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Oltra J, Segura B, Strafella AP, van Eimeren T, Ibarretxe-Bilbao N, Diez-Cirarda M, Eggers C, Lucas-Jiménez O, Monté-Rubio GC, Ojeda N, Peña J, Ruppert MC, Sala-Llonch R, Theis H, Uribe C, Junque C. A multi-site study on sex differences in cortical thickness in non-demented Parkinson's disease. NPJ Parkinsons Dis 2024; 10:69. [PMID: 38521776 PMCID: PMC10960793 DOI: 10.1038/s41531-024-00686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024] Open
Abstract
Clinical, cognitive, and atrophy characteristics depending on sex have been previously reported in Parkinson's disease (PD). However, though sex differences in cortical gray matter measures in early drug naïve patients have been described, little is known about differences in cortical thickness (CTh) as the disease advances. Our multi-site sample comprised 211 non-demented PD patients (64.45% males; mean age 65.58 ± 8.44 years old; mean disease duration 6.42 ± 5.11 years) and 86 healthy controls (50% males; mean age 65.49 ± 9.33 years old) with available T1-weighted 3 T MRI data from four international research centers. Sex differences in regional mean CTh estimations were analyzed using generalized linear models. The relation of CTh in regions showing sex differences with age, disease duration, and age of onset was examined through multiple linear regression. PD males showed thinner cortex than PD females in six frontal (bilateral caudal middle frontal, bilateral superior frontal, left precentral and right pars orbitalis), three parietal (bilateral inferior parietal and left supramarginal), and one limbic region (right posterior cingulate). In PD males, lower CTh values in nine out of ten regions were associated with longer disease duration and older age, whereas in PD females, lower CTh was associated with older age but with longer disease duration only in one region. Overall, male patients show a more widespread pattern of reduced CTh compared with female patients. Disease duration seems more relevant to explain reduced CTh in male patients, suggesting worse prognostic over time. Further studies should explore sex-specific cortical atrophy trajectories using large longitudinal multi-site data.
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Affiliation(s)
- Javier Oltra
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Faculty of Medicine, Clínic Campus, Carrer de Casanova, 143, Ala Nord, 5th floor, 08036, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Catalonia, Spain
| | - Barbara Segura
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Faculty of Medicine, Clínic Campus, Carrer de Casanova, 143, Ala Nord, 5th floor, 08036, Barcelona, Catalonia, Spain.
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Catalonia, Spain.
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Hospital Clínic Barcelona, Carrer de Villarroel, 170, 08036, Barcelona, Catalonia, Spain.
| | - Antonio P Strafella
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, 250 College St., M5T 1R8, Toronto, ON, Canada
- Edmond J. Safra Parkinson Disease Program, Neurology Division, Toronto Western Hospital & Krembil Brain Institute, University Health Network, University of Toronto, 399 Bathurst Street, M5T 2S8, Toronto, ON, Canada
| | - Thilo van Eimeren
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, University Medical Center Cologne, Kerpener Straße, 62, 50937, Cologne, Germany
- Department of Neurology, University Medical Center Cologne, Kerpener Straße, 62, 50937, Cologne, Germany
| | - Naroa Ibarretxe-Bilbao
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Basque Country, Spain
| | - Maria Diez-Cirarda
- Department of Neurology, Hospital Clínico San Carlos, Health Research Institute 'San Carlos' (IdISCC), Complutense University of Madrid, Calle del Profesor Martín Lagos, s/n, 28040, Madrid, Spain
| | - Carsten Eggers
- Department of Neurology, University Medical Center Cologne, Kerpener Straße, 62, 50937, Cologne, Germany
- Department of Neurology, University Hospital of Giessen and Marburg, Center for Mind, Brain and Behavior, University of Marburg and Giessen Universiy, Hans-Meerwein-Straße, 6, 35043, Marburg, Germany
| | - Olaia Lucas-Jiménez
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Basque Country, Spain
| | - Gemma C Monté-Rubio
- Centre for Comparative Medicine and Bioimaging (CMCiB), Gemans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 08916, Badalona, Catalonia, Spain
| | - Natalia Ojeda
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Basque Country, Spain
| | - Javier Peña
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Basque Country, Spain
| | - Marina C Ruppert
- Department of Neurology, University Hospital of Giessen and Marburg, Center for Mind, Brain and Behavior, University of Marburg and Giessen Universiy, Hans-Meerwein-Straße, 6, 35043, Marburg, Germany
| | - Roser Sala-Llonch
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Catalonia, Spain
- Department of Biomedicine, Institute of Neurosciences, University of Barcelona, Faculty of Medicine, Clínic Campus, Carrer de Casanova, 143, Ala Nord, 5th floor, 08036, Barcelona, Catalonia, Spain
- Biomedical Imaging Group, Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN: CB06/01/1039-ISCIII), Carrer de Casanova, 143, 08036, Barcelona, Catalonia, Spain
| | - Hendrik Theis
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, University Medical Center Cologne, Kerpener Straße, 62, 50937, Cologne, Germany
- Department of Neurology, University Medical Center Cologne, Kerpener Straße, 62, 50937, Cologne, Germany
| | - Carme Uribe
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, 250 College St., M5T 1R8, Toronto, ON, Canada
| | - Carme Junque
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Faculty of Medicine, Clínic Campus, Carrer de Casanova, 143, Ala Nord, 5th floor, 08036, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Hospital Clínic Barcelona, Carrer de Villarroel, 170, 08036, Barcelona, Catalonia, Spain
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D'Iorio A, Guida P, Maggi G, Redgrave P, Santangelo G, Obeso I. Neuropsychological spectrum in early PD: Insights from controlled and automatic behavioural regulation. Neurosci Biobehav Rev 2021; 126:465-480. [PMID: 33836213 DOI: 10.1016/j.neubiorev.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/05/2021] [Accepted: 04/02/2021] [Indexed: 11/15/2022]
Abstract
Initial changes in Parkinson's disease (PD) are marked by loss of automatic movements and decline of some cognitive functions. Yet, the exact profile and extent of cognitive impairments in early stages of PD as well as their mechanisms related to automatic motor dysfunction remain unclear. Our objective was to examine the neuropsychological changes in early PD and their association to automatic and controlled modes of behavioural control. Significant relationships between early PD and cognitive dysfunction in set-shifting, abstraction ability/concept formation, processing speed, visuospatial/constructional abilities and verbal-visual memory was found. We also noted that tests with a strong effortful and controlled component were similarly affected as automatic tests by early PD, particularly those testing verbal memory, processing speed and visuospatial/constructional functions. Our findings indicate that initial stages of PD sets constraints over most of the cognitive domains normally assessed and are not easily explained in terms of either automatic or controlled mechanisms, as both appear similarly altered in early PD.
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Affiliation(s)
- Alfonsina D'Iorio
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Pasqualina Guida
- HM CINAC. Centro Integral de Neurociencias AC. HM Hospitales CEU San Pablo University, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain
| | - Gianpaolo Maggi
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Peter Redgrave
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Gabriella Santangelo
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Ignacio Obeso
- HM CINAC. Centro Integral de Neurociencias AC. HM Hospitales CEU San Pablo University, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain.
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Gallagher J, Rick J, Xie SX, Martinez-Martin P, Mamikonyan E, Chen-Plotkin A, Dahodwala N, Morley J, Duda JE, Trojanowski JQ, Siderowf A, Weintraub D. Psychometric Properties of the Clinical Dementia Rating Scale Sum of Boxes in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 11:737-745. [PMID: 33386814 PMCID: PMC8058172 DOI: 10.3233/jpd-202390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND A composite measure that assesses both cognitive and functional abilities in Parkinson's disease (PD) would be useful for diagnosing mild cognitive impairment (MCI) and PD dementia (PDD) and as an outcome measure in randomized controlled trials. The Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) was designed to assess both cognition and basic-instrumental activities of daily living in Alzheimer's disease but has not yet been validated in PD. OBJECTIVE To validate the CDR-SOB as a composite cognitive-functional measure for PD patients, as well as to assess its sensitivity to change. METHODS The CDR-SOB and a comprehensive cognitive and functional battery was administered to 101 PD patients at baseline (39 normal cognition [NC], 41 MCI and 21 PDD by expert consensus panel), and re-administered to 64 patients after 1-2 years follow-up (32 NC and 32 cognitive impairment [CI] at baseline). RESULTS Cross-sectionally, CDR-SOB and domain scores were correlated with corresponding neuropsychological or functional measures and were significantly different between cognitive subgroups both at baseline and at follow-up. In addition, CDR-SOB ROC curves distinguished between normal cognition and dementia with high sensitivity, but did not distinguish well between NC and MCI. Longitudinal changes in the CDR-SOB and domain scores were not significant and were inconsistent in predicting change in commonly-used cognitive and functional tests. CONCLUSION The CDR-SOB detects dementia-level cognitive impairment in PD but may not be appropriate for predicting longitudinal combined cognitive-functional changes in patients without significant cognitive impairment at baseline.
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Affiliation(s)
- Julia Gallagher
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jacqueline Rick
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon X Xie
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Eugenia Mamikonyan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - James Morley
- Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veteran's Affairs Medical Center, Philadelphia, PA, USA
| | - John E Duda
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veteran's Affairs Medical Center, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew Siderowf
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Weintraub
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veteran's Affairs Medical Center, Philadelphia, PA, USA
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4
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Howard E, Irwin DJ, Rascovsky K, Nevler N, Shellikeri S, Tropea TF, Spindler M, Deik A, Chen-Plotkin A, Siderowf A, Dahodwala N, Weintraub D, Shaw LM, Trojanowski JQ, Vaishnavi SN, Wolk DA, Mechanic-Hamilton D, Morley JF, Duda JE, Grossman M, Cousins KAQ. Cognitive Profile and Markers of Alzheimer Disease-Type Pathology in Patients With Lewy Body Dementias. Neurology 2021; 96:e1855-e1864. [PMID: 33593865 PMCID: PMC8105963 DOI: 10.1212/wnl.0000000000011699] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/06/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To determine whether patients with Lewy body dementia (LBD) with likely Alzheimer disease (AD)-type copathology are more impaired on confrontation naming than those without likely AD-type copathology. METHODS We selected 57 patients with LBD (dementia with Lewy bodies [DLB], n = 38; Parkinson disease dementia [PDD], n = 19) with available AD CSF biomarkers and neuropsychological data. CSF β-amyloid1-42 (Aβ42), phosphorylated-tau (p-tau), and total-tau (t-tau) concentrations were measured. We used an autopsy-validated CSF cut point (t-tau:Aβ42 ratio > 0.3, n = 43), or autopsy data when available (n = 14), to categorize patients as having LBD with (LBD + AD, n = 26) and without (LBD - AD, n = 31) likely AD-type copathology. Analysis of covariance tested between-group comparisons across biologically defined groups (LBD + AD, LBD - AD) and clinical phenotypes (DLB, PDD) on confrontation naming (30-item Boston Naming Test [BNT]), executive abilities (letter fluency [LF], reverse digit span [RDS]), and global cognition (Mini-Mental State Examination [MMSE]), with adjustment for age at dementia onset, time from dementia onset to test date, and time from CSF to test date. Spearman correlation related cognitive performance to CSF analytes. RESULTS Patients with LBD + AD performed worse on BNT than patients with LBD - AD (F = 4.80, p = 0.03); both groups performed similarly on LF, RDS, and MMSE (all p > 0.1). Clinically defined PDD and DLB groups did not differ in performance on any of these measures (all p > 0.05). A correlation across all patients showed that BNT score was negatively associated with CSF t-tau (ρ = -0.28, p < 0.05) and p-tau (ρ = -0.26, p = 0.05) but not Aβ42 (p > 0.1). CONCLUSION Markers of AD-type copathology are implicated in impaired language performance in LBD. Biologically based classification of LBD may be advantageous over clinically defined syndromes to elucidate clinical heterogeneity.
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Affiliation(s)
- Erica Howard
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - David J Irwin
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Katya Rascovsky
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Naomi Nevler
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Sanjana Shellikeri
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Thomas F Tropea
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Meredith Spindler
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Andres Deik
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Alice Chen-Plotkin
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Andrew Siderowf
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Nabila Dahodwala
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Daniel Weintraub
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Leslie M Shaw
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - John Q Trojanowski
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Sanjeev N Vaishnavi
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - David A Wolk
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Dawn Mechanic-Hamilton
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - James F Morley
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - John E Duda
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Murray Grossman
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Katheryn A Q Cousins
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA.
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5
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Málišová E, Dančík D, Heretik A, Abrahámová M, Krakovská S, Brandoburová P, Hajdúk M. Slovak version of the Trail Making Test: Normative data. APPLIED NEUROPSYCHOLOGY. ADULT 2021; 29:1-8. [PMID: 33761301 DOI: 10.1080/23279095.2021.1890596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The Trail Making Test (TMT) is a popular measure of cognitive functioning, especially processing speed and cognitive flexibility. This study aims to provide normative data for the Slovak adult population. The secondary aim is to test the convergent validity by examining relationships of direct and derived indices to other neuropsychological measures. A sample of 487 healthy adults undertook neuropsychological testing. The relationships of TMT scores to demographic variables and other neuropsychological measures were tested. Age was positively correlated with TMT-A (r = 0.444, p < .01), TMT-B (r = 0.426, p < .01), and the B-A index (r = 0.317, p < .01). Years of education were negatively correlated with TMT-B (r = -0.183, p < .01), B-A difference (r = -0.188, p < .01) and B/A ratio (r = -0.119, p < .01). There were no statistically significant differences in performance based on gender. The test scores were correlated with other measures of processing speed and executive functions. Presented normative data are stratified into 7 age categories. For more accurate interpretation, regression equations were calculated to take years of education into account. TMT-A and B performance, as well as B-A difference score, must be interpreted in relation to age, while education can provide additional information. The B/A ratio is independent from age but should be also corrected for educational level.
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Affiliation(s)
- Eva Málišová
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
| | - Daniel Dančík
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
- The Centre for Psychiatric Disorders Research, Science Park, Comenius University, Bratislava, Slovakia
| | - Anton Heretik
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
- The Centre for Psychiatric Disorders Research, Science Park, Comenius University, Bratislava, Slovakia
| | - Miroslava Abrahámová
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
| | - Simona Krakovská
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
- The Memory Centre, Bratislava, Slovakia
| | | | - Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
- The Centre for Psychiatric Disorders Research, Science Park, Comenius University, Bratislava, Slovakia
- The Psychiatric Clinic, Faculty of Medicine, Comenius University, Bratislava, Slovakia
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6
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Resting-state EEG alpha/theta ratio related to neuropsychological test performance in Parkinson's Disease. Clin Neurophysiol 2021; 132:756-764. [PMID: 33571883 DOI: 10.1016/j.clinph.2021.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/23/2020] [Accepted: 01/06/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine possible associations of hemispheric-regional alpha/theta ratio (α/θ) with neuropsychological test performance in Parkinson's Disease (PD) non-demented patients. METHODS 36 PD were matched to 36 Healthy Controls (HC). The α/θ in eight hemispheric regions was computed from the relative power spectral density of the resting-state quantitative electroencephalogram (qEEG). Correlations between α/θ and performance in several neuropsychological tests were conducted, significant findings were included in a moderation analysis. RESULTS The α/θ in all regions was lower in PD than in HC, with larger effect sizes in the posterior regions. Right parietal, and right and left occipital α/θ had significant positive correlations with performance in Judgement of Line Orientation Test (JLOT) in PD. Adjusted moderation analysis indicated that right, but not left, occipital α/θ influenced the JLOT performance related to PD. CONCLUSIONS Reduction of the occipital α/θ, in particular on the right side, was associated with visuospatial performance impairment in PD. SIGNIFICANCE Visuospatial impairment in PD, which is highly correlated with the subsequent development of dementia, is reflected in α/θ in the right posterior regions. The right occipital α/θ may represent a useful qEEG marker for evaluating the presence of early signs of cognitive decline in PD and the subsequent risk of dementia.
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7
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Gryc W, Roberts KA, Zabetian CP, Weintraub D, Trojanowski JQ, Quinn JF, Hiller AL, Chung KA, Poston KL, Yang L, Hu SC, Edwards KL, Montine TJ, Cholerton BA. Hallucinations and Development of Dementia in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2020; 10:1643-1648. [PMID: 32741842 DOI: 10.3233/jpd-202116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Neuropsychiatric symptoms are common in Parkinson's disease (PD). We investigated the relationship between neuropsychiatric symptoms and current and future diagnosis of PD dementia (PDD). Individuals with PD who had a study partner were enrolled (n = 696). Study partners were administered the Neuropsychiatric Inventory or Neuropsychiatric Inventory Questionnaire at baseline. Participants were assigned a cognitive diagnosis at baseline and follow up visits. Hallucinations were significantly associated with a diagnosis of PDD cross-sectionally (p < 0.001) and with shortened time to dementia longitudinally among initially nondemented participants (n = 444; p = 0.005). Screening for hallucinations may be useful for assessing risk of dementia in participants with PD.
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Affiliation(s)
- Wojciech Gryc
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Kathryn A Roberts
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Cyrus P Zabetian
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Daniel Weintraub
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.,Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Institute on Aging, University of Pennsylvania, Philadelphia, PA
| | - Joseph F Quinn
- Portland Veterans Affairs Medical Center, Portland, OR, USA.,Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Amie L Hiller
- Portland Veterans Affairs Medical Center, Portland, OR, USA.,Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Kathryn A Chung
- Portland Veterans Affairs Medical Center, Portland, OR, USA.,Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Kathleen L Poston
- Department of Neurology and Neurological Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Laurice Yang
- Department of Neurology and Neurological Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Shu-Ching Hu
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Karen L Edwards
- Department of Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Thomas J Montine
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Brenna A Cholerton
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
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8
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Coughlin DG, Ittyerah R, Peterson C, Phillips JS, Miller S, Rascovsky K, Weintraub D, Siderowf AD, Duda JE, Hurtig HI, Wolk DA, McMillan CT, Yushkevich PA, Grossman M, Lee EB, Trojanowski JQ, Irwin DJ. Hippocampal subfield pathologic burden in Lewy body diseases vs. Alzheimer's disease. Neuropathol Appl Neurobiol 2020; 46:707-721. [PMID: 32892355 DOI: 10.1111/nan.12659] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/21/2020] [Accepted: 08/22/2020] [Indexed: 12/16/2022]
Abstract
AIMS Lewy body diseases (LBD) are characterized by alpha-synuclein (SYN) pathology, but comorbid Alzheimer's disease (AD) pathology is common and the relationship between these pathologies in microanatomic hippocampal subfields is understudied. Here we use digital histological methods to test the association between hippocampal SYN pathology and the distribution of tau and amyloid-beta (Aβ) pathology in LBD and contrast with AD subjects. We also correlate pathologic burden with antemortem episodic memory testing. METHODS Hippocampal sections from 49 autopsy-confirmed LBD cases, 30 with no/low AD copathology (LBD - AD) and 19 with moderate/severe AD copathology (LBD + AD), and 30 AD patients were stained for SYN, tau, and Aβ. Sections underwent digital histological analysis of subfield pathological burden which was correlated with antemortem memory testing. RESULTS LBD - AD and LBD + AD had similar severity and distribution of SYN pathology (P > 0.05), CA2/3 being the most affected subfield (P < 0.02). In LBD, SYN correlated with tau across subfields (R = 0.49, P < 0.001). Tau burden was higher in AD than LBD + AD (P < 0.001), CA1/subiculum and entorhinal cortex (ERC) being most affected regions (P = 0.04 to <0.01). However, tau pathology in LBD - AD was greatest in CA2/3, which was equivalent to LBD + AD. Aβ severity and distribution was similar between LBD + AD and AD. Total hippocampal tau and CA2/3 tau was inversely correlated with memory performance in LBD (R = -0.52, -0.69, P = 0.04, 0.009). CONCLUSIONS Our findings suggest that tau burden in hippocampal subfields may map closely with the distribution of SYN pathology in subfield CA2/3 in LBD diverging from traditional AD and contribute to episodic memory dysfunction in LBD.
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Affiliation(s)
- D G Coughlin
- Penn Digital Neuropathology Laboratory at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurosciences, University California San Diego, San Diego, CA, USA
| | - R Ittyerah
- Department of Radiology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - C Peterson
- Penn Digital Neuropathology Laboratory at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - J S Phillips
- Penn Digital Neuropathology Laboratory at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Frontotemporal Dementia Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - S Miller
- Penn Digital Neuropathology Laboratory at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - K Rascovsky
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Frontotemporal Dementia Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D Weintraub
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,LBDA Research Center of Excellence at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Michael J. Crescenz VA Medical Center, Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA, USA
| | - A D Siderowf
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,LBDA Research Center of Excellence at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - J E Duda
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,LBDA Research Center of Excellence at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Michael J. Crescenz VA Medical Center, Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA, USA
| | - H I Hurtig
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D A Wolk
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Alzheimer's disease Research Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - C T McMillan
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Frontotemporal Dementia Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - P A Yushkevich
- Department of Radiology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M Grossman
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Frontotemporal Dementia Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - E B Lee
- Department of Pathology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Center for Neurodegenerative Disease Research at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - J Q Trojanowski
- Department of Pathology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Center for Neurodegenerative Disease Research at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D J Irwin
- Penn Digital Neuropathology Laboratory at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Frontotemporal Dementia Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,LBDA Research Center of Excellence at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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9
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Coughlin DG, Phillips JS, Roll E, Peterson C, Lobrovich R, Rascovsky K, Ungrady M, Wolk DA, Das S, Weintraub D, Lee EB, Trojanowski JQ, Shaw LM, Vaishnavi S, Siderowf A, Nasrallah IM, Irwin DJ, McMillan CT. Multimodal in vivo and postmortem assessments of tau in Lewy body disorders. Neurobiol Aging 2020; 96:137-147. [PMID: 33002767 DOI: 10.1016/j.neurobiolaging.2020.08.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022]
Abstract
We compared regional retention of 18F-flortaucipir between 20 patients with Lewy body disorders (LBD), 12 Alzheimer's disease patients with positive amyloid positron emission tomography (PET) scans (AD+Aβ) and 15 healthy controls with negative amyloid PET scans (HC-Aβ). In LBD subjects, we compared the relationship between 18F-flortaucipir retention and cerebrospinal fluid (CSF) tau, cognitive performance, and neuropathological tau at autopsy. The LBD cohort was stratified using an Aβ42 cut-off of 192 pg/mL to enrich for groups likely harboring tau pathology (LBD+Aβ = 11, LBD-Aβ = 9). 18F-flortaucipir retention was higher in LBD+AB than HC-Aβ in five, largely temporal-parietal regions with sparing of medial temporal regions. Higher retention was associated with higher CSF total-tau levels (p = 0.04), poorer domain-specific cognitive performance (p = 0.02-0.04), and greater severity of neuropathological tau in corresponding regions. While 18F-flortaucipir retention in LBD is intermediate between healthy controls and AD, retention relates to cognitive impairment, CSF total-tau, and neuropathological tau. Future work in larger autopsy-validated cohorts is needed to define LBD-specific tau biomarker profiles.
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Affiliation(s)
- David G Coughlin
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Digital Neuropathology Laboratory, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Lewy Body Disease Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jeffrey S Phillips
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Frontotemporal Degeneration Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Emily Roll
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Frontotemporal Degeneration Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Claire Peterson
- Digital Neuropathology Laboratory, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca Lobrovich
- Digital Neuropathology Laboratory, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Katya Rascovsky
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Frontotemporal Degeneration Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Molly Ungrady
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Frontotemporal Degeneration Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - David A Wolk
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Alzheimer's Disease Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Sandhitsu Das
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Alzheimer's Disease Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Weintraub
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Michael J. Crescenz VA Medical Center, Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA, USA
| | - Edward B Lee
- Alzheimer's Disease Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Alzheimer's Disease Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Center for Neurodegenerative Disease Research, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Leslie M Shaw
- Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Sanjeev Vaishnavi
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Lewy Body Disease Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew Siderowf
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Lewy Body Disease Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Ilya M Nasrallah
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - David J Irwin
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Digital Neuropathology Laboratory, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Lewy Body Disease Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Frontotemporal Degeneration Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Corey T McMillan
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA; Frontotemporal Degeneration Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
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10
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Purri R, Brennan L, Rick J, Xie SX, Deck BL, Chahine LM, Dahodwala N, Chen-Plotkin A, Duda JE, Morley JF, Akhtar RS, Trojanowski JQ, Siderowf A, Weintraub D. Subjective Cognitive Complaint in Parkinson's Disease Patients With Normal Cognition: Canary in the Coal Mine? Mov Disord 2020; 35:1618-1625. [PMID: 32520435 DOI: 10.1002/mds.28115] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine the frequency and impact of subjective cognitive complaint (SCC) in Parkinson's disease (PD) patients with normal cognition. METHODS Patients with PD with expert consensus-determined normal cognition at baseline were asked a single question regarding the presence of SCC. Baseline (N = 153) and longitudinal (up to 4 follow-up visits during a 5-year period; N = 121) between-group differences in patients with PD with (+SCC) and without (-SCC) cognitive complaint were examined, including cognitive test performance and self-rated and informant-rated functional abilities. RESULTS A total of 81 (53%) participants reported a cognitive complaint. There were no between-group differences in global cognition at baseline. Longitudinally, the +SCC group declined more than the -SCC group on global cognition (Mattis Dementia Rating Scale-2 total score, F1,431 = 5.71, P = 0.02), processing speed (Symbol Digit Modalities Test, F1,425 = 7.52, P = 0.006), and executive function (Trail Making Test Part B, F1,419 = 4.48, P = 0.04), although the results were not significant after correction for multiple testing. In addition, the +SCC group was more likely to progress to a diagnosis of cognitive impairment over time (hazard ratio = 2.61, P = 0.02). The +SCC group also demonstrated significantly lower self-reported and knowledgeable informant-reported cognition-related functional abilities at baseline, and declined more on an assessment of global functional abilities longitudinally. CONCLUSIONS Patients with PD with normal cognition, but with SCC, report poorer cognition-specific functional abilities, and are more likely to be diagnosed with cognitive impairment and experience global functional ability decline long term. These findings suggest that SCC and worse cognition-related functional abilities may be sensitive indicators of initial cognitive decline in PD. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Rachael Purri
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Laura Brennan
- Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Jacqueline Rick
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Sharon X Xie
- Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Benjamin L Deck
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Lana M Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nabila Dahodwala
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Alice Chen-Plotkin
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - John E Duda
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.,Parkinson's Disease Research, Education, and Clinical Center, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - James F Morley
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.,Parkinson's Disease Research, Education, and Clinical Center, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Rizwan S Akhtar
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Andrew Siderowf
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Daniel Weintraub
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.,Parkinson's Disease Research, Education, and Clinical Center, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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11
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Auclair-Ouellet N, Mandl S, Kibreab M, Haffenden A, Hanganu A, Cheetham J, Kathol I, Sarna J, Martino D, Monchi O. Characterization of cognition in mild cognitive impairment with and without Parkinson's disease. Clin Park Relat Disord 2020; 3:100034. [PMID: 34316620 PMCID: PMC8298772 DOI: 10.1016/j.prdoa.2020.100034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/03/2019] [Accepted: 12/09/2019] [Indexed: 11/24/2022] Open
Abstract
Screening tests can diagnose PD-MCI but do not give detailed cognitive profiles. Criteria based on a complete neuropsychological battery identify more PD patients with MCI. The overall cognitive profile is similar in PD-MCI and MCI. Neuropsychological batteries and definition of impairment cut-offs should be refined.
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Affiliation(s)
- N Auclair-Ouellet
- School of Communication Sciences and Disorders, Faculty of Medicine, McGill University, Montreal, Canada.,Centre for Research on Brain, Language and Music, Montreal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Canada
| | - S Mandl
- Centre for Research on Brain, Language and Music, Montreal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Canada.,Cognitive Science Program, Faculty of Arts and Faculty of Science, McGill University, Montreal, Canada
| | - M Kibreab
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - A Haffenden
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - A Hanganu
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Canada.,Département de Psychologie, Faculté des Arts et des Sciences, Université de Montréal, Montreal, Canada
| | - J Cheetham
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - I Kathol
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - J Sarna
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - D Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - O Monchi
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.,Département de Radiologie, Faculté de Médecine, Université de Montréal, Montreal, Canada
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12
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Hoogland J, Boel JA, de Bie RMA, Schmand BA, Geskus RB, Dalrymple-Alford JC, Marras C, Adler CH, Weintraub D, Junque C, Pedersen KF, Mollenhauer B, Goldman JG, Tröster AI, Burn DJ, Litvan I, Geurtsen GJ. Risk of Parkinson's disease dementia related to level I MDS PD-MCI. Mov Disord 2019; 34:430-435. [PMID: 30653248 DOI: 10.1002/mds.27617] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/18/2018] [Accepted: 12/23/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The International Parkinson and Movement Disorders Society criteria for mild cognitive impairment in PD need validation. The objectives of this present study were to evaluate prognostic validity of level I (abbreviated) International Parkinson and Movement Disorders Society mild cognitive impairment in PD criteria for development of PD dementia and compared them with level II (comprehensive) criteria. METHODS We analyzed data from 8 international studies (1045 patients) from our consortium that included baseline data on demographics, motor signs, depression, detailed neuropsychological testing, and longitudinal follow-up for conversion to Parkinson's disease dementia. Survival analysis evaluated their contribution to the hazard of Parkinson's disease dementia. RESULTS Level I mild cognitive impairment in PD, increasing age, male sex, and severity of PD motor signs independently increased the hazard of Parkinson's disease dementia. Level I and level II mild cognitive impairment in PD classification had similar discriminative ability with respect to the time to Parkinson's disease dementia. CONCLUSIONS Level I mild cognitive impairment in PD classification independently contributes to the hazard of Parkinson's disease dementia. This finding supports the prognostic validity of the abbreviated mild cognitive impairment in PD criteria. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jeroen Hoogland
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Judith A Boel
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Rob M A de Bie
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ben A Schmand
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.,Department of Medical Psychology, Academic Medical Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ronald B Geskus
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - John C Dalrymple-Alford
- New Zealand Brain Research Institute, Brain Research New Zealand - Rangahau Roro Aotearoa, Christchurch, New Zealand
| | - Connie Marras
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Ontario, Canada
| | - Charles H Adler
- Arizona Parkinson's Disease Consortium, Mayo Clinic Arizona, Scottsdale, Arizona, USA, and Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, University of Pennsylvania School of Medicine, and Parkinson's Disease and Mental Illness Research, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Carmen Junque
- Department of Medicine, Faculty of Medicine, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Kenn F Pedersen
- The Norwegian Centre for Movement Disorders, Department of Neurology, and Memory Clinic, Stavanger University Hospital, Stavanger, Norway
| | - Brit Mollenhauer
- Department of Neurosurgery and Institute of Neuropathology, Paracelsus-Elena-Klinik, Kassel, Germany, and University Medical Center Goettingen, Goettingen, Germany
| | - Jennifer G Goldman
- Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, Illinois, USA
| | - Alexander I Tröster
- Department of Clinical Neuropsychology and Center for Neuromodulation, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - David J Burn
- Institute of Neuroscience, Newcastle University, Upon Tyne, Newcastle, UK
| | - Irene Litvan
- Department of Neurosciences University of California San Diego, Parkinson and Other Movement Disorder Center, San Diego, California, USA
| | - Gert J Geurtsen
- Department of Medical Psychology, Academic Medical Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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13
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Coughlin D, Xie SX, Liang M, Williams A, Peterson C, Weintraub D, McMillan CT, Wolk DA, Akhtar RS, Hurtig HI, Branch Coslett H, Hamilton RH, Siderowf AD, Duda JE, Rascovsky K, Lee EB, Lee VMY, Grossman M, Trojanowski JQ, Irwin DJ. Cognitive and Pathological Influences of Tau Pathology in Lewy Body Disorders. Ann Neurol 2019; 85:259-271. [PMID: 30549331 DOI: 10.1002/ana.25392] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To use digital histology in a large autopsy cohort of Lewy body disorder (LBD) patients with dementia to test the hypotheses that co-occurring Alzheimer disease (AD) pathology impacts the anatomic distribution of α-synuclein (SYN) pathology and that co-occurring neocortical tau pathology in LBDs associates with worse cognitive performance and occurs in a pattern differing from AD. METHODS Fifty-five autopsy-confirmed LBD (Parkinson disease with dementia, n = 36; dementia with Lewy bodies, n = 19) patients and 25 AD patients were studied. LBD patients were categorized as having moderate/severe AD copathology (SYN + AD = 20) or little/no AD copathology (SYN-AD = 35). Digital measures of tau, β-amyloid (Aβ), and SYN histopathology in neocortical and subcortical/limbic regions were compared between groups and related to antemortem cognitive testing. RESULTS SYN burden was higher in SYN + AD than SYN-AD in each neocortical region (F1, 54 = 5.6-6.0, p < 0.02) but was equivalent in entorhinal cortex and putamen (F1, 43-49 = 0.7-1.7, p > 0.2). SYN + AD performed worse than SYN-AD on a temporal lobe-mediated naming task (t27 = 2.1, p = 0.04). Antemortem cognitive test scores inversely correlated with tau burden (r = -0.39 to -0.68, p < 0.05). AD had higher tau than SYN + AD in all regions (F1, 43 = 12.8-97.2, p < 0.001); however, SYN + AD had a greater proportion of tau in the temporal neocortex than AD (t41 = 2.0, p < 0.05), whereas AD had a greater proportion of tau in the frontal neocortex than SYN + AD (t41 = 3.3, p < 0.002). SYN + AD had similar severity and distribution of neocortical Aβ compared to AD (F1, 40-43 = 1.6-2.0, p > 0.1). INTERPRETATION LBD patients with AD copathology harbor greater neocortical SYN pathology. Regional tau pathology relates to cognitive performance in LBD dementia, and its distribution may diverge from pure AD. Tau copathology contributes uniquely to the heterogeneity of cognitive impairment in LBD. Ann Neurol 2018; 1-13 ANN NEUROL 2019;85:259-271.
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Affiliation(s)
- David Coughlin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Digital Neuropathology Laboratory, Perelman School of Medicine at the University of Pennsylvania.,Frontotemporal Dementia Center, Perelman School of Medicine at the University of Pennsylvania.,Parkinson's Disease and Movement Disorders Center, Perelman School of Medicine at the University of Pennsylvania
| | - Sharon X Xie
- Alzheimer's Disease Center, Perelman School of Medicine at the University of Pennsylvania.,Department of Biostatistics, Epidemiology and Informatics Perelman School of Medicine at the University of Pennsylvania
| | - Mendy Liang
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Digital Neuropathology Laboratory, Perelman School of Medicine at the University of Pennsylvania
| | - Andrew Williams
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Digital Neuropathology Laboratory, Perelman School of Medicine at the University of Pennsylvania
| | - Claire Peterson
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Digital Neuropathology Laboratory, Perelman School of Medicine at the University of Pennsylvania
| | - Daniel Weintraub
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Parkinson's Disease and Movement Disorders Center, Perelman School of Medicine at the University of Pennsylvania.,Michael J. Crescenz VA Medical Center, Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA, USA 19104
| | - Corey T McMillan
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Frontotemporal Dementia Center, Perelman School of Medicine at the University of Pennsylvania
| | - David A Wolk
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Alzheimer's Disease Center, Perelman School of Medicine at the University of Pennsylvania
| | - Rizwan S Akhtar
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Parkinson's Disease and Movement Disorders Center, Perelman School of Medicine at the University of Pennsylvania
| | - Howard I Hurtig
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Parkinson's Disease and Movement Disorders Center, Perelman School of Medicine at the University of Pennsylvania
| | - H Branch Coslett
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Center for Cognitive Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Roy H Hamilton
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Center for Cognitive Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Andrew D Siderowf
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Parkinson's Disease and Movement Disorders Center, Perelman School of Medicine at the University of Pennsylvania
| | - John E Duda
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Michael J. Crescenz VA Medical Center, Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA, USA 19104
| | - Katya Rascovsky
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Frontotemporal Dementia Center, Perelman School of Medicine at the University of Pennsylvania
| | - Edward B Lee
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania.,Center for Neurodegenerative Disease Research, Perelman School of Medicine at the University of Pennsylvania.,Alzheimer's Disease Center, Perelman School of Medicine at the University of Pennsylvania
| | - Virginia M-Y Lee
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania.,Center for Neurodegenerative Disease Research, Perelman School of Medicine at the University of Pennsylvania.,Alzheimer's Disease Center, Perelman School of Medicine at the University of Pennsylvania
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Frontotemporal Dementia Center, Perelman School of Medicine at the University of Pennsylvania
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania.,Center for Neurodegenerative Disease Research, Perelman School of Medicine at the University of Pennsylvania.,Alzheimer's Disease Center, Perelman School of Medicine at the University of Pennsylvania
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania.,Digital Neuropathology Laboratory, Perelman School of Medicine at the University of Pennsylvania.,Frontotemporal Dementia Center, Perelman School of Medicine at the University of Pennsylvania
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14
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Das T, Hwang JJ, Poston KL. Episodic recognition memory and the hippocampus in Parkinson's disease: A review. Cortex 2018; 113:191-209. [PMID: 30660957 DOI: 10.1016/j.cortex.2018.11.021] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 10/02/2018] [Accepted: 11/15/2018] [Indexed: 01/09/2023]
Abstract
Parkinson's disease is a progressive neurodegenerative disorder of aging. The hallmark pathophysiology includes the development of neuronal Lewy bodies in the substantia nigra of the midbrain with subsequent loss of dopaminergic neurons. These neuronal losses lead to the characteristic motor symptoms of bradykinesia, rigidity, and rest tremor. In addition to these cardinal motor symptoms patients with PD experience a wide range of non-motor symptoms, the most important being cognitive impairments that in many circumstances lead to dementia. People with PD experience a wide range of cognitive impairments; in this review we will focus on memory impairment in PD and specifically episodic memory, which are memories of day-to-day events of life. Importantly, these memory impairments severely impact the lives of patients and caregivers alike. Traditionally episodic memory is considered to be markedly dependent on the hippocampus; therefore, it is important to understand the exact nature of PD episodic memory deficits in relation to hippocampal function and dysfunction. In this review, we discuss an aspect of episodic memory called recognition memory and its subcomponents called recollection and familiarity. Recognition memory is believed to be impaired in PD; thus, we discuss what aspects of the hippocampus are expected to be deficient in function as they relate to these recognition memory impairments. In addition to the hippocampus as a whole, we will discuss the role of hippocampal subfields in recognition memory impairments.
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Affiliation(s)
- Tanusree Das
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Jaclyn J Hwang
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA; Department of Neuroscience, University of Pittsburgh, USA.
| | - Kathleen L Poston
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
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15
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Hoogland J, van Wanrooij LL, Boel JA, Goldman JG, Stebbins GT, Dalrymple-Alford JC, Marras C, Adler CH, Junque C, Pedersen KF, Mollenhauer B, Zabetian CP, Eslinger PJ, Lewis SJG, Wu RM, Klein M, Rodriguez-Oroz MC, Cammisuli DM, Barone P, Biundo R, de Bie RMA, Schmand BA, Tröster AI, Burn DJ, Litvan I, Filoteo JV, Geurtsen GJ, Weintraub D. Detecting Mild Cognitive Deficits in Parkinson's Disease: Comparison of Neuropsychological Tests. Mov Disord 2018; 33:1750-1759. [PMID: 30216541 DOI: 10.1002/mds.110] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/11/2018] [Accepted: 06/25/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Numerous neuropsychological tests and test versions are used in Parkinson's disease research, but their relative capacity to detect mild cognitive deficits and their comparability across studies are unknown. The objective of this study was to identify neuropsychological tests that consistently detect cognitive decline in PD across studies. METHODS Data from 30 normed neuropsychological tests across 20 international studies in up to 2908 nondemented PD patients were analyzed. A subset of 17 tests was administered to up to 1247 healthy controls. A 2-step meta-analytic approach using standardized scores compared performance in PD with normative data. RESULTS Pooled estimates of the differences between PD and site-specific healthy controls identified significant cognitive deficits in PD patients on 14 test scores across 5 commonly assessed cognitive domains (attention or working memory, executive, language, memory, and visuospatial abilities), but healthy control performance was statistically above average on 7 of these tests. Analyses based on published norms only, as opposed to direct assessment of healthy controls, showed high between-study variability that could not be accounted for and led to inconclusive results. CONCLUSIONS Normed neuropsychological tests across multiple cognitive domains consistently detect cognitive deficits in PD when compared with site-specific healthy control performance, but relative PD performance was significantly affected by the inclusion and type of healthy controls versus the use of published norms only. Additional research is needed to identify a cognitive battery that can be administered in multisite international studies and that is sensitive to cognitive decline, responsive to therapeutic interventions, and superior to individual cognitive tests. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jeroen Hoogland
- Department of Neurology, Academic Medical Center Amsterdam, The Netherlands
| | | | - Judith A Boel
- Department of Neurology, Academic Medical Center Amsterdam, The Netherlands
| | - Jennifer G Goldman
- Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, Illinois, USA
| | - Glenn T Stebbins
- Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, Illinois, USA
| | - John C Dalrymple-Alford
- New Zealand Brain Research Institute, Brain Research New Zealand - Rangahau Roro Aotearoa, Christchurch, New Zealand
| | - Connie Marras
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J Safra Program in Parkinson's disease, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Charles H Adler
- Arizona Parkinson's Disease Consortium, Mayo Clinic Arizona, Scottsdale, Arizona, USA and Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Carme Junque
- Department of Medicine, Faculty of Medicine, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Kenn F Pedersen
- The Norwegian Centre for Movement Disorders, Department of Neurology, and Memory Clinic, Stavanger University Hospital, Stavanger, Norway
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel, Germany, and University Medical Center Goettingen, Department of Neurology, Goettingen, Germany
| | - Cyrus P Zabetian
- VA Puget Sound Health Care System and Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Paul J Eslinger
- Department of Neurology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Simon J G Lewis
- Brain & Mind Centre, The University of Sydney, Sydney, Australia
| | - Ruey-Meei Wu
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Martin Klein
- Department of Medical Psychology, section Medical Neuropsychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Maria C Rodriguez-Oroz
- Department of Neurology, Hospital Donostia, Donostia, San Sebastian and Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Davide M Cammisuli
- Fifth Local Sanitary Unit, Hospital Psychology, Pisa, Italy and Department of Surgical, Medical, Molecular, and Critical Area Pathology, Pisa University School of Medicine, Pisa, Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases (CEMAND) Neuroscience Section, Department of Medicine University of Salerno, Salerno, Italy
| | | | - Rob M A de Bie
- Department of Neurology, Academic Medical Center Amsterdam, The Netherlands
| | - Ben A Schmand
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.,Department of Psychology, University of Amsterdam, The Netherlands
| | - Alexander I Tröster
- Department of Clinical Neuropsychology and Center for Neuromodulation, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - David J Burn
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Irene Litvan
- Department of Neurosciences University of California San Diego, Parkinson and Other Movement Disorders Center, San Diego, California, USA
| | - J Vincent Filoteo
- Department of Neurosciences University of California San Diego, Parkinson and Other Movement Disorders Center, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, and VA San Diego Healthcare System, San Diego, California, USA
| | - Gert J Geurtsen
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, University of Pennsylvania School of Medicine, and Parkinson's Disease and Mental Illness Research, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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Getz SJ, Levin B. Cognitive and Neuropsychiatric Features of Early Parkinson's Disease. Arch Clin Neuropsychol 2018; 32:769-785. [PMID: 29077803 DOI: 10.1093/arclin/acx091] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/05/2017] [Indexed: 12/31/2022] Open
Abstract
The clinical definition of Parkinson's disease (PD) is based on cardinal motor features including bradykinesia as well as an additional symptom of tremor, postural instability, or rigidity. Evidence from neuropathological, imaging, and clinical research suggests a premotor, early phase of PD pathology. Further understanding of the earliest biomarkers of PD is crucial for the development of neuroprotective, disease modifying, cognitive, and psychiatric interventions. Recent research has explored early non-motor markers of PD pathology. This issue is especially timely as the International Parkinson and Movement Disorder Society has recently provided a research definition for prodromal PD which includes combinations of prodromal markers and risk factors aimed at identifying target populations for disease-prevention trials. In this review of early PD, we will outline early non-motor symptoms, early cognitive and neuropsychiatric features, neuropsychological assessment strategies, emerging evidence for early biomarkers, and treatment recommendations.
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Affiliation(s)
- Sarah J Getz
- Department of Neurology, Division of Neuropsychology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bonnie Levin
- Department of Neurology, Division of Neuropsychology, University of Miami Miller School of Medicine, Miami, FL, USA
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17
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de Roos P, Bloem BR, Kelley TA, Antonini A, Dodel R, Hagell P, Marras C, Martinez-Martin P, Mehta SH, Odin P, Chaudhuri KR, Weintraub D, Wilson B, Uitti RJ. A Consensus Set of Outcomes for Parkinson's Disease from the International Consortium for Health Outcomes Measurement. JOURNAL OF PARKINSONS DISEASE 2018; 7:533-543. [PMID: 28671140 PMCID: PMC5685544 DOI: 10.3233/jpd-161055] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is a progressive neurodegenerative condition that is expected to double in prevalence due to demographic shifts. Value-based healthcare is a proposed strategy to improve outcomes and decrease costs. To move towards an actual value-based health care system, condition-specific outcomes that are meaningful to patients are essential. OBJECTIVE Propose a global consensus standard set of outcome measures for PD. METHODS Established methods for outcome measure development were applied, as outlined and used previously by the International Consortium for Health Outcomes Measurement (ICHOM). An international group, representing both patients and experts from the fields of neurology, psychiatry, nursing, and existing outcome measurement efforts, was convened. The group participated in six teleconferences over a six-month period, reviewed existing data and practices, and ultimately proposed a standard set of measures by which patients should be tracked, and how often data should be collected. RESULTS The standard set applies to all cases of idiopathic PD, and includes assessments of motor and non-motor symptoms, ability to work, PD-related health status, and hospital admissions. Baseline demographic and clinical variables are included to enable case mix adjustment. CONCLUSIONS The Standard Set is now ready for use and pilot testing in the clinical setting. Ultimately, we believe that using the set of outcomes proposed here will allow clinicians and scientists across the world to document, report, and compare PD-related outcomes in a standardized fashion. Such international benchmarks will improve our understanding of the disease course and allow for identification of 'best practices', ultimately leading to better informed treatment decisions.
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Affiliation(s)
- Paul de Roos
- Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.,International Consortium for Health Outcomes Measurement, Cambridge, USA
| | - Bastiaan R Bloem
- Radboud University Medical Center; Donders Institute for Brain, Cognition and Behavior; Department of Neurology, Nijmegen, The Netherlands
| | - Thomas A Kelley
- International Consortium for Health Outcomes Measurement, Cambridge, USA
| | - Angelo Antonini
- Department of Neuroscience (DNS), Padova University, Padova, Italy; Fondazione Ospedale San Camillo-I.R.C.C.S., Parkinson and Movement Disorders Unit, Venice, Italy
| | | | - Peter Hagell
- The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Connie Marras
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, University of Toronto, Toronto, Canada
| | - Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
| | | | - Per Odin
- Skåne University Hospital, Lund, Sweden
| | | | - Daniel Weintraub
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.,Philadelphia Veterans Affairs Medical Center, Philadelphia, USA
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18
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Vavougios GD, Doskas T, Kormas C, Krogfelt KA, Zarogiannis SG, Stefanis L. Identification of a prospective early motor progression cluster of Parkinson's disease: Data from the PPMI study. J Neurol Sci 2018; 387:103-108. [DOI: 10.1016/j.jns.2018.01.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 10/25/2017] [Accepted: 01/22/2018] [Indexed: 12/15/2022]
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Fleisher JE, Dahodwala NA, Xie SX, Mayo M, Weintraub D, Chodosh J, Shea JA. Development and Validation of the Parkinson's Disease Medication Beliefs Scale (PD-Rx). JOURNAL OF PARKINSONS DISEASE 2017; 6:383-92. [PMID: 27061070 DOI: 10.3233/jpd-150765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Medication non-adherence is common in Parkinson's disease (PD) and is associated with increased disability and healthcare costs. Individuals' beliefs regarding their medical conditions and treatments impact medication adherence. While instruments exist to measure patients' beliefs about medications in general, no such tool exists for PD. OBJECTIVES Create an instrument eliciting medication beliefs of persons with PD; identify demographic and clinical characteristics associated with beliefs; and examine whether beliefs are associated with dopaminergic therapy adherence. METHODS We developed the Parkinson's Disease Medication Beliefs Scale (PD-Rx) in four phases: focus groups of patients and caregivers to generate items, scale development, expert and patient revision of items, and a cross-sectional validation sample (n = 75). Adherence was calculated using two approaches incorporating self-reported medication lists. RESULTS The PD-Rx consists of 11 items covering benefits and risks of PD pharmacotherapies. The scale covers motor improvement, current adverse effects, and future concerns. Higher scores indicate more positive beliefs. Internal consistency was acceptable (Cronbach's alpha = 0.67). Test-retest reliability was 0.47. Quality of life was associated with PD-Rx scores, and lower scores were associated with non-adherence. CONCLUSIONS Negative beliefs about PD treatments are associated with lower quality of life and may be related to medication non-adherence. Further study of any causal relationship between beliefs and medication non-adherence in PD will inform the design of future patient-centered interventions to improve adherence.
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Affiliation(s)
- Jori E Fleisher
- The Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, New York University School of Medicine, Departments of Neurology and Population Health, New York, NY, USA
| | - Nabila A Dahodwala
- University of Pennsylvania Perelman School of Medicine, Department of Neurology, Philadelphia, PA, USA
| | - Sharon X Xie
- University of Pennsylvania Perelman School of Medicine, Department of Biostatistics and Epidemiology., Philadelphia, PA, USA
| | - Mark Mayo
- University of Pennsylvania Perelman School of Medicine, Department of Neurology, Philadelphia, PA, USA
| | - Daniel Weintraub
- University of Pennsylvania Perelman School of Medicine, Department of Neurology, Philadelphia, PA, USA
| | - Joshua Chodosh
- New York University School of Medicine, Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York, NY, USA
| | - Judy A Shea
- University of Pennsylvania Perelman School of Medicine, Department of Medicine, Philadelphia, PA, USA
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20
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Madhyastha TM, Askren MK, Boord P, Zhang J, Leverenz JB, Grabowski TJ. Cerebral perfusion and cortical thickness indicate cortical involvement in mild Parkinson's disease. Mov Disord 2015; 30:1893-900. [PMID: 25759166 PMCID: PMC4567553 DOI: 10.1002/mds.26128] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/28/2014] [Accepted: 11/20/2014] [Indexed: 12/22/2022] Open
Abstract
Cortical dysfunction in Parkinson's disease (PD) may be caused by disruption to ascending systems or by intrinsic cortical neuropathology. We introduce and conduct a joint analysis of metabolism and atrophy capable of identifying whether metabolic disruption occurs in mild PD without cortical atrophy, to determine the extent and spatial pattern of cortical involvement in mild PD. The design was observational, studying 23 cognitively normal participants with mild PD (mean Hoehn & Yahr stage 2) and 21 healthy controls. Cortical thickness (obtained from analysis of structural magnetic resonance imaging [MRI] with FreeSurfer) and cerebral perfusion measures (obtained from arterial spin labeling [ASL]) analyzed independently and then together in a joint multiple factorial analysis to identify spatial patterns of perfusion and cortical thickness. We identify a pattern of changes in perfusion and cortical thickness characterized by symmetric parietal cortical thinning and reduced precuneus perfusion, with relative preservation of thickness and perfusion in the anterior cingulate cortex (ACC), right prefrontal gyrus, and medial frontal gyrus. The expression of this pattern is correlated with motor system symptoms and speed of processing. A spatial pattern of joint parietal cortical thinning and disproportionate reduction in perfusion occurs in our nondemented PD sample. We found no PD-related components of reduced perfusion without cortical thinning. This suggests that PD affects the cortex itself, even when symptoms are relatively mild.
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Affiliation(s)
| | - Mary K Askren
- Department of Radiology, University of Washington, Seattle, USA
| | - Peter Boord
- Department of Radiology, University of Washington, Seattle, USA
| | - Jing Zhang
- Department of Pathology, University of Washington, Seattle, USA
| | - James B Leverenz
- Cleveland Lou Ruvo Center for Brain Health at Cleveland Clinic, Cleveland, Ohio, USA
| | - Thomas J Grabowski
- Department of Radiology, University of Washington, Seattle, USA
- Department of Neurology, University of Washington, Seattle, USA
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22
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Pigott K, Rick J, Xie SX, Hurtig H, Chen-Plotkin A, Duda JE, Morley JF, Chahine LM, Dahodwala N, Akhtar RS, Siderowf A, Trojanowski JQ, Weintraub D. Longitudinal study of normal cognition in Parkinson disease. Neurology 2015; 85:1276-82. [PMID: 26362285 DOI: 10.1212/wnl.0000000000002001] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 05/07/2015] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To report the rates and predictors of progression from normal cognition to either mild cognitive impairment (MCI) or dementia using standardized neuropsychological methods. METHODS A prospective cohort of patients diagnosed with Parkinson disease (PD) and baseline normal cognition was assessed for cognitive decline, performance, and function for a minimum of 2 years, and up to 6. A panel of movement disorders experts classified patients as having normal cognition, MCI, or dementia, with 55/68 (80.9%) of eligible patients seen at year 6. Kaplan-Meier curves and Cox proportional hazard models were used to examine cognitive decline and its predictors. RESULTS We enrolled 141 patients, who averaged 68.8 years of age, 63% men, who had PD on average for 5 years. The cumulative incidence of cognitive impairment was 8.5% at year 1, increasing to 47.4% by year 6. All incident MCI cases had progressed to dementia by year 5. In a multivariate analysis, predictors of future decline were male sex (p = 0.02), higher Unified Parkinson's Disease Rating Scale motor score (p ≤ 0.001), and worse global cognitive score (p < 0.001). CONCLUSIONS Approximately half of patients with PD with normal cognition at baseline develop cognitive impairment within 6 years and all new MCI cases progress to dementia within 5 years. Our results show that the transition from normal cognition to cognitive impairment, including dementia, occurs frequently and quickly. Certain clinical and cognitive variables may be useful in predicting progression to cognitive impairment in PD.
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Affiliation(s)
- Kara Pigott
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Jacqueline Rick
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Sharon X Xie
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Howard Hurtig
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Alice Chen-Plotkin
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - John E Duda
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - James F Morley
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Lama M Chahine
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Nabila Dahodwala
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Rizwan S Akhtar
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Andrew Siderowf
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - John Q Trojanowski
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Daniel Weintraub
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA.
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Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease. Parkinsonism Relat Disord 2015; 21:692-7. [PMID: 25943529 DOI: 10.1016/j.parkreldis.2015.04.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 03/26/2015] [Accepted: 04/07/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Research suggests an association between global cognition and postural instability/gait disturbance (PIGD) in Parkinson disease (PD), but the relationship between specific cognitive domains and PIGD symptoms is not clear. This study examined the association of cognition (global and specific cognitive domains) with PIGD symptoms in a large, well-characterized sample of individuals with PD. METHODS Cognitive function was measured with a detailed neuropsychological assessment, including global cognition, executive function, memory, visuospatial function, and language. PIGD symptoms were measured using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III, Motor Examination subscale. Multiple linear regression analyses were performed to assess the relationship between cognition and PIGD symptoms with models adjusting for age, sex, education, enrollment site, disease duration, and motor symptom severity. RESULTS The analysis included 783 participants, with mean (standard deviation) age of 67.3 (9.7) years and median (interquartile range) MDS-UPDRS Motor Subscale score of 26 (17, 35). Deficits in global cognition, executive function, memory, and phonemic fluency were associated with more severe PIGD symptoms. Deficits in executive function were associated with impairments in gait, freezing, and postural stability, while visuospatial impairments were associated only with more severe freezing, and poorer memory function was associated only with greater postural instability. DISCUSSION While impairments in global cognition and aspects of executive functioning were associated with more severe PIGD symptoms, specific cognitive domains were differentially related to distinct PIGD components, suggesting the presence of multiple neural pathways contributing to associations between cognition and PIGD symptoms in persons with PD.
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Cholerton BA, Zabetian CP, Quinn JF, Chung KA, Peterson A, Espay AJ, Revilla FJ, Devoto J, Watson GS, Hu SC, Edwards KL, Montine TJ, Leverenz JB. Pacific Northwest Udall Center of excellence clinical consortium: study design and baseline cohort characteristics. JOURNAL OF PARKINSONS DISEASE 2014; 3:205-14. [PMID: 23938350 DOI: 10.3233/jpd-130189] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The substantial proportion of individuals with Parkinson's disease (PD) who have or are expected to develop concomitant cognitive impairment emphasizes the need for large, well-characterized participant cohorts to serve as a basis for research into the causes, manifestations, and potential treatments of cognitive decline in those with PD. OBJECTIVE To establish a multi-site clinical core that cognitively and clinically characterizes patients with PD by obtaining quality longitudinal clinical, neuropsychological, and validated biomarker data. METHODS Six hundred nineteen participants with idiopathic PD (68.0 ± 9.1 years, 7.1 ± 6.2 years since diagnosis, 70% males) were enrolled in the Pacific Northwest Udall Center (PANUC), one of the Morris K. Udall Centers of Excellence for Parkinson's Research, Clinical Consortium and underwent comprehensive clinical and neuropsychological assessment. Participants were diagnosed with no cognitive impairment (PD-NCI), mild cognitive impairment (PD-MCI), or dementia (PDD) at a diagnostic consensus conference. RESULTS A substantial proportion of the overall sample was diagnosed with cognitive impairment at baseline: 22% with PDD and 59% with PD-MCI. A higher rate of cognitive impairment was observed in men than women (87% vs. 68%, p < 0.0001), despite a higher level of education. Most patients older than 50 years at the time of diagnosis and with disease duration greater than 10 years were cognitively impaired or demented. CONCLUSIONS The PANUC Clinical Consortium is a clinically and cognitively well-characterized cohort of patients with PD. Baseline cohort characteristics demonstrate a high rate of cognitive impairment in the sample, as well as potential sex differences with regard to cognitive diagnosis. The PANUC Clinical Consortium, with its access to biomarker, genetic, and autopsy data, provides an excellent foundation for detailed research related to cognitive impairment in PD.
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Affiliation(s)
- Brenna A Cholerton
- Geriatric Research, Education, & Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98493, USA.
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