 0.403, 95% confidence interval = (0.261, 0.622), P = 4.03 × 10-5). Furthermore, the concentrations of 9 systemic inflammatory regulators might be influenced by neuropsychiatric disorders, including 2 by ADHD, 2 by BIP, 3 by MDD, and 2 by SCZ, and the causal effects of ASD, AN, and OCD need to be further assessed when more significant genetic variants are identified in the future. Overall, this study provides additional insights into the relationships between systemic inflammation and psychiatric disorders and may provide new clues regarding the aetiology, diagnosis and treatment of psychiatric disorders.
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Affiliation(s)
- Xinzhen Chen
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Ting Yao
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jinliang Cai
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Xihang Fu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Huiru Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jing Wu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
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El-Domiaty HF, El-Roghy ES, Salem HR. Combination of magnesium supplementation with treadmill exercise improves memory deficit in aged rats by enhancing hippocampal neurogenesis and plasticity: a functional and histological study. Appl Physiol Nutr Metab 2022; 47:296-308. [PMID: 35225658 DOI: 10.1139/apnm-2021-0133] [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: 11/22/2022]
Abstract
This study aimed to investigate the possible ameliorative effects of co-supplementation with Mg2+ and treadmill exercise on memory deficit in aged rats. Fifty male albino rats (10 young and 40 aged rats) were divided into 5 groups (10 rats/group): young, aged sedentary, aged exercised, aged Mg2+-supplemented, and aged exercised and Mg2+-supplemented. Memory was assessed using the Y-maze and novel object recognition tests. Plasma samples were collected for measurement of C-reactive protein (CRP). Subsequently, brain malondialdehyde and catalase levels were measured. Histological and immunohistochemical analyses of the hippocampi were performed. Our results showed impaired memory in aged sedentary rats, with significantly elevated plasma CRP and brain malondialdehyde levels and decreased brain catalase. The hippocampus of aged sedentary rats showed cellular degeneration, downregulation of synaptophysin (SYP) and proliferating cell nuclear antigen (PCNA), and upregulation of glial fibrillary acidic protein (GFAP) and caspase-3. Mg2+ supplementation and/or treadmill exercise significantly improved memory tests in aged rats, which could be explained by the upregulation of hippocampal SYP and PCNA expression and downregulation of GFAP and caspase-3 expression with antioxidant and anti-inflammatory mechanisms. The combined therapy had a better effect than both treatments alone, confirming the role of Mg2+ supplementation with physical exercise in enhancing age-related memory deficit. Novelty: Magnesium supplementation with treadmill exercise improves memory deficit in aged rats. The possible mechanisms are upregulation of the hippocampal synaptophysin and PCNA, downregulation of GFAP and caspase-3, the antioxidant and anti-inflammatory mechanisms.
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Affiliation(s)
- Heba Fathy El-Domiaty
- Medical Physiology Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia Governorate, Egypt
| | - Eman S El-Roghy
- Histology Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia Governorate, Egypt
| | - Heba Rady Salem
- Medical Physiology Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia Governorate, Egypt
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24
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Beck D, de Lange AG, Pedersen ML, Alnæs D, Maximov II, Voldsbekk I, Richard G, Sanders A, Ulrichsen KM, Dørum ES, Kolskår KK, Høgestøl EA, Steen NE, Djurovic S, Andreassen OA, Nordvik JE, Kaufmann T, Westlye LT. Cardiometabolic risk factors associated with brain age and accelerate brain ageing. Hum Brain Mapp 2022; 43:700-720. [PMID: 34626047 PMCID: PMC8720200 DOI: 10.1002/hbm.25680] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 09/02/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022] Open
Abstract
The structure and integrity of the ageing brain is interchangeably linked to physical health, and cardiometabolic risk factors (CMRs) are associated with dementia and other brain disorders. In this mixed cross-sectional and longitudinal study (interval mean = 19.7 months), including 790 healthy individuals (mean age = 46.7 years, 53% women), we investigated CMRs and health indicators including anthropometric measures, lifestyle factors, and blood biomarkers in relation to brain structure using MRI-based morphometry and diffusion tensor imaging (DTI). We performed tissue specific brain age prediction using machine learning and performed Bayesian multilevel modeling to assess changes in each CMR over time, their respective association with brain age gap (BAG), and their interaction effects with time and age on the tissue-specific BAGs. The results showed credible associations between DTI-based BAG and blood levels of phosphate and mean cell volume (MCV), and between T1-based BAG and systolic blood pressure, smoking, pulse, and C-reactive protein (CRP), indicating older-appearing brains in people with higher cardiometabolic risk (smoking, higher blood pressure and pulse, low-grade inflammation). Longitudinal evidence supported interactions between both BAGs and waist-to-hip ratio (WHR), and between DTI-based BAG and systolic blood pressure and smoking, indicating accelerated ageing in people with higher cardiometabolic risk (smoking, higher blood pressure, and WHR). The results demonstrate that cardiometabolic risk factors are associated with brain ageing. While randomized controlled trials are needed to establish causality, our results indicate that public health initiatives and treatment strategies targeting modifiable cardiometabolic risk factors may also improve risk trajectories and delay brain ageing.
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Affiliation(s)
- Dani Beck
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Ann‐Marie G. de Lange
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- LREN, Centre for Research in Neurosciences‐Department of Clinical NeurosciencesCHUV and University of LausanneLausanneSwitzerland
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Mads L. Pedersen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Dag Alnæs
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Bjørknes CollegeOsloNorway
| | - Ivan I. Maximov
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Department of Health and FunctioningWestern Norway University of Applied SciencesBergenNorway
| | - Irene Voldsbekk
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Geneviève Richard
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Anne‐Marthe Sanders
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Kristine M. Ulrichsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Erlend S. Dørum
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Knut K. Kolskår
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Einar A. Høgestøl
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Srdjan Djurovic
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- KG Jebsen Centre for Neurodevelopmental DisordersUniversity of OsloOsloNorway
| | | | - Tobias Kaufmann
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of Psychiatry and PsychotherapyUniversity of TübingenTubingenGermany
| | - Lars T. Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- KG Jebsen Centre for Neurodevelopmental DisordersUniversity of OsloOsloNorway
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25
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Kim KY, Shin KY, Chang KA. Potential Biomarkers for Post-Stroke Cognitive Impairment: A Systematic Review and Meta-Analysis. Int J Mol Sci 2022; 23:ijms23020602. [PMID: 35054785 PMCID: PMC8775398 DOI: 10.3390/ijms23020602] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 01/27/2023] Open
Abstract
Stroke is a primary debilitating disease in adults, occurring in 15 million individuals each year and causing high mortality and disability rates. The latest estimate revealed that stroke is currently the second leading cause of death worldwide. Post-stroke cognitive impairment (PSCI), one of the major complications after stroke, is frequently underdiagnosed. However, stroke has been reported to increase the risk of cognitive impairment by at least five to eight times. In recent decades, peripheral blood molecular biomarkers for stroke have emerged as diagnostic, prognostic, and therapeutic targets. In this study, we aimed to evaluate some blood-derived proteins for stroke, especially related to brain damage and cognitive impairments, by conducting a systematic review and meta-analysis and discussing the possibility of these proteins as biomarkers for PSCI. Articles published before 26 July 2021 were searched in PubMed, Embase, the Web of Science, and the Cochrane Library to identify all relevant studies reporting blood biomarkers in patients with stroke. Among 1820 articles, 40 were finally identified for this study. We meta-analyzed eight peripheral biomarker candidates: homocysteine (Hcy), high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), uric acid, and glycated hemoglobin (HbA1c). The Hcy, CRP, TC, and LDL-C levels were significantly higher in patients with PSCI than in the non-PSCI group; however, the HDL-C, TG, uric acid, and HbA1c levels were not different between the two groups. Based on our findings, we suggest the Hcy, CRP, TC, and LDL-C as possible biomarkers in patients with post-stroke cognitive impairment. Thus, certain blood proteins could be suggested as effective biomarkers for PSCI.
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Affiliation(s)
- Ka Young Kim
- Department of Nursing, College of Nursing, Gachon University, Incheon 21936, Korea;
- Neuroscience Research Institute, Gachon University, Incheon 21565, Korea
| | - Ki Young Shin
- Bio-MAX Institute, Seoul National University, Seoul 08826, Korea
- Correspondence: (K.Y.S.); (K.-A.C.)
| | - Keun-A Chang
- Neuroscience Research Institute, Gachon University, Incheon 21565, Korea
- Department of Pharmacology, College of Medicine, Gachon University, Incheon 21936, Korea
- Neuroscience of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences and Technology, Gachon University, Incheon 21936, Korea
- Correspondence: (K.Y.S.); (K.-A.C.)
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Abstract
The overarching objective is to review how early exposure to adversity interacts with inflammation to alter brain maturation. Both adversity and inflammation are significant risk factors for psychopathology. Literature relevant to the effects of adversity in children and adolescents on brain development is reviewed. These studies are supported by research in animals exposed to species-relevant stressors during development. While it is known that exposure to adversity at any age increases inflammation, the effects of inflammation are exacerbated at developmental stages when the immature brain is uniquely sensitive to experiences. Microglia play a vital role in this process, as they scavenge cellular debris and prune synapses to optimize performance. In essence, microglia modify the synapse to match environmental demands, which is necessary for someone with a history of adversity. Overall, by piecing together clinical and preclinical research areas, what emerges is a picture of how adversity uniquely sculpts the brain. Microglia interactions with the inhibitory neurotransmitter GABA (specifically, the subtype expressing parvalbumin) are discussed within contexts of development and adversity. A review of inflammation markers in individuals with a history of abuse is combined with preclinical studies to describe their effects on maturation. Inconsistencies within the literature are discussed, with a call for standardizing methodologies relating to the age of assessing adversity effects, measures to quantify stress and inflammation, and more brain-based measures of biochemistry. Preclinical studies pave the way for interventions using anti-inflammation-based agents (COX-2 inhibitors, CB2 agonists, meditation/yoga) by identifying where, when, and how the developmental trajectory goes awry.
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Adverse childhood experiences and cognitive function in adulthood: examining the roles of depressive symptoms and inflammation in a prospective cohort study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2367-2377. [PMID: 35753000 PMCID: PMC9244111 DOI: 10.1007/s00127-022-02315-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 05/18/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE Adverse childhood experiences (ACEs) have been associated with cognitive decline in adulthood. However, the underlying mechanisms implicated remain unclear. This study investigated depressive symptoms and systemic inflammation as potential mediators of the association between ACEs and later cognitive function. METHODS Participants were adults aged 50 + from the English Longitudinal Study of Ageing (N = 3029; 54.8% female). Measures included self-reported ACEs at wave 3 (2006-2007), C-reactive protein (CRP) and depressive symptoms at wave 4 (2008-2009), and cognitive function at waves 3 and 7 (2014-2015). Mediation analyses examined the direct associations between ACEs and cognitive function at wave 7 and the indirect associations via depressive symptoms and CRP at wave 4. In a first set of analyses, models were adjusted for sociodemographic factors and baseline cognitive function. In a second set of analyses, models were additionally adjusted for BMI and health behaviours (n = 1915). RESULTS Cumulative ACEs exposure positively predicted depressive symptoms (b = 0.184, s.e. = 0.034, p < .001), which in turn predicted poorer cognitive function at wave 7 (b = - 0.035, s.e. = 0.008, p < .001). ACEs also positively predicted systemic inflammation as measured by CRP (b = 0.031, s.e. = 0.01, p = 0.0016). However, CRP did not mediate the association between ACEs and later cognitive function (b = - 0.0002, 95% CI: - 0.002, 0.002). CONCLUSION These findings suggest that ACEs may be related to cognitive decline partly via depressive symptoms and corroborate prior research linking ACEs with systemic inflammation in adulthood.
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28
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Wittfeld K, Raman MR, Conner SC, Aslam A, Teumer A, Nauck M, Hosten N, Habes M, DeCarli C, Vasan RS, Beiser AS, Himali JJ, Seshadri S, Grabe HJ, Satizabal CL. Insulin-Like Growth Factor, Inflammation, and MRI Markers of Alzheimer's Disease in Predominantly Middle-Aged Adults. J Alzheimers Dis 2022; 88:311-322. [PMID: 35599493 PMCID: PMC9472289 DOI: 10.3233/jad-220356] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Insulin-like growth factor 1 (IGF-1) signaling has been implicated in Alzheimer's disease pathogenesis, and further evidence suggests inflammation can be a moderator of this association. However, most research to date has been conducted on older adults. OBJECTIVE To investigate the association of serum IGF-1 and IGF binding protein 3 (IGFBP-3) concentrations with MRI markers of Alzheimer's disease in predominantly middle-aged adults, and further assess moderation by chronic inflammation. METHODS We included participants from the Framingham Heart Study (n = 1,852, mean age 46±8, 46% men) and the Study of Health in Pomerania (n = 674, mean age 50±13, 42% men) with available serum IGF-1, IFGBP-3, as well as brain MRI. IGF-1 and IFGBP-3 were related to MRI outcomes (i.e., total brain, cortical gray matter, white matter, white matter hyperintensities (WMH), and hippocampal volumes) using multivariable regression models adjusting for potential confounders. Subgroup analyses by C-reactive protein (CRP) concentrations were also performed. Cohort-specific summary statistics were meta-analyzed using random-effects models and corrected for multiple comparisons. RESULTS Meta-analysis results revealed that higher IGF-1 concentrations were associated with lower WMH (estimate [β] [95% CI], -0.05 [-0.09, -0.02], p = 0.006) and larger hippocampal volumes (0.07 [0.02, 0.12], p = 0.01), independent of vascular risk factors. These associations occurred predominantly in individuals with CRP concentrations < 75th percentile. We did not observe associations between IGFBP-3 and MRI outcomes. CONCLUSION Our findings suggest that IGF-1-related signaling may be implicated in brain health as early as midlife.
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Affiliation(s)
- Katharina Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Mekala R Raman
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Sarah C Conner
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Asra Aslam
- Long School of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Matthias Nauck
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Norbert Hosten
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Mohamad Habes
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
- Department of Radiology, Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Charles DeCarli
- Department of Neurology, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Ramachandran S Vasan
- Framingham Heart Study, Framingham, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston MA, USA
| | - Alexa S Beiser
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jayandra J Himali
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
| | - Sudha Seshadri
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
| | - Hans J Grabe
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Claudia L Satizabal
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
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29
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Conole ELS, Stevenson AJ, Muñoz Maniega S, Harris SE, Green C, Valdés Hernández MDC, Harris MA, Bastin ME, Wardlaw JM, Deary IJ, Miron VE, Whalley HC, Marioni RE, Cox SR. DNA Methylation and Protein Markers of Chronic Inflammation and Their Associations With Brain and Cognitive Aging. Neurology 2021; 97:e2340-e2352. [PMID: 34789543 PMCID: PMC8665430 DOI: 10.1212/wnl.0000000000012997] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/15/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To investigate chronic inflammation in relation to cognitive aging by comparison of an epigenetic and serum biomarker of C-reactive protein and their associations with neuroimaging and cognitive outcomes. METHODS At baseline, participants (n = 521) were cognitively normal, around 73 years of age (mean 72.4, SD 0.716), and had inflammation, vascular risk (cardiovascular disease history, hypertension, diabetes, smoking, alcohol consumption, body mass index), and neuroimaging (structural and diffusion MRI) data available. Baseline inflammatory status was quantified by a traditional measure of peripheral inflammation-serum C-reactive protein (CRP)-and an epigenetic measure (DNA methylation [DNAm] signature of CRP). Linear models were used to examine the inflammation-brain health associations; mediation analyses were performed to interrogate the relationship between chronic inflammation, brain structure, and cognitive functioning. RESULTS We demonstrate that DNAm CRP shows significantly (on average 6.4-fold) stronger associations with brain health outcomes than serum CRP. DNAm CRP is associated with total brain volume (β = -0.197, 95% confidence interval [CI] -0.28 to -0.12, p FDR = 8.42 × 10-6), gray matter volume (β = -0.200, 95% CI -0.28 to -0.12, p FDR = 1.66 × 10-5), and white matter volume (β = -0.150, 95% CI -0.23 to -0.07, p FDR = 0.001) and regional brain atrophy. We also find that DNAm CRP has an inverse association with global and domain-specific (speed, visuospatial, and memory) cognitive functioning and that brain structure partially mediates this CRP-cognitive association (up to 29.7%), dependent on lifestyle and health factors. DISCUSSION These results support the hypothesis that chronic inflammation may contribute to neurodegenerative brain changes that underlie differences in cognitive ability in later life and highlight the potential of DNAm proxies for indexing chronic inflammatory status. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that a DNAm signature of CRP levels is more strongly associated with brain health outcomes than serum CRP levels.
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Affiliation(s)
- Eleanor L S Conole
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK.
| | - Anna J Stevenson
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Susana Muñoz Maniega
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Sarah E Harris
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Claire Green
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Maria Del C Valdés Hernández
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Mathew A Harris
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Mark E Bastin
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Joanna M Wardlaw
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Ian J Deary
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Veronique E Miron
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Heather C Whalley
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Riccardo E Marioni
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
| | - Simon R Cox
- From the Lothian Birth Cohorts Group, Department of Psychology (E.L.S.C., S.M.M., S.E.H., M.d.C.V.H., M.A.H., J.M.W., I.J.D., R.E.M., S.R.C.), Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer (E.L.S.C., A.J.S., R.E.M.), Centre for Clinical Brain Sciences (E.L.S.C., S.M.M., M.d.C.V.H., M.E.B., J.M.W., H.C.W.), UK Dementia Research Institute, Edinburgh Medical School (A.J.S., V.E.M.), Division of Psychiatry, Royal Edinburgh Hospital (C.G., M.A.H., H.C.W.), and The Queen's Medical Research Institute, Edinburgh BioQuarter (V.E.M.), University of Edinburgh, UK
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Bettcher BM, Tansey MG, Dorothée G, Heneka MT. Peripheral and central immune system crosstalk in Alzheimer disease - a research prospectus. Nat Rev Neurol 2021; 17:689-701. [PMID: 34522039 PMCID: PMC8439173 DOI: 10.1038/s41582-021-00549-x] [Citation(s) in RCA: 178] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2021] [Indexed: 02/08/2023]
Abstract
Dysregulation of the immune system is a cardinal feature of Alzheimer disease (AD), and a considerable body of evidence indicates pathological alterations in central and peripheral immune responses that change over time. Considering AD as a systemic immune process raises important questions about how communication between the peripheral and central compartments occurs and whether this crosstalk represents a therapeutic target. We established a whitepaper workgroup to delineate the current status of the field and to outline a research prospectus for advancing our understanding of peripheral-central immune crosstalk in AD. To guide the prospectus, we begin with an overview of seminal clinical observations that suggest a role for peripheral immune dysregulation and peripheral-central immune communication in AD, followed by formative animal data that provide insights into possible mechanisms for these clinical findings. We then present a roadmap that defines important next steps needed to overcome conceptual and methodological challenges, opportunities for future interdisciplinary research, and suggestions for translating promising mechanistic studies into therapeutic interventions.
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Affiliation(s)
- Brianne M Bettcher
- Behavioral Neurology Section, Department of Neurology, University of Colorado Alzheimer's and Cognition Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Malú G Tansey
- Department of Neuroscience, Center for Translational Research in Neurodegenerative Disease, University of Florida College of Medicine, Gainesville, FL, USA
| | - Guillaume Dorothée
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, Team "Immune System and Neuroinflammation", Hôpital Saint-Antoine, Paris, France
| | - Michael T Heneka
- Department of Neurodegenerative Diseases & Geropsychiatry/Neurology, University of Bonn Medical Center, Bonn, Germany
- Department of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, MA, USA
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31
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Inflammatory markers and tract-based structural connectomics in older adults with a preliminary exploration of associations by race. Brain Imaging Behav 2021; 16:130-140. [PMID: 34272684 DOI: 10.1007/s11682-021-00483-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 10/20/2022]
Abstract
Peripheral inflammation has been implicated in cognitive dysfunction and dementia. While studies outline the relationship between elevated inflammation and individual gray or white matter alterations, less work has examined inflammation as related to connectivity between gray and white matter or variability in these associations by race. We examined the relationship between peripheral inflammation and tract-based structural connectomics in 74 non-demented participants (age = 69.19 ± 6.80 years; 53% female; 45% Black) who underwent fasting venipuncture and MRI. Serum was assayed for C-reactive protein, interleukin-6, and interleukin-1β. Graph theory analysis integrated T1-derived gray matter volumes and DTI-derived white matter tractography into connectivity matrices analyzed for local measures of nodal strength and efficiency in a priori regions of interest associated with cardiovascular disease risk factors and dementia. Linear regressions adjusting for relevant covariates showed associations between inflammatory markers and nodal strength in the isthmus, posterior and caudal anterior cingulate (p's ≤ .042). Adding an inflammatory marker*race term showed race-modified associations between C-reactive protein and efficiency in the thalamus and amygdala, and nodal strength in the putamen (p's ≤ .048), between interleukin-6 and efficiency in the pars triangularis and amygdala (p's ≤ .024), and between interleukin-1β and nodal strength in the pars opercularis (p = .048). Higher levels of inflammation associated with lower efficiency and higher strength for White participants but higher efficiency and lower strength for Black participants. Results suggest inflammation is associated with tract-based structural connectomics in an older diverse cohort and that differential relationships may exist by race within prefrontal and limbic brain regions.
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32
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Caldwell JZK, Kinney JW, Ritter A, Salazar A, Wong CG, Cordes D, Slavich GM. Inflammatory cytokine levels implicated in Alzheimer's disease moderate the effects of sex on verbal memory performance. Brain Behav Immun 2021; 95:27-35. [PMID: 33301871 PMCID: PMC8793982 DOI: 10.1016/j.bbi.2020.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/24/2020] [Accepted: 12/04/2020] [Indexed: 12/01/2022] Open
Abstract
Despite having an initial verbal memory advantage over men, women have greater rates of Alzheimer's disease and more rapid cognitive decline once diagnosed. Moreover, although Alzheimer's disease is influenced by inflammation, which itself has known sex differences, no study has investigated whether sex differences in memory are moderated by peripheral inflammatory activity. To address this issue, we analyzed data from 109 individuals (50 women, Mage = 71.62, range = 55-87) diagnosed as cognitively normal, or having mild cognitive impairment or Alzheimer's disease dementia. We then followed the sample for 12 months, as part of a longitudinal study of aging and Alzheimer's disease. At baseline, we assessed levels of the inflammatory cytokines interleukin (IL)-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) in plasma. At baseline and 12 months, we assessed verbal memory using the Rey Auditory Verbal Learning Test and nonverbal memory using the Brief Visuospatial Memory Test-Revised. As hypothesized, for the full sample, women exhibited stronger verbal (but not nonverbal) memory than men. In women, but not men, higher IL-1β at baseline related to poorer verbal learning across both time points and delayed recall at 12 months. The effect of sex on memory also differed by IL-1β level, with women exhibiting a memory advantage both at baseline and 12 months, but only for those with low-to-moderate IL-1β levels. Therefore, high peripheral inflammation levels may lead to a sex-specific memory vulnerability relevant for Alzheimer's disease.
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Affiliation(s)
| | | | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Arnold Salazar
- Department of Brain Health, University of Nevada, Las Vegas, NV, USA
| | - Christina G Wong
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Dietmar Cordes
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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33
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Chadwick HK, Abbott J, Hurley MA, Dye L, Lawton CL, Mansfield MW, Peckham D. Cystic fibrosis-related diabetes (CFRD) and cognitive function in adults with cystic fibrosis. J Cyst Fibros 2021; 21:519-528. [PMID: 34134937 DOI: 10.1016/j.jcf.2021.04.014] [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: 11/27/2020] [Revised: 03/15/2021] [Accepted: 04/26/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Being able to function cognitively is imperative for successful achievement in school, working life, and disease self-management. Diabetes is known to cause changes in brain structure and long-term cognitive dysfunction. This work investigated cystic fibrosis-related diabetes (CFRD) as a mechanism for cognitive impairment in people with CF. It was hypothesised that cognition would be poorer in adults with CFRD than in those with CF without diabetes (CFND) or in healthy controls. METHODS Cognitive performance was assessed using the Cambridge Neuropsychological Test Automated Battery which provides a comprehensive cognitive assessment with tests mapping onto specific brain regions. Demographic, clinical and self-reported health data were documented for all participants. CF specific clinical variables were recorded for the two CF groups. RESULTS Ninety-eight people with CF (49CFRD,49CFND) and 49 healthy controls were recruited. People with CF demonstrated deficits in aspects of verbal and spatial memory, processing speed and cognitive flexibility compared with healthy controls, with all areas of the brain implicated. Those with CFRD had additional difficulties with higher-level processes known collectively as 'executive function', which demand greater cognitive load and recruit the prefrontal cortex. Compared with healthy controls, those with CFND and CFRD had an estimated 20% and up to 40% reduction in processing speed respectively. CONCLUSION Managing CF requires higher order executive function. Impairments may be sufficient to interfere with self-care and the ability to perform everyday tasks efficiently. At which point in the CF disease trajectory these difficulties begin, and what may attenuate them, has yet to be determined.
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Affiliation(s)
- Helen K Chadwick
- School of Psychology, University of Leeds, Leeds LS2 9JT, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds LS2 9JT, UK; Adult Cystic Fibrosis Unit, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK.
| | - Janice Abbott
- School of Psychology, University of Central Lancashire, Preston PR1 2HE, UK
| | - Margaret Anne Hurley
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston PR1 2HE, UK
| | - Louise Dye
- School of Psychology, University of Leeds, Leeds LS2 9JT, UK
| | - Clare L Lawton
- School of Psychology, University of Leeds, Leeds LS2 9JT, UK
| | - Michael W Mansfield
- Leeds Centre for Diabetes and Endocrinology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK
| | - Daniel Peckham
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds LS2 9JT, UK; Adult Cystic Fibrosis Unit, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK
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Peterson RL, Butler EA, Ehiri JE, Fain MJ, Carvajal SC. Mechanisms of Racial Disparities in Cognitive Aging: An Examination of Material and Psychosocial Well-Being. J Gerontol B Psychol Sci Soc Sci 2021; 76:574-582. [PMID: 31942631 DOI: 10.1093/geronb/gbaa003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES We tested the hypothesis that education's effect on cognitive aging operates in part through measures of material and psychosocial well-being. METHOD Our sample was of non-Latino black and white participants of the National Social Life Health and Aging Project who had valid cognitive assessments in Waves 2 and 3 (n = 2,951; age range: 48-95). We used structural equation modeling to test for mediation and moderated mediation by income, assets, perceived stress, social status, and allostatic load on the relationships between race, education, and cognition at two time points. RESULTS Education consistently mediated the race-cognition relationship, explaining about 20% of the relationship between race and cognition in all models. Income and assets were moderated by race; these factors were associated with cognition for whites but not blacks. Social status mediated the association between race and cognition, and social status and perceived stress mediated the education-cognition pathway. Allostatic load was not a mediator of any relationship. DISCUSSION Education remains the best explanatory factor for cognitive aging disparities, though material well-being and subjective social status help to explain a portion of the racial disparity in cognitive aging.
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Affiliation(s)
- Rachel L Peterson
- Department of Public Health Sciences, University of California, Davis
| | - Emily A Butler
- Department of Family Studies and Human Development, University of Arizona, Tucson
| | - John E Ehiri
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson
| | - Mindy J Fain
- University of Arizona Center on Aging; Department of Medicine, University of Arizona, Tucson
| | - Scott C Carvajal
- Mel and Enid Zuckerman College of Public Health, University of Arizona; Arizona Prevention Research Center, Tucson
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Green C, Shen X, Stevenson AJ, Conole ELS, Harris MA, Barbu MC, Hawkins EL, Adams MJ, Hillary RF, Lawrie SM, Evans KL, Walker RM, Morris SW, Porteous DJ, Wardlaw JM, Steele JD, Waiter GD, Sandu AL, Campbell A, Marioni RE, Cox SR, Cavanagh J, McIntosh AM, Whalley HC. Structural brain correlates of serum and epigenetic markers of inflammation in major depressive disorder. Brain Behav Immun 2021; 92:39-48. [PMID: 33221487 PMCID: PMC7910280 DOI: 10.1016/j.bbi.2020.11.024] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/09/2020] [Accepted: 11/17/2020] [Indexed: 02/06/2023] Open
Abstract
Inflammatory processes are implicated in the aetiology of Major Depressive Disorder (MDD); however, the relationship between peripheral inflammation, brain structure and depression remains unclear, partly due to complexities around the use of acute/phasic inflammatory biomarkers. Here, we report the first large-scale study of both serological and methylomic signatures of CRP (considered to represent acute and chronic measures of inflammation respectively) and their associations with depression status/symptoms, and structural neuroimaging phenotypes (T1 and diffusion MRI) in a large community-based sample (Generation Scotland; NMDD cases = 271, Ncontrols = 609). Serum CRP was associated with overall MDD severity, and specifically with current somatic symptoms- general interest (β = 0.145, PFDR = 6 × 10-4) and energy levels (β = 0.101, PFDR = 0.027), along with reduced entorhinal cortex thickness (β = -0.095, PFDR = 0.037). DNAm CRP was significantly associated with reduced global grey matter/cortical volume and widespread reductions in integrity of 16/24 white matter tracts (with greatest regional effects in the external and internal capsules, βFA= -0.12 to -0.14). In general, the methylation-based measures showed stronger associations with imaging metrics than serum-based CRP measures (βaverage = -0.15 versus βaverage = 0.01 respectively). These findings provide evidence for central effects of peripheral inflammation from both serological and epigenetic markers of inflammation, including in brain regions previously implicated in depression. This suggests that these imaging measures may be involved in the relationship between peripheral inflammation and somatic/depressive symptoms. Notably, greater effects on brain morphology were seen for methylation-based rather than serum-based measures of inflammation, indicating the importance of such measures for future studies.
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Affiliation(s)
- Claire Green
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK.
| | - Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Anna J Stevenson
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
| | - Eleanor L S Conole
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, University of Edinburgh, Edinburgh, UK
| | - Mathew A Harris
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Miruna C Barbu
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Emma L Hawkins
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Mark J Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Robert F Hillary
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | | | - Kathryn L Evans
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Rosie M Walker
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Stewart W Morris
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - David J Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- UK Dementia Research Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J Douglas Steele
- Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, UK
| | - Gordon D Waiter
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Anca-Larisa Sandu
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Riccardo E Marioni
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohorts Group, University of Edinburgh, Edinburgh, UK
| | - Jonathan Cavanagh
- Institute of Infection, Immunity & Inflammation, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK; Institute of Health and Wellbeing, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK; Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
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Sabbatinelli J, Ramini D, Giuliani A, Recchioni R, Spazzafumo L, Olivieri F. Connecting vascular aging and frailty in Alzheimer's disease. Mech Ageing Dev 2021; 195:111444. [PMID: 33539904 DOI: 10.1016/j.mad.2021.111444] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/05/2021] [Accepted: 01/26/2021] [Indexed: 12/15/2022]
Abstract
Aging plays an important role in the etiology of the most common age-related diseases (ARDs), including Alzheimer's disease (AD). The increasing number of AD patients and the lack of disease-modifying drugs warranted intensive research to tackle the pathophysiological mechanisms underpinning AD development. Vascular aging/dysfunction is a common feature of almost all ARDs, including cardiovascular (CV) diseases, diabetes and AD. To this regard, interventions aimed at modifying CV outcomes are under extensive investigation for their pleiotropic role in ameliorating and slowing down cognitive impairment in middle-life and elderly individuals. Evidence from observational and clinical studies confirm the notion that the earlier the interventions are conducted, the most favorable are the effects on cognitive function. Therefore, epidemiological research should focus on the early detection of deviations from a healthy cognitive aging trajectory, through the stratification of adult individuals according to the rate of aging. Here, we review the interplay between vascular and cognitive dysfunctions associated with aging, to disentangle the complex mechanisms underpinning the development and progression of neurodegenerative disorders, with a specific focus on AD.
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Affiliation(s)
- Jacopo Sabbatinelli
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Deborah Ramini
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Angelica Giuliani
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy.
| | - Rina Recchioni
- Center of Clinical Pathology and Innovative Therapy, IRCCS INRCA, Ancona, Italy
| | - Liana Spazzafumo
- Epidemiologic Observatory, Regional Health Agency, Regione Marche, Ancona, Italy
| | - Fabiola Olivieri
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy; Center of Clinical Pathology and Innovative Therapy, IRCCS INRCA, Ancona, Italy
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37
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O’Donovan A, Bahorik A, Sidney S, Launer LJ, Yaffe K. Relationships of inflammation trajectories with white matter volume and integrity in midlife. Brain Behav Immun 2021; 91:81-88. [PMID: 32966872 PMCID: PMC7749816 DOI: 10.1016/j.bbi.2020.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Elevated inflammation is associated with worse late-life cognitive functioning and brain health. Our goal was to examine the relationship between inflammation trajectories and white matter integrity in midlife. METHODS Participants were 508 adults from the Coronary Artery Risk Development in Young Adults Study (CARDIA; 51% female). Latent class analysis was used to identify inflammation trajectories based on repeated measures of the inflammatory marker C-reactive protein (CRP) over the 18 years before brain magnetic resonance imaging (MRI). Outcomes were brain MRI measures of total and region-specific white matter volume and integrity at a mean age of 50.6 ± 3.4 years. Linear regression was used to examine if inflammation trajectories were associated with brain MRI outcomes, adjusting for potential confounds in all models and for disease and health behaviors in follow-up models. RESULTS Lower-stable (38%), moderate-increasing (7%), and consistently-higher (54%), trajectories emerged. Compared to the lower-stable group, the moderate-increasing group showed lower white matter volume (β = -0.18, 95% CI -0.29, -0.06) and worse white matter integrity as indexed by lower fractional anisotropy (FA; β = -0.37, 95% CI -0.70, -0.04) and higher mean diffusivity (β = 0.44, 95% CI 0.11, 0.78) in the whole brain. The consistently-higher group showed lower whole-brain FA (β = -0.20, -0.38, -0.03). In exploratory analyses, the moderate-increasing group showed lower white matter volume, lower FA and higher MD in the frontal, temporal, and parietal lobes compared to the lower-stable group. The consistently-higher group showed lower white matter volume in the parietal lobe and lower FA in the frontal, temporal, and parietal lobes, but similar MD, compared to the lower-stable group. Findings for the moderate-increasing, but not the consistently-higher, group were robust to adjustment for disease and lifestyle factors. CONCLUSION Increasing or high inflammation trajectories from early to mid adulthood are associated with worse brain health, as indexed by lower white matter volume and/or worse white matter integrity.
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Affiliation(s)
- Aoife O’Donovan
- University of California, San Francisco, CA,Corresponding Author: Aoife O’Donovan, PhD, Department of Psychiatry, University of California, San Francisco, 4150 Clement Street, San Francisco, CA 94121, Phone: +01 (415) 221-4810 X24959,
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Boots EA, Castellanos KJ, Zhan L, Barnes LL, Tussing-Humphreys L, Deoni SCL, Lamar M. Inflammation, Cognition, and White Matter in Older Adults: An Examination by Race. Front Aging Neurosci 2020; 12:553998. [PMID: 33192454 PMCID: PMC7662133 DOI: 10.3389/fnagi.2020.553998] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/12/2020] [Indexed: 11/18/2022] Open
Abstract
Objectives Non-Latino Black adults have greater risk for Alzheimer’s dementia compared to non-Latino White adults, possibly due to factors disproportionally affecting Black adults including cardiovascular disease (CVD). Chronic peripheral inflammation is implicated in both Alzheimer’s dementia and CVD and is known to impact cognition and cerebral white matter, yet little work has examined these associations by race. This study examined associations between inflammation, cognition, and cerebral white matter generally, and by race. Methods Eighty-six non-demented older Black and White participants (age = 69.03; 50% female; 45% Black participants) underwent fasting venipuncture, cognitive testing, and MRI. Serum was assayed for interleukin-6 (IL-6), C-reactive protein (CRP), and interleukin 1-beta. Cognitive domains included memory, executive function, and attention/information processing. MRI measures included white matter hyperintensity volumes (WMH) and quantification of white matter integrity in areas outside WMHs via DTI-derived fractional anisotropy (FA) and mean diffusivity, as well as multi-component relaxometry derived myelin water fraction (MWF). Results Black and White participants did not differ on age, sex, or CVD risk. Separate linear regression models adjusting for relevant confounders revealed that higher IL-6 associated with lower executive function and higher CRP levels associated with lower FA and MWF. Stratified analyses revealed that these association were significant for Black participants only. Discussion These findings suggest that peripheral inflammation is inversely associated with select cognitive domains and white matter integrity (but not WMHs), particularly in older Black adults. It is important to consider race when investigating inflammatory associates of brain and behavior.
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Affiliation(s)
- Elizabeth A Boots
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Karla J Castellanos
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States
| | - Liang Zhan
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Lisa Tussing-Humphreys
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, United States.,Division of Academic Internal Medicine and Geriatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States.,University of Illinois Cancer Center, Chicago, IL, United States
| | - Sean C L Deoni
- Advanced Baby Imaging Lab, Women and Infants Hospital, and Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Melissa Lamar
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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Abu Bakar ZH, Damanhuri HA, Makpol S, Wan Kamaruddin WMA, Abdul Sani NF, Amir Hamzah AIZ, Nor Aripin KN, Mohd Rani MD, Noh NA, Razali R, Mazlan M, Abdul Hamid H, Mohamad M, Wan Ngah WZ. Effect of Age on the Protein Profile of Healthy Malay Adults and its Association with Cognitive Function Competency. J Alzheimers Dis 2020; 70:S43-S62. [PMID: 30594926 PMCID: PMC6706781 DOI: 10.3233/jad-180511] [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] [Indexed: 12/17/2022]
Abstract
Background: Many studies on biochemical and psychological variables have aimed to elucidate the association between aging and cognitive function. Demographic differences and protein expression have been reported to play a role in determining the cognitive capability of a population. Objective: This study aimed to determine the effect of age on the protein profile of Malay individuals and its association with cognitive competency. Methods: A total of 160 individuals were recruited and grouped accordingly. Cognitive competency of each subject was assessed with several neuropsychological tests. Plasma samples were collected and analyzed with Q Exactive HF Orbitrap. Proteins were identified and quantitated with MaxQuant and further analyzed with Perseus to determine differentially expressed proteins. PANTHER, Reactome, and STRING were applied for bioinformatics output. Results: Our data showed that the Malay individuals are vulnerable to the deterioration of cognitive function with aging, and most of the proteins were differentially expressed in concordance. Several physiological components and pathways were shown to be involved, giving a hint of a promising interpretation on the induction of aging toward the state of the Malays’ cognitive function. Nevertheless, some proteins have shown a considerable interaction with the generated protein network, which provides a direction of focus for further investigation. Conclusion: This study demonstrated notable changes in the expression of several proteins as age increased. These changes provide a promising platform for understanding the biochemical factors affecting cognitive function in the Malay population. The exhibited network of protein-protein interaction suggests the possibility of implementing regulatory intervention in ameliorating Malay cognitive function.
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Affiliation(s)
- Zulzikry Hafiz Abu Bakar
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Hanafi Ahmad Damanhuri
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Suzana Makpol
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | | | - Nur Fathiah Abdul Sani
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Ahmad Imran Zaydi Amir Hamzah
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Khairun Nain Nor Aripin
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran MPAJ, Jalan Pandan Utama, Pandan Indah, Kuala Lumpur, Malaysia
| | - Mohd Dzulkhairi Mohd Rani
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran MPAJ, Jalan Pandan Utama, Pandan Indah, Kuala Lumpur, Malaysia
| | - Nor Azila Noh
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran MPAJ, Jalan Pandan Utama, Pandan Indah, Kuala Lumpur, Malaysia
| | - Rosdinom Razali
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Musalmah Mazlan
- Faculty of Medicine, Universiti Teknologi Mara, Jalan Hospital, Selangor Darul Ehsan, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology Hospital Chancellor Tuanku Mukhriz, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Mazlyfarina Mohamad
- Department Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Wan Zurinah Wan Ngah
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
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Brett BL, Savitz J, Nitta M, España L, Teague TK, Nelson LD, McCrea MA, Meier TB. Systemic inflammation moderates the association of prior concussion with hippocampal volume and episodic memory in high school and collegiate athletes. Brain Behav Immun 2020; 89:380-388. [PMID: 32717401 PMCID: PMC7572869 DOI: 10.1016/j.bbi.2020.07.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/13/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND There is a need to determine why prior concussion has been associated with adverse outcomes in some retired and active athletes. We examined whether serum inflammatory markers moderate the associations of prior concussion with hippocampal volumes and neurobehavioral functioning in active high school and collegiate athletes. METHODS Athletes (N = 201) completed pre-season clinical testing and serum collection (C-reactive protein [CRP]; Interleukin-6 [IL]-6; IL-1 receptor antagonist [RA]) and in-season neuroimaging. Linear mixed-effects models examined associations of prior concussion with inflammatory markers, self-reported symptoms, neurocognitive function, and hippocampal volumes. Models examined whether inflammatory markers moderated associations of concussion history and hippocampal volume and/or clinical measures. RESULTS Concussion history was significantly associated with higher symptom severity, p = 0.012, but not hippocampal volume or inflammatory markers (ps > 0.05). A significant interaction of prior concussion and CRP was observed for hippocampal volume, p = 0.006. Follow-up analyses showed that at high levels of CRP, athletes with two or more prior concussions had smaller hippocampal volume compared to athletes without prior concussion, p = 0.008. There was a significant interaction between prior concussion and levels of IL-1RA on memory scores, p = 0.044, i.e., at low levels of IL-1RA, athletes with two or more concussions had worse memory performance than those without prior concussion (p = 0.014). CONCLUSION Findings suggest that certain markers of systemic inflammation moderate the association between prior concussion and hippocampal volume and episodic memory performance. Current findings highlight potential markers for predicting at-risk individuals and identify therapeutic targets for mitigating the long-term adverse consequences of cumulative concussion.
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Affiliation(s)
- Benjamin L Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK, United States; Oxley College of Health Sciences, Tulsa, OK, United States
| | - Morgan Nitta
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Psychology, Marquette University, Milwaukee, WI, United States
| | - Lezlie España
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - T Kent Teague
- Departments of Surgery and Psychiatry, The University of Oklahoma, School of Community Medicine, United States; Department of Pharmaceutical Sciences, University of Oklahoma College of Pharmacy, United States
| | - Lindsay D Nelson
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, United States; Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, United States.
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The association between systemic inflammation and cognitive performance in healthy adults. J Neuroimmunol 2020; 345:577272. [PMID: 32534387 DOI: 10.1016/j.jneuroim.2020.577272] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/22/2020] [Accepted: 05/22/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Several studies have indicated that mild systemic inflammation is associated with the risk of cognitive impairment. However, not every cognitive domain has been evaluated to have a correlation with peripheral inflammation in healthy individuals. Therefore, we aimed to investigate the association between C-reactive protein (CRP) as a marker of peripheral inflammation with various domains of cognition in healthy adults. METHOD This study consisted of 216 healthy native German adults (138 males and 78 females, mean age: 39.12 ± 20.19 years) from "Leipzig Study for Mind-Body-Emotion Interactions" (LEMON) database. After the initial assessment and conducting the cognitive battery, a blood sample was collected and CRP level was evaluated. Patients were categorized into three groups based on their CRP level. Subsequently, demographic and cognitive features were compared across three groups and to confirm the association between CRP level and cognitive performance, general linear models (GLM) were applied. RESULTS All California Verbal Learning Task (CVLT)-evaluated aspects of memory performance were inversely associated with CRP level, some of which remained significant after the adjustment for age, gender, education, smoking status and body mass index. Moreover, GLM analysis indicated that mean reaction time of the Test of Attentional Performance-Alertness (TAP-A) test (with and without signal) was also significantly associated with CRP level. CONCLUSION The current study indicated that healthy subjects with higher levels of CRP exhibit poorer performance in verbal learning memory and general wakefulness domains of cognition.
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Fernandes A, Tábuas-Pereira M, Duro D, Lima M, Gens H, Santiago B, Durães J, Almeida MR, Leitão MJ, Baldeiras I, Santana I. C-reactive protein as a predictor of mild cognitive impairment conversion into Alzheimer's disease dementia. Exp Gerontol 2020; 138:111004. [PMID: 32561398 DOI: 10.1016/j.exger.2020.111004] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 06/10/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS Increasing evidence suggests that inflammation plays an important role in brain aging and neurodegeneration. Pathological studies demonstrate the presence of C-reactive protein (CRP) in the senile plaques and neurofibrillary tangles in Alzheimer's disease (AD) brain tissue suggesting that CRP may play a role in its neuropathological processes. Some findings suggest that midlife elevations of serum CRP are a risk factor for AD. However, others found lower CRP levels in mild or moderate AD than in controls, suggesting that CRP levels could be different in different stages of disease. We aimed to assess the role of CRP as a predictor of Mild cognitive impairment (MCI) conversion into AD dementia. METHODS We retrospectively reviewed the cohort of MCI patients followed at the Dementia Clinic, Neurology Department of University Hospital of Coimbra. We collected demographical, neuropsychological, genetic and laboratorial variables (including serum CRP measurements at the time of baseline laboratory tests). A Cox regression model was performed adjusted for the collected variables preconsidered to be predictors of dementia and the variable being studied (CRP) to assess for independent predictors of conversion. RESULTS We included 130 patients, 58.5% female, with a mean age of onset of 65.5 ± 9.1 years and age at first assessment of 69.3 ± 8.5 years. The mean CRP was 0.33 ± 0.58 mg/dl. At follow-up (mean, 36.9 ± 27.0 months) 42.3% of MCI patients converted to dementia. Lower CSF Aβ42 (HR = 0.999, 95%CI = [0.997, 1.000], p = 0.015), lower MMSE score (HR = 0.864, 95%CI = [0.510, 1.595], p = 0.008) and lower CRP quartile (HR = 0.597, 95%CI = [0.435, 0.819], p = 0.001) were independent predictors of conversion. CONCLUSION CRP may add information of risk of conversion in MCI patients. Patients with lower CRP levels appear to have a more rapid conversion to AD dementia.
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Affiliation(s)
- Andreia Fernandes
- Neurology Department, Centro Hospitalar e Universitário de Lisboa Central, Alameda de Santo António dos Capuchos, 1169-050 Lisboa, Portugal.
| | - Miguel Tábuas-Pereira
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Diana Duro
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Marisa Lima
- Faculty of Psychology and Educational Sciences, University of Coimbra, R. Colégio Novo, 3000-115 Coimbra, Portugal
| | - Helena Gens
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Beatriz Santiago
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - João Durães
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Maria Rosário Almeida
- Faculty of Medicine, University of Coimbra, R. Larga, 3004-504 Coimbra, Portugal; Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - Maria João Leitão
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - Inês Baldeiras
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal; Faculty of Medicine, University of Coimbra, R. Larga, 3004-504 Coimbra, Portugal; Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal; Faculty of Medicine, University of Coimbra, R. Larga, 3004-504 Coimbra, Portugal; Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
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Darnell EP, Wroblewski KE, Pagel KL, Kern DW, McClintock MK, Pinto JM. IL-1Rahigh-IL-4low-IL-13low: A Novel Plasma Cytokine Signature Associated with Olfactory Dysfunction in Older US Adults. Chem Senses 2020; 45:407-414. [PMID: 32369568 PMCID: PMC7320218 DOI: 10.1093/chemse/bjaa029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Inflammation has been implicated in physical frailty, but its role in sensory impairment is unclear. Given that olfactory impairment predicts dementia and mortality, determining the role of the immune system in olfactory dysfunction would provide insights mechanisms of neurosensory decline. We analyzed data from the National Social Life, Health and Aging Project, a representative sample of home-dwelling older US adults. Plasma levels of 18 cytokines were measured using standard protocols (Luminex xMAP). Olfactory function was assessed with validated tools (n-butanol sensitivity and odor identification, each via Sniffin' Sticks). We tested the association between cytokine profiles and olfactory function using multivariate ordinal logistic regression, adjusting for age, gender, race/ethnicity, education level, cognitive function, smoking status, and comorbidity. Older adults with the IL-1Rahigh-IL-4low-IL-13low cytokine profile had worse n-butanol odor sensitivity (odds ratio [OR] = 1.61, 95% confidence interval [CI] 1.19-2.17) and worse odor identification (OR = 1.42, 95% CI 1.11-1.80). Proinflammatory, Th1, or Th2 cytokine profiles were not associated with olfactory function. Moreover, accounting for physical frailty did not alter the main findings. In conclusion, we identified a plasma cytokine signature-IL-1Rahigh-IL-4low-IL-13low-that is associated with olfactory dysfunction in older US adults. These data implicate systemic inflammation in age-related olfactory dysfunction and support a role for immune mechanisms in this process, a concept that warrants additional scrutiny.
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Affiliation(s)
- Eli P Darnell
- Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | - Kristina L Pagel
- Department of Comparative Human Development, The University of Chicago, Chicago, IL, USA
- Center on Demography and Aging, The University of Chicago, Chicago, IL, USA
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, USA
| | - David W Kern
- Department of Comparative Human Development, The University of Chicago, Chicago, IL, USA
| | - Martha K McClintock
- Department of Comparative Human Development, The University of Chicago, Chicago, IL, USA
- Center on Demography and Aging, The University of Chicago, Chicago, IL, USA
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, USA
| | - Jayant M Pinto
- Center on Demography and Aging, The University of Chicago, Chicago, IL, USA
- Section of Otolaryngology—Head and Neck Surgery, Department of Surgery, The University of Chicago, Chicago, IL, USA
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Effects of Exercise on Cognitive Performance in Older Adults: A Narrative Review of the Evidence, Possible Biological Mechanisms, and Recommendations for Exercise Prescription. J Aging Res 2020; 2020:1407896. [PMID: 32509348 PMCID: PMC7244966 DOI: 10.1155/2020/1407896] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 04/02/2020] [Accepted: 04/13/2020] [Indexed: 01/11/2023] Open
Abstract
Physical activity and exercise have emerged as potential methods to improve brain health among older adults. However, there are currently no physical activity guidelines aimed at improving cognitive function, and the mechanisms underlying these cognitive benefits are poorly understood. The purpose of this narrative review is to present the current evidence regarding the effects of physical activity and exercise on cognition in older adults without cognitive impairment, identify potential mechanisms underlying these effects, and make recommendations for exercise prescription to enhance cognitive performance. The review begins with a summary of evidence of the effect of chronic physical activity and exercise on cognition. Attention then turns to four main biological mechanisms that appear to underlie exercise-induced cognitive improvement, including the upregulation of growth factors and neuroplasticity, inhibition of inflammatory biomarker production, improved vascular function, and hypothalamic-pituitary-adrenal axis regulation. The last section provides an overview of exercise parameters known to optimize cognition in older adults, such as exercise type, frequency, intensity, session duration, and exercise program duration.
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Thomas (neé Negrao) BL, Bipath P, Viljoen M. Inflammatory activity and academic performance in university students. JOURNAL OF PSYCHOLOGY IN AFRICA 2020. [DOI: 10.1080/14330237.2020.1712802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Priyesh Bipath
- Department of Physiology, School of Medicine, University of Pretoria, Pretoria, South Africa
| | - Margaretha Viljoen
- 3Department of Psychiatry, School of Medicine, University of Pretoria, Pretoria, South Africa
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John A, Rusted J, Richards M, Gaysina D. Accumulation of affective symptoms and midlife cognitive function: The role of inflammation. Brain Behav Immun 2020; 84:164-172. [PMID: 31785399 DOI: 10.1016/j.bbi.2019.11.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/23/2019] [Accepted: 11/26/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The aim of the present study was to test whether C-Reactive Protein (CRP), a proxy measure of inflammation, is elevated in people with higher childhood and adulthood affective symptoms and whether elevated CRP predicts midlife cognitive function. METHODS Data were used from the National Child Development Study (n = 6276). Measures of memory, verbal fluency, information processing speed and accuracy were available in midlife (age 50). Affective symptoms were assessed in childhood (ages 7, 11, 16) and in adulthood (ages 23, 33, 42, 50). The level of plasma CRP was measured at age 44. Pathway models, unadjusted and fully adjusted for sex, education, childhood socioeconomic position, childhood cognitive ability and affective symptoms at age 50, were fitted to test direct associations between affective symptoms and midlife cognitive function, and indirect associations via the inflammatory pathway (CRP level). RESULTS In a fully adjusted model, there were significant indirect associations between adulthood affective symptoms and immediate memory (β = -0.01, SE = 0.003, p = .03) and delayed memory (β = -0.01, SE = 0.004, p = .03) via CRP. In addition, there were significant indirect associations between affective symptoms in childhood and immediate memory (β = -0.001, SE = 0.00, p = .03) and delayed memory (β = -0.001, SE = 0.001, p = .03), via adulthood affective symptoms and associated CRP. Independent of CRP, there was a significant direct association between adulthood affective symptoms and information processing errors (β = 0.47, SE = 0.21, p = .02). There were no direct or indirect associations between affective symptoms and verbal fluency or information processing speed. CONCLUSIONS CRP at age 44 is elevated in people with higher affective symptoms from age 7 to 42, and elevated CRP is associated with poorer immediate and delayed memory at age 50.
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Affiliation(s)
- Amber John
- EDGE Lab, School of Psychology, University of Sussex, Brighton, United Kingdom.
| | - Jennifer Rusted
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Darya Gaysina
- EDGE Lab, School of Psychology, University of Sussex, Brighton, United Kingdom
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Beydoun MA, Hossain S, Beydoun HA, Shaked D, Weiss J, Evans MK, Zonderman AB. Red Cell Distribution Width Is Directly Associated with Poor Cognitive Performance among Nonanemic, Middle-Aged, Urban Adults. J Nutr 2020; 150:128-139. [PMID: 31912144 PMCID: PMC6946901 DOI: 10.1093/jn/nxz182] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/08/2019] [Accepted: 07/15/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Epidemiological evidence suggests that both anemia and elevated red cell distribution width (RDW) are associated with cognitive impairment. However, the interplay between these 2 predictors has been understudied. OBJECTIVES We examined sex- and anemia-specific associations between RDW and cognitive performance among urban adults in the United States. METHODS Data from the Healthy Aging in Neighborhoods of Diversity Across the Life Span Study (Baltimore, MD; participants aged 30-65 y at baseline, ∼59% African-American, 45% men) were used. Participants were selected based on the completion of 11 cognitive tasks at baseline (2004-2009) and follow-up (2009-2013) visits (mean time between visits: 4.64 ± 0.93 y) and availability of exposure and covariate data, yielding a sample of between 1526 and 1646 adults out of the initial 3720 adults recruited at baseline. Multiple linear mixed-effects regression models were conducted with RDW as the main exposure of interest and anemia/sex as the key effect modifiers. RESULTS Overall, high RDWs were linked to poorer baseline performance on the California Verbal Learning Test (CVLT) List A (per 1 unit increase in RDW %, main effect: γ01 = -0.369 ± 0.114; P = 0.001) and to slower rates of decline on the CVLT Delayed Free Recall (per 1 unit increase in RDW %, RDW × time: γ11 = +0.036 ± 0.013; P = 0.007). Among nonanemic participants, RDWs were consistently associated with poorer baseline performance on the Trailmaking Test, Part A (γ01 = +3.11 ± 0.89; P < 0.001) and on the CVLT List A (γ01 = -0.560 ± 0.158; P < 0.001). Moreover, RDWs were associated with poorer baseline performance on the Brief Test of Attention in the total population (γ01 = -0.123 ± 0.039; P = 0.001) and among men (γ01 = -0.221 ± 0.068; P = 0.001). We did not detect an association between hemoglobin (Hb) and baseline cognitive performance or changes over time. CONCLUSIONS Elevated RDW had a consistent cross-sectional association with poor cognitive performance in the domains of verbal memory and attention among the nonanemic group in a sample of middle-aged, urban adults. Anemia and Hb concentrations were not associated with cognition. More longitudinal studies are needed to replicate our findings.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Danielle Shaked
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Jordan Weiss
- Population Studies Center and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD, USA
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Beydoun MA, Obhi HK, Weiss J, Canas JA, Beydoun HA, Evans MK, Zonderman AB. Systemic inflammation is associated with depressive symptoms differentially by sex and race: a longitudinal study of urban adults. Mol Psychiatry 2020; 25:1286-1300. [PMID: 31019266 PMCID: PMC6813878 DOI: 10.1038/s41380-019-0408-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/18/2019] [Accepted: 03/05/2019] [Indexed: 12/22/2022]
Abstract
Systemic inflammation may influence trajectories of depressive symptoms over time, perhaps differentially by sex and race. Inflammatory markers and the Center for Epidemiologic Studies-Depression scale [total score: CES-Dtotal and four distinctive domains: somatic complaints, depressed affect, positive affect and interpersonal problems] were examined among African-American (AA) and White urban adults participating in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study [2004-2013, Agebase:30-64 y, mean ± SD follow-up time: 4.64 ± 0.93 y, N = 150 (with cytokine data) to N = 1,767 (with other inflammatory markers)]. Findings suggest that serum concentrations of high-sensitivity C-reactive protein (hsCRP), z-inflammation composite score [ICS, combining elevated hsCRP and ESR with low serum albumin and iron], and serum interleukin (IL) 1β were positively associated with ΔCES-Dtotal (Δ: annual rate of increase) among Whites only. IL-12 was directly related to ΔCES-Dtotal among men and AA. The race-specific associations of hsCRP, ICS, IL-1β and the sex-specific association of IL-12 with ΔCES-Dtotal were replicated for the "depressed affect" domain. Similarly, among men, lower serum albumin and higher ICS were linked with higher baseline "somatic complaints". IL-10 among AA and IL-12 among men were inversely related to Δ"positive affect", while "interpersonal problems" were cross-sectionally associated with IL-6 among AA and IL-10 among Whites. Finally, baseline ICS was positively associated with incident "elevated depressive symptoms" (EDS: CES-Dtotal ≥ 16) among AA (HR = 1.28, 95% CI: 1.04-1.56, P = 0.017). Overall, systemic inflammation was directly linked to increased depressive symptoms over time and at baseline, differentially across sex and race groups. More longitudinal research is needed to replicate our findings.
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Affiliation(s)
- May A. Beydoun
- 0000 0000 9372 4913grid.419475.aLaboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD USA
| | - Hardeep K. Obhi
- 0000 0000 9372 4913grid.419475.aLaboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD USA
| | - Jordan Weiss
- 0000 0000 9372 4913grid.419475.aLaboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD USA ,0000 0004 1936 8972grid.25879.31Population Studies Center and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA USA
| | - Jose A. Canas
- 0000 0004 0467 2330grid.413611.0Johns Hopkins All Children’s Hospital, St. Petersburg, FL USA
| | - Hind A. Beydoun
- 0000 0004 0595 1323grid.413661.7Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA USA
| | - Michele K. Evans
- 0000 0000 9372 4913grid.419475.aLaboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD USA
| | - Alan B. Zonderman
- 0000 0000 9372 4913grid.419475.aLaboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD USA
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Beydoun MA, Shaked D, Tajuddin SM, Weiss J, Evans MK, Zonderman AB. Accelerated epigenetic age and cognitive decline among urban-dwelling adults. Neurology 2019; 94:e613-e625. [PMID: 31879275 DOI: 10.1212/wnl.0000000000008756] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Epigenetic modifications are closely linked with aging, but their relationship with cognition remains equivocal. Given known sex differences in epigenetic aging, we explored sex-specific associations of 3 DNA methylation (DNAm)-based measures of epigenetic age acceleration (EAA) with baseline and longitudinal change in cognitive performance among middle-aged urban adults. METHODS We used exploratory data from a subgroup of participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study with complete DNA samples and whose baseline ages were >50.0 years (2004-2009) to estimate 3 DNAm EAA measures: (1) universal EAA (AgeAccel); (2) intrinsic EAA (IEAA); and (3) extrinsic EAA (EEAA). Cognitive performance was measured at baseline visit (2004-2009) and first follow-up (2009-2013) with 11 test scores covering global mental status and specific domains such as learning/memory, attention, visuospatial, psychomotor speed, language/verbal, and executive function. A series of mixed-effects regression models were conducted adjusting for covariates and multiple testing (n = 147-156, ∼51% men, k = 1.7-1.9 observations/participant, mean follow-up time ∼4.7 years). RESULTS EEAA, a measure of both biological age and immunosenescence, was consistently associated with greater cognitive decline among men on tests of visual memory/visuoconstructive ability (Benton Visual Retention Test: γ11 = 0.0512 ± 0.0176, p = 0.004) and attention/processing speed (Trail-Making Test, part A: γ11 = 0.219 ± 0.080, p = 0.007). AgeAccel and IEAA were not associated with cognitive change in this sample. CONCLUSIONS EEAA capturing immune system cell aging was associated with faster decline among men in domains of attention and visual memory. Larger longitudinal studies are needed to replicate our findings.
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Affiliation(s)
- May A Beydoun
- From the Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD.
| | - Danielle Shaked
- From the Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Salman M Tajuddin
- From the Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Jordan Weiss
- From the Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Michele K Evans
- From the Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Alan B Zonderman
- From the Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
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Zahodne LB, Sharifian N, Manly JJ, Sumner JA, Crowe M, Wadley VG, Howard VJ, Murchland AR, Brenowitz WD, Weuve J. Life course biopsychosocial effects of retrospective childhood social support and later-life cognition. Psychol Aging 2019; 34:867-883. [PMID: 31566397 PMCID: PMC6829036 DOI: 10.1037/pag0000395] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Social support during childhood lays the foundation for social relationships throughout the life course and has been shown to predict a wide range of mental and physical health outcomes. Social support measured in late life is prospectively associated with better cognitive aging, but few studies have evaluated social support received earlier in the life course. We quantified the effects of childhood social support, reported retrospectively, on later-life cognitive trajectories and investigated biopsychosocial mechanisms underlying these associations. Latent growth curve models estimated 10-year cognitive trajectories in 8,538 participants (baseline ages 45-93; Mage = 63) in the REasons for Geographic And Racial Differences in Stroke (REGARDS) project. Independent of sociodemographics, childhood socioeconomic status, and household size, greater retrospective childhood social support was associated with better initial episodic memory, but not verbal fluency or cognitive change, in later adulthood. Associations with initial memory level were mediated by sociodemographic and psychosocial variables; specifically, those who reported greater childhood social support reported higher educational attainment and had better physical and emotional health in adulthood, which were each associated with better memory. These results provide support for broad and enduring effects of childhood social support on mental, physical, and cognitive health decades later. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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