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Camerino I, Ferreira J, Vonk JM, Kessels RPC, de Leeuw FE, Roelofs A, Copland D, Piai V. Systematic Review and Meta-Analyses of Word Production Abilities in Dysfunction of the Basal Ganglia: Stroke, Small Vessel Disease, Parkinson's Disease, and Huntington's Disease. Neuropsychol Rev 2024; 34:1-26. [PMID: 36564612 DOI: 10.1007/s11065-022-09570-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 10/13/2022] [Accepted: 11/16/2022] [Indexed: 12/25/2022]
Abstract
Clinical populations with basal ganglia pathologies may present with language production impairments, which are often described in combination with comprehension measures or attributed to motor, memory, or processing-speed problems. In this systematic review and meta-analysis, we studied word production in four (vascular and non-vascular) pathologies of the basal ganglia: stroke affecting the basal ganglia, small vessel disease, Parkinson's disease, and Huntington's disease. We compared scores of these clinical populations with those of matched cognitively unimpaired adults on four well-established production tasks, namely picture naming, category fluency, letter fluency, and past-tense verb inflection. We conducted a systematic search in PubMed and PsycINFO with terms for basal ganglia structures, basal ganglia disorders and language production tasks. A total of 114 studies were included, containing results for one or more of the tasks of interest. For each pathology and task combination, effect sizes (Hedges' g) were extracted comparing patient versus control groups. For all four populations, performance was consistently worse than that of cognitively unimpaired adults across the four language production tasks (p-values < 0.010). Given that performance in picture naming and verb inflection across all pathologies was quantified in terms of accuracy, our results suggest that production impairments cannot be fully explained by motor or processing-speed deficits. Our review shows that while language production difficulties in these clinical populations are not negligible, more evidence is necessary to determine the exact mechanism that leads to these deficits and whether this mechanism is the same across different pathologies.
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Affiliation(s)
- Ileana Camerino
- Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands
| | - João Ferreira
- Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands.
| | - Jet M Vonk
- Department of Neurology, Memory and Aging Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roy P C Kessels
- Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Donders Centre for Medical Neuroscience, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Centre for Medical Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ardi Roelofs
- Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands
| | - David Copland
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, QLD, Australia
- Queensland Aphasia Research Centre, The University of Queensland, Herston, QLD, Australia
| | - Vitória Piai
- Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands
- Donders Centre for Medical Neuroscience, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
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Ng YL, Tan CS, Egle M, Gyanwali B, Tozer DJ, Markus HS, Chen C, Hilal S. The association of diffusion tensor MRI measures of normal appearing white matter and cognition. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100174. [PMID: 37457665 PMCID: PMC10344700 DOI: 10.1016/j.cccb.2023.100174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/29/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
Objective Median and peak height of fractional anisotropy (FA) and mean diffusivity (MD) are diffusion tensor imaging (DTI) markers used to quantify white matter microstructure changes. We examine the association of DTI histogram-derived measures in global normal appearing white matter (NAWM) and cognitive decline in patients with normal cognition and cognitive impairment no dementia from a memory clinic in Singapore. Methods A total of 252 patients (mean age: 71.1 ± 7.6 years, 53.2% women) were included. All patients underwent clinical assessments, a brain MRI scan at baseline, and neuropsychological assessments annually for 2 years. DTI scans were processed to obtain MD and FA histogram-derived measures. The National Institute of Neurological Disorders and Stroke and the Canadian Stroke Network harmonization neuropsychological battery were used to assess cognitive function. Linear regression models with generalised estimating equation (GEE) and logistic regression models were used to examine the association between DTI histogram measures and cognitive decline. Results When compared to baseline, MD and FA measures at Year 2 were associated with an accelerated worsening in global cognition (all p for interaction <0.001; Year 0 vs 2, MD median: -0.29 (95%CI: -0.49, -0.09) vs -0.45 (95%CI: -0.65,-0.25); MD peak height: 0.22 (95%CI: 0.07, 0.37) vs 0.37 (95%CI: 0.21, 0.53); FA median: 0.11 (95%CI: -0.05, 0.26) vs 0.22 (95%CI: 0.07, 0.37); FA peak height: -0.14 (95%CI: -0.28, 0.00) vs -0.24 (95%CI: -0.38, -0.10);). Similar findings were observed for executive function and visuomotor speed while only MD measures predicted worsening in memory domain. Interpretation This study shows that DTI histogram measures are associated with accelerated cognitive decline suggesting the utility of DTI as a pre-clinical marker in predicting the worsening of cognition in clinical trials.
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Affiliation(s)
- Yi Lin Ng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Marco Egle
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Bibek Gyanwali
- Memory Aging and Cognition Centre, National University Health System, Singapore
| | - Daniel J. Tozer
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Hugh S. Markus
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, Cambridge, United Kingdom
| | - Christopher Chen
- Memory Aging and Cognition Centre, National University Health System, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Saima Hilal
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Cantone M, Fisicaro F, Ferri R, Bella R, Pennisi G, Lanza G, Pennisi M. Sex differences in mild vascular cognitive impairment: A multimodal transcranial magnetic stimulation study. PLoS One 2023; 18:e0282751. [PMID: 36867595 PMCID: PMC9983846 DOI: 10.1371/journal.pone.0282751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/21/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Sex differences in vascular cognitive impairment (VCI) at risk for future dementia are still debatable. Transcranial magnetic stimulation (TMS) is used to evaluate cortical excitability and the underlying transmission pathways, although a direct comparison between males and females with mild VCI is lacking. METHODS Sixty patients (33 females) underwent clinical, psychopathological, functional, and TMS assessment. Measures of interest consisted of: resting motor threshold, latency of motor evoked potentials (MEPs), contralateral silent period, amplitude ratio, central motor conduction time (CMCT), including the F wave technique (CMCT-F), short-interval intracortical inhibition (SICI), intracortical facilitation, and short-latency afferent inhibition, at different interstimulus intervals (ISIs). RESULTS Males and females were comparable for age, education, vascular burden, and neuropsychiatric symptoms. Males scored worse at global cognitive tests, executive functioning, and independence scales. MEP latency was significantly longer in males, from both sides, as well CMCT and CMCT-F from the left hemisphere; a lower SICI at ISI of 3 ms from the right hemisphere was also found. After correction for demographic and anthropometric features, the effect of sex remained statistically significant for MEP latency, bilaterally, and for CMCT-F and SICI. The presence of diabetes, MEP latency bilaterally, and both CMCT and CMCT-F from the right hemisphere inversely correlated with executive functioning, whereas TMS did not correlate with vascular burden. CONCLUSIONS We confirm the worse cognitive profile and functional status of males with mild VCI compared to females and first highlight sex-specific changes in intracortical and cortico-spinal excitability to multimodal TMS in this population. This points to some TMS measures as potential markers of cognitive impairment, as well as targets for new drugs and neuromodulation therapies.
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Affiliation(s)
- Mariagiovanna Cantone
- Neurology Unit, University Hospital Policlinico “G. Rodolico-San Marco”, Catania, Italy
| | - Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Raffaele Ferri
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Giovanni Pennisi
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy
| | - Giuseppe Lanza
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
- * E-mail:
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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Chiu YL, Tsai HH, Lai YJ, Tseng HY, Wu YW, Peng YS, Chiu CM, Chuang YF. Cognitive impairment in patients with end-stage renal disease: Accelerated brain aging? J Formos Med Assoc 2019; 118:867-875. [DOI: 10.1016/j.jfma.2019.01.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 12/22/2022] Open
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5
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Ye Q, Bai F. Contribution of diffusion, perfusion and functional MRI to the disconnection hypothesis in subcortical vascular cognitive impairment. Stroke Vasc Neurol 2018; 3:131-139. [PMID: 30294468 PMCID: PMC6169607 DOI: 10.1136/svn-2017-000080] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 01/26/2018] [Accepted: 02/14/2018] [Indexed: 11/29/2022] Open
Abstract
Vascular cognitive impairment (VCI) describes all forms of cognitive impairment caused by any type of cerebrovascular disease. Early identification of VCI is quite difficult due to the lack of both sensitive and specific biomarkers. Extensive damage to the white matter tracts, which connect the cortical and subcortical regions, has been shown in subcortical VCI (SVCI), the most common subtype of VCI that is caused by small vessel disease. Two specific MRI sequences, including diffusion tensor imaging (DTI) and functional MRI (fMRI), have emerged as useful tools for identifying subtle white matter changes and the intrinsic connectivity between distinct cortical regions. This review describes the advantages of these two modalities in SVCI research and the current DTI and fMRI findings on SVCI. Using DTI technique, a variety of studies found that white matter microstructural damages in the anterior and superior areas are more specific to SVCI. Similarly, functional brain abnormalities detected by fMRI have also been mainly shown in anterior brain areas in SVCI. The characteristic distribution of brain abnormalities in SVCI interrupts the prefrontal-subcortical loop that results in cognitive impairments in particular domains, which further confirms the ‘disconnection syndrome’ hypothesis. In addition, another MRI technique, arterial spin labelling (ASL), has been used to describe the disconnection patterns in a variety of conditions by measuring cerebral blood flow. The role of the ASL technique in SVCI research is also assessed. Finally, the review proposes the application of multimodality fusion in the investigation of SVCI pathogenesis.
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Affiliation(s)
- Qing Ye
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
| | - Feng Bai
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
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6
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Yu J, Lam CLM, Lee TMC. White matter microstructural abnormalities in amnestic mild cognitive impairment: A meta-analysis of whole-brain and ROI-based studies. Neurosci Biobehav Rev 2017; 83:405-416. [PMID: 29092777 DOI: 10.1016/j.neubiorev.2017.10.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 10/24/2017] [Accepted: 10/27/2017] [Indexed: 12/29/2022]
Abstract
Studies that examined white matter (WM) alterations in amnestic mild cognitive impairment (aMCI) abound. This timely meta-analysis aims to synthesize the results of these studies. Seventy-seven studies (totalNaMCI=1844) were included. Fourteen region-of-interest-based (ROI-based) (k≥8;NaMCI≥284 per ROI) and two activation likelihood estimation (ALE) meta-analyses (fractional anisotropy [FA]: k=15;NaMCI=463; mean diffusivity [MD]: k=8;NaMCI=193) were carried out. Among the many significant ROI-related findings, reliable FA and MD alterations in the fornix, uncinate fasciculus, and parahippocampal cingulum were observed in aMCI. Larger effects were observed in MD relative to FA. The ALE meta-analysis revealed a significant FA decrease among aMCI subjects in the posterior corona radiata. These results provide robust evidence of the presence of WM abnormalities in aMCI. Our findings also highlight the importance of carrying out both ROI-based and whole-brain-based research to obtain a complete picture of WM microstructural alterations associated with the condition..
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Affiliation(s)
- Junhong Yu
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong
| | - Charlene L M Lam
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong
| | - Tatia M C Lee
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Institute of Clinical Neuropsychology, The University of Hong Kong, Hong Kong.
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Lao Y, Nguyen B, Tsao S, Gajawelli N, Law M, Chui H, Weiner M, Wang Y, Leporé N. A T1 and DTI fused 3D corpus callosum analysis in MCI subjects with high and low cardiovascular risk profile. Neuroimage Clin 2016; 14:298-307. [PMID: 28210541 PMCID: PMC5299209 DOI: 10.1016/j.nicl.2016.12.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 12/13/2016] [Accepted: 12/20/2016] [Indexed: 01/08/2023]
Abstract
Understanding the extent to which vascular disease and its risk factors are associated with prodromal dementia, notably Alzheimer's disease (AD), may enhance predictive accuracy as well as guide early interventions. One promising avenue to determine this relationship consists of looking for reliable and sensitive in-vivo imaging methods capable of characterizing the subtle brain alterations before the clinical manifestations. However, little is known from the imaging perspective about how risk factors such as vascular disease influence AD progression. Here, for the first time, we apply an innovative T1 and DTI fusion analysis of 3D corpus callosum (CC) on mild cognitive impairment (MCI) populations with different levels of vascular profile, aiming to de-couple the vascular factor in the prodromal AD stage. Our new fusion method successfully increases the detection power for differentiating MCI subjects with high from low vascular risk profiles, as well as from healthy controls. MCI subjects with high and low vascular risk profiles showed differed alteration patterns in the anterior CC, which may help to elucidate the inter-wired relationship between MCI and vascular risk factors.
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Affiliation(s)
- Yi Lao
- CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, USA
- Department of Biomedical Engineering, University of Southern California, USA
| | - Binh Nguyen
- CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, USA
| | - Sinchai Tsao
- CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, USA
| | - Niharika Gajawelli
- CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, USA
- Department of Biomedical Engineering, University of Southern California, USA
| | - Meng Law
- Department of Biomedical Engineering, University of Southern California, USA
- Department of Radiology, Keck School of Medicine, University of Southern California, USA
| | - Helena Chui
- Department of Biomedical Engineering, University of Southern California, USA
- Department of Radiology, Keck School of Medicine, University of Southern California, USA
| | - Michael Weiner
- Department of Radiology, University of California, San Francisco, USA
| | - Yalin Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, USA
| | - Natasha Leporé
- CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, USA
- Department of Biomedical Engineering, University of Southern California, USA
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Sudo FK, Alves GS, Tiel C, Ericeira-Valente L, Moreira DM, Laks J, Engelhardt E. Neuroimaging criteria and cognitive performance in vascular mild cognitive impairment: A systematic review. Dement Neuropsychol 2015; 9:394-404. [PMID: 29213989 PMCID: PMC5619322 DOI: 10.1590/1980-57642015dn94000394] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The recognition of Cerebrovascular Disease (CVD) at earlier clinical stages may
favor the control of vascular risk factors and prevention of dementia. However,
operational criteria for symptomatic phases at non-dementia stages are often
difficult, as the current criteria normally require the evidence of extensive
subcortical disease.
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Affiliation(s)
- Felipe Kenji Sudo
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro RJ, Brazil
| | - Gilberto Sousa Alves
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro RJ, Brazil.,Departamento de Medicina Clínica, Universidade Federal do Ceará, Fortaleza CE, Brazil
| | - Chan Tiel
- Instituto de Neurologia Deolindo Couto, Setor de Neurologia Cognitiva e do Comportamento-INDC-CDA/IPUB, UFRJ, Rio de Janeiro RJ, Brazil
| | - Letice Ericeira-Valente
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro RJ, Brazil
| | - Denise Madeira Moreira
- Serviço de Radiologia, Instituto de Neurologia Deolindo Couto (UFRJ); Hospital Pró-Cardíaco, Rio de Janeiro RJ, Brazil
| | - Jerson Laks
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro RJ, Brazil.,Universidade do Estado do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Eliasz Engelhardt
- Instituto de Neurologia Deolindo Couto, Setor de Neurologia Cognitiva e do Comportamento-INDC-CDA/IPUB, UFRJ, Rio de Janeiro RJ, Brazil
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Glodzik L, Sollberger M, Gass A, Gokhale A, Rusinek H, Babb JS, Hirsch JG, Amann M, Monsch AU, Gonen O. Global N-acetylaspartate in normal subjects, mild cognitive impairment and Alzheimer's disease patients. J Alzheimers Dis 2015; 43:939-47. [PMID: 25125458 DOI: 10.3233/jad-140609] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is an intermediary state on the way to Alzheimer's disease (AD). Little is known about whole brain concentration of the neuronal marker, N-acetylaspartate (NAA) in MCI patients. OBJECTIVE To test the hypothesis that since MCI and AD are both neurodegenerative, quantification of the NAA in their whole brain (WBNAA) could differentiate them from cognitively-intact matched controls. METHODS Proton MR spectroscopy to quantify the WBNAA was applied to 197 subjects (86 females) 72.6 ± 8.4 years old (mean ± standard deviation). Of these, 102 were cognitively intact, 42 diagnosed as MCI, and 53 as probable AD. Their WBNAA amounts were converted into absolute concentration by dividing with the brain volume segmented from the MRI that also yielded the fractional brain volume (fBPV), an atrophy metric. RESULTS WBNAA concentration of MCI and AD patients (10.5 ± 3.0 and 10.1 ± 2.9 mM) were not significantly different (p = 0.85). They were, however, highly significantly 25-29% lower than the 14.1 ± 2.4 mM of normal matched controls (p < 10-4). The fBPV of MCI and AD patients (72.9 ± 4.9 and 69.9 ± 4.7%) differed significantly from each other (4%, p = 0.02) and both were significantly lower than the 74.6 ± 4.4% of normal elderly (2%, p = 0.003 for MCI; 6%, p < 10-4 for AD). ROC curve analysis has shown WBNAA to have 70.5% sensitivity and 84.3% specificity to differentiate MCI or AD patients from normal elderly versus just 68.4 and 65.7% for fBPV. CONCLUSION Low WBNAA in MCI patients compared with cognitively normal contemporaries may indicate early neuronal damage accumulation and supports the notion of MCI as an early stage of AD. It also suggests WBNAA as a potential marker of early AD pathology.
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Affiliation(s)
- Lidia Glodzik
- Department of Radiology, New York University School of Medicine, New York, NY, USA Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Marc Sollberger
- Department of Neurology and Neuroradiology, University Hospital Basel, Basel, Switzerland Department of Geriatrics, University Hospital Basel, Basel, Switzerland
| | - Achim Gass
- Department of Neurology and Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - Amit Gokhale
- Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Henry Rusinek
- Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - James S Babb
- Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Jochen G Hirsch
- Department of Neurology and Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - Michael Amann
- Department of Neurology and Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - Andreas U Monsch
- Department of Geriatrics, University Hospital Basel, Basel, Switzerland
| | - Oded Gonen
- Department of Radiology, New York University School of Medicine, New York, NY, USA
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10
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Microstructural White Matter Abnormalities and Cognitive Dysfunction in Subcortical Ischemic Vascular Disease: an Atlas-Based Diffusion Tensor Analysis Study. J Mol Neurosci 2015; 56:363-70. [DOI: 10.1007/s12031-015-0550-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/23/2015] [Indexed: 11/24/2022]
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11
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Te M, Zhao E, Xingyue Z, Qinjian S, Chuanqiang Q. Leukoaraiosis with mild cognitive impairment. Neurol Res 2015; 37:410-4. [DOI: 10.1179/1743132815y.0000000028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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12
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Hoza D, Vlasák A, Hořínek D, Sameš M, Alfieri A. DTI-MRI biomarkers in the search for normal pressure hydrocephalus aetiology: a review. Neurosurg Rev 2014; 38:239-44; discussion 244. [DOI: 10.1007/s10143-014-0584-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 08/16/2014] [Accepted: 08/31/2014] [Indexed: 11/28/2022]
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13
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Cyprien F, Courtet P, Poulain V, Maller J, Meslin C, Bonafé A, Le Bars E, Ancelin ML, Ritchie K, Artero S. Corpus callosum size may predict late-life depression in women: a 10-year follow-up study. J Affect Disord 2014; 165:16-23. [PMID: 24882172 DOI: 10.1016/j.jad.2014.04.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 04/15/2014] [Accepted: 04/16/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND Recent research on late-life depression (LLD) pathophysiology suggests the implication of abnormalities in cerebral white matter and particularly in interhemispheric transfer. Corpus callosum (CC) is the main brain interhemispheric commissure. Hence, we investigated the association between baseline CC measures and risk of LDD. METHODS We studied 467 non-demented individuals without LLD at baseline from a cohort of elderly community-dwelling people (the ESPRIT study). LLD was assessed at year 2, 4, 7 and 10 of the study follow-up. At baseline, T1-weighted magnetic resonance images were manually traced to measure the mid-sagittal areas of the anterior, mid and posterior CC. Multivariate Cox proportional hazards models stratified by sex were used to predict LLD incidence over 10 years. RESULTS A significant interaction between gender and CC size was found (p=0.02). LLD incidence in elderly women, but not in men, was significantly associated with smaller anterior (HR 1.37 [1.05-1.79] p=0.017), mid (HR 1.43 [1.09-1.86] p=0.008), posterior (HR 1.39 [1.12-1.74] p=0.002) and total (HR 1.53 [1.16-2.00] p=0.002) CC areas at baseline in Cox models adjusted for age, education, global cognitive impairment, ischemic pathologies, left-handedness, white matter lesion, intracranial volume and past depression. LIMITATIONS The main limitation was the retrospective assessment of major depression. CONCLUSION Smaller CC size is a predictive factor of incident LLD over 10 years in elderly women independently of cognitive deterioration. Our finding suggests a possible role of CC and reduced interhemispheric connectivity in LLD pathophysiology. Extensive explorations are needed to clarify the mechanisms leading to CC morphometric changes in mood disorders.
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Affiliation(s)
- Fabienne Cyprien
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier 1, Montpellier F-34000, France; CHRU Carémeau, Nîmes, France
| | - Philippe Courtet
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier 1, Montpellier F-34000, France; CHRU Montpellier, Montpellier, France
| | - Vanessa Poulain
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France
| | - Jerome Maller
- Monash Alfred Psychiatry Research Centre, The Alfred & Monash University School of Psychology and Psychiatry, Melbourne, Australia
| | - Chantal Meslin
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Alain Bonafé
- University of Montpellier 1, Montpellier F-34000, France; CHRU Montpellier, Montpellier, France
| | | | - Marie-Laure Ancelin
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier 1, Montpellier F-34000, France
| | - Karen Ritchie
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier 1, Montpellier F-34000, France; Faculty of Medicine, Imperial College, St Mary׳s Hospital, London, United Kingdom
| | - Sylvaine Artero
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier 1, Montpellier F-34000, France.
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Ancelin ML, Ripoche E, Dupuy AM, Samieri C, Rouaud O, Berr C, Carrière I, Ritchie K. Gender-specific associations between lipids and cognitive decline in the elderly. Eur Neuropsychopharmacol 2014; 24:1056-66. [PMID: 24721317 DOI: 10.1016/j.euroneuro.2014.02.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 02/07/2014] [Accepted: 02/09/2014] [Indexed: 12/14/2022]
Abstract
The aim of this study was to examine the associations between serum lipid levels and cognitive function in a community-based sample of non-demented subjects aged 65 years and over. Participants were 2737 men and 4118 women from a population-based cohort recruited from three French cities. Visual memory, verbal fluency, psychomotor speed, and executive abilities were evaluated at baseline, and after 2, 4, and 7 years of follow-up. Lipid levels were evaluated at baseline. Multiadjusted Cox models stratified by gender were adjusted for sociodemographic and lifestyle characteristics, mental and physical health, and genetic vulnerability to dyslipidemia (apolipoprotein E and A, and cholesteryl ester transfer protein) and taking into account baseline vascular pathologies. In men, a hypercholesterolemic pattern in late-life (high total cholesterol (T-C), low HDL-C, high LDL-C levels) was associated with a 25 to 50% increased risk of decline over 7 years in psychomotor speed, executive abilities, and verbal fluency. Specific associations with low T-C and low LDL-C levels were also observed which may depend on genetic vulnerability to dyslipidemia (related to apolipoprotein A5 and cholesteryl exchange transfer protein). In contrast, in women, a 30% higher rate of decline was found in psychomotor speed with high HDL-C levels and in executive abilities with low levels of LDL-C and triglycerides, in interaction with hormonal treatment. For men and women, vascular pathologies only slightly outweighed the risk related to lipids. This suggests a complex gender-specific pattern of cognitive decline involving genetic vulnerability in men and hormonal status in women.
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Affiliation(s)
- Marie-Laure Ancelin
- Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France.
| | - Emmanuelle Ripoche
- Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France
| | - Anne-Marie Dupuy
- Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France; CHRU Montpellier, Hop Lapeyronie, Laboratoire de Biochimie, Montpellier, France
| | - Cécilia Samieri
- Univ Bordeaux, ISPED, U897-Epidemiologie-Biostatistique, Bordeaux, France; Insem, U897, Bordeaux, France
| | - Olivier Rouaud
- CHRU Dijon, Centre Mémoire Ressources et Recherche, Dijon, France
| | - Claudine Berr
- Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France
| | - Isabelle Carrière
- Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France
| | - Karen Ritchie
- Inserm, U1061, Montpellier, F-34093, France; Univ Montpellier 1, U1061, Montpellier, France; Faculty of Medicine, Imperial College, London, UK
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15
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Vasquez BP, Zakzanis KK. The neuropsychological profile of vascular cognitive impairment not demented: A meta-analysis. J Neuropsychol 2014; 9:109-36. [DOI: 10.1111/jnp.12039] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 11/12/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Brandon P. Vasquez
- Rotman Research Institute; Baycrest; Toronto Canada
- Department of Psychology; University of Toronto; Canada
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16
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Diffusion tensor imaging (DTI) in the detection of white matter lesions in patients with mild cognitive impairment (MCI). Acta Neurol Belg 2013; 113:441-51. [PMID: 23625776 DOI: 10.1007/s13760-013-0197-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Accepted: 04/04/2013] [Indexed: 10/26/2022]
Abstract
Mild cognitive impairment (MCI) is recognized as a precursor to dementia. The amnestic MCI progresses usually to Alzheimer disease. Amnestic MCI multiple domain (md-MCI) seems to progress more rapidly than amnestic MCI single domain (a-MCI). In an attempt to identify patients at risk, we examined white matter changes in MCI subtypes using diffusion tensor imaging (DTI). We also tried to correlate DTI findings to neuropsychological tests. Forty-four amnestic single domain (a-MCI) patients, 19 amnestic multi domain (md-MCI), and 25 cognitively normal (NC) controls were included in the present study. All participants were assessed clinically using a battery of cognitive tests. DTI was performed to measure fractional anisotropy (FA) and apparent diffusion coefficient (ADC). Areas studied were corpus callosum, posterior cingulum (PC), anterior cingulum (AC), and superior longitudinal fasciculus (SLF). ADC and FA of the above areas were related to the scores of certain neuropsychological tests that evaluate visual and verbal memory. No difference in DTI measurements was found between the two MCI subtypes. ADC in MCI cases was increased in comparison with NC in the genu, PC, right SLF, and left AC. FA was spared. Verbal memory was related to ADC of the genu, PC, right AC and right SLF, and to FA of the left SLF. Visual memory was related to ADC of the genu, PC, right AC, and SLF. The strongest correlation found was between the visual memory and the ADC of the right PC (Spearman ρ = 0.45, p < 0.001). DTI revealed that ADC was increased in certain brain areas in MCI patients. No difference in DTI measurements was found between the two MCI subtypes. DTI indices correlate with cognitive performance.
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17
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Fu JL, Liu Y, Li YM, Chang C, Li WB. Use of diffusion tensor imaging for evaluating changes in the microstructural integrity of white matter over 3 years in patients with amnesic-type mild cognitive impairment converting to Alzheimer's disease. J Neuroimaging 2013; 24:343-8. [PMID: 24251793 DOI: 10.1111/jon.12061] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Revised: 07/02/2013] [Accepted: 07/03/2013] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND AND PURPOSE Patients with amnestic mild cognitive impairment (aMCI) are at risk of developing Alzheimer's disease (AD). It is therefore important to identify biomarkers of conversion to AD. This study examined whether the integrity of white matter can predict this conversion. METHODS Magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) and neuropsychological features of aMCI subjects (n = 41) were compared with normal controls (n = 20) for 12-36 months. RESULTS Compared to controls, 22 aMCI subjects had lower fractional anisotropy (FA) values in the cingulate fasciculus (CF) at baseline, and 19 of those converted to AD during follow-up. Only two of the other 19 aMCI patients converted to AD. Compared to baseline, AD converters showed lower FA values in the anterior frontal lobe, temporal lobe, hippocampus, inferior fronto-occipital fascicles, corpus callosum genu and CF, and higher apparent diffusion coefficient values in the temporal lobe and hippocampus. CONCLUSIONS Those aMCI subjects with lower than normal FA values in the CF were more likely to convert to AD. The connectivity of the hippocampus and cingulate bundles may be affected in the early stage of AD. Impairment of white matter and fiber bundles was more severe at the AD stage than the aMCI stage.
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Affiliation(s)
- Jian-Liang Fu
- Department of Neurology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
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18
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Decreased white matter integrity in neuropsychologically defined mild cognitive impairment is independent of cortical thinning. J Int Neuropsychol Soc 2013; 19:925-37. [PMID: 23809097 PMCID: PMC4356249 DOI: 10.1017/s1355617713000660] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Improved understanding of the pattern of white matter changes in early and prodromal Alzheimer’s disease (AD) states such as mild cognitive impairment (MCI) is necessary to support earlier preclinical detection of AD, and debate remains whether white matter changes in MCI are secondary to gray matter changes. We applied neuropsychologically based MCI criteria to a sample of normally aging older adults; 32 participants met criteria for MCI and 81 participants were classified as normal control (NC) subjects. Whole-head high resolution T1 and diffusion tensor imaging scans were completed. Tract-Based Spatial Statistics was applied and a priori selected regions of interest were extracted. Hippocampal volume and cortical thickness averaged across regions with known vulnerability to AD were derived. Controlling for corticalthic kness, the MCI group showed decreased average fractional anisotropy (FA) and decreased FA in parietal white matter and in white matter underlying the entorhinal and posterior cingulate cortices relative to the NC group. Statistically controlling for cortical thickness, medial temporal FA was related to memory and parietal FA was related to executive functioning. These results provide further support for the potential role of white matter integrity as an early biomarker for individuals at risk for AD and highlight that changes in white matter may be independent of gray matter changes.
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19
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Liu J, Yin C, Xia S, Jia L, Guo Y, Zhao Z, Li X, Han Y, Jia J. White matter changes in patients with amnestic mild cognitive impairment detected by diffusion tensor imaging. PLoS One 2013; 8:e59440. [PMID: 23555673 PMCID: PMC3605411 DOI: 10.1371/journal.pone.0059440] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Accepted: 02/14/2013] [Indexed: 01/03/2023] Open
Abstract
Compared to normal aging adults, individuals with amnestic mild cognitive impairment (aMCI) have significantly increased risk for progressing into Alzheimer's disease (AD). Autopsy studies found that most of the brains of aMCI cases showed anatomical features associated with AD pathology. The recent development of non-invasive neuroimaging technique, such as diffusion tensor imaging (DTI), makes it possible to investigate the microstructures of the cerebral white matter in vivo. We hypothesized that disrupted white matter (WM) integrity existed in aMCI. So we used DTI technique, by measuring fractional anisotropy (FA) and mean diffusivity (MD), to test the brain structures involved in patients with aMCI. DTI scans were collected from 40 patients with aMCI, and 28 normal controls (NC). Tract-based spatial statistics (TBSS) analyses of whole-brain FA and MD images in each individual and group comparisons were carried out. Compared to NC, aMCI patients showed significant FA reduction bilaterally, in the association and projection fibers of frontal, parietal, and temporal lobes, corpus callosum, bilateral corona radiation, right posterior thalamic radiation and right sagittal stratum. aMCI patients also showed significantly increased MD widespreadly in the association and projection fibers of frontal, parietal and temporal lobes, and corpus callosum. Assessment of the WM integrity of the frontal, parietal, temporal lobes, and corpus callosum by using DTI measures may aid early diagnosis of aMCI.
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Affiliation(s)
- Jianghong Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, PR China
- Key Neurodegenerative Laboratory of Ministry of Education of the People’s Republic of China, Beijing, PR China
| | - Changhao Yin
- Department of Neurology, Hongqi Hospital of Mudanjiang Medical College, Mudangjiang, China
| | - Shugao Xia
- Gruss Magnetic Resonance Research Center, Departments of Radiology, Neuroscience, Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, United States of America
| | - Longfei Jia
- Department of Neurology, Tongren Hospital, Capital Medical University, Beijing, China
| | - Yanqin Guo
- Department of Neurology, Hongqi Hospital of Mudanjiang Medical College, Mudangjiang, China
| | - Zhilian Zhao
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaobo Li
- Gruss Magnetic Resonance Research Center, Departments of Radiology, Neuroscience, Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, United States of America
| | - Ying Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, PR China
- Key Neurodegenerative Laboratory of Ministry of Education of the People’s Republic of China, Beijing, PR China
| | - Jianping Jia
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, PR China
- Key Neurodegenerative Laboratory of Ministry of Education of the People’s Republic of China, Beijing, PR China
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20
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Alves GS, O'Dwyer L, Jurcoane A, Oertel-Knöchel V, Knöchel C, Prvulovic D, Sudo F, Alves CE, Valente L, Moreira D, Fußer F, Karakaya T, Pantel J, Engelhardt E, Laks J. Different patterns of white matter degeneration using multiple diffusion indices and volumetric data in mild cognitive impairment and Alzheimer patients. PLoS One 2012; 7:e52859. [PMID: 23300797 PMCID: PMC3534120 DOI: 10.1371/journal.pone.0052859] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 11/23/2012] [Indexed: 01/15/2023] Open
Abstract
Alzheimeŕs disease (AD) represents the most prevalent neurodegenerative disorder that causes cognitive decline in old age. In its early stages, AD is associated with microstructural abnormalities in white matter (WM). In the current study, multiple indices of diffusion tensor imaging (DTI) and brain volumetric measurements were employed to comprehensively investigate the landscape of AD pathology. The sample comprised 58 individuals including cognitively normal subjects (controls), amnestic mild cognitive impairment (MCI) and AD patients. Relative to controls, both MCI and AD subjects showed widespread changes of anisotropic fraction (FA) in the corpus callosum, cingulate and uncinate fasciculus. Mean diffusivity and radial changes were also observed in AD patients in comparison with controls. After controlling for the gray matter atrophy the number of regions of significantly lower FA in AD patients relative to controls was decreased; nonetheless, unique areas of microstructural damage remained, e.g., the corpus callosum and uncinate fasciculus. Despite sample size limitations, the current results suggest that a combination of secondary and primary degeneration occurrs in MCI and AD, although the secondary degeneration appears to have a more critical role during the stages of disease involving dementia.
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Affiliation(s)
- Gilberto Sousa Alves
- Alzheimer's Disease Center-Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Brazil.
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21
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van der Holst HM, Tuladhar AM, van Norden AGW, de Laat KF, van Uden IWM, van Oudheusden LJB, Zwiers MP, Norris DG, Kessels RPC, de Leeuw FE. Microstructural integrity of the cingulum is related to verbal memory performance in elderly with cerebral small vessel disease: the RUN DMC study. Neuroimage 2012; 65:416-23. [PMID: 23032491 DOI: 10.1016/j.neuroimage.2012.09.060] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 09/24/2012] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Cerebral small vessel disease (SVD) is related to verbal memory failures. It is suggested that early white matter damage, is located, among others, in the (posterior) cingulum at an early stage in neurodegeneration. Changes in the microstructural integrity of the cingulum assessed with diffusion tensor imaging (DTI), beyond detection with conventional MRI, may precede macrostructural changes and be related to verbal memory failures. OBJECTIVE To investigate the relation between cingular microstructural integrity and verbal memory performance in 503 non-demented elderly with cerebral SVD. METHODS The RUN DMC study is a prospective cohort study in elderly (50-85 years) with cerebral SVD. All participants underwent T1 MPRAGE, FLAIR and DTI scanning and the Rey Auditory Verbal Learning Test. Mean diffusivity (MD) and fractional anisotropy (FA) were assessed in six different cingular regions of interests (ROIs). Linear regression analysis was used to assess the relation between verbal memory performance and cingular DTI parameters, with appropriate adjustments. Furthermore a TBSS analysis of the whole brain was performed to investigate the specificity of our findings. RESULTS Both our ROI-based and TBSS analysis showed that FA was positively related to immediate memory, delayed recall, delayed recognition and overall verbal memory performance of the cingulum, independent of confounders. A similar distribution was seen for the inverse association with MD and verbal memory performance with TBSS analysis. No significant relations were found with psychomotor speed, visuospatial memory and MMSE. When stratified on hippocampal integrity, the MD and FA values of the cingular ROIs differed significantly between participants with a good and poor hippocampal integrity. CONCLUSION Microstructural integrity of the cingulum, assessed by DTI, is specifically related to verbal memory performance, in elderly with SVD. Furthermore we found that when the integrity of the hippocampus is disrupted, the cingulum integrity is impaired as well.
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Affiliation(s)
- H M van der Holst
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands
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22
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Abstract
BACKGROUND Previous studies using diffusion tensor imaging (DTI) have observed microstructural abnormalities in white matter regions in both Alzheimer's disease and mild cognitive impairment (MCI). The aim of this work was to examine the abnormalities in white matter and subcortical regions of MCI and its subtypes in a large, community-dwelling older aged cohort. METHODS A community-based sample of 396 individuals without dementia underwent medical assessment, neuropsychiatric testing, and neuroimaging. Of these, 158 subjects were classified as MCI and 238 as cognitively normal (controls) based on international MCI consensus criteria. Regional fractional anisotropy (FA) and mean diffusivity (MD) measures were calculated from the DTI and compared between groups. The false discovery rate correction was applied for multiple testing. RESULTS Subjects with MCI did not have significant differences in FA compared with controls after correction for multiple testing, but had increased MD in the right putamen, right anterior limb of the internal capsule, genu and splenium of the corpus callosum, right posterior cingulate gyrus, left superior frontal gyrus, and right and left corona radiata. When compared with controls, changes in left anterior cingulate, left superior frontal gyrus, and right corona radiata were associated with amnestic MCI (aMCI), whereas changes in the right putamen, right anterior limb of the internal capsule, and the right corona radiata were associated with non-amnestic MCI (naMCI). On logistic regression, the FA values in the left superior gyrus and MD values in the anterior cingulate distinguished aMCI from naMCI. CONCLUSIONS MCI is associated with changes in white matter and subcortical regions as seen on DTI. Changes in some anterior brain regions distinguish aMCI from naMCI.
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23
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Alves GS, Sudo FK, Alves CEDO, Ericeira-Valente L, Moreira DM, Engelhardt E, Laks J. Diffusion tensor imaging studies in vascular disease: A review of the literature. Dement Neuropsychol 2012; 6:158-163. [PMID: 29213790 PMCID: PMC5618963 DOI: 10.1590/s1980-57642012dn06030008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cerebrovascular disease (CVD) is often present in old age and may be associated
with microstructural pathology of white matter (WM) and cognitive dysfunction.
The current review investigated the relationship between CVD, cognitive status
and WM integrity as assessed by diffusion tensor imaging (DTI).
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Affiliation(s)
- Gilberto Sousa Alves
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Felipe Kenji Sudo
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | | | | | - Denise Madeira Moreira
- Institute of Neurology, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Radiology Service of the Procardíaco Hospital, Rio de Janeiro RJ, Brazil
| | - Eliasz Engelhardt
- Institute of Neurology, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Jerson Laks
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Universidade Estadual do Rio de Janeiro, Rio de Janeiro RJ, Brazil
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24
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Sudo FK, Alves CEO, Alves GS, Ericeira-Valente L, Tiel C, Moreira DM, Laks J, Engelhardt E. Dysexecutive syndrome and cerebrovascular disease in non-amnestic mild cognitive impairment: A systematic review of the literature. Dement Neuropsychol 2012; 6:145-151. [PMID: 29213788 PMCID: PMC5618961 DOI: 10.1590/s1980-57642012dn06030006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective Non-amnestic dysexecutive Vascular Mild Cognitive Impairment (VaMCI) may
represent preclinical Vascular Dementia (VaD). The aim of this study was to
summarize the clinical, neuropsychological and neuroimaging aspects of
VaMCI; and to assess its patterns of progression to dementia. Methods Searches were made in the ISI Web of Knowledge, PubMed and Lilacs databases,
using the terms "mild cognitive impairment" and "executive function".
Altogether, 944 articles were retrieved. Results VaMCI cases had poorer performances on fronto-executive tasks, a higher
prevalence of stroke, presence of periventricular and profound white matter
hyperintensities on MRI images, as well as more extrapyramidal signs and
behavioral symptoms. Executive dysfunction might be associated with
disconnection of fronto-parietal-subcortical circuits. Progression to
dementia was associated with baseline deficits in executive function, in
simple sustained attention and language, and large periventricular WMH. Discussion VaMCI develops with impairment in non-memory domains and subcortical white
matter changes on MRI images, which are consistent with clinical and
neuroimaging findings in VaD.
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Affiliation(s)
- Felipe Kenji Sudo
- Instituto de Psiquiatria, Center for Alzheimer's Disease (CDA/IPUB), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Carlos Eduardo Oliveira Alves
- Instituto de Psiquiatria, Center for Alzheimer's Disease (CDA/IPUB), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Gilberto Sousa Alves
- Instituto de Psiquiatria, Center for Alzheimer's Disease (CDA/IPUB), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Letice Ericeira-Valente
- Instituto de Psiquiatria, Center for Alzheimer's Disease (CDA/IPUB), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Chan Tiel
- Instituto de Neurologia Deolindo Couto (INDC), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Cognitive and Behavioral Neurology Unit, INDC-CDA/IPUB, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Denise Madeira Moreira
- Instituto de Neurologia Deolindo Couto (INDC), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Hospital Pró-Cardíaco, Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Jerson Laks
- Instituto de Psiquiatria, Center for Alzheimer's Disease (CDA/IPUB), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Universidade do Estado do Rio de Janeiro
| | - Eliasz Engelhardt
- Instituto de Neurologia Deolindo Couto (INDC), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Cognitive and Behavioral Neurology Unit, INDC-CDA/IPUB, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
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25
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Deprez S, Amant F, Yigit R, Porke K, Verhoeven J, Van den Stock J, Smeets A, Christiaens MR, Leemans A, Van Hecke W, Vandenberghe J, Vandenbulcke M, Sunaert S. Chemotherapy-induced structural changes in cerebral white matter and its correlation with impaired cognitive functioning in breast cancer patients. Hum Brain Mapp 2011; 32:480-93. [PMID: 20725909 DOI: 10.1002/hbm.21033] [Citation(s) in RCA: 203] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
A subgroup of patients with breast cancer suffers from mild cognitive impairment after chemotherapy. To uncover the neural substrate of these mental complaints, we examined cerebral white matter (WM) integrity after chemotherapy using magnetic resonance diffusion tensor imaging (DTI) in combination with detailed cognitive assessment. Postchemotherapy breast cancer patients (n = 17) and matched healthy controls (n = 18) were recruited for DTI and neuropsychological testing, including the self-report cognitive failure questionnaire (CFQ). Differences in DTI WM integrity parameters [fractional anisotropy (FA) and mean diffusivity (MD)] between patients and healthy controls were assessed using a voxel-based two-sample-t-test. In comparison with healthy controls, the patient group demonstrated decreased FA in frontal and temporal WM tracts and increased MD in frontal WM. These differences were also confirmed when comparing this patient group with an additional control group of nonchemotherapy-treated breast cancer patients (n = 10). To address the heterogeneity observed in cognitive function after chemotherapy, we performed a voxel-based correlation analysis between FA values and individual neuropsychological test scores. Significant correlations of FA with neuropsychological tests covering the domain of attention and processing/psychomotor speed were found in temporal and parietal WM tracts. Furthermore, CFQ scores correlated negatively in frontal and parietal WM. These studies show that chemotherapy seems to affect WM integrity and that parameters derived from DTI have the required sensitivity to quantify neural changes related to chemotherapy-induced mild cognitive impairment.
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Affiliation(s)
- Sabine Deprez
- Department of Radiology, University Hospital Gasthuisberg of the K.U. Leuven, Leuven, Belgium
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26
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Ancelin ML, de Roquefeuil G, Scali J, Bonnel F, Adam JF, Cheminal JC, Cristol JP, Dupuy AM, Carrière I, Ritchie K. Long-term post-operative cognitive decline in the elderly: the effects of anesthesia type, apolipoprotein E genotype, and clinical antecedents. J Alzheimers Dis 2011; 22 Suppl 3:105-13. [PMID: 20858969 DOI: 10.3233/jad-2010-100807] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cognitive dysfunction in the elderly commonly observed following anesthesia has been attributed to age-related neuronal changes exacerbated by pharmacotoxic effects. However, the extent to which these changes may persist following recovery from surgery is still largely unknown. This study investigates the long-term effects of anesthesia on cognitive functioning after orthopedic surgery in 270 elderly patients over the age of 65 who completed a computerized cognitive battery before and 8 days, 4 and 13 months after surgery. Their performance was compared to those of 310 elderly controls who completed the same neuropsychiatric evaluation at baseline and one-year interval. Multivariate analyses adjusted for socio-demographic variables, depressive symptomatology, vascular pathology as well as baseline cognitive performance. We found early and transient post-operative decline in reaction time and constructional praxis. With regard to long-term changes we observed improvement compared to controls in most verbal tasks (probably due to learning effects). On the other hand, a clear dissociation effect was observed for several areas of visuospatial functioning which persisted up to the 13-month follow-up. This specific pattern of visuospatial deficit was found to be independent of apolipoprotein E genotype and closely resembles what has recently been termed vascular mild cognitive impairment, in turn associated with subtle sub-cortical vascular changes. The observation of only minor differences between persons operated by general and regional anesthesia makes it difficult to attribute these changes directly to the anesthetic agents themselves, suggesting that cognitive dysfunction may be attributable at least in part to peri-operative conditions, notably stress and glucocorticoid exposure.
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Zhao S, Liu G, Shen Y, Zhao Y. Reasonable neuropsychological battery to identify mild cognitive impairment. Med Hypotheses 2011; 76:50-3. [DOI: 10.1016/j.mehy.2010.08.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Revised: 08/03/2010] [Accepted: 08/09/2010] [Indexed: 10/19/2022]
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Ferrer I. Cognitive impairment of vascular origin: neuropathology of cognitive impairment of vascular origin. J Neurol Sci 2010; 299:139-49. [PMID: 20846674 DOI: 10.1016/j.jns.2010.08.039] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Revised: 08/15/2010] [Accepted: 08/24/2010] [Indexed: 12/31/2022]
Abstract
The term cognitive impairment of vascular origin is used to designate global cognitive deficits as well as focal neurological deficits such as aphasia, apraxia and agnosia of vascular/circulatory origin. It has been useful for identifying early clinical and neuroradiological alterations that might permit therapeutic strategies geared to curbing the progression of cerebrovascular disease. Multi-infarct encephalopathy, infarcts in strategic areas, lacunae and lacunar status, Binswanger's encephalopathy, hippocampal sclerosis, cortical granular atrophy and watershed infarcts are common lesions. Hypertension and vascular diseases such as arteriosclerosis, small blood vessel disease, inflammatory diseases of the blood vessels, Sneddon syndrome, cerebral amyloid angiopathies, cerebral autosomic dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), and Maeda's syndrome are causative of cognitive impairment of vascular origin. Other less common causes are hereditary endotheliopathy with retinopathy, neuropathy and strokes (HERNS), cerebro-retinian vasculopathy (CRV), hereditary vascular retinopathy (HVR) (all three linked to 3p21.1-p21.3), hereditary infantile hemiparesis with arteriolar retinopathy and leukoencephalopathy (HIHRATL) (not linked to 3p21), fibromuscular dysplasia, and moya-moya disease. Lack of uniformity of clinical manifestations, the variety of vascular diseases and circulatory factors, the diverse, but often convergent, neuropathological substrates, and the common association with unrelated neurodegenerative diseases in the elderly, make it hard to assume a single clinical approach in the diagnosis and treatment of cognitive impairment of vascular origin. Rather, environmental and genetic risk factors, underlying vascular diseases, associated systemic, metabolic and neurodegenerative diseases and identification of extent and distribution of lesions with morphological and functional neuroimaging methods should be applied in every individual patient.
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Affiliation(s)
- Isidre Ferrer
- Institut de Neuropatologia, Servei Anatomia Patològica, IDIBELL-Hospital Universitari de Bellvitge, 08907 Hospitalet de LLobregat, Spain.
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Hong YJ, Yoon B, Shim YS, Cho AH, Lim SC, Ahn KJ, Yang DW. Differences in microstructural alterations of the hippocampus in Alzheimer disease and idiopathic normal pressure hydrocephalus: a diffusion tensor imaging study. AJNR Am J Neuroradiol 2010; 31:1867-72. [PMID: 20671063 DOI: 10.3174/ajnr.a2207] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE DTI can be used to assess the degradation of WM tracts by measuring the FA and MD. Decreased FA/increased MD values in the AD hippocampus have been reported by many studies. In contrast, only a few studies reported on hydrocephalus by using the DTI technique. In elderly patients with dementia and with dilated ventricles, it is often difficult to differentiate iNPH from AD with visual measurements on MR imaging. The aim of this study was to investigate the changes of microstructural integrity of the hippocampus in iNPH by using DTI and determining whether this method could be a new diagnostic tool to differentiate iNPH from AD. MATERIALS AND METHODS We recruited 43 participants (15 healthy controls, 15 patients with AD, and 13 patients with iNPH). The FA and MD values were measured by using the region-of-interest method in the hippocampal head, body, and tail on both sides. Clinical history, neurologic examination, and neuropsychological assessment were included. RESULTS The FA values were the lowest in the patients with AD, the patients with iNPH, and the healthy controls in this order. The MD values were the highest in the same order. These findings were consistent in the 3 subdivisions of the bilateral hippocampal regions. Hippocampal volume was not different between patients with iNPH and AD. CONCLUSIONS The microstructural alterations of the hippocampus were more sensitive than the volumetric changes in AD and iNPH. DTI analysis might be a useful tool for discriminating AD from iNPH.
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Affiliation(s)
- Y J Hong
- Departments of Neurology, The Catholic University of Korea, Seoul, Korea
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A meta-analysis of diffusion tensor imaging in mild cognitive impairment and Alzheimer's disease. Neurobiol Aging 2010; 32:2322.e5-18. [PMID: 20619504 DOI: 10.1016/j.neurobiolaging.2010.05.019] [Citation(s) in RCA: 233] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 05/14/2010] [Accepted: 05/17/2010] [Indexed: 12/20/2022]
Abstract
We reviewed case-control studies of diffusion tensor imaging (DTI) in patients with Alzheimer's dementia (AD) and mild cognitive impairment (MCI), in order to establish the relative severity and location of white matter microstructural changes. EMBASE and MEDLINE were searched using the keywords, (["diffusion tensor"] and ["Alzheimer*" or "mild cognitive impairment"]), as were reference lists of relevant papers. Forty-one diffusion tensor imaging studies contained data that were suitable for inclusion. Group means and standard deviations for fractional anisotropy and mean diffusivity, or p values from 2-sample tests, were extracted and pooled, using standard methods of meta-analysis and metaregression. Fractional anisotropy was decreased in AD in all regions except parietal white matter and internal capsule, while patients with MCI had lower values in all white matter regions except parietally and occipitally. Mean diffusivity was increased in AD in all regions, and in MCI in all but occipital and frontal regions.
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White matter diffusivity predicts memory in patients with subjective and mild cognitive impairment and normal CSF total tau levels. J Int Neuropsychol Soc 2010; 16:58-69. [PMID: 19835655 DOI: 10.1017/s1355617709990932] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Subjective and mild cognitive impairment (SCI and MCI) are etiologically heterogeneous conditions. This poses problems for assessment of pathophysiological mechanisms and risk of conversion to dementia. Neuropsychological, imaging, and cerebrospinal fluid (CSF) findings serve to distinguish Alzheimer's disease (AD) and other etiological subgroups. Tau-molecules stabilize axonal microtubuli; high CSF total tau (T-tau) reflects ongoing axonal damage consistent with AD. Here, we stratify patients by CSF T-tau pathology to determine if memory network diffusion tensor imaging (DTI) predicts memory performance in the absence of elevated T-tau. We analyzed neuropsychological test results, hippocampus volume (HcV) and white matter diffusivity in 45 patients (35 with normal T-tau). The T-tau pathology group showed more hippocampus atrophy and memory impairment than the normal T-tau group. In the T-tau normal group: (1) memory was related with white matter diffusivity [fractional anisotropy (FA) and radial diffusivity (DR)], and (2) FA of the genu corpus callosum was a unique predictor of variance for verbal learning, and HcV did not contribute to this prediction. The smaller sample size in the T-tau pathology group precludes firm conclusions. In the normal T-tau group, white matter tract and memory changes may be associated with normal aging, or with non-tau related pathological mechanisms.
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Kennedy KM, Raz N. Pattern of normal age-related regional differences in white matter microstructure is modified by vascular risk. Brain Res 2009; 1297:41-56. [PMID: 19712671 DOI: 10.1016/j.brainres.2009.08.058] [Citation(s) in RCA: 153] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Revised: 08/10/2009] [Accepted: 08/13/2009] [Indexed: 11/29/2022]
Abstract
Even successful aging is associated with regional brain shrinkage and deterioration of the cerebral white matter. Aging also brings about an increase in vascular risk, and vascular impairment may be a potential mechanism behind the observed patterns of aging. The goals of this study were to characterize the normal age differences in white matter integrity in several brain regions across the adult life span and to assess the modifying effect of vascular risk on the observed pattern of regional white matter integrity. We estimated fractional anisotropy and diffusivity of white matter in nine cerebral regions of interest in 77 healthy adults (19-84 years old). There was a widespread reduction of white matter anisotropy with age, and prefrontal and occipital regions evidenced the greatest age-related differences. Diffusivity increased with age, and the magnitude of age differences increased beginning with the middle of the fifth decade. Vascular risk factors modified age differences in white matter integrity. Clinically diagnosed and treated arterial hypertension was associated with reduced white matter anisotropy and increased diffusivity beyond the effects of age. In the normotensive participants, elevation of arterial pulse pressure (a surrogate of arterial stiffness) was linked to deterioration of the white matter integrity in the frontal regions. Although the causal role of vascular risk in brain aging is unclear, the observed pattern of effects suggests that vascular risk may drive the expansion of age-related white matter damage from anterior to posterior regions.
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Affiliation(s)
- Kristen M Kennedy
- Center for Brain Health, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
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Abnormal white matter independent of hippocampal atrophy in amnestic type mild cognitive impairment. Neurosci Lett 2009; 462:147-51. [PMID: 19596405 DOI: 10.1016/j.neulet.2009.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 07/01/2009] [Accepted: 07/05/2009] [Indexed: 11/23/2022]
Abstract
Hippocampal atrophy is the key marker in the pathogenesis of Alzheimer's disease (AD), which is associated with white matter (WM) disruption. This type of WM disruption could partly explain AD-related pathology. However, relatively little attention has been directed toward WM disruption which may be independent of these fundamental gray matter (GM) changes in amnestic mild cognitive impairment (aMCI) which is associated with high risk of AD. To evaluate the differences of WM integrity between aMCI patients (N=32) and healthy controls (N=31), whole-brain voxel-based methods were applied to diffusion tensor imaging. To explore the possible independence of WM changes from GM loss, an index of hippocampal atrophy was used to partial out GM effects. aMCI patients showed WM disruption in frontal lobe, temporal lobe, internal capsule, cingulate gyrus and precuneus. The findings supported the evidence of independent patterns of degeneration in WM tracts which may co-act in the WM pathological process of aMCI patients. As aMCI is a putatively prodromal syndrome to AD, these data may assist with a better understanding of WM pathological change associated with the development of AD.
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Bai F, Zhang Z, Watson DR, Yu H, Shi Y, Yuan Y, Qian Y, Jia J. Abnormal integrity of association fiber tracts in amnestic mild cognitive impairment. J Neurol Sci 2009; 278:102-6. [DOI: 10.1016/j.jns.2008.12.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 12/07/2008] [Accepted: 12/09/2008] [Indexed: 11/28/2022]
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