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Santillo AF, Strandberg TO, Reislev NH, Nilsson M, Stomrud E, Spotorno N, van Westen D, Hansson O. Divergent functional connectivity changes associated with white matter hyperintensities. Neuroimage 2024; 296:120672. [PMID: 38851551 DOI: 10.1016/j.neuroimage.2024.120672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/17/2024] [Accepted: 06/06/2024] [Indexed: 06/10/2024] Open
Abstract
Age-related white matter hyperintensities are a common feature and are known to be negatively associated with structural integrity, functional connectivity, and cognitive performance. However, this has yet to be fully understood mechanistically. We analyzed multiple MRI modalities acquired in 465 non-demented individuals from the Swedish BioFINDER study including 334 cognitively normal and 131 participants with mild cognitive impairment. White matter hyperintensities were automatically quantified using fluid-attenuated inversion recovery MRI and parameters from diffusion tensor imaging were estimated in major white matter fibre tracts. We calculated fMRI resting state-derived functional connectivity within and between predefined cortical regions structurally linked by the white matter tracts. How change in functional connectivity is affected by white matter lesions and related to cognition (in the form of executive function and processing speed) was explored. We examined the functional changes using a measure of sample entropy. As expected hyperintensities were associated with disrupted structural white matter integrity and were linked to reduced functional interregional lobar connectivity, which was related to decreased processing speed and executive function. Simultaneously, hyperintensities were also associated with increased intraregional functional connectivity, but only within the frontal lobe. This phenomenon was also associated with reduced cognitive performance. The increased connectivity was linked to increased entropy (reduced predictability and increased complexity) of the involved voxels' blood oxygenation level-dependent signal. Our findings expand our previous understanding of the impact of white matter hyperintensities on cognition by indicating novel mechanisms that may be important beyond this particular type of brain lesions.
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Affiliation(s)
- Alexander F Santillo
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden
| | - Tor O Strandberg
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden
| | - Nina H Reislev
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Markus Nilsson
- Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Diagnostic Radiology, Lund. Diagnostic Radiology, Lunds Universitet/SUS/Lund, 221 85 Lund, Sweden, Sweden
| | - Erik Stomrud
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Nicola Spotorno
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden
| | - Danielle van Westen
- Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Diagnostic Radiology, Lund. Diagnostic Radiology, Lunds Universitet/SUS/Lund, 221 85 Lund, Sweden, Sweden
| | - Oskar Hansson
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden. Postal address: Memory Clinic, Skåne University Hospital, SE-20502 Malmö, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Andriuta D, Roussel M, Chene G, Fischer C, Mangin JF, Dubois B, Vellas B, Pasquier F, Tison F, Blanc F, Hanon O, Paquet C, Gabelle A, Ceccaldi M, Annweiler C, Krolak-Salmon P, David R, Rouch-Leroyer I, Benetos A, Moreaud O, Sellal F, Jalenques I, Vandel P, Bouteloup V, Godefroy O. The pattern of cortical thickness associated with executive dysfunction in MCI and SCC: The MEMENTO cohort. Rev Neurol (Paris) 2024:S0035-3787(24)00534-4. [PMID: 38866655 DOI: 10.1016/j.neurol.2024.02.394] [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: 01/18/2023] [Revised: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND The association between the pattern of cortical thickness (CT) and executive dysfunction (ED) in mild cognitive impairment (MCI) and subjective cognitive complaints (SCC) is still poorly understood. We aimed to investigate the association between CT and ED in a large French cohort (MEMENTO) of 2323 participants with MCI or SCC. METHODS All participants with available CT and executive function data (verbal fluency and Trail Making Test [TMT]) were selected (n=1924). Linear regressions were performed to determine relationships between executive performance and the brain parenchymal fraction (BPF) and CT using FreeSurfer. RESULTS The global executive function score was related to the BPF (sß: 0.091, P<0.001) and CT in the right supramarginal (sß: 0.060, P=0.041) and right isthmus cingulate (sß: 0.062, P=0.011) regions. Literal verbal fluency was related to the BPF (sß: 0.125, P<0.001) and CT in the left parsorbitalis region (sß: 0.045, P=0.045). Semantic verbal fluency was related to the BPF (sß: 0.101, P<0.001) and CT in the right supramarginal region (sß: 0.061, P=0.042). The time difference between the TMT parts B and A was related to the BPF (sß: 0.048, P=0.045) and CT in the right precuneus (sß: 0.073, P=0.019) and right isthmus cingulate region (sß: 0.054, P=0.032). CONCLUSIONS In a large clinically based cohort of participants presenting with either MCI or SCC (a potential early stage of Alzheimer's disease [AD]), ED was related to the BPF and CT in the left pars orbitalis, right precuneus, right supramarginal, and right isthmus cingulate regions. This pattern of lesions adds knowledge to the conventional anatomy of ED and could contribute to the early diagnosis of AD.
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Affiliation(s)
- D Andriuta
- Department of Neurology and Functional Neuroscience and Pathology Laboratory, Jules-Verne University of Picardy, Amiens University Hospital, CHU de Amiens-Picardie, 80054 Amiens, France.
| | - M Roussel
- Department of Neurology and Functional Neuroscience and Pathology Laboratory, Jules-Verne University of Picardy, Amiens University Hospital, CHU de Amiens-Picardie, 80054 Amiens, France
| | - G Chene
- School of Public Health, Inserm U1219, institut de santé publique, d'épidémiologie et de développement, université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - C Fischer
- University Hospital, Sorbonne Universities, Pierre-et-Marie-Curie University, 75006 Paris, France; Institut du cerveau et la moelle (ICM), hôpital Pitié-Salpêtrière, Paris, France
| | - J-F Mangin
- University Hospital, Sorbonne Universities, Pierre-et-Marie-Curie University, 75006 Paris, France; Institut du cerveau et la moelle (ICM), hôpital Pitié-Salpêtrière, Paris, France
| | - B Dubois
- University Hospital, Sorbonne Universities, Pierre-et-Marie-Curie University, 75006 Paris, France; Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Brain and Spine Institute (ICM) UMR S 1127, AP-HP Pitié-Salpêtrière, Paris, France
| | - B Vellas
- Memory Resource and Research Centre of Toulouse, CHU de Toulouse, hôpital La Grave-Casselardit, Toulouse, France
| | - F Pasquier
- Memory Resource and Research Centre of Lille, hôpital Roger-Salengro, CHRU de Lille, 59000 Lille, France
| | - F Tison
- Institute for Neurodegenerative diseases, CMRR, University and University Hospital of Bordeaux, Bordeaux, France
| | - F Blanc
- Department of Neurology, CHU de Strasbourg, Strasbourg, France
| | - O Hanon
- Memory Resource and Research Centre of Paris Broca, hôpital Broca, AP-HP, 75013 Paris, France; Université Paris Descartes, Sorbonne-Paris-Cité, EA 4468, Paris, France
| | - C Paquet
- Cognitive Neurology Centre, groupe hospitalier Saint-Louis-Lariboisière-Fernand-Widal, université de Paris, Paris, France
| | - A Gabelle
- Memory Resource and Research Centre of Montpellier, Hôpital Gui-de-Chauliac, CHU de Montpellier, 34000 Montpellier, France
| | - M Ceccaldi
- Memory Resource and Research Centre of Marseille, hôpital La Timone, CHU de Marseille, 13000 Marseille, France
| | - C Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France; UPRES EA 4638, University of Angers, Angers, France; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - P Krolak-Salmon
- Memory Resource and Research Centre of Lyon, hospices civils de Lyon, hôpital des Charpennes, 69000 Lyon, France
| | - R David
- Memory Resource and Research Centre of Nice, CHU de Nice, Nice, France; Institut Claude-Pompidou, EA 7276 CoBTeK "Cognition Behaviour Technology", 06100 Nice, France
| | - I Rouch-Leroyer
- Memory Resource and Research Centre of Saint-Étienne, hôpital Nord, CHU de Saint-Étienne, 42000 Saint-Étienne, France
| | - A Benetos
- Memory Resource and Research Centre of Nancy, CHU de Nancy, 54000 Nancy, France
| | - O Moreaud
- Memory Resource and Research Centre of Grenoble, hôpital de la Tronche, CHU de Grenoble Alpes, 38000 Grenoble, France
| | - F Sellal
- Memory Resource and Research Centre of Strasbourg/Colmar, hôpitaux civils de Colmar, 68000 Colmar, France; Inserm U-1118, Strasbourg University, 67000 Strasbourg, France
| | - I Jalenques
- Memory Resource and Research Centre of Clermont-Ferrand, Clermont-Auvergne University, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - P Vandel
- Memory Resource and Research Centre of Besançon, hôpital Jean-Minjoz, hôpital Saint-Jacques, CHU de Besançon, 25000 Besançon, France
| | - V Bouteloup
- School of Public Health, Inserm U1219, institut de santé publique, d'épidémiologie et de développement, université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - O Godefroy
- Department of Neurology and Functional Neuroscience and Pathology Laboratory, Jules-Verne University of Picardy, Amiens University Hospital, CHU de Amiens-Picardie, 80054 Amiens, France
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Andriuta D, Wiener E, Perron A, Ouin E, Masmoudi I, Thibaut W, Martin J, Roussel M, Constans JM, Aarabi A, Godefroy O. Neuroimaging determinants of cognitive impairment in the memory clinic: how important is the vascular burden? J Neurol 2024; 271:504-518. [PMID: 37777991 DOI: 10.1007/s00415-023-12009-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023]
Abstract
While neurodegenerative and vascular neurocognitive disorder (NCD) often co-occur, the contribution of vascular lesions, especially stroke lesions identified on MRI, to global cognition in a real-life memory clinic population remains unclear. The main objective of this retrospective study was to determine NCD neuroimaging correlates: the GM atrophy pattern and vascular lesions (especially stroke lesion localization by voxel-based lesion-symptom mapping, VLSM) in a memory clinic. We included 336 patients with mild or major NCD who underwent cerebral MRI and a neuropsychological assessment. The GM atrophy pattern (obtained by voxel-based morphometry, VBM) and the stroke lesion localization (obtained by VLSM) associated with G5 z-score (a global cognitive score), were included as independent variables with other neuroimaging and clinical indices in a stepwise linear regression model. The mean age was 70.3 years and the mean MMSE score 21.3. On MRI, 75 patients had at least one stroke lesion. The G 5 z-score was associated with GM density in the pattern selected by the VBM analysis (R2 variation = 0.166, p < 0.001) and the presence of a stroke lesion in the region selected by the VSLM analysis (mainly in the right frontal region; R2 variation = 0.018, p = 0.008). The interaction between the two factors was insignificant (p = 0.374). In conclusion, in this first study combining VBM and VLSM analysis in a memory clinic, global cognition was associated with a specific GM atrophy pattern and the presence of a stroke lesion mainly in the right frontal region.
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Affiliation(s)
- Daniela Andriuta
- Department of Neurology, Amiens University Medical Center, Amiens University Hospital, 80054, Amiens, France.
- Laboratoire de Neurosciences Fonctionnelles Et Pathologies (UR UPJV 4559), Jules Verne University of Picardy, Amiens, France.
| | - Emmanuel Wiener
- Department of Neurology, Versailles - Le Chesnay Medical Center, Le Chesnay-Rocquencourt, France
| | - Alexandre Perron
- Department of Neurology, Amiens University Medical Center, Amiens University Hospital, 80054, Amiens, France
- Laboratoire de Neurosciences Fonctionnelles Et Pathologies (UR UPJV 4559), Jules Verne University of Picardy, Amiens, France
| | - Elisa Ouin
- Department of Neurology, Amiens University Medical Center, Amiens University Hospital, 80054, Amiens, France
- Laboratoire de Neurosciences Fonctionnelles Et Pathologies (UR UPJV 4559), Jules Verne University of Picardy, Amiens, France
| | - Ines Masmoudi
- Department of Neurology, Amiens University Medical Center, Amiens University Hospital, 80054, Amiens, France
- Laboratoire de Neurosciences Fonctionnelles Et Pathologies (UR UPJV 4559), Jules Verne University of Picardy, Amiens, France
| | - William Thibaut
- Department of Neurology, La Reunion University Medical Center, Site South Saint-Pierre, Saint-Pierre, La Reunion, France
| | - Jeanne Martin
- Department of Neurology, Bretagne Atlantique Medical Center, Vannes, France
| | - Martine Roussel
- Department of Neurology, Amiens University Medical Center, Amiens University Hospital, 80054, Amiens, France
- Laboratoire de Neurosciences Fonctionnelles Et Pathologies (UR UPJV 4559), Jules Verne University of Picardy, Amiens, France
| | - Jean-Marc Constans
- Department of Radiology, Amiens University Medical Center, Amiens, France
| | - Ardalan Aarabi
- Laboratoire de Neurosciences Fonctionnelles Et Pathologies (UR UPJV 4559), Jules Verne University of Picardy, Amiens, France
| | - Olivier Godefroy
- Department of Neurology, Amiens University Medical Center, Amiens University Hospital, 80054, Amiens, France
- Laboratoire de Neurosciences Fonctionnelles Et Pathologies (UR UPJV 4559), Jules Verne University of Picardy, Amiens, France
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Ali DG, Bahrani AA, El Khouli RH, Gold BT, Jiang Y, Zachariou V, Wilcock DM, Jicha GA. White matter hyperintensities influence distal cortical β-amyloid accumulation in default mode network pathways. Brain Behav 2023; 13:e3209. [PMID: 37534614 PMCID: PMC10570488 DOI: 10.1002/brb3.3209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND AND PURPOSE Cerebral small vessel disease (SVD) has been suggested to contribute to the pathogenesis of Alzheimer's disease (AD). Yet, the role of SVD in potentially contributing to AD pathology is unclear. The main objective of this study was to test the hypothesis that WMHs influence amyloid β (Aβ) levels within connected default mode network (DMN) tracts and cortical regions in cognitively unimpaired older adults. METHODS Regional standard uptake value ratios (SUVr) from Aβ-PET and white matter hyperintensity (WMH) volumes from three-dimensional magnetic resonance imaging FLAIR images were analyzed across a sample of 72 clinically unimpaired (mini-mental state examination ≥26), older adults (mean age 74.96 and standard deviation 8.13) from the Alzheimer's Disease Neuroimaging Initiative (ADNI3). The association of WMH volumes in major fiber tracts projecting from cortical DMN regions and Aβ-PET SUVr in the connected cortical DMN regions was analyzed using linear regression models adjusted for age, sex, ApoE, and total brain volumes. RESULTS The regression analyses demonstrate that increased WMH volumes in the superior longitudinal fasciculus were associated with increased regional SUVr in the inferior parietal lobule (p = .011). CONCLUSION The findings suggest that the relation between Aβ in parietal cortex is associated with SVD in downstream white matter (WM) pathways in preclinical AD. The biological relationships and interplay between Aβ and WM microstructure alterations that precede overt WMH development across the continuum of AD progression warrant further study.
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Affiliation(s)
- Doaa G. Ali
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Behavioral Science, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Ahmed A. Bahrani
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Neurology, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Riham H. El Khouli
- Department of Radiology, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Brian T. Gold
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Neuroscience, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Yang Jiang
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Behavioral Science, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Valentinos Zachariou
- Department of Neuroscience, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Donna M. Wilcock
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Physiology, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Gregory A. Jicha
- Sanders‐Brown Center on Aging, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Behavioral Science, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
- Department of Neurology, College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
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Li M, Habes M, Grabe H, Kang Y, Qi S, Detre JA. Disconnectome associated with progressive white matter hyperintensities in aging: a virtual lesion study. Front Aging Neurosci 2023; 15:1237198. [PMID: 37719871 PMCID: PMC10500060 DOI: 10.3389/fnagi.2023.1237198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/04/2023] [Indexed: 09/19/2023] Open
Abstract
Objective White matter hyperintensities (WMH) are commonly seen on T2-weighted magnetic resonance imaging (MRI) in older adults and are associated with an increased risk of cognitive decline and dementia. This study aims to estimate changes in the structural connectome due to age-related WMH by using a virtual lesion approach. Methods High-quality diffusion-weighted imaging data of 30 healthy subjects were obtained from the Human Connectome Project (HCP) database. Diffusion tractography using q-space diffeomorphic reconstruction (QSDR) and whole brain fiber tracking with 107 seed points was conducted using diffusion spectrum imaging studio and the brainnetome atlas was used to parcellate a total of 246 cortical and subcortical nodes. Previously published WMH frequency maps across age ranges (50's, 60's, 70's, and 80's) were used to generate virtual lesion masks for each decade at three lesion frequency thresholds, and these virtual lesion masks were applied as regions of avoidance (ROA) in fiber tracking to estimate connectivity changes. Connections showing significant differences in fiber density with and without ROA were identified using paired tests with False Discovery Rate (FDR) correction. Results Disconnections appeared first from the striatum to middle frontal gyrus (MFG) in the 50's, then from the thalamus to MFG in the 60's and extending to the superior frontal gyrus in the 70's, and ultimately including much more widespread cortical and hippocampal nodes in the 80's. Conclusion Changes in the structural disconnectome due to age-related WMH can be estimated using the virtual lesion approach. The observed disconnections may contribute to the cognitive and sensorimotor deficits seen in aging.
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Affiliation(s)
- Meng Li
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Mohamad Habes
- Biggs Alzheimer’s Institute, University of Texas San Antonio, San Antonio, TX, United States
| | - Hans Grabe
- Department of Psychiatry and Psychotherapy, University of Greifswald, Stralsund, Germany
| | - Yan Kang
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Shouliang Qi
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China
| | - John A. Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
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Luo X, Hong H, Li K, Zeng Q, Wang S, Li Z, Fu Y, Liu X, Hong L, Li J, Zhang X, Zhong S, Jiaerken Y, Liu Z, Chen Y, Huang P, Zhang M. Distinct cerebral small vessel disease impairment in early- and late-onset Alzheimer's disease. Ann Clin Transl Neurol 2023; 10:1326-1337. [PMID: 37345812 PMCID: PMC10424647 DOI: 10.1002/acn3.51824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 05/10/2023] [Accepted: 05/26/2023] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVE This study investigated cerebral small vessel disease (CSVD) damage patterns in early-onset and late-onset Alzheimer's disease (EOAD and LOAD) and their effects on cognitive function. METHODS This study included 93 participants, 45 AD patients (14 EOAD and 31 LOAD), and 48 normal controls (13 YNC and 35 ONC) from the ADNI database. All participants had diffusion tensor imaging data; some had amyloid PET and plasma p-tau181 data. The study used peak width of skeletonized mean diffusivity (PSMD) to measure CSVD severity and compared PSMD between patients and age-matched controls. The effect of age on the relationship between PSMD and cognition was also examined. The study also repeated the analysis in amyloid-positive AD patients and amyloid-negative controls in another independent database (31 EOAD and 38 LOAD), and the merged database. RESULTS EOAD and LOAD showed similar cognitive function and disease severity. PSMD was validated as a reliable correlate of cognitive function. In the ADNI database, PSMD was significantly higher for LOAD and showed a tendency to increase for EOAD; in the independent and merged databases, PSMD was significantly higher for both LOAD and EOAD. The impact of PSMD on cognitive function was notably greater in the younger group (YNC and EOAD) than in the older group (ONC and LOAD), as supported by the ADNI and merged databases. INTERPRETATION EOAD has less CSVD burden than LOAD, but has a greater impact on cognition. Proactive cerebrovascular prevention strategies may have potential clinical value for younger older adults with cognitive decline.
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Affiliation(s)
- Xiao Luo
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Hui Hong
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Kaicheng Li
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Qingze Zeng
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Shuyue Wang
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Zheyu Li
- Department of NeurologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Yanv Fu
- Department of NeurologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Xiaocao Liu
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Luwei Hong
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Jixuan Li
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Xinyi Zhang
- Department of NeurologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Siyan Zhong
- Department of NeurologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Yeerfan Jiaerken
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Zhirong Liu
- Department of NeurologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Yanxing Chen
- Department of NeurologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Peiyu Huang
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Minming Zhang
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
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Roseborough AD, Saad L, Goodman M, Cipriano LE, Hachinski VC, Whitehead SN. White matter hyperintensities and longitudinal cognitive decline in cognitively normal populations and across diagnostic categories: A meta-analysis, systematic review, and recommendations for future study harmonization. Alzheimers Dement 2023; 19:194-207. [PMID: 35319162 DOI: 10.1002/alz.12642] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The primary aim of this paper is to improve the clinical interpretation of white matter hyperintensities (WMHs) and provide an overarching summary of methodological approaches, allowing researchers to design future studies targeting current knowledge gaps. METHODS A meta-analysis and systematic review was performed investigating associations between baseline WMHs and longitudinal cognitive outcomes in cognitively normal populations, and populations with mild cognitive impairment (MCI), Alzheimer's disease (AD), and stroke. RESULTS Baseline WMHs increase the risk of cognitive impairment and dementia across diagnostic categories and most consistently in MCI and post-stroke populations. Apolipoprotein E (APOE) genotype and domain-specific cognitive changes relating to strategic anatomical locations, such as frontal WMH and executive decline, represent important considerations. Meta-analysis reliability was assessed using multiple methods of estimation, and results suggest that heterogeneity in study design and reporting remains a significant barrier. DISCUSSION Recommendations and future directions for study of WMHs are provided to improve cross-study comparison and translation of research into consistent clinical interpretation.
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Affiliation(s)
- Austyn D Roseborough
- Vulnerable Brain Laboratory, Department of Anatomy and Cell Biology, The Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Lorenzo Saad
- Vulnerable Brain Laboratory, Department of Anatomy and Cell Biology, The Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Maren Goodman
- Western Libraries, The University of Western Ontario, London, Ontario, Canada
| | - Lauren E Cipriano
- Ivey Business School and Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
| | - Vladimir C Hachinski
- Department of Clinical Neurological Sciences, The Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Shawn N Whitehead
- Vulnerable Brain Laboratory, Department of Anatomy and Cell Biology, The Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
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Tsentidou G, Moraitou D, Tsolaki M, Masoura E, Papaliagkas V. Trajectories of Cognitive Impairment in Adults Bearing Vascular Risk Factors, with or without Diagnosis of Mild Cognitive Impairment: Findings from a Longitudinal Study Assessing Executive Functions, Memory, and Social Cognition. Diagnostics (Basel) 2022; 12:diagnostics12123017. [PMID: 36553024 PMCID: PMC9777412 DOI: 10.3390/diagnostics12123017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
With the aging of the population, a key concern of both societies and health services is to keep the population cognitively healthy until the maximum age limit. It is a well-known fact that vascular aging has a negative effect on the cognitive skills of adults, putting them at greater risk of developing dementia. The present longitudinal study aimed to evaluate the main dimensions of cognition in two pathological groups with different health profiles: a group of adults with vascular risk factors (VRF) (n = 35) and a group of adults with vascular risk factors and mild cognitive impairment (VRF + MCI) (n = 35). The two groups were matched in age, education, and gender. They were assessed with extensive neuropsychological testing at three different times with a distance of about 8 months between them; the assessment regarded executive functions, memory capacity, and Theory of Mind abilities. The analyses carried out were (a) mixed-measures ANOVA, (b) repeated measures ANOVA, and (c) ANOVA. The findings showed that global cognitive status and short-term memory are the main cognitive abilities that decline in community dwelling people bearing VRF. Hence, this group of adults should be examined at least every 2 years for this decline. As regards people with both VRF and MCI, it seems that the assessment of Theory of Mind abilities can better capture their further impairment. Global cognitive status, task/rule switching function, and long-term memory (delayed verbal recall) were revealed as the abilities that clearly and steadily differentiate VRF people with and without MCI.
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Affiliation(s)
- Glykeria Tsentidou
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6983140302
| | - Despina Moraitou
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders, 546 43 Thessaloniki, Greece
| | - Magdalini Tsolaki
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders, 546 43 Thessaloniki, Greece
| | - Elvira Masoura
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 574 00 Sindos, Greece
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9
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Palmer WC, Park SM, Levendovszky SR. Brain state transition analysis using ultra-fast fMRI differentiates MCI from cognitively normal controls. Front Neurosci 2022; 16:975305. [PMID: 36248645 PMCID: PMC9555083 DOI: 10.3389/fnins.2022.975305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Conventional resting-state fMRI studies indicate that many cortical and subcortical regions have altered function in Alzheimer's disease (AD) but the nature of this alteration has remained unclear. Ultrafast fMRIs with sub-second acquisition times have the potential to improve signal contrast and enable advanced analyses to understand temporal interactions between brain regions as opposed to spatial interactions. In this work, we leverage such fast fMRI acquisitions from Alzheimer's disease Neuroimaging Initiative to understand temporal differences in the interactions between resting-state networks in 55 older adults with mild cognitive impairment (MCI) and 50 cognitively normal healthy controls. Methods We used a sliding window approach followed by k-means clustering. At each window, we computed connectivity i.e., correlations within and across the regions of the default mode, salience, dorsal attention, and frontoparietal network. Visual and somatosensory networks were excluded due to their lack of association with AD. Using the Davies-Bouldin index, we identified clusters of windows with distinct connectivity patterns, also referred to as brain states. The fMRI time courses were converted into time courses depicting brain state transition. From these state time course, we calculated the dwell time for each state i.e., how long a participant spent in each state. We determined how likely a participant transitioned between brain states. Both metrics were compared between MCI participants and controls using a false discovery rate correction of multiple comparisons at a threshold of. 0.05. Results We identified 8 distinct brain states representing connectivity within and between the resting state networks. We identified three transitions that were different between controls and MCI, all involving transitions in connectivity between frontoparietal, dorsal attention, and default mode networks (p<0.04). Conclusion We show that ultra-fast fMRI paired with dynamic functional connectivity analysis allows us to capture temporal transitions between brain states. Most changes were associated with transitions between the frontoparietal and dorsal attention networks connectivity and their interaction with the default mode network. Although future work needs to validate these findings, the brain networks identified in our work are known to interact with each other and play an important role in cognitive function and memory impairment in AD.
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10
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Liu K, Wang X, Zhang T, Wang W, Li R, Lu L, Deng Y, Xu K, Kwok T. Cortical Short-Range Fiber Connectivity and Its Association With Deep Brain White Matter Hyperintensities in Older Diabetic People With Low Serum Vitamin B12. Front Aging Neurosci 2022; 14:754997. [PMID: 35401148 PMCID: PMC8990772 DOI: 10.3389/fnagi.2022.754997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 03/03/2022] [Indexed: 11/25/2022] Open
Abstract
Although previous studies have indicated that older people with diabetes mellitus (DM) had an approximately two times larger white matter hyperintensity (WMH) load than those without DM, the influence of WMHs on cognition is uncertain and inconsistent in the literature. It is unclear whether the short-range fibers in the juxtacortical region, traditionally considered to be spared from WMH pathology, are enhanced as an adaptive response to deep WM degeneration in older diabetic people with normal cognition. Moreover, the specific effect of vitamin B12 deficiency, commonly accompanied by DM, remains to be investigated. This study implemented a specialized analysis of the superficial cortical short-range fiber connectivity density (SFiCD) based on a data-driven framework in 70 older individuals with DM and low serum vitamin B12. Moreover, the effects of time and vitamin B12 supplementation were assessed based on a randomized placebo-controlled trial in 59 individuals. The results demonstrated a higher SFiCD in diabetic individuals with a higher deep WMH load. Additionally, a significant interaction between DWMH load and homocysteine on SFiCD was found. During the 27-month follow-up period, a longitudinal increase in the SFiCD was observed in the bilateral frontal cortices. However, the observed longitudinal SFiCD change was not dependent on vitamin B12 supplementation; thus, the specific reason for the longitudinal cortical short fiber densification may need further study. Overall, these findings may help us better understand the neurobiology of brain plasticity in older patients with DM, as well as the interplay among DM, WMH, and vitamin B12 deficiency.
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Affiliation(s)
- Kai Liu
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
| | - Xiaopeng Wang
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Teng Zhang
- Department of Nuclear Medicine and PET-CT Center, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Wang
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
| | - Ruohan Li
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
| | - Li Lu
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
| | - Yanjia Deng
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
- *Correspondence: Yanjia Deng,
| | - Kai Xu
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Kai Xu,
| | - Timothy Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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11
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Zhu Y, Pan D, He L, Rong X, Li H, Li Y, Pi Y, Xu Y, Tang Y. China Registry Study on Cognitive Impairment in the Elderly: Protocol of a Prospective Cohort Study. Front Aging Neurosci 2022; 13:797704. [PMID: 35002683 PMCID: PMC8733254 DOI: 10.3389/fnagi.2021.797704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/25/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: To develop appropriate strategies for early diagnosis and intervention of cognitive impairment, the identification of minimally invasive and cost-effective biomarkers for the early diagnosis of cognitive impairment is crucial and desirable. Therefore, the CHina registry study on cOgnitive imPairment in the Elderly (HOPE) study is designed to investigate the natural course of cognitive decline and explore the clinical, imaging, and biochemical markers for the detection and diagnosis of cognitive impairment on its earliest stage. Methods: Approximately 5,000 Chinese elderly aged more than 50 years were recruited from Sun Yat-sen Memorial Hospital, Sun Yat-sen University in Guangzhou, China by the year 2024. All subjects were invited to complete the clinical assessment, neuropsychological assessment, the biological samples collection (blood and cerebrospinal fluid (CSF)], magnetic resonance imaging (MRI) examination, and optional amyloid and tau PET. The follow-up survey was conducted every 1 year to repeat these assessments for 20 years. To better clarify the relationship between potential risk factors and endpoint events [changes in cognitive score or incidence of mild cognitive impairment (MCI) and/or dementia], appropriate statistical methods were used to analyze the data, including but not limited to, such as linear mixed-effect model, competing risk model, or the least absolute shrinkage and selection operator model. Significance: The CHina registry study on cOgnitive imPairment in the Elderly study is designed to explore the longitudinal changes in characteristics of participants with cognitive decline and to identify potential plasma and imaging biomarkers with cost-benefit and scalability advantages. The results will enable broader clinical access and efficient population screening and then improve the development of treatment and the quality of life for cognitive impairment at the early stage. Trial registration number: NCT04360200.
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Affiliation(s)
- Yingying Zhu
- Clinical Research Design Division, Clinical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dong Pan
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei He
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Honghong Li
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yi Li
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yaxuan Pi
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yongteng Xu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yamei Tang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Brain Function and Disease, Sun Yat-sen University, Guangzhou, China
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12
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Lydon EA, Nguyen LT, Shende SA, Chiang HS, Spence JS, Mudar RA. EEG theta and alpha oscillations in early versus late mild cognitive impairment during a semantic Go/NoGo task. Behav Brain Res 2022; 416:113539. [PMID: 34416304 DOI: 10.1016/j.bbr.2021.113539] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/02/2022]
Abstract
Amnestic mild cognitive impairment (aMCI) is marked by episodic memory deficits, which can be used to classify individuals into early MCI (EMCI) and late MCI (LMCI). Although mounting evidence suggests that individuals with aMCI have additional cognitive alterations including deficits in cognitive control, few have examined if EMCI and LMCI differ on processes other than episodic memory. Using a semantic Go/NoGo task, we examined differences in cognitive control between EMCI and LMCI on behavioral (accuracy and reaction time) and neural (scalp-recorded event-related oscillations in theta and alpha band) measures. Although no behavioral differences were observed between the EMCI and LMCI groups, differences in neural oscillations were observed. The LMCI group had higher theta synchronization on Go trials at central electrodes compared to the EMCI group. In addition, the EMCI group showed differences in theta power at central electrodes and alpha power at central and centro-parietal electrodes between Go and NoGo trials, while the LMCI group did not exhibit such differences. These findings suggest that while behavioral differences may not be observable, neural changes underlying cognitive control processes may differentiate EMCI and LMCI stages and may be useful to understand the trajectory of aMCI in future studies.
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Affiliation(s)
- Elizabeth A Lydon
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, 901 South 6th Street, Champaign, IL, 61820, United States
| | - Lydia T Nguyen
- Neuroscience Program, University of Illinois Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, 61801, United States
| | - Shraddha A Shende
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, 901 South 6th Street, Champaign, IL, 61820, United States
| | - Hsueh-Sheng Chiang
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, United States; School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W Campbell Rd, Richardson, TX, United States
| | - Jeffrey S Spence
- Center for BrainHealth, The University of Texas at Dallas, 2200 West Mockingbird Ln, Dallas, TX, United States
| | - Raksha A Mudar
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, 901 South 6th Street, Champaign, IL, 61820, United States; Neuroscience Program, University of Illinois Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, 61801, United States.
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13
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Korn A, Baylan U, Simsek S, Schalkwijk CG, Niessen HWM, Krijnen PAJ. Myocardial infarction coincides with increased NOX2 and N ε-(carboxymethyl) lysine expression in the cerebral microvasculature. Open Heart 2021; 8:openhrt-2021-001842. [PMID: 34819349 PMCID: PMC8614153 DOI: 10.1136/openhrt-2021-001842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/05/2021] [Indexed: 12/24/2022] Open
Abstract
Background Myocardial infarction (MI) is associated with mental health disorders, in which neuroinflammation and cerebral microvascular dysfunction may play a role. Previously, we have shown that the proinflammatory factors Nε-(carboxymethyl)lysine (CML) and NADPH oxidase 2 (NOX2) are increased in the human infarcted heart microvasculature. The aim of this study was to analyse the presence of CML and NOX2 in the cerebral microvasculature of patients with MI. Methods Brain tissue was obtained at autopsy from 24 patients with MI and nine control patients. According to their infarct age, patients with MI were divided into three groups: 3–6 hours old (phase I), 6 hours–5 days old (phase II) and 5–14 days old (phase III). CML and NOX2 in the microvasculature were studied through immunohistochemical analysis. Results We observed a 2.5-fold increase in cerebral microvascular CML in patients with phase II and phase III MI (phase II: 21.39±7.91, p=0.004; phase III: 24.21±10.37, p=0.0007) compared with non-MI controls (8.55±2.98). NOX2 was increased in microvessels in patients with phase II MI (p=0.002) and phase III MI (p=0.04) compared with controls. No correlation was found between CML and NOX2 (r=0.58, p=0.13). Conclusions MI coincides with an increased presence of CML and NOX2 in the brain microvasculature. These data point to proinflammatory alterations in the brain microvasculature that may underlie MI-associated mental health disorders.
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Affiliation(s)
- Amber Korn
- Department of Pathology, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands .,Amsterdam Cardiovascular Sciences, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Umit Baylan
- Department of Pathology, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Suat Simsek
- Department of Internal Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.,Department of Internal Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Hans W M Niessen
- Department of Pathology, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Paul A J Krijnen
- Department of Pathology, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
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14
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Vettore M, De Marco M, Pallucca C, Bendini M, Gallucci M, Venneri A. White-Matter Hyperintensity Load and Differences in Resting-State Network Connectivity Based on Mild Cognitive Impairment Subtype. Front Aging Neurosci 2021; 13:737359. [PMID: 34690743 PMCID: PMC8529279 DOI: 10.3389/fnagi.2021.737359] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
"Mild cognitive impairment" (MCI) is a diagnosis characterised by deficits in episodic memory (aMCI) or in other non-memory domains (naMCI). Although the definition of subtypes is helpful in clinical classification, it provides little insight on the variability of neurofunctional mechanisms (i.e., resting-state brain networks) at the basis of symptoms. In particular, it is unknown whether the presence of a high load of white-matter hyperintensities (WMHs) has a comparable effect on these functional networks in aMCI and naMCI patients. This question was addressed in a cohort of 123 MCI patients who had completed an MRI protocol inclusive of T1-weighted, fluid-attenuated inversion recovery (FLAIR) and resting-state fMRI sequences. T1-weighted and FLAIR images were processed with the Lesion Segmentation Toolbox to quantify whole-brain WMH volumes. The CONN toolbox was used to preprocess all fMRI images and to run an independent component analysis for the identification of four large-scale haemodynamic networks of cognitive relevance (i.e., default-mode, salience, left frontoparietal, and right frontoparietal networks) and one control network (i.e., visual network). Patients were classified based on MCI subtype (i.e., aMCI vs. naMCI) and WMH burden (i.e., low vs. high). Maps of large-scale networks were then modelled as a function of the MCI subtype-by-WMH burden interaction. Beyond the main effects of MCI subtype and WMH burden, a significant interaction was found in the salience and left frontoparietal networks. Having a low WMH burden was significantly more associated with stronger salience-network connectivity in aMCI (than in naMCI) in the right insula, and with stronger left frontoparietal-network connectivity in the right frontoinsular cortex. Vice versa, having a low WMH burden was significantly more associated with left-frontoparietal network connectivity in naMCI (than in aMCI) in the left mediotemporal lobe. The association between WMH burden and strength of connectivity of resting-state functional networks differs between aMCI and naMCI patients. Although exploratory in nature, these findings indicate that clinical profiles reflect mechanistic interactions that may play a central role in the definition of diagnostic and prognostic statuses.
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Affiliation(s)
- Martina Vettore
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom.,Department of General Psychology, University of Padua, Padua, Italy
| | - Matteo De Marco
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Claudia Pallucca
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.,Cognitive Impairment Center, Local Health Authority n.2 Marca Trevigiana, Treviso, Italy
| | - Matteo Bendini
- Unit of Neuroradiology, Treviso Regional Hospital, Treviso, Italy
| | - Maurizio Gallucci
- Cognitive Impairment Center, Local Health Authority n.2 Marca Trevigiana, Treviso, Italy
| | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom.,Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
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15
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Jung Y, Viviano RP, van Rooden S, van der Grond J, Rombouts SARB, Damoiseaux JS. White Matter Hyperintensities and Apolipoprotein E Affect the Association Between Mean Arterial Pressure and Objective and Subjective Cognitive Functioning in Older Adults. J Alzheimers Dis 2021; 84:1337-1350. [PMID: 34657884 DOI: 10.3233/jad-210695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND White matter hyperintensities (WMH) show a robust relationship with arterial pressure as well as objective and subjective cognitive functioning. In addition, APOE ɛ4 carriership may influence how arterial pressure affects cognitive functioning. OBJECTIVE To determine the role of region-specific WMH burden and APOE ɛ4 carriership on the relationship between mean arterial pressure (MAP) and cognitive function as well as subjective cognitive decline (SCD). METHODS The sample consisted of 87 cognitively unimpaired middle-aged to older adults aged 50-85. We measured WMH volume for the whole brain, anterior thalamic radiation (ATR), forceps minor, and superior longitudinal fasciculus (SLF). We examined whether WMH burden mediated the relationship between MAP and cognition (i.e., TMT-A score for processing speed; Stroop performance for executive function) as well as SCD (i.e., Frequency of Forgetting (FoF)), and whether APOE ɛ4 carriership moderated that mediation. RESULTS WMH burden within SLF mediated the effect of MAP on Stroop performance. Both whole brain and ATR WMH burden mediated the effect of MAP on FoF score. In the MAP-WMH-Stroop relationship, the mediation effect of SLF WMH and the effect of MAP on SLF WMH were significant only in APOE ɛ4 carriers. In the MAP-WMH-FoF relationship, the effect of MAP on whole brain WMH burden was significant only in ɛ4 carriers. CONCLUSION WMH burden and APOE genotype explain the link between blood pressure and cognitive function and may enable a more accurate assessment of the effect of high blood pressure on cognitive decline and risk for dementia.
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Affiliation(s)
- Youjin Jung
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Raymond P Viviano
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Sanneke van Rooden
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands.,Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Jessica S Damoiseaux
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Institute of Gerontology, Wayne State University, Detroit, MI, USA
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16
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Xing Y, Sun Y, Wang S, Feng F, Zhang D, Li H. Nocturnal blood pressure rise as a predictor of cognitive impairment among the elderly: a retrospective cohort study. BMC Geriatr 2021; 21:462. [PMID: 34380417 PMCID: PMC8359081 DOI: 10.1186/s12877-021-02406-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background This study investigated the different blood pressure patterns that were evaluated by ambulatory blood pressure monitoring (ABPM) among elderly patients and explored the effect of pressure patterns on cognitive impairment and mortality. Methods A total of 305 elderly participants aged ≥65 years were divided into the cognitive impairment group (CI, n = 130) and the non-cognitive impairment group (NCI, n = 175) according to the MMSE score. All participants underwent ABPM to evaluate possible hypertensive disorder and cerebral MRI for the evaluation of cerebral small vessel disease. Follow-up was performed by telephone or medical records. The primary outcome was all-cause mortality. Secondary endpoints were major adverse cardiac and cerebrovascular events (MACCE). Results Among 305 participants, 130 (42.6%) were identified with cognitive impairment (CI), with average systolic blood pressure (BP) of 127 mmHg and diastolic BP of 66 mmHg. According to ABPM, only 13.1% had a dipper pattern, 45.6% had a nocturnal BP rise, while 41.3% had a non-dipper pattern. Compared with NCI patients, the CI group had significantly higher night-time systolic BP (130.0 ± 18.2 vs. 123.9 ± 15.1, p = 0.011), and more participants had nocturnal BP rise (52.3% vs. 40.6%, p = 0.042). Nocturnal BP rise was associated with greater white matter hyperintensities (WMH) (p = 0.013). After 2.03 years of follow-up, there were 35 all-cause deaths and 33 cases of major adverse cardiac and cerebrovascular events (MACCE). CI was independently associated with all-cause mortality during long-term observation (p < 0.01). Nocturnal BP rise had no significant predictive ability for all-cause mortality in elderly patients (p = 0.178). Conclusions Nocturnal BP rise contributed to greater cognitive impairment in elderly patients. Not nocturnal BP rise, but CI could significantly increase all-cause mortality. Controlling BP based on ABPM is critical for preventing the progression of cognitive dysfunction.
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Affiliation(s)
- Yunli Xing
- Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, PR China
| | - Ying Sun
- Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, PR China
| | - Shan Wang
- Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, PR China
| | - Feng Feng
- Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, PR China
| | - Deqiang Zhang
- Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, PR China
| | - Hongwei Li
- Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, PR China. .,Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95, Yongan Road, Xicheng District, Beijing, 100050, PR China.
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17
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Du J, Zhu H, Yu L, Lu P, Qiu Y, Zhou Y, Cao W, Lu D, Zhao W, Yang J, Sun J, Xu Q. Multi-Dimensional Diffusion Tensor Imaging Biomarkers for Cognitive Decline From the Preclinical Stage: A Study of Post-stroke Small Vessel Disease. Front Neurol 2021; 12:687959. [PMID: 34322083 PMCID: PMC8311001 DOI: 10.3389/fneur.2021.687959] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: We aim to investigate whether multi-dimensional diffusion tensor imaging (DTI) measures can sensitively identify different cognitive status of cerebral small vessel disease (CSVD) and to explore the underlying pattern of white matter disruption in CSVD. Methods: Two hundred and two participants were recruited, composed of 99 CSVD patients with mild cognitive impairment (VaMCI) and 60 with no cognitive impairment (NCI) and 43 healthy subjects as normal controls (NC). Full domain neuropsychological tests and diffusion-weighted imaging were performed on each subject. DTI metrics such as fractional anisotropy (FA), mean diffusivity (MD), the skeletonized mean diffusivity (PSMD), and structural brain network measures including network strength, global efficiency (EGlobal), and local efficiency (ELocal) were calculated. Region of interest (ROI) analysis of 42 white matter tracts was performed to examine the regional anatomical white matter disruption for each group. Results: Significant differences of multiple cognitive test scores across all cognitive domains especially processing and executive function existed among the three groups. DTI measures (FA, MD, and PSMD) showed significant group difference with the cognitive status changing. FA and EGlobal showed significant correlation with processing speed, executive function, and memory. ROI analysis found that white matter integrity impairment occurred from the preclinical stage of vascular cognitive impairment (VCI) due to CSVD. These lesions in the NCI group mainly involved some longitudinal fibers such as right superior longitudinal fasciculus (SLF-R), right superior fronto-occipital fasciculus (SFO-R), and right uncinate fasciculus (UNC-R), which might be more vulnerable to the cerebrovascular aging and disease process. Conclusions: DTI measures are sensitive neuroimaging markers in detecting the early cognitive impairment and able to differentiate the different cognitive status due to CSVD. Subtle changes of some vulnerable white matter tracts may be observed from the preclinical stage of VCI and have a local to general spreading pattern during the disease progression.
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Affiliation(s)
- Jing Du
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Neurology, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Health Management Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Hong Zhu
- Shanghai Med-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yu
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Neurology, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Peiwen Lu
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Neurology, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Health Management Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Yage Qiu
- Department of Radiology, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Yan Zhou
- Department of Radiology, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Wenwei Cao
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Neurology, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Dong Lu
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Neurology, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Wei Zhao
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Neurology, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Jie Yang
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Neurology, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Junfeng Sun
- Shanghai Med-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Qun Xu
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Neurology, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.,Department of Health Management Center, Renji Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China
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18
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Zhang R, Yu W, Wu X, Jiaerken Y, Wang S, Hong H, Li K, Zeng Q, Luo X, Yu X, Xu X, Zhang M, Huang P. Disentangling the pathologies linking white matter hyperintensity and geriatric depressive symptoms in subjects with different degrees of vascular impairment. J Affect Disord 2021; 282:1005-1010. [PMID: 33601672 DOI: 10.1016/j.jad.2020.12.171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 09/27/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND White matter hyperintensity (WMH) is closely associated with geriatric depressive symptoms, but its underlying neural mechanism is unclear. We aim to disentangle the contribution of vascular degeneration and fiber disruption to depressive symptoms in elderly subjects at different clinical status. METHODS One hundred and thirty-three normal elderly subjects, as well as 43 patients with cerebral small vessel disease (CSVD) were included. The Hamilton Depression Rating Scale (HAMD) was used to measure depressive symptoms. Based on the diffusion tensor imaging data, a free water elimination analytical model was adopted to reflect fiber tract disruption (measure: tissue fractional anisotropy, tFA) and increased white matter water content (measure: free water fraction, FW). RESULTS We found that WMH severity was significantly correlated with decreased tFA and increased FW in all subjects. In normal elderly subjects, the HAMD score was correlated with mean tFA, but not FW. Compared to the traditional fractional anisotropy measure, tFA showed stronger correlation with clinical symptoms. In CSVD subjects, the correlation was only significant for FW, and marginally significant for tFA. LIMITATIONS Most subjects had only mild to moderate depressive symptoms. Further validation in patients with major depressive disorder is needed to confirm these findings. CONCLUSIONS The neural mechanisms of depressive symptoms may be different in elderly people with or without severe vascular damage. The free water elimination model may disentangle the effects of fiber disruption and increased free water, providing sensitive imaging markers that could potentially be used on monitoring disease treatment.
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Affiliation(s)
- Ruiting Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Wenke Yu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Xiao Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Yeerfan Jiaerken
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Shuyue Wang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Hui Hong
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Kaicheng Li
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Qingze Zeng
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Xiao Luo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Xinfeng Yu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Xiaopei Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China.
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000, Hangzhou, China.
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19
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Roseborough AD, Langdon KD, Hammond R, Cipriano LE, Pasternak SH, Whitehead SN, Khan AR. Post-mortem 7 Tesla MRI detection of white matter hyperintensities: A multidisciplinary voxel-wise comparison of imaging and histological correlates. Neuroimage Clin 2020; 27:102340. [PMID: 32679554 PMCID: PMC7364158 DOI: 10.1016/j.nicl.2020.102340] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/02/2020] [Accepted: 07/02/2020] [Indexed: 12/31/2022]
Abstract
White matter hyperintensities (WMH) occur in normal aging and across diagnostic categories of neurodegeneration. Ultra-high field imaging (UHF) MRI machines offer the potential to improve our understanding of WMH. Post-mortem imaging using UHF magnetic resonance imaging (MRI) is a useful way of assessing WMH, however, the responsiveness of UHF-MRI to pathological changes within the white matter has not been characterized. In this study we report post-mortem MRI sequences of white matter hyperintensities in normal aging, Alzheimer's disease, and cerebrovascular disease. Seven Tesla post-mortem MRI reliably detected periventricular WMH using both FLAIR and T2 sequences and reflects underlying pathology of myelin and axon density despite prolonged fixation time. Co-registration of histological images to MRI allowed for direct voxel- wise comparison of imaging findings and pathological changes. Myelin content and cerebrovascular pathology were the most significant predictors of MRI white matter intensity as revealed by linear mixed models. Future work investigating the utility of UHF- MRI in studying cell-specific changes within WMH is required to better understand radio-pathologic correlations.
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Affiliation(s)
- Austyn D Roseborough
- Department of Anatomy and Cell Biology, The Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Kristopher D Langdon
- Department of Pathology and Laboratory Medicine, The Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Robert Hammond
- Department of Pathology and Laboratory Medicine, The Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Lauren E Cipriano
- Ivey Business School and Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
| | - Stephen H Pasternak
- Department of Clinical Neurological Sciences, Robarts Research Institute, The Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Shawn N Whitehead
- Department of Anatomy and Cell Biology, The Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
| | - Ali R Khan
- Department of Medical Biophysics, The Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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20
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Wang S, Jiaerken Y, Yu X, Shen Z, Luo X, Hong H, Sun J, Xu X, Zhang R, Zhou Y, Lou M, Huang P, Zhang M. Understanding the association between psychomotor processing speed and white matter hyperintensity: A comprehensive multi-modality MR imaging study. Hum Brain Mapp 2019; 41:605-616. [PMID: 31675160 PMCID: PMC7267958 DOI: 10.1002/hbm.24826] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/22/2019] [Accepted: 10/02/2019] [Indexed: 01/01/2023] Open
Abstract
Cognitive processing speed is crucial for human cognition and declines with aging. White matter hyperintensity (WMH), a common sign of WM vascular damage in the elderly, is closely related to slower psychomotor processing speed. In this study, we investigated the association between WMH and psychomotor speed changes through a comprehensive assessment of brain structural and functional features. Multi-modal MRIs were acquired from 60 elderly adults. Psychomotor processing speeds were assessed using the Trail Making Test Part A (TMT-A). Linear regression analyses were performed to assess the associations between TMT-A and brain features, including WMH volumes in five cerebral regions, diffusivity parameters in the major WM tracts, regional gray matter volume, and brain activities across the whole brain. Hierarchical regression analysis was used to demonstrate the contribution of each index to slower psychomotor processing speed. Linear regression analysis demonstrated that WMH volume in the occipital lobe and fractional anisotropy of the forceps major, an occipital association tract, were associated with TMT-A. Besides, resting-state brain activities in the visual cortex connected to the forceps major were associated with TMT-A. Hierarchical regression showed fractional anisotropy of the forceps major and regional brain activities were significant predictors of TMT-A. The occurrence of WMH, combined with the disruption of passing-through fiber integrity and altered functional activities in areas connected by this fiber, are associated with a decline of psychomotor processing speed. While the causal relationship of this WMH-Tract-Function-Behavior link requires further investigation, this study enhances our understanding of these complex mechanisms.
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Affiliation(s)
- Shuyue Wang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yeerfan Jiaerken
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xinfeng Yu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhujing Shen
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Luo
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Hong
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jianzhong Sun
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ruiting Zhang
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Zhou
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Min Lou
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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21
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van den Berg E, Geerlings MI, Biessels GJ, Nederkoorn PJ, Kloppenborg RP. White Matter Hyperintensities and Cognition in Mild Cognitive Impairment and Alzheimer's Disease: A Domain-Specific Meta-Analysis. J Alzheimers Dis 2019; 63:515-527. [PMID: 29630548 DOI: 10.3233/jad-170573] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND White matter hyperintensities (WMHs) are related to cognitive dysfunction in the general population. The clinical relevance of WMHs in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) is, however, unclear. OBJECTIVE This meta-analysis aimed to quantify the association of WMHs and specific cognitive domains in patients with MCI or AD. METHODS PubMed (January 1990-January 2017) was searched for studies that used MRI to quantify WMHs, and measured cognitive functioning (≥1 predefined cognitive domain with ≥1 test) in a well-defined population of persons diagnosed with MCI or AD. Fischer's Z was used as the common metric for effect size. Modifying effects of demographics, MMSE, and WMH location were examined. RESULTS Twelve cross-sectional studies on AD (total n = 1,370, median age 75 years) and 10 studies on MCI (9 cross-sectional, 1 longitudinal; total n = 2,286, median age 73 years) were included. The association between WMHs and overall cognition was significantly stronger for MCI (-0.25, -0.36 to -0.14) than for AD (-0.11, -0.14 to -0.08; QM = 10.7, p < 0.05). For both groups, largest effect sizes were found in attention and executive functions (-0.26, -0.36 to -0.15) and processing speed (-0.21, -0.35 to -0.12). No significant modifying effects of age and gender were found. CONCLUSION WMHs have a medium-sized association with different cognitive functions in patients with MCI and a small, but statistically significant, association with cognition in AD. These result underscore the role of co-occurring vascular brain damage in MCI and AD.
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Affiliation(s)
- Esther van den Berg
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul J Nederkoorn
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
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22
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Jiménez-Balado J, Riba-Llena I, Abril O, Garde E, Penalba A, Ostos E, Maisterra O, Montaner J, Noviembre M, Mundet X, Ventura O, Pizarro J, Delgado P. Cognitive Impact of Cerebral Small Vessel Disease Changes in Patients With Hypertension. Hypertension 2019; 73:342-349. [DOI: 10.1161/hypertensionaha.118.12090] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Joan Jiménez-Balado
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Iolanda Riba-Llena
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Oscar Abril
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Edurne Garde
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Anna Penalba
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Elena Ostos
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Olga Maisterra
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Joan Montaner
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Maria Noviembre
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Xavier Mundet
- Primary Healthcare University Research Institute IDIAP Jordi Gol (X.M.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Oriol Ventura
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Jesus Pizarro
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
| | - Pilar Delgado
- From the Neurovascular Research Lab, Vall Hebron Research Institute (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., O.V., J.P., P.D.)
- Universitat Autònoma de Barcelona, Spain (J.J.-B., I.R.-L., O.A., E.G., A.P., E.O., O.M., J.M., M.N., X.M., O.V., J.P., P.D.)
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23
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Langen CD, Cremers LGM, de Groot M, White T, Ikram MA, Niessen WJ, Vernooij MW. Disconnection due to white matter hyperintensities is associated with lower cognitive scores. Neuroimage 2018; 183:745-756. [PMID: 30144572 DOI: 10.1016/j.neuroimage.2018.08.037] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/27/2018] [Accepted: 08/16/2018] [Indexed: 11/17/2022] Open
Abstract
Previous studies have linked global burden of age-related white matter hyperintensities (WMHs) to cognitive impairment. We aimed to determine how WMHs in individual white matter connections relate to measures of cognitive function relative to measures of connectivity which do not take WMHs into account. Brain connectivity and WMH-related disconnectivity were derived from 3714 participants of the population-based Rotterdam Study. Connectivity was represented by the structural connectome, which was defined using diffusion tensor data, whereas the disconnectome represented disconnectivity due to WMH. The relationship between (dis)connectivity and cognitive measures was estimated using linear regression. We found that lower disconnectivity and higher connectivity corresponded to better cognitive function. There were many more significant associations with cognitive function in the disconnectome than in the connectome. Most connectome associations attenuated when disconnection was included in the model. WMH-related disconnectivity was especially related to worse executive functioning. Better cognitive speed corresponded to higher connectivity in specific connections independent of WMH presence. We conclude that WMH-related disconnectivity explains more variation in cognitive function than does connectivity. Efficient wiring in specific connections is important to information processing speed independent of WMH presence.
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Affiliation(s)
- Carolyn D Langen
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Medical Informatics, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Lotte G M Cremers
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Marius de Groot
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Medical Informatics, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Tonya White
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - M Arfan Ikram
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Wiro J Niessen
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Medical Informatics, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Imaging Physics, Faculty of Applied Sciences, PO Box 5046, 2600GA, Delft University of Technology, Delft, the Netherlands.
| | - Meike W Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, PO Box 2040, 3000CA, Rotterdam, the Netherlands.
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Waldron-Perrine B, Kisser JE, Brody A, Haacke EM, Dawood R, Millis S, Levy P. MRI and Neuropsychological Correlates in African Americans With Hypertension and Left Ventricular Hypertrophy. Am J Hypertens 2018; 31:865-868. [PMID: 29672672 DOI: 10.1093/ajh/hpy060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 04/21/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND African Americans (AAs) are at high risk for hypertension (HTN) and poor blood pressure (BP) control. Persistently elevated BP contributes to cardiovascular morbidity. White matter hyperintensities (WMHs) are a definable magnetic resonance imaging (MRI) marker of cerebrovascular injury linked to impairments in higher level thinking (i.e., executive functions), memory formation, and speed of perceptual-motor processing. METHODS This subinvestigation evaluated neuropsychological functioning in association with WMH on brain MRIs in 23 otherwise-healthy hypertensive AAs participating in an NIH-funded study of the effects of vitamin D on BP and cardiac remodeling in AA patients 30-74 years of age with HTN and left ventricular hypertrophy. Neuropsychological assessment included psychomotor processing speed [(Symbol Digit Modality Test (SDMT) and Trail Making Test], executive functioning (Controlled Oral Word Association Test and Trail Making Test Part B), memory (Rey Auditory Verbal Learning Test), and fine motor functioning (Finger Tapping). RESULTS Significant correlations (P < 0.05) were found between volume of periventricular lesions and trails A (r = 0.51) and dominant hand finger tapping speed (r = -0.69) and between subcortical lesion volume and trails A (r = 0.60), both dominant (r = -0.62) and nondominant hand finger tapping speed (r = -0.76) and oral SDMT (r = -0.60); higher lesion volumes correlated to worse neuropsychological performance. CONCLUSIONS Psychomotor tests including the Trail Making Test and finger tapping speed are sensitive indicators of subclinical deficits in mental processing speed and could serve as early markers of deep subcortical cerebrovascular injury in otherwise-healthy individuals with uncontrolled chronic HTN.
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Affiliation(s)
- Brigid Waldron-Perrine
- Department of Physical Medicine and Rehabilitation, Wayne State University and Detroit Medical Center, Detroit, Michigan, USA
| | - Jason E Kisser
- Department of Psychology and Neuropsychology, Detroit Medical Center, Detroit, Michigan, USA
| | - Aaron Brody
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - E Mark Haacke
- Department of Radiology,Wayne State University and Detroit Medical Center, Detroit, Michigan, USA
| | - Rachelle Dawood
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan, USA
| | - Scott Millis
- Department of Physical Medicine and Rehabilitation, Wayne State University and Detroit Medical Center, Detroit, Michigan, USA
| | - Phillip Levy
- Department of Emergency Medicine and Integrative Biosciences Center, Wayne State University, Detroit, Michigan, USA
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Riphagen JM, Gronenschild EHBM, Salat DH, Freeze WM, Ivanov D, Clerx L, Verhey FRJ, Aalten P, Jacobs HIL. Shades of white: diffusion properties of T1- and FLAIR-defined white matter signal abnormalities differ in stages from cognitively normal to dementia. Neurobiol Aging 2018; 68:48-58. [PMID: 29704648 DOI: 10.1016/j.neurobiolaging.2018.03.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 03/24/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
Abstract
The underlying pathology of white matter signal abnormalities (WMSAs) is heterogeneous and may vary dependent on the magnetic resonance imaging contrast used to define them. We investigated differences in white matter diffusivity as an indicator for white matter integrity underlying WMSA based on T1-weighted and fluid-attenuated inversion recovery (FLAIR) imaging contrast. In addition, we investigated which white matter region of interest (ROI) could predict clinical diagnosis best using diffusion metrics. One hundred three older individuals with varying cognitive impairment levels were included and underwent neuroimaging. Diffusion metrics were extracted from WMSA areas based on T1 and FLAIR contrast and from their overlapping areas, the border surrounding the WMSA and the normal-appearing white matter (NAWM). Regional diffusivity differences were calculated with linear mixed effects models. Multinomial logistic regression determined which ROI diffusion values classified individuals best into clinically defined diagnostic groups. T1-based WMSA showed lower white matter integrity compared to FLAIR WMSA-defined regions. Diffusion values of NAWM predicted diagnostic group best compared to other ROI's. To conclude, T1- or FLAIR-defined WMSA provides distinct information on the underlying white matter integrity associated with cognitive decline. Importantly, not the "diseased" but the NAWM is a potentially sensitive indicator for cognitive brain health status.
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Affiliation(s)
- Joost M Riphagen
- Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Anesthesiology, Sankt-Willibrord Spital, Emmerich am Rhein, Germany; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Department of Radiology, Charlestown, MA, USA.
| | - Ed H B M Gronenschild
- Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - David H Salat
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Department of Radiology, Charlestown, MA, USA; Neuroimaging Research for Veterans Center, Boston VA, VA Healthcare System, Boston, MA, USA
| | - Whitney M Freeze
- Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Dimo Ivanov
- Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Lies Clerx
- Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Frans R J Verhey
- Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Pauline Aalten
- Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Heidi I L Jacobs
- Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands; Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital/Harvard Medical School, Boston, MA
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26
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Liu Z, Dai X, Zhang J, Li X, Chen Y, Ma C, Chen K, Peng D, Zhang Z. The Interactive Effects of Age and PICALM rs541458 Polymorphism on Cognitive Performance, Brain Structure, and Function in Non-demented Elderly. Mol Neurobiol 2018; 55:1271-1283. [PMID: 28116548 PMCID: PMC5820373 DOI: 10.1007/s12035-016-0358-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 12/28/2016] [Indexed: 12/04/2022]
Abstract
The PICALM rs541458 T allele has been recognized as a risk factor for late-onset Alzheimer's disease, and age might modulate the effects that genetic factors have on cognitive functions and brain. Thus, the current study intended to examine whether the effects of rs541458 on cognitive functions, brain structure, and function were modulated by age in non-demented Chinese elderly. We enrolled 638 subjects aged 50 to 82 years and evaluated their cognitive functions through a series of neuropsychological tests. Seventy-eight of these participants also received T1-weighted structural and resting state functional magnetic resonance imaging. Dividing subjects into groups <65 and ≥65 years old, results of neuropsychological tests showed that interactive effects of rs541458 × age existed with regard to executive function and processing speed after controlling for gender, years of education and APOE ε4 status. In addition, the effects of rs541458 on resting state functional connectivity of left superior parietal gyrus within left frontal-parietal network and on gray matter volume of left middle temporal gyrus were modulated by age. Furthermore, reduction of functional connectivity of left superior parietal gyrus was closely related with better executive function in the T allele carriers <65 years old. Further, greater volume of left middle temporal gyrus was significantly related to better executive function in both CC genotype <65 years old and CC genotype ≥65 years old groups, separately. Pending further confirmation from additional studies, our results support the hypothesis that the modulation of age, with respect to the rs541458, has interactional effects on cognitive performance, brain function, and structural measurements.
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Affiliation(s)
- Zhen Liu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, People's Republic of China
- BABRI Centre, Beijing Normal University, Beijing, 100875, People's Republic of China
| | - Xiangwei Dai
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, People's Republic of China
- BABRI Centre, Beijing Normal University, Beijing, 100875, People's Republic of China
| | - Junying Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, People's Republic of China
- BABRI Centre, Beijing Normal University, Beijing, 100875, People's Republic of China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, People's Republic of China
- BABRI Centre, Beijing Normal University, Beijing, 100875, People's Republic of China
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, People's Republic of China
- BABRI Centre, Beijing Normal University, Beijing, 100875, People's Republic of China
| | - Chao Ma
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, People's Republic of China
- BABRI Centre, Beijing Normal University, Beijing, 100875, People's Republic of China
| | - Kewei Chen
- BABRI Centre, Beijing Normal University, Beijing, 100875, People's Republic of China
- Banner Alzheimer's Institute, Phoenix, AZ, 85006, USA
| | - Dantao Peng
- Department of Neurology, China-Japan Friendship Hospital, Beijing, 100029, People's Republic of China.
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, People's Republic of China.
- BABRI Centre, Beijing Normal University, Beijing, 100875, People's Republic of China.
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27
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De Carolis A, Cipollini V, Donato N, Sepe-Monti M, Orzi F, Giubilei F. Cognitive profiles in degenerative dementia without evidence of small vessel pathology and small vessel vascular dementia. Neurol Sci 2016; 38:101-107. [PMID: 27655157 DOI: 10.1007/s10072-016-2716-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 09/14/2016] [Indexed: 12/18/2022]
Abstract
Although a large number of studies have examined possible differences in cognitive performance between Alzheimer's disease (AD) and vascular dementia (VaD), the data in the literature are conflicting. The aims of this study were to analyze the neuropsychological pattern of subjects affected by degenerative dementia without evidence of small vessel pathology (DD) and small vessel VaD subjects in the early stages and to investigate differences in the progression of cognitive impairment. Seventy-five patients with probable VaD and 75 patients with probable DD were included. All the subjects underwent a standard neuropsychological evaluation, including the following test: Visual Search, Attentional matrices, Story Recall, Raven's Coloured Progressive Matrices, Phonological and Semantic Verbal Fluency, Token, and Copying Drawings. The severity of cognitive impairment was stratified according to the MMSE score. Fifteen subjects with probable DD and 10 subjects with probable VaD underwent a 12-month cognitive re-evaluation. No significant difference was found between DD and VaD subjects in any of the neuropsychological tests except Story Recall in the mild cognitive impairment (P < 0.001). The re-test value was significantly worse than the baseline value in the MMSE (P = 0.037), Corsi (P = 0.041), Story Recall (P = 0.032), Phonological Verbal Fluency (P = 0.02), and Copying Drawings (P = 0.043) in DD patients and in the Visual Search test (P = 0.036) in VaD subjects. These results suggest that a neuropsychological evaluation might help to differentiate degenerative dementia without evidence of small vessel pathology from small vessel VaD in the early stages of these diseases.
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Affiliation(s)
- Antonella De Carolis
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Virginia Cipollini
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, via di Grottarossa 1035-1039, 00189, Rome, Italy.
| | - Nicole Donato
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Micaela Sepe-Monti
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Francesco Orzi
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Franco Giubilei
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, via di Grottarossa 1035-1039, 00189, Rome, Italy
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28
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Taylor ANW, Kambeitz-Ilankovic L, Gesierich B, Simon-Vermot L, Franzmeier N, Araque Caballero MÁ, Müller S, Hesheng L, Ertl-Wagner B, Bürger K, Weiner MW, Dichgans M, Duering M, Ewers M. Tract-specific white matter hyperintensities disrupt neural network function in Alzheimer's disease. Alzheimers Dement 2016; 13:225-235. [PMID: 27432800 PMCID: PMC5319922 DOI: 10.1016/j.jalz.2016.06.2358] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 05/27/2016] [Accepted: 06/02/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION White matter hyperintensities (WMHs) increase the risk of Alzheimer's disease (AD). Whether WMHs are associated with the decline of functional neural networks in AD is debated. METHOD Resting-state functional magnetic resonance imaging and WMH were assessed in 78 subjects with increased amyloid levels on AV-45 positron emission tomography (PET) in different clinical stages of AD. We tested the association between WMH volume in major atlas-based fiber tract regions of interest (ROIs) and changes in functional connectivity (FC) between the tracts' projection areas within the default mode network (DMN). RESULTS WMH volume within the inferior fronto-occipital fasciculus (IFOF) was the highest among all tract ROIs and associated with reduced FC in IFOF-connected DMN areas, independently of global AV-45 PET. Higher AV-45 PET contributed to reduced FC in IFOF-connected, temporal, and parietal DMN areas. CONCLUSIONS High fiber tract WMH burden is associated with reduced FC in connected areas, thus adding to the effects of amyloid pathology on neuronal network function.
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Affiliation(s)
- Alexander N W Taylor
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Benno Gesierich
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Lee Simon-Vermot
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Miguel Á Araque Caballero
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Sophia Müller
- Institute of Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Liu Hesheng
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Birgit Ertl-Wagner
- Institute of Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Katharina Bürger
- Institute of Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Michael W Weiner
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA; VA Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany.
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29
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Smith CD, Johnson ES, Van Eldik LJ, Jicha GA, Schmitt FA, Nelson PT, Kryscio RJ, Murphy RR, Wellnitz CV. Peripheral (deep) but not periventricular MRI white matter hyperintensities are increased in clinical vascular dementia compared to Alzheimer's disease. Brain Behav 2016; 6:e00438. [PMID: 26925303 PMCID: PMC4754499 DOI: 10.1002/brb3.438] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 12/18/2015] [Accepted: 12/21/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND PURPOSE Vascular dementia (VAD) is a complex diagnosis at times difficult to distinguish from Alzheimer's disease (AD). MRI scans often show white matter hyperintensities (WMH) in both conditions. WMH increase with age, and both VAD and AD are associated with aging, thus presenting an attribution conundrum. In this study, we sought to show whether the amount of WMH in deep white matter (dWMH), versus periventricular white matter (PVH), would aid in the distinction between VAD and AD, independent of age. METHODS Blinded semiquantitative ratings of WMH validated by objective quantitation of WMH volume from standardized MRI image acquisitions. PVH and dWMH were rated separately and independently by two different examiners using the Scheltens scale. Receiver operator characteristic (ROC) curves were generated using logistic regression to assess classification of VAD (13 patients) versus AD (129 patients). Clinical diagnoses were made in a specialty memory disorders clinic. RESULTS Using PVH rating alone, overall classification (area under the ROC curve, AUC) was 75%, due only to the difference in age between VAD and AD patients in our study and not PVH. In contrast, dWMH rating produced 86% classification accuracy with no independent contribution from age. A global Longstreth rating that combines dWMH and PVH gave an 88% AUC. CONCLUSIONS Increased dWMH indicate a higher likelihood of VAD versus AD. Assessment of dWMH on MRI scans using Scheltens and Longstreth scales may aid the clinician in distinguishing the two conditions.
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Affiliation(s)
- Charles D Smith
- Department of Neurology University of Kentucky College of Medicine Lexington Kentucky; Magnetic Resonance Imaging and Spectroscopy Center University of Kentucky Lexington Kentucky
| | - Eleanor S Johnson
- Magnetic Resonance Imaging and Spectroscopy Center University of Kentucky Lexington Kentucky
| | - Linda J Van Eldik
- Alzheimers Disease Center Sanders-Brown Center on Aging University of Kentucky Lexington Kentucky; Department of Anatomy and Neurobiology University of Kentucky College of Medicine Lexington Kentucky
| | - Gregory A Jicha
- Department of Neurology University of Kentucky College of Medicine Lexington Kentucky; Alzheimers Disease Center Sanders-Brown Center on Aging University of Kentucky Lexington Kentucky
| | - Frederick A Schmitt
- Department of Neurology University of Kentucky College of Medicine Lexington Kentucky; Alzheimers Disease Center Sanders-Brown Center on Aging University of Kentucky Lexington Kentucky
| | - Peter T Nelson
- Alzheimers Disease Center Sanders-Brown Center on Aging University of Kentucky Lexington Kentucky; Department of Pathology & Laboratory Medicine University of Kentucky College of Medicine Lexington Kentucky
| | - Richard J Kryscio
- Alzheimers Disease Center Sanders-Brown Center on Aging University of Kentucky Lexington Kentucky; Department of Statistics University of Kentucky Lexington Kentucky
| | - Ronan R Murphy
- Department of Neurology University of Kentucky College of Medicine Lexington Kentucky; Alzheimers Disease Center Sanders-Brown Center on Aging University of Kentucky Lexington Kentucky
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Are transversal MR images sufficient to distinguish persons with mild cognitive impairment from healthy controls? Acad Radiol 2015; 22:1172-80. [PMID: 26162248 DOI: 10.1016/j.acra.2015.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/14/2015] [Accepted: 04/15/2015] [Indexed: 12/27/2022]
Abstract
RATIONALE AND OBJECTIVES Mild cognitive impairment (MCI) is associated with an increased risk of developing dementia. This study aims to determine whether current standard magnetic resonance imaging (MRI) is providing markers that can distinguish between subjects with amnestic MCI (aMCI), nonamnestic MCI (naMCI), and healthy controls (HCs). MATERIALS AND METHODS A subset of 126 MCI subjects and 126 age-, gender-, and education-appropriate HCs (mean age, 70.9 years) were recruited from 4157 participants in the longitudinal community-based Heinz Nixdorf Recall Study. The burden of white matter hyperintensities (WMHs), cerebral microbleeds, and brain atrophy was evaluated on transversal MR images from a single 1.5-T MR scanner by two blinded neuroradiologists. Logistic regression and receiver-operating characteristic analysis were used for statistical analysis. RESULTS Occipital WMH burden was significantly increased in aMCI, but not in naMCI relative to HCs (P = .01). The combined MCI group showed brain atrophy relative to HCs (P = .01) pronounced at caudate nuclei (P = .01) and temporal horn level (P = .004) of aMCI patients and increased at the frontal and occipital horns of naMCI patients compared to either aMCI or HCs. Microbleeds were equally distributed in the MCI and control group, but more frequent in aMCI (22 of 84) compared to naMCI subjects (3 of 23). CONCLUSIONS In his cohort, increased occipital WMHs and cortical and subcortical brain atrophies at temporal horn and caudate nuclei level distinguished aMCI from naMCI subjects and controls. Volumetric indices appear of interest and should be assessed under reproducible conditions to gain diagnostic accuracy.
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Abstract
Psychosis is relatively common in later life and can present in a wide variety of contexts, including early-onset and late-onset schizophrenia, delusional disorder, mood disorders, and various dementias. It can also occur as the result of numerous medical and neurological diseases and from the use of certain medications. Although identifying the cause of psychosis in older patients can be challenging, the unique clinical features associated with the different disorders can help in making the diagnosis. Accurate diagnosis of psychosis in older populations is essential, as its treatment varies depending on the context in which it appears. Despite the safety concerns regarding the use of antipsychotics in older patients, certain pharmacological treatments appear to be both efficacious and reasonably safe in treating psychosis in older populations. Additionally, although research is limited, numerous psychosocial therapies appear promising. This review summarizes the literature on the epidemiology, clinical characteristics, neuroimaging, and treatment of psychosis in later life, and serves as an update to past reviews on this topic.
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Love S, Miners JS. White matter hypoperfusion and damage in dementia: post-mortem assessment. Brain Pathol 2015; 25:99-107. [PMID: 25521180 DOI: 10.1111/bpa.12223] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 10/08/2014] [Indexed: 01/19/2023] Open
Abstract
Neuroimaging has revealed a range of white matter abnormalities that are common in dementia, some that predict cognitive decline. The abnormalities may result from structural diseases of the cerebral vasculature, such as arteriolosclerosis and amyloid angiopathy, but can also be caused by nonstructural vascular abnormalities (eg, of vascular contractility or permeability), neurovascular instability or extracranial cardiac or vascular disease. Conventional histopathological assessment of the white matter has tended to conflate morphological vascular abnormalities with changes that reflect altered interstitial fluid dynamics or white matter ischemic damage, even though the latter may be of extracranial or nonstructural etiology. However, histopathology is being supplemented by biochemical approaches, including the measurement of proteins involved in the molecular responses to brain ischemia, myelin proteins differentially susceptible to ischemic damage, vessel-associated proteins that allow rapid measurement of microvessel density, markers of blood-brain barrier dysfunction and axonal injury, and mediators of white matter damage. By combining neuroimaging with histopathology and biochemical analysis, we can provide reproducible, quantitative data on the severity of white matter damage, and information on its etiology and pathogenesis. Together these have the potential to inform and improve treatment, particularly in forms of dementia to which white matter hypoperfusion makes a significant contribution.
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Affiliation(s)
- Seth Love
- Dementia Research Group, Institute of Clinical Neurosciences, University of Bristol, Learning and Research Level 2, Southmead Hospital, Bristol, UK
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Liu CH. Anatomical, functional and molecular biomarker applications of magnetic resonance neuroimaging. FUTURE NEUROLOGY 2015; 10:49-65. [DOI: 10.2217/fnl.14.60] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
ABSTRACT MRI and magnetic resonance spectroscopy (MRS) along with computed tomography and PET are the most common imaging modalities used in the clinics to detect structural abnormalities and pathological conditions in the brain. MRI generates superb image resolution/contrast without radiation exposure that is associated with computed tomography and PET; MRS and spectroscopic imaging technologies allow us to measure changes in brain biochemistry. Increasingly, neurobiologists and MRI scientists are collaborating to solve neuroscience problems across sub-cellular through anatomical levels. To achieve successful cross-disciplinary collaborations, neurobiologists must have sufficient knowledge of magnetic resonance principles and applications in order to effectively communicate with their MRI colleagues. This review provides an overview of magnetic resonance techniques and how they can be used to gain insight into the active brain at the anatomical, functional and molecular levels with the goal of encouraging neurobiologists to include MRI/MRS as a research tool in their endeavors.
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Nowrangi MA, Lyketsos C, Rao V, Munro CA. Systematic review of neuroimaging correlates of executive functioning: converging evidence from different clinical populations. J Neuropsychiatry Clin Neurosci 2014; 26:114-25. [PMID: 24763759 PMCID: PMC5171230 DOI: 10.1176/appi.neuropsych.12070176] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Executive functioning (EF) is an important cognitive domain that is negatively affected in a number of neuropsychiatric conditions. Neuroimaging methods have led to insights into the anatomical and functional nature of EF. The authors conducted a systematic review of the recent cognitive and neuroimaging literature to investigate how the neuroimaging correlates of EF compare between different diagnostic groups. The authors found that the frontal, parietal, and cerebellar lobes were most frequently associated with EF when comparing results from different clinical populations; the occipital lobe was not correlated with EF in any group. These findings suggest that individual disease processes affect circuits within an identifiable distributed network rather than isolated regions.
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35
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Hahn C, Lim HK, Lee CU. Neuroimaging findings in late-onset schizophrenia and bipolar disorder. J Geriatr Psychiatry Neurol 2014; 27:56-62. [PMID: 24401535 DOI: 10.1177/0891988713516544] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In recent years, there has been an increasing interest in late-onset mental disorders. Among them, geriatric schizophrenia and bipolar disorder are significant health care risks and major causes of disability. We discussed whether late-onset schizophrenia (LOS) and late-onset bipolar (LOB) disorder can be a separate entity from early-onset schizophrenia (EOS) and early-onset bipolar (EOB) disorder in a subset of late-life schizophrenia or late-life bipolar disorder through neuroimaging studies. A literature search for imaging studies of LOS or LOB was performed in the PubMed database. Search terms used were "(imaging OR MRI OR CT OR SPECT OR DTI OR PET OR fMRI) AND (schizophrenia or bipolar disorder) AND late onset." Articles that were published in English before October 2013 were included. There were a few neuroimaging studies assessing whether LOS and LOB had different disease-specific neural substrates compared with EOS and EOB. These researches mainly observed volumetric differences in specific brain regions, white matter hyperintensities, diffusion tensor imaging, or functional neuroimaging to explore the differences between LOS and LOB and EOS and EOB. The aim of this review was to highlight the neural substrates involved in LOS and LOB through neuroimaging studies. The exploration of neuroanatomical markers may be the key to the understanding of underlying neurobiology in LOS and LOB.
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Affiliation(s)
- Changtae Hahn
- Department of Psychiatry, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Chincarini A, Bosco P, Gemme G, Esposito M, Rei L, Squarcia S, Bellotti R, Minthon L, Frisoni G, Scheltens P, Frölich L, Soininen H, Visser PJ, Nobili F. Automatic temporal lobe atrophy assessment in prodromal AD: Data from the DESCRIPA study. Alzheimers Dement 2013; 10:456-467. [PMID: 24035058 DOI: 10.1016/j.jalz.2013.05.1774] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 05/10/2013] [Accepted: 05/23/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND In the framework of the clinical validation of research tools, this investigation presents a validation study of an automatic medial temporal lobe atrophy measure that is applied to a naturalistic population sampled from memory clinic patients across Europe. METHODS The procedure was developed on 1.5-T magnetic resonance images from the Alzheimer's Disease Neuroimaging Initiative database, and it was validated on an independent data set coming from the DESCRIPA study. All images underwent an automatic processing procedure to assess tissue atrophy that was targeted at the hippocampal region. For each subject, the procedure returns a classification index. Once provided with the clinical assessment at baseline and follow-up, subjects were grouped into cohorts to assess classification performance. Each cohort was divided into converters (co) and nonconverters (nc) depending on the clinical outcome at follow-up visit. RESULTS We found the area under the receiver operating characteristic curve (AUC) was 0.81 for all co versus nc subjects, and AUC was 0.90 for subjective memory complaint (SMCnc) versus all co subjects. Furthermore, when training on mild cognitive impairment (MCI-nc/MCI-co), the classification performance generally exceeds that found when training on controls versus Alzheimer's disease (CTRL/AD). CONCLUSIONS Automatic magnetic resonance imaging analysis may assist clinical classification of subjects in a memory clinic setting even when images are not specifically acquired for automatic analysis.
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Affiliation(s)
- Andrea Chincarini
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy.
| | - Paolo Bosco
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy
| | - Gianluca Gemme
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy
| | - Mario Esposito
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy
| | - Luca Rei
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy
| | - Sandro Squarcia
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy
| | - Roberto Bellotti
- Dipartimento Interateneo di Fisica "M. Merlin" and TIRES, Università degli Studi di Bari, Bari, Italy; Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Bari, Italy
| | - Lennart Minthon
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö Lund University, Malmo, Sweden
| | - Giovanni Frisoni
- IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Philip Scheltens
- Alzheimer Centre, Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Pieter-Jelle Visser
- Alzheimer Centre, Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Flavio Nobili
- Neurofisiologia Clinica, Dipartimento di Neuroscienze, Oftalmologia e Genetica, Azienda Ospedale-Università S. Martino, Genova, Italy
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Leritz EC, Shepel J, Williams VJ, Lipsitz LA, McGlinchey RE, Milberg WP, Salat DH. Associations between T1 white matter lesion volume and regional white matter microstructure in aging. Hum Brain Mapp 2013; 35:1085-100. [PMID: 23362153 DOI: 10.1002/hbm.22236] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 10/16/2012] [Accepted: 11/11/2012] [Indexed: 01/18/2023] Open
Abstract
White matter lesions, typically manifesting as regions of signal intensity abnormality (WMSA) on MRI, increase in frequency with age. However, the role of this damage in cognitive decline and disease is still not clear, as lesion volume has only loosely been associated with clinical status. Diffusion tensor imaging (DTI) has been used to examine the quantitative microstructural integrity of white matter, and has applications in the examination of subtle changes to tissue that appear visually normal on conventional imaging. The primary goal of this study was to determine whether major macrostructural white matter damage, (total WMSA volume), is associated with microstructural integrity of normal appearing white matter, and if these macrostructural changes fully account for microstructural changes. Imaging was performed in 126 nondemented individuals, ages 43-85 years, with no history of cerebrovascular disease. Controlling for age, greater WMSA volume was associated with decreased fractional anisotropy (FA) in widespread brain regions. Patterns were similar for FA and radial diffusivity but in contrast, WMSA was associated with axial diffusivity in fewer areas. Age was associated with FA in several regions, and many of these effects remained even when controlling for WMSA volume, suggesting the etiology of WMSAs does not fully account for all age-associated white matter deterioration. These results provide evidence that WMSA volume is associated with the integrity of normal-appearing white matter. In addition, our results suggest that overt lesions may not account for the association of increasing age with decreased white matter tissue integrity.
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Affiliation(s)
- Elizabeth C Leritz
- Geriatric Research, Education and Clinical Center (GRECC) and Neuroimaging Research for Veterans Center (NeRVe), VA Boston Healthcare System, Boston, Massachusetts; Division of Aging, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts
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Brickman AM, Provenzano FA, Muraskin J, Manly JJ, Blum S, Apa Z, Stern Y, Brown TR, Luchsinger JA, Mayeux R. Regional white matter hyperintensity volume, not hippocampal atrophy, predicts incident Alzheimer disease in the community. ARCHIVES OF NEUROLOGY 2012; 69:1621-7. [PMID: 22945686 PMCID: PMC3597387 DOI: 10.1001/archneurol.2012.1527] [Citation(s) in RCA: 190] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND New-onset Alzheimer disease (AD) is often attributed to degenerative changes in the hippocampus. However, the contribution of regionally distributed small vessel cerebrovascular disease, visualized as white matter hyperintensities (WMHs) on magnetic resonance imaging, remains unclear. OBJECTIVE To determine whether regional WMHs and hippocampal volume predict incident AD in an epidemiological study. DESIGN A longitudinal community-based epidemiological study of older adults from northern Manhattan, New York. SETTING The Washington Heights/Inwood Columbia Aging Project. PARTICIPANTS Between 2005 and 2007, 717 participants without dementia received magnetic resonance imaging scans. A mean (SD) of 40.28 (9.77) months later, 503 returned for follow-up clinical examination and 46 met criteria for incident dementia (45 with AD). Regional WMHs and relative hippocampal volumes were derived. Three Cox proportional hazards models were run to predict incident dementia, controlling for relevant variables. The first included all WMH measurements; the second included relative hippocampal volume; and the third combined the 2 measurements. MAIN OUTCOME MEASURE Incident AD. RESULTS White matter hyperintensity volume in the parietal lobe predicted time to incident dementia (hazard ratio [HR] = 1.194; P = .03). Relative hippocampal volume did not predict incident dementia when considered alone (HR = 0.419; P = .77) or with the WMH measures included in the model (HR = 0.302; P = .70). Including hippocampal volume in the model did not notably alter the predictive utility of parietal lobe WMHs (HR = 1.197; P = .049). CONCLUSIONS The findings highlight the regional specificity of the association of WMHs with AD. It is not clear whether parietal WMHs solely represent a marker for cerebrovascular burden or point to distinct injury compared with other regions. Future work should elucidate pathogenic mechanisms linking WMHs and AD pathology.
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Affiliation(s)
- Adam M. Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Frank A. Provenzano
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Jordan Muraskin
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Jennifer J. Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Sonja Blum
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Zoltan Apa
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Yaakov Stern
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Truman R. Brown
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC
| | - José A. Luchsinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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Sudo FK, Alves CEO, Alves GS, Ericeira-Valente L, Tiel C, Moreira DM, Laks J, Engelhardt E. Dysexecutive syndrome and cerebrovascular disease in non-amnestic mild cognitive impairment: A systematic review of the literature. Dement Neuropsychol 2012; 6:145-151. [PMID: 29213788 PMCID: PMC5618961 DOI: 10.1590/s1980-57642012dn06030006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective Non-amnestic dysexecutive Vascular Mild Cognitive Impairment (VaMCI) may
represent preclinical Vascular Dementia (VaD). The aim of this study was to
summarize the clinical, neuropsychological and neuroimaging aspects of
VaMCI; and to assess its patterns of progression to dementia. Methods Searches were made in the ISI Web of Knowledge, PubMed and Lilacs databases,
using the terms "mild cognitive impairment" and "executive function".
Altogether, 944 articles were retrieved. Results VaMCI cases had poorer performances on fronto-executive tasks, a higher
prevalence of stroke, presence of periventricular and profound white matter
hyperintensities on MRI images, as well as more extrapyramidal signs and
behavioral symptoms. Executive dysfunction might be associated with
disconnection of fronto-parietal-subcortical circuits. Progression to
dementia was associated with baseline deficits in executive function, in
simple sustained attention and language, and large periventricular WMH. Discussion VaMCI develops with impairment in non-memory domains and subcortical white
matter changes on MRI images, which are consistent with clinical and
neuroimaging findings in VaD.
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Affiliation(s)
- Felipe Kenji Sudo
- Instituto de Psiquiatria, Center for Alzheimer's Disease (CDA/IPUB), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Carlos Eduardo Oliveira Alves
- Instituto de Psiquiatria, Center for Alzheimer's Disease (CDA/IPUB), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Gilberto Sousa Alves
- Instituto de Psiquiatria, Center for Alzheimer's Disease (CDA/IPUB), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Letice Ericeira-Valente
- Instituto de Psiquiatria, Center for Alzheimer's Disease (CDA/IPUB), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Chan Tiel
- Instituto de Neurologia Deolindo Couto (INDC), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Cognitive and Behavioral Neurology Unit, INDC-CDA/IPUB, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Denise Madeira Moreira
- Instituto de Neurologia Deolindo Couto (INDC), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Hospital Pró-Cardíaco, Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Jerson Laks
- Instituto de Psiquiatria, Center for Alzheimer's Disease (CDA/IPUB), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Universidade do Estado do Rio de Janeiro
| | - Eliasz Engelhardt
- Instituto de Neurologia Deolindo Couto (INDC), Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.,Cognitive and Behavioral Neurology Unit, INDC-CDA/IPUB, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
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Hommet C, Mondon K, Constans T, Beaufils E, Desmidt T, Camus V, Cottier JP. Review of cerebral microangiopathy and Alzheimer's disease: relation between white matter hyperintensities and microbleeds. Dement Geriatr Cogn Disord 2012; 32:367-78. [PMID: 22301385 DOI: 10.1159/000335568] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2011] [Indexed: 01/18/2023] Open
Abstract
Although Alzheimer's disease (AD) is basically considered to be a neurodegenerative disorder, cerebrovascular disease is also involved. The role of vascular risk factors and vascular disease in the progression of AD remains incompletely understood. With the development of brain MRI, it is now possible to detect small-vessel disease, whose prevalence and severity increase with age. The first types of small-vessel disease to be described were white matter hyperintensities (WMHs). More recently, small areas of signal loss on T(2)*-weighted images, also called microbleeds (MBs), have been reported. Cerebral MBs are focal deposits of hemosiderin that indicate prior microhemorrhages around small vessels, related to either ruptured atherosclerotic microvessels or amyloid angiopathy. Consequently, using brain MRI for the detection of microangiopathy may prove useful to improve our understanding of the impact of the vascular burden in AD pathology. The relationship between microangiopathy and the clinical course of AD or the conversion of mild cognitive impairment to AD remains questionable in terms of cognitive or affective symptoms, particularly if we consider MBs.
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Affiliation(s)
- C Hommet
- Médecine Interne Gériatrique et CMRR, Hôpital Bretonneau, CHRU Tours, Tours, France.
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Abstract
There are many reports of relations between age and cognitive variables and of relations between age and variables representing different aspects of brain structure and a few reports of relations between brain structure variables and cognitive variables. These findings have sometimes led to inferences that the age-related brain changes cause the age-related cognitive changes. Although this conclusion may well be true, it is widely recognized that simple correlations are not sufficient to warrant causal conclusions, and other types of correlational information, such as mediation and correlations between longitudinal brain changes and longitudinal cognitive changes, also have limitations with respect to causal inferences. These issues are discussed, and the existing results on relations of regional volume, white matter hyperintensities, and diffusion tensor imaging measures of white matter integrity to age and to measures of cognitive functioning are reviewed. It is concluded that at the current time the evidence that these aspects of brain structure are neuroanatomical substrates of age-related cognitive decline is weak. The final section contains several suggestions concerning measurement and methodology that may lead to stronger conclusions in the future.
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Affiliation(s)
- Timothy A Salthouse
- Department of Psychology, University of Virginia, Charlottesville, VA 22904-4400, USA.
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Allopregnanolone promotes regeneration and reduces β-amyloid burden in a preclinical model of Alzheimer's disease. PLoS One 2011; 6:e24293. [PMID: 21918687 PMCID: PMC3168882 DOI: 10.1371/journal.pone.0024293] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 08/04/2011] [Indexed: 11/20/2022] Open
Abstract
Previously, we demonstrated that allopregnanolone (APα) promoted proliferation of rodent and human neural progenitor cells in vitro. Further, we demonstrated that APα promoted neurogenesis in the hippocampal subgranular zone (SGZ) and reversed learning and memory deficits in the male triple transgenic mouse model of Alzheimer's (3xTgAD). In the current study, we determined the efficacy of APα to promote the survival of newly generated neural cells while simultaneously reducing Alzheimer's disease (AD) pathology in the 3xTgAD male mouse model. Comparative analyses between three different APα treatment regimens indicated that APα administered 1/week for 6 months was maximally efficacious for simultaneous promotion of neurogenesis and survival of newly generated cells and reduction of AD pathology. We further investigated the efficacy of APα to impact Aβ burden. Treatment was initiated either prior to or post intraneuronal Aβ accumulation. Results indicated that APα administered 1/week for 6 months significantly increased survival of newly generated neurons and simultaneously reduced Aβ pathology with greatest efficacy in the pre-pathology treatment group. APα significantly reduced Aβ generation in hippocampus, cortex, and amygdala, which was paralleled by decreased expression of Aβ-binding-alcohol-dehydrogenase. In addition, APα significantly reduced microglia activation as indicated by reduced expression of OX42 while increasing CNPase, an oligodendrocyte myelin marker. Mechanistic analyses indicated that pre-pathology treatment with APα increased expression of liver-X-receptor, pregnane-X-receptor, and 3-hydroxy-3-methyl-glutaryl-CoA-reductase (HMG-CoA-R), three proteins that regulate cholesterol homeostasis and clearance from brain. Together these findings provide preclinical evidence for the optimal treatment regimen of APα to achieve efficacy as a disease modifying therapeutic to promote regeneration while simultaneously decreasing the pathology associated with Alzheimer's disease.
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