1
|
Kim J, Kim E, Lee SH, Lee G, Kim YH. Use of cortical hemodynamic responses in digital therapeutics for upper limb rehabilitation in patients with stroke. J Neuroeng Rehabil 2024; 21:115. [PMID: 38987817 PMCID: PMC11238451 DOI: 10.1186/s12984-024-01404-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/11/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Stroke causes long-term disabilities, highlighting the need for innovative rehabilitation strategies for reducing residual impairments. This study explored the potential of functional near-infrared spectroscopy (fNIRS) for monitoring cortical activation during rehabilitation using digital therapeutics. METHODS This cross-sectional study included 18 patients with chronic stroke, of whom 13 were men. The mean age of the patients was 67.0 ± 7.1 years. Motor function was evaluated through various tests, including the Fugl-Meyer assessment for upper extremity (FMA-UE), grip and pinch strength test, and box and block test. All the patients completed the digital rehabilitation program (MotoCog®, Cybermedic Co., Ltd., Republic of Korea) while being monitored using fNIRS (NIRScout®, NIRx Inc., Germany). Statistical parametric mapping (SPM) was employed to analyze the cortical activation patterns from the fNIRS data. Furthermore, the K-nearest neighbor (K-NN) algorithm was used to analyze task performance and fNIRS data to classify the severity of motor impairment. RESULTS The participants showed diverse task performances in the digital rehabilitation program, demonstrating distinct patterns of cortical activation that correlated with different motor function levels. Significant activation was observed in the ipsilesional primary motor area (M1), primary somatosensory area (S1), and contralateral prefrontal cortex. The activation patterns varied according to the FMA-UE scores. Positive correlations were observed between the FMA-UE scores and SPM t-values in the ipsilesional M1, whereas negative correlations were observed in the ipsilesional S1, frontal lobe, and parietal lobe. The incorporation of cortical hemodynamic responses with task scores in a digital rehabilitation program substantially improves the accuracy of the K-NN algorithm in classifying upper limb functional levels in patients with stroke. The accuracy for tasks, such as the gas stove-operation task, increased from 44.4% using only task scores to 83.3% when these scores were combined with oxy-Hb t-values from the ipsilesional M1. CONCLUSIONS The results advocated the development of tailored digital rehabilitation strategies by combining the behavioral and cerebral hemodynamic data of patients with stroke. This approach aligns with the evolving paradigm of personalized rehabilitation in stroke recovery, highlighting the need for further extensive research to optimize rehabilitation outcomes.
Collapse
Affiliation(s)
- Jinuk Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, 16419, Republic of Korea
| | - Eunmi Kim
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Suwon, 16419, Republic of Korea
| | - Su-Hyun Lee
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Suwon, 16419, Republic of Korea
| | - Gihyoun Lee
- Department of Biomedical Engineering, Chonnam National University, Yeosu, 59626, Republic of Korea.
- School of Healthcare and Biomedical Engineering, Chonnam National University, Yeosu, 59626, Republic of Korea.
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Suwon, 16419, Republic of Korea.
- Myongji Choonhey Rehabilitation Hospital, Seoul, 07378, Republic of Korea.
| |
Collapse
|
2
|
Hsieh PI, Chen YC, Chen TF, Chiou JM, Chen JH. Multimorbid Patterns and Cognitive Performance in the Presence of Informative Dropout Among Community-Dwelling Taiwanese Older Adults. Innov Aging 2023; 7:igad012. [PMID: 37007640 PMCID: PMC10053640 DOI: 10.1093/geroni/igad012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Indexed: 02/10/2023] Open
Abstract
Background and Objectives Longitudinal studies among older adults often feature elevated dropout rates and multiple chronic conditions. How Taiwanese multimorbid patterns relate to different cognitive domains remains unclear. This study aims to identify sex-specific multimorbid patterns and associate them with cognitive performance while modeling the risk for dropout. Research Design and Methods A prospective cohort study (2011-19) in Taiwan recruited 449 Taiwanese older adults without dementia. Global and domain-specific cognition were assessed biennially. We used exploratory factor analysis to identify baseline sex-specific multimorbid patterns of 19 self-reported chronic conditions. We utilized a joint model incorporating longitudinal and time-to-dropout data to examine the association between multimorbid patterns and cognitive performance accounting for the informative dropout via the shared random effect. Results At the end of the study, 324 participants (72.1%) remained in the cohort, with an average annual attrition rate of 5.5%. We found that advanced age, low levels of physical activities, and poor cognition at baseline were associated with increased dropout risks. Besides, 6 multimorbid patterns were identified, labeled Mental, Renal-vascular, and Cancer-urinary patterns in men, and Mental, Cardiometabolic, and Cancer-endocrine patterns in women. For men, as the follow-up time increased, the Mental pattern was associated with poor global cognition and attention; the Renal-vascular pattern was associated with poor executive function. For women, the Mental pattern was associated with poor memory; as follow-up time increased, and Cardiometabolic patterns were related to poor memory. Discussion and Implications Sex-specific multimorbid patterns identified in the Taiwanese older population showed differences (notably Renal-vascular pattern in men) from patterns found in Western countries and were differentially associated with cognitive impairment over time. When informative dropout is suspected, appropriate statistical methods should be applied.
Collapse
Affiliation(s)
- Pei-Iun Hsieh
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistical Science, Academia Sinica, Nankang District, Taipei, Taiwan
- Institute of Statistics and Data Science, National Taiwan University, Taipei, Taiwan
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
3
|
Oishi K, Soldan A, Pettigrew C, Hsu J, Mori S, Albert M, Oishi K. Changes in pairwise functional connectivity associated with changes in cognitive performance in cognitively normal older individuals: A two-year observational study. Neurosci Lett 2022; 781:136618. [PMID: 35398188 PMCID: PMC9990522 DOI: 10.1016/j.neulet.2022.136618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/15/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
Abstract
Neurobiological substrates of cognitive decline in cognitively normal older individuals have been investigated by resting-state functional magnetic resonance imaging, but little is known about the relationship between longitudinal changes in the whole brain. In this study, we examined two-year changes in functional connectivity among 80 gray matter areas and investigated the relationship to two-year changes in cognitive performance. A cross-validated permutation variable importance measure was applied to select features related to a change in cognitive performance. Age-corrected changes in eleven pairs of functional connections were selected as important features, all related to brain areas that belong to the default mode network. A linear regression model with cross-validation demonstrated a mean correlation coefficient of 0.55 between measured and predicted changes in the cognitive composite score. These results suggest that intra- and inter-network connections in the default mode network are associated with cognitive changes over two years among cognitively normal individuals.
Collapse
Affiliation(s)
- Kumiko Oishi
- Center for Imaging Science, The Johns Hopkins University, Whiting School of Engineering, The Johns Hopkins University, Baltimore, MD, USA
| | - Anja Soldan
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Corinne Pettigrew
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Johnny Hsu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Susumu Mori
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marilyn Albert
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kenichi Oishi
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
4
|
Qin S, Basak C. Fitness and arterial stiffness in healthy aging: Modifiable cardiovascular risk factors contribute to altered default mode network patterns during executive function. Neuropsychologia 2022; 172:108269. [PMID: 35595064 DOI: 10.1016/j.neuropsychologia.2022.108269] [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: 10/11/2021] [Revised: 05/07/2022] [Accepted: 05/12/2022] [Indexed: 11/28/2022]
Abstract
Increases in cardiovascular risks such as high blood pressure and low physical fitness have been independently associated with altered default mode network (DMN) activation patterns in healthy aging. However, cardiovascular risk is a multidimensional health problem. Therefore, we need to investigate multiple cardiovascular risk factors and their contributions to cognition and DMN activations in older adults, which has not yet been done. The current fMRI study examined contributions of two common modifiable cardiovascular risk factors (arterial stiffness and physical fitness) on DMN activations involved during random n-back, a task of executive functioning and working memory, in older adults. The results how that high cardiovascular risk of either increased arterial stiffness or decreased fitness independently contributed to worse task performance and reduced deactivations in two DMN regions: the anterior and posterior cingulate cortices. We then examined not only the potential interaction between the two risk factors, but also their additive (i.e., combined) effect on performance and DMN deactivations. A significant interaction between the two cardiovascular risk factors was observed on performance, with arterial stiffness moderating the relationship between physical fitness and random n-back accuracy. The additive effect of the two factors on task performance was driven by arterial stiffness. Arterial stiffness was also found to be the driving factor when the additive effect of the two risk factors was examined on DMN deactivations. However, in posterior cingulate cortex, a hub region of the DMN, the additive effect on its deactivation was significantly higher than the effect of each risk factor alone. These results suggest that the effects of cardiovascular risks on the aging brain are complicated and multi-dimensional, with arterial stiffness moderating or driving the combined effects on performance and anterior DMN deactivations, but physical fitness contributing additional effect to posterior DMN deactivation during executive functioning.
Collapse
Affiliation(s)
- Shuo Qin
- Center for Vital Longevity, University of Texas at Dallas, United States
| | - Chandramallika Basak
- Center for Vital Longevity, University of Texas at Dallas, United States; Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, United States.
| |
Collapse
|
5
|
Carlson MC. Productive Social Engagement as a Vehicle to Promote Activity and Neuro-Cognitive Health in Later Adulthood. Arch Clin Neuropsychol 2021; 36:1274-1278. [PMID: 34651650 DOI: 10.1093/arclin/acab058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE We have witnessed two key findings that shift our understanding of human brain aging in new directions. First, we learned that the adult brain remains plastic beyond childhood development, generating new neurons in response to activity and new experiences, particularly in regions that integrate memories in social contexts. The second emerging finding is the importance of physical activity and social engagement to cognitive aging. I integrate these and other empirical findings with our understanding of brain development over the life span and the later-life developmental need to give back to younger generations to posit the importance of maintaining our "social" brain through retirement and into later life when activity remains beneficial to brain health. CONCLUSIONS Opportunities for improved cognitive and brain health that can be brought to scale need to capitalize on aging adults' need to remain socially relevant and on community infrastructures so that those with lower neighborhood access to activity can safely engage. Evidence is summarized here from one such community-based model of social engagement through school-based, volunteer service, entitled Experience Corps®. This program seeks to increase daily physical, cognitive, and social activity to promote cognitive and mental health.
Collapse
Affiliation(s)
- Michelle C Carlson
- Johns Hopkins Bloomberg School of Public Health, The Johns Hopkins Center on Aging and Health, Baltimore, MD, 21205, USA
| |
Collapse
|
6
|
Schoemaker D, Velilla-Jimenez L, Zuluaga Y, Baena A, Ospina C, Bocanegra Y, Alvarez S, Ochoa-Escudero M, Guzmán-Vélez E, Martinez J, Lopera F, Arboleda-Velasquez JF, Quiroz YT. Global Cardiovascular Risk Profile and Cerebrovascular Abnormalities in Presymptomatic Individuals with CADASIL or Autosomal Dominant Alzheimer's Disease. J Alzheimers Dis 2021; 82:841-853. [PMID: 34092645 DOI: 10.3233/jad-210313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiovascular risk factors increase the risk of developing dementia, including Alzheimer's disease and vascular dementia. OBJECTIVE Studying individuals with autosomal dominant mutations leading to the early onset of dementia, this study examines the effect of the global cardiovascular risk profile on early cognitive and neuroimaging features of Alzheimer's disease and vascular dementia. METHODS We studied 85 non-demented and stroke-free individuals, including 20 subjects with Presenilin1 (PSEN1) E280A mutation leading to the early onset of autosomal dominant Alzheimer's disease (ADAD), 20 subjects with NOTCH3 mutations leading to cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and to the early onset of vascular dementia, and 45 non-affected family members (non-carriers). All subjects underwent clinical and neuropsychological evaluations and an MRI. The global cardiovascular risk profile was estimated using the office-based Framingham Cardiovascular Risk Profile (FCRP) score. RESULTS In individuals with CADASIL, a higher FCRP score was associated with a reduced hippocampal volume (B = -0.06, p < 0.05) and an increased severity of cerebral microbleeds (B = 0.13, p < 0.001), lacunes (B = 0.30, p < 0.001), and perivascular space enlargement in the basal ganglia (B = 0.50, p < 0.05). There was no significant association between the FCRP score and neuroimaging measures in ADAD or non-carrier subjects. While the FCRP score was related to performance in executive function in non-carrier subjects (B = 0.06, p < 0.05), it was not significantly associated with cognitive performance in individuals with CADASIL or ADAD. CONCLUSION Our results suggest that individuals with CADASIL and other forms of vascular cognitive impairment might particularly benefit from early interventions aimed at controlling cardiovascular risks.
Collapse
Affiliation(s)
- Dorothee Schoemaker
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA, USA
| | | | - Yesica Zuluaga
- Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia
| | - Ana Baena
- Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia
| | - Carolina Ospina
- Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia
| | - Yamile Bocanegra
- Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia
| | - Sergio Alvarez
- Department of Radiology, Hospital Pablo Tobon Uribe, Medellín, Colombia
| | | | - Edmarie Guzmán-Vélez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jairo Martinez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Francisco Lopera
- Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia
| | - Joseph F Arboleda-Velasquez
- Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Yakeel T Quiroz
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
7
|
Yasar S, Moored KD, Adam A, Zabel F, Chuang YF, Varma VR, Carlson MC. Angiotensin II Blood Levels Are Associated with Smaller Hippocampal and Cortical Volumes in Cognitively Normal Older Adults. J Alzheimers Dis 2021; 75:521-529. [PMID: 32280103 DOI: 10.3233/jad-200118] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND There is emerging evidence about possible involvement of the renin-angiotensin system (RAS) in the pathogenesis of Alzheimer's disease (AD) and decline of cognitive function. However, little is known about associations with brain biomarkers. OBJECTIVE Our study aimed to examine associations between blood ACE-1 and ANG II levels and brain MRI based volumes in non-demented participants, and whether these associations were mediated by blood pressure. METHODS This cross-sectional study was conducted in 34 older participants from the Baltimore Experience Corps Trial (BECT) Brain Health Sub-study (BHS). Blood ANGII and ACE-1 levels were measured by ELISA and brain MRI volumes were generated using FreeSurfer 6.0. Multiple linear regression analysis, adjusting for intracranial volume and confounders, was used to determine associations between log transformed ANGII and ACE-1 levels and MRI volumes (mm3). RESULTS Participants were predominantly female (76%), African-American (94%), with mean age of 66.9 and education of 14.4 years. In the fully adjusted model we observed significant inverse associations between log ANGII levels and total grey matter (β=Angiotensin II associated with smaller hippocampus14,935.50, ±7,444.83, p = 0.05), total hippocampus (β=-129.97, ±105.27, p = 0.03), rostral middle frontal (β= -1580.40, ±584.74, p = 0.02), and supramarginal parietal (β= -978.90, ±365.54, p = 0.02) volumes. There were no associations between ANGII levels and total white matter or entorhinal cortex volumes, or ACE-1 levels and any brain volumes. CONCLUSION We observed that increased blood ANGII levels were associated with lower total grey matter, hippocampal, rostral middle frontal, and supramarginal parietal volumes, which are associated with cognitive domains that decline in preclinical AD.
Collapse
Affiliation(s)
- Sevil Yasar
- Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Kyle D Moored
- Department of Mental Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Atif Adam
- Department of Mental Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Fiona Zabel
- Baltimore Polytechnic Institute, Baltimore, MD, USA
| | - Yi-Fang Chuang
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Vijay R Varma
- National Institute on Aging, Intramural Research program, Laboratory of Behavioral Neuroscience, Baltimore, MD, USA
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
8
|
Noriega de la Colina A, Badji A, Robitaille-Grou MC, Gagnon C, Boshkovski T, Lamarre-Cliche M, Joubert S, Gauthier CJ, Bherer L, Cohen-Adad J, Girouard H. Associations Between Relative Morning Blood Pressure, Cerebral Blood Flow, and Memory in Older Adults Treated and Controlled for Hypertension. Hypertension 2021; 77:1703-1713. [PMID: 33775122 DOI: 10.1161/hypertensionaha.120.16124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Adrián Noriega de la Colina
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,Department of Biomedical Sciences, Faculty of Medicine (A.N.C.), Université de Montreal, QC, Canada.,Montreal Heart Institute (MHI), Montreal, QC, Canada (A.N.C., C.G., C.J.G., L.B.).,Groupe de Recherche sur le Système Nerveux Central (GRSNC) (A.N.C., A.B., J.C.-A., H.G.).,Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA) (A.N.C., A.B., H.G.)
| | - Atef Badji
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,Department of Neurosciences, Faculty of Medicine (A.B.), Université de Montreal, QC, Canada.,NeuroPoly Laboratory, Institute of Biomedical Engineering, Polytechnique Montréal, QC, Canada (A.B., T.B., J.C.-A.).,Groupe de Recherche sur le Système Nerveux Central (GRSNC) (A.N.C., A.B., J.C.-A., H.G.).,Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA) (A.N.C., A.B., H.G.)
| | - Marie-Christine Robitaille-Grou
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.)
| | - Christine Gagnon
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,Montreal Heart Institute (MHI), Montreal, QC, Canada (A.N.C., C.G., C.J.G., L.B.)
| | - Tommy Boshkovski
- NeuroPoly Laboratory, Institute of Biomedical Engineering, Polytechnique Montréal, QC, Canada (A.B., T.B., J.C.-A.)
| | - Maxime Lamarre-Cliche
- Institut de Recherches Cliniques de Montreal (IRCM) (M.L.-C.), Université de Montreal, QC, Canada
| | - Sven Joubert
- Department of Psychology, Faculty of Arts and Sciences (S.J.), Université de Montreal, QC, Canada
| | - Claudine J Gauthier
- Department of Physics (C.J.G.), Concordia University, Montreal, QC, Canada.,PERFORM Centre (C.J.G.), Concordia University, Montreal, QC, Canada
| | - Louis Bherer
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,Department of Medicine, Faculty of Medicine (L.B.), Université de Montreal, QC, Canada.,Montreal Heart Institute (MHI), Montreal, QC, Canada (A.N.C., C.G., C.J.G., L.B.)
| | - Julien Cohen-Adad
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,NeuroPoly Laboratory, Institute of Biomedical Engineering, Polytechnique Montréal, QC, Canada (A.B., T.B., J.C.-A.).,Groupe de Recherche sur le Système Nerveux Central (GRSNC) (A.N.C., A.B., J.C.-A., H.G.)
| | - Hélène Girouard
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,Department of Pharmacology and Physiology, Faculty of Medicine (H.G.), Université de Montreal, QC, Canada.,Groupe de Recherche sur le Système Nerveux Central (GRSNC) (A.N.C., A.B., J.C.-A., H.G.).,Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA) (A.N.C., A.B., H.G.)
| |
Collapse
|
9
|
Talamonti D, Vincent T, Fraser S, Nigam A, Lesage F, Bherer L. The Benefits of Physical Activity in Individuals with Cardiovascular Risk Factors: A Longitudinal Investigation Using fNIRS and Dual-Task Walking. J Clin Med 2021; 10:jcm10040579. [PMID: 33557109 PMCID: PMC7913805 DOI: 10.3390/jcm10040579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/30/2021] [Indexed: 11/16/2022] Open
Abstract
Cardiovascular fitness is linked to better executive functions, preserved gait speed, and efficient cortical activity. Older adults with cardiovascular risk factors (CVRFs) typically show poor cognitive performance, low physical fitness, and altered brain functioning compared with healthy individuals. In the current study, the impact of regular physical activity on cognition, locomotion, and brain functions was explored in a cohort of older adults with low or high CVRFs. Cortical activation of the frontal areas was investigated using functional Near-Infrared Spectroscopy (fNIRS) at baseline, at 6 months and at 12 months. Evoked cortical response and behavioral performance were assessed using the dual-task walking paradigm, consisting of three conditions: single cognitive task (2-back task), single walking task (walking), and dual-task (2-back whilst walking). Results show greater task-related cortical response at baseline in individuals with high CVRFs compared to those with low CVRFs. Moreover, participants with high CVRFs benefitted the most from participating in regular physical activity, as their cortical response decreased at the 12-month follow-up and became comparable to that of participants with low CVRFs. These changes were observed in conjunction with improved cognitive performance and stable gait speed throughout the 12-month period in both groups. Our findings provide evidence that participation in regular physical activity may be especially beneficial in individuals with CVRFs by promoting brain and cognitive health, thus potentially contributing to prevention of cognitive decline. Future research may explore whether such effects are maintained in the long-term in order to design ad-hoc interventions in this specific population.
Collapse
Affiliation(s)
- Deborah Talamonti
- Montreal Heart Institute, Research Centre and Centre EPIC, Montreal, QC H1T 1N6, Canada; (T.V.); (A.N.); (F.L.); (L.B.)
- Correspondence:
| | - Thomas Vincent
- Montreal Heart Institute, Research Centre and Centre EPIC, Montreal, QC H1T 1N6, Canada; (T.V.); (A.N.); (F.L.); (L.B.)
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Anil Nigam
- Montreal Heart Institute, Research Centre and Centre EPIC, Montreal, QC H1T 1N6, Canada; (T.V.); (A.N.); (F.L.); (L.B.)
- Department of Medicine, Université de Montreal, Montreal, QC H3T 1J4, Canada
| | - Frédéric Lesage
- Montreal Heart Institute, Research Centre and Centre EPIC, Montreal, QC H1T 1N6, Canada; (T.V.); (A.N.); (F.L.); (L.B.)
- École Polytechnique de Montreal, Montreal, QC H3T 1J4, Canada
| | - Louis Bherer
- Montreal Heart Institute, Research Centre and Centre EPIC, Montreal, QC H1T 1N6, Canada; (T.V.); (A.N.); (F.L.); (L.B.)
- Department of Medicine, Université de Montreal, Montreal, QC H3T 1J4, Canada
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, QC H3W 1W5, Canada
| |
Collapse
|
10
|
Abstract
The concept of brain health has been inconsistently used across disciplines. This concept analysis sought to clarify brain health and construct a unified definition that may lead to consistent use of this concept. The analysis used Walker and Avant's framework to identify scholarly reports on the concept of brain health from various electronic databases. Building on the identified data sources, brain health can be understood as the brain's ability to optimally adapt to internal and external human conditions through cognitive and emotional responses across one's lifespan, which result in sustainable positive changes in brain structures and functional features. This analysis emphasized that maintaining brain health has positive implications on an individual's lifelong quality of health, independence, and delaying cognitive decline. By clarifying uses and definitions of the concept of brain health, this concept analysis may enable researchers and clinicians to evaluate and interpret the concept related data consistently.
Collapse
Affiliation(s)
- Boniface Harerimana
- Parkwood Institute Research, Lawson Health Research Institute, London, Canada.,Arthur Labatt Family School of Nursing, University of Western Ontario, London, Canada
| | - Cheryl Forchuk
- Parkwood Institute Research, Lawson Health Research Institute, London, Canada.,Arthur Labatt Family School of Nursing, University of Western Ontario, London, Canada.,Schulich Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Julie Walsh
- Parkwood Institute Research, Lawson Health Research Institute, London, Canada
| | - Jennifer Fogarty
- Parkwood Institute Research, Lawson Health Research Institute, London, Canada.,Schulich Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Michael Borrie
- Parkwood Institute Research, Lawson Health Research Institute, London, Canada.,Schulich Medicine & Dentistry, University of Western Ontario, London, Canada
| |
Collapse
|
11
|
Gowey MA, Neumeier WH, Henry S, Wadley VG, Phillips J, Hayden KM, Espeland MA, Coday M, Lewis CE, Dutton GR. Executive function in individuals with clinically significant weight loss via behavioral intervention. Obes Sci Pract 2021; 7:25-34. [PMID: 33680489 PMCID: PMC7909588 DOI: 10.1002/osp4.458] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Executive function (EF) is associated with obesity development and self-management. Individuals who demonstrate or self-report poorer EF performance tend to have poorer short-term outcomes in obesity treatment. There may be distinct behavioral self-management strategies and EF domains related to initial weight loss as compared to weight loss maintenance. OBJECTIVE To characterize EF in individuals who achieved clinically significant weight loss via behavioral intervention and examine potential differences in EF between those who maintained versus regained lost weight. METHODS Participants who previously achieved ≥5% weight loss via lifestyle intervention were included (N = 44). "Maintainers" (n = 16) maintained this minimum level of weight loss for ≥1 year. "Regainers" (n = 28) regained some or all initially lost weight. Performance-based EF, intelligence quotient, health literacy, depression, anxiety, binge eating, demographics, and medical/weight history were assessed using a cross-sectional design. Descriptive statistics and age-, gender-, education-adjusted reference ranges were used to characterize EF. Analyses of covariance were conducted to examine EF differences between maintainers and regainers. RESULTS The sample consisted primarily of females with obesity over age 50. Approximately half self-identified as African-American. Decision-making performance was better in maintainers than regainers (p = 0.003, partη2 = 0.19). There were no differences between maintainers and regainers in inhibitory control, verbal fluency, planning/organization, cognitive flexibility, or working memory (ps > 0.05, partη2s = 0.003-0.07). At least 75% of the sample demonstrated average-above average EF test performance, indicated by scaled scores ≥13 or t-scores > 60. CONCLUSIONS Most individuals with obesity who achieved clinically significant weight loss via behavioral intervention had average to above average EF. Individuals who maintained (vs. regained) their lost weight performed better on tests of decision-making.
Collapse
Affiliation(s)
| | - William H. Neumeier
- U.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Samantha Henry
- Department of NeurologyBaylor College of MedicineHoustonTexasUSA
| | | | | | | | | | - Mace Coday
- University of Tennessee Health Science CenterMemphisTennesseeUSA
| | - Cora E. Lewis
- University of Alabama at BirminghamBirminghamAlabamaUSA
| | | |
Collapse
|
12
|
Lowry E, Puthusseryppady V, Johnen AK, Renoult L, Hornberger M. Cognitive and neuroimaging markers for preclinical vascular cognitive impairment. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2021; 2:100029. [PMID: 36324708 PMCID: PMC9616378 DOI: 10.1016/j.cccb.2021.100029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 12/22/2022]
Abstract
Explores the cognitive correlates of midlife risk factors of pre-clinical vascular cognitive impairment. Midlife cardiovascular risks associated with reduces neural integrity in parietal to anterior structures and may identify at-risk individuals. Novel experimental investigation testing fronto-parietal structures is required to increase specificity and sensitivity to pre-clinical VCI and inform clinical testing and diagnostic pathways of at-risk individuals.
Detection of incipient cognitive impairment and dementia pathophysiology is critical to identify preclinical populations and target potentially disease modifying interventions towards them. There are currently concerted efforts for such detection for Alzheimer's disease (AD). By contrast, the examination of cognitive markers and their relationship to biomarkers for Vascular Cognitive Impairment (VCI) is far less established, despite VCI being highly prevalent and often concomitantly presenting with AD. Critically, vascular risk factors are currently associated with the most viable treatment options via pharmacological and non-pharmacological intervention, hence early identification of vascular factors have important implications for modifying dementia disease trajectories. The aim of this review is to examine the current evidence of cognitive marker correlates to VCI pathology. We begin by examining midlife risk factors that predict VCI. Next, discuss preclinical cognitive hallmarks of VCI informed by insights from neuropsychological assessment, network connectivity and ERP/EEG experimental findings. Finally, we discuss limitations of current cognitive assessments and the need for future cognitive test development to inform diagnostic assessment. As well as, intervention outcome measures for preclinical VCI. In turn, these tests will inform earlier detection of vascular changes and allow implementation of disease intervention approaches.
Collapse
Affiliation(s)
- Ellen Lowry
- School of Psychology, University of East Anglia, Norwich NR4 7TJ, United Kingdom
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | | | - Ann-Kathrin Johnen
- School of Psychology, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - Louis Renoult
- School of Psychology, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - Michael Hornberger
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, United Kingdom
- Corresponding author at: Norwich Medical School, 2.04 Bob Champion Research and Education Building, University of East Anglia, Norwich NR4 7TJ, United Kingdom.
| |
Collapse
|
13
|
Qin S, Basak C. Influence of Multiple Cardiovascular Risk Factors on Task-Switching in Older Adults: An fMRI Study. Front Hum Neurosci 2020; 14:561877. [PMID: 33033477 PMCID: PMC7509111 DOI: 10.3389/fnhum.2020.561877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/13/2020] [Indexed: 11/13/2022] Open
Abstract
Not only are the effects of cardiovascular risk factors such as high blood pressure and low fitness on executive functions and brain activations in older adults scarcely investigated, no fMRI study has investigated the combined effects of multiple risk factors on brain activations in older adults. This fMRI study examined the independent and combined effects of two cardiovascular risk factors, arterial plasticity, and physical fitness, on brain activations during task-switching in older adults. The effects of these two risk factors on age-related differences in activation between older and younger adults were also examined. Independently, low physical fitness and low arterial plasticity were related to reduced suppressions of occipital brain regions. The combined effects of these two risks on occipital regions were greater than the independent effects of either risk factor. Age-related overactivations in frontal cortex were observed in low fitness older adults. Brain-behavior correlation indicates that these frontal overactivations are maladaptive to older adults' task performance. It is possible that the resulting effects of cardiovascular risks on the aging brain, especially the maladaptive overactivations of frontal brain regions by high risk older adults, contribute to often found posterior-anterior shift in aging (PASA) brain activations. Furthermore, observed age-related differences in brain activations during task-switching can be partially attributed to individual differences in cardiovascular risks among older adults.
Collapse
Affiliation(s)
- Shuo Qin
- Center for Vital Longevity, The University of Texas at Dallas, Dallas, TX, United States
| | - Chandramallika Basak
- Center for Vital Longevity, The University of Texas at Dallas, Dallas, TX, United States
| |
Collapse
|
14
|
Balbim GM, Ajilore OA, Erickson KI, Lamar M, Aguiñaga S, Bustamante EE, Marquez DX. The Impact of the BAILAMOS™ Dance Program on Brain Functional Connectivity and Cognition in Older Latino Adults: A Pilot Study. JOURNAL OF COGNITIVE ENHANCEMENT 2020; 5:1-14. [PMID: 33748658 DOI: 10.1007/s41465-020-00185-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Dance is a culturally salient form of physical activity (PA) for older Latinos. Resting-state functional connectivity (FC) is a putative biomarker for age-related cognitive decline. We aimed to investigate the impact of the BAILAMOS™ dance program on FC in three brain functional networks (Default Mode [DMN], Frontoparietal [FPN], and Salience [SAL] networks), and cognition. Ten cognitively healthy older Latinos participated in the four-month BAILAMOS™ dance program. We assessed PA levels (self-reported and device-assessed) and estimated cardiorespiratory fitness, cognition, and resting-state FC via functional magnetic resonance imaging at baseline and post-intervention. We performed paired t-tests and Pearson correlations. Given the pilot nature of the study, significance levels were set at p < 0.05 and effect sizes are reported. We observed a significant increase in self-reported moderate leisure-time PA from pre- to post-intervention (t(9) = 3.16, p = 0.011, d = 0.66). FC within-FPN regions of interest (ROIs) significantly increased pre- to post-intervention (t(9) = 2.35, p = 0.043, d = 0.70). DMN ROIs showed an increase, with a moderate effect size, in the integration with other networks' ROIs (t(9) = 1.96, p = 0.081, d = 0.64) post-intervention. Increases in moderate leisure-time PA at post-intervention were associated with increases in the FC within-FPN (R = 0.79, p = 0.006). Our results suggest that dance might be a promising approach for improving age-related disruption of FC within- and between-networks commonly associated with cognitive decline.
Collapse
Affiliation(s)
- Guilherme M Balbim
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, Chicago, Illinois, United States
| | - Olusola A Ajilore
- University of Illinois at Chicago, Department of Psychiatry, Chicago, Illinois, United States
| | - Kirk I Erickson
- University of Pittsburgh, Department of Psychology, Pittsburgh, Pennsylvania, United States
| | - Melissa Lamar
- Rush University, Division of Behavioral Sciences, Chicago, Illinois, United States
| | - Susan Aguiñaga
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, Champaign, Illinois, United States
| | - Eduardo E Bustamante
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, Chicago, Illinois, United States
| | - David X Marquez
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, Chicago, Illinois, United States
| |
Collapse
|
15
|
Keage HAD, Feuerriegel D, Greaves D, Tregoweth E, Coussens S, Smith AE. Increasing Objective Cardiometabolic Burden Associated With Attenuations in the P3b Event-Related Potential Component in Older Adults. Front Neurol 2020; 11:643. [PMID: 32903798 PMCID: PMC7438865 DOI: 10.3389/fneur.2020.00643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/29/2020] [Indexed: 11/13/2022] Open
Abstract
Cardiometabolic diseases and risk factors increase the risk of late-life cognitive impairment and dementia and have also been associated with detrimental gray and white matter changes. However, the functional brain changes associated with cardiometabolic health in late-life are unclear. We sought to characterize these functional changes by recording event-related potentials (ERPs) during an n-back working memory task (0, 1, and 2 back) in 85 adults (60% female) between 50 and 80 years of age. Due to a stratified recruitment approach, participants varied widely in relation to cognitive function and cardiometabolic health. Standard and objective cut-offs for high blood glucose, waist to hip ratio (i.e., obesity), high blood cholesterol, and hypertension were employed to generate a summative score for cardiometabolic burden (none, one, or two or more above cut-off). Mixed effects modeling (covarying for age and gender) revealed no statistically significant associations between cardiometabolic burden and visual P1 and N1 component amplitudes. There was a significant effect for the P3b component: as cardiometabolic burden increased, P3b amplitude decreased. We show that cardiometabolic factors related to the development of cognitive impairment and dementia in late-life associate with brain activity, as recorded via ERPs. Findings have relevance for the monitoring of lifestyle interventions (typically targeting cardiometabolic factors) in aging, as ERPs may provide a more sensitive measure of change than cognitive performance. Further, our results raise questions related to the findings of a broad range of ERP studies where the groups compared may differ in their cardiometabolic health status (not only in psychological symptomatology).
Collapse
Affiliation(s)
- Hannah A. D. Keage
- Cognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society, University of South Australia, Adelaide, SA, Australia
| | - Daniel Feuerriegel
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Danielle Greaves
- Cognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society, University of South Australia, Adelaide, SA, Australia
| | - Emma Tregoweth
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Scott Coussens
- Cognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society, University of South Australia, Adelaide, SA, Australia
| | - Ashleigh E. Smith
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| |
Collapse
|
16
|
Bremner JD, Fani N, Cheema FA, Ashraf A, Vaccarino V. Effects of a mental stress challenge on brain function in coronary artery disease patients with and without depression. Health Psychol 2019; 38:910-924. [PMID: 31380683 PMCID: PMC6746592 DOI: 10.1037/hea0000742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Coronary artery disease (CAD) patients with comorbid depression show an increase in mortality compared to cardiac patients without depression, but the mechanisms mediating this effect remain obscure. One possible explanation for this finding is that depressed patients with CAD exhibit an increased vulnerability to stress. The purpose of this study was to assess the effects of stress and depression on brain function and to explore its relationship with myocardial ischemia in CAD patients. METHODS Patients with CAD and depression (N = 13) and CAD without depression (N = 15) underwent imaging of the brain with positron emission tomography and [O-15] water and imaging of the heart with single photon emission computed tomography (SPECT) and [Tc-99m] sestamibi under mental stress task and control conditions. RESULTS CAD patients with depression compared to nondepressed showed decreased function with mental stress in the rostral anterior cingulate, the hippocampus, parts of the dorsolateral temporal and parietal cortex, the cerebellum, and the uncus, with increased blood flow in the parahippocampus, visual association cortex, and posterior cingulate. Depressed CAD patients who became ischemic during a mental stress task had relative decreases in the caudal and posterior cingulate, orbitofrontal cortex, and cerebellum, and increased activation in the parietal cortex and precuneus/visual association cortex compared to nonischemic depressed CAD patients. CONCLUSIONS These findings are consistent with dysfunction in a network of brain regions involved in the stress response in patients with comorbid CAD and depression that has direct and indirect links to the heart, suggesting a pathway by which stress and depression could lead to increased risk of heart disease related morbidity and mortality. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences
| | | | - Ali Ashraf
- Department of Psychiatry and Behavioral Sciences
| | | |
Collapse
|
17
|
Mejía-Rentería H, Matias-Guiu JA, Lauri F, Yus M, Escaned J. Microcirculatory dysfunction in the heart and the brain. Minerva Cardioangiol 2019; 67:318-329. [DOI: 10.23736/s0026-4725.18.04701-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
18
|
Yasar S, Varma VR, Harris GC, Carlson MC. Associations of Angiotensin Converting Enzyme-1 and Angiotensin II Blood Levels and Cognitive Function. J Alzheimers Dis 2019; 63:655-664. [PMID: 29660936 DOI: 10.3233/jad-170944] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Emerging evidence suggests a possible role of the renin angiotensin system in the pathophysiologic process of Alzheimer's disease, of which angiotensin converting enzyme-1 (ACE-1) and angiotensin II (ANGII) are important proteins. Few studies evaluated associations between blood ACE-1 and none between ANGII levels, and cognition. OBJECTIVE Our pilot study was aimed to examine associations between blood ACE-1 and ANG II levels and cognitive function in non-demented participants at baseline and over a 1-year period. METHODS 56 participants were included from the Brain Health Substudy of the Baltimore Experience Corps Study. Linear regression analysis, adjusting for confounders, was used to determine associations between baseline ACE-1 and ANGII, and baseline and 1-year follow-up measures of psychomotor and processing speed, executive function, verbal learning memory and working memory, and whether these associations were mediated by blood pressure. RESULTS Participants were predominantly female (75%), African-American (93%), with mean age of 67.8 years and education of 14.3 years. There were no associations between baseline ACE-1 or ANGII levels and cognitive function; however, there were significant association between baseline ACE-1 levels and 1-year follow-up Trail Making Test, Part A (β= 0.003, p = 0.04) and Digit Span (β= -0.001, p = 0.02). CONCLUSIONS In this cognitively intact sample, elevated ACE-1 levels were associated with worse processing speed and working memory after 1 year. Findings from this pilot study suggest that changes in the RAS are associated with alterations in cognitive function warranting further assessment of the role of RAS in neurodegenerative disorders.
Collapse
Affiliation(s)
- Sevil Yasar
- Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Vijay R Varma
- National Institute on Aging, Intramural Research Program, Laboratory of Behavioral Neuroscience, Baltimore, MD, USA
| | | | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
19
|
Bremner JD, Campanella C, Khan Z, Shah M, Hammadah M, Wilmot K, Mheid IA, Lima BB, Garcia EV, Nye J, Ward L, Kutner MH, Raggi P, Pearce BD, Shah A, Quyyumi A, Vaccarino V. Brain Correlates of Mental Stress-Induced Myocardial Ischemia. Psychosom Med 2019; 80:515-525. [PMID: 29794945 PMCID: PMC6023737 DOI: 10.1097/psy.0000000000000597] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Coronary artery disease (CAD) is a major cause of morbidity and mortality, and despite important advances in our understanding of this disorder, the underlying mechanisms remain under investigation. Recently, increased attention has been placed on the role of behavioral factors such as emotional stress on CAD risk. Brain areas involved in memory and the stress response, including medial prefrontal cortex, insula, and parietal cortex, also have outputs to the peripheral cardiovascular system. The purpose of this study was to assess the effects of mental stress on brain and cardiac function in patients with CAD. METHODS CAD patients (N = 170) underwent cardiac imaging with [Tc-99m] sestamibi single-photon emission tomography at rest and during a public speaking mental stress task. On another day, they underwent imaging of the brain with [O-15] water positron emission tomography (PET) during mental stress (arithmetic and public speaking) and control conditions. RESULTS Patients with mental stress-induced myocardial ischemia showed increased activation with stress in anterior cingulate, inferior frontal gyrus, and parietal cortex (p < .005). This was seen with both arithmetic stress and public speaking stress. Arithmetic stress was additionally associated with left insula activation, and public speaking with right pre/postcentral gyrus and middle temporal gyrus activation (p < .005). CONCLUSIONS These findings suggest that mental stress-induced myocardial ischemia is associated with activation in brain areas involved in the stress response and autonomic regulation of the cardiovascular system. Altered brain reactivity to stress could possibly represent a mechanism through which stress leads to increased risk of CAD-related morbidity and mortality.
Collapse
Affiliation(s)
- J. Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
- Department of Radiology, Emory University School of Medicine, Atlanta, GA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - Carolina Campanella
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Zehra Khan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Majid Shah
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Muhammad Hammadah
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
| | - Kobina Wilmot
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
| | - Ibhar Al Mheid
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
| | - Bruno B. Lima
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
| | - Ernest V. Garcia
- Department of Radiology, Emory University School of Medicine, Atlanta, GA
| | - Jonathon Nye
- Department of Radiology, Emory University School of Medicine, Atlanta, GA
| | - Laura Ward
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael H. Kutner
- Department Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute and the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Brad D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amit Shah
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - Arshed Quyyumi
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|
20
|
Carmichael O, Newton R. Brain MRI findings related to Alzheimer's disease in older African American adults. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 165:3-23. [PMID: 31481168 DOI: 10.1016/bs.pmbts.2019.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Although a substantial body of research has identified brain MRI measures as important markers of Alzheimer's disease (AD) risk, progression, and treatment response, most of that research has been performed in non-Hispanic white American populations, leading to questions about the utility of the brain MRI measures among individuals of other races or ethnicities. African American individuals in particular are under-represented in AD research, and may exhibit differences in prevalence of AD risk factors, prevalence of AD, incidence of AD, the clinical course of cognitive decline, and AD neuropathology, each of which could influence the utility of brain MRI markers. Unfortunately, while current evidence suggests that African Americans exhibit poorer brain health late in life based on brain MRI measurements, several other aspects of brain MRI markers in this population are unclear, including trajectories of brain MRI markers leading up to old age, relationships between traditional brain health risk factors and brain MRI findings, and the status of brain MRI markers as correlates of cognitive impairment. This unclear state of affairs highlights the urgency of future research in which large numbers of older African American adults contribute longitudinal brain MRI measurements concurrent with clinical, cognitive, and molecular biomarker measurements, ideally in the context of AD preventive or therapeutic trials.
Collapse
Affiliation(s)
- Owen Carmichael
- Pennington Biomedical Research Center, Baton Rouge, LA, United States.
| | - Robert Newton
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| |
Collapse
|
21
|
Bremner JD, Campanella C, Khan Z, Fani N, Kasher N, Evans S, Reiff C, Mishra S, Ladd S, Nye JA, Raggi P, Vaccarino V. Brain mechanisms of stress and depression in coronary artery disease. J Psychiatr Res 2019; 109:76-88. [PMID: 30508746 PMCID: PMC6317866 DOI: 10.1016/j.jpsychires.2018.11.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/24/2018] [Accepted: 11/20/2018] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Major depression is associated with an increased risk for and mortality from coronary artery disease (CAD), however the mechanisms by which this occurs are not clear. Depression, which is linked to stress, is associated with changes in brain areas involved in memory and the stress response, and it is likely that these regions play an important role in this increased risk. This study assessed the effects of stress on brain and cardiac function in patients with CAD with and without depression. METHODS CAD patients with (N = 17) and without (N = 21) major depression based on the Structured Clinical Interview for DSM-IV (DSM-IV) and/or a Hamilton Depression Scale score of nine or greater underwent imaging of the brain with high resolution positron emission tomography (HR-PET) and [O-15] water and imaging of the heart with single photon emission tomography (SPECT) and [Tc-99 m] sestamibi during mental stress (mental arithmetic) and control conditions. RESULTS Patients with CAD and major depression showed increased parietal cortex activation and a relative failure of medial prefrontal/anterior cingulate activation during mental stress compared to CAD patients without depression. Depressed CAD patients with stress-induced myocardial ischemia, however, when compared to depressed CAD patients without showed increased activation in rostral portions of the anterior cingulate. CONCLUSIONS These findings are consistent with a role for brain areas implicated in stress and depression in the mechanism of increased risk for CAD morbidity and mortality in CAD patients with the diagnosis of major depression.
Collapse
Affiliation(s)
- J Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA; Department of Radiology, and Internal Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA.
| | | | - Zehra Khan
- Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Nicole Kasher
- Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Sarah Evans
- Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Collin Reiff
- Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Sanskriti Mishra
- Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Stacy Ladd
- Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Jonathon A Nye
- Department of Radiology, and Internal Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA, USA
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute and the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Viola Vaccarino
- Department of Internal Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|
22
|
Shah A, Chen C, Campanella C, Kasher N, Evans S, Reiff C, Mishra S, Hammadah M, Lima BB, Wilmot K, Mheid IA, Alkhoder A, Isakadze N, Levantsevych O, Pimple PM, Garcia EV, Wittbrodt M, Nye J, Ward L, Lewis TT, Kutner M, Raggi P, Quyyumi A, Vaccarino V, Bremner JD. Brain correlates of stress-induced peripheral vasoconstriction in patients with cardiovascular disease. Psychophysiology 2019; 56:e13291. [PMID: 30276815 PMCID: PMC6331265 DOI: 10.1111/psyp.13291] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/27/2018] [Accepted: 08/21/2018] [Indexed: 01/15/2023]
Abstract
The influence of acute psychological stress on cardiovascular disease is an emerging public health concern. Identification of brain mechanisms underlying this may aid in the discovery of possible treatments. Acute psychological stress may induce arteriolar vasoconstriction and reduce blood flow to vital organs. We hypothesized that functional changes in brain regions involved with memory and autonomic/emotional regulation are implicated in the vasoconstrictive stress response, including the medial prefrontal cortex (anterior cingulate), insula, and dorsolateral prefrontal cortex. Subjects with a history of coronary artery disease (N = 59) underwent measurement of microvascular vasomotor tone with the EndoPAT device and O-15 positron emission tomography (PET) imaging of the brain during exposure to mental stress and control conditions. The peripheral arterial tonometry (PAT) ratio was calculated as the mean peripheral vasomotor tone during stress divided by the mean tone during rest. Whole brain contrasts were performed between groups above and below the median PAT ratio, and significant contrasts were defined with cutoff p < 0.005. Stress-induced peripheral vasoconstriction (below median PAT ratio) was associated with increased stress activation in insula and parietal cortex, and decreased activation in the medial prefrontal cortex with stress tasks compared to control tasks. These findings demonstrate that stress-induced vasoreactivity is associated with changes in brain responses to stress in areas involved in emotion and autonomic regulation. These findings have important implications on possible treatments for mental stress-induced vascular toxicity.
Collapse
Affiliation(s)
- Amit Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, and the Departments
- Division of Cardiology, Department of Medicine, Emory University School of Medicine
- Atlanta Veterans Affairs Medical Center, Decatur, GA
| | - Chuqing Chen
- Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, USA
| | | | - Nicole Kasher
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, and the Departments
| | - Sarah Evans
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Collin Reiff
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Sanskriti Mishra
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Muhammad Hammadah
- Division of Cardiology, Department of Medicine, Emory University School of Medicine
| | - Bruno B. Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, and the Departments
- Division of Cardiology, Department of Medicine, Emory University School of Medicine
| | - Kobina Wilmot
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, and the Departments
- Division of Cardiology, Department of Medicine, Emory University School of Medicine
| | - Ibhar Al Mheid
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, and the Departments
- Division of Cardiology, Department of Medicine, Emory University School of Medicine
| | - Ayman Alkhoder
- Division of Cardiology, Department of Medicine, Emory University School of Medicine
| | - Nino Isakadze
- Division of Cardiology, Department of Medicine, Emory University School of Medicine
| | - Oleksiy Levantsevych
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, and the Departments
| | - Pratik M Pimple
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, and the Departments
| | | | - Matthew Wittbrodt
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Jonathon Nye
- Department of Radiology, Emory University School of Medicine
| | - Laura Ward
- Department of Biostatistics, Rollins School of Public Health, Emory University
| | - Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, and the Departments
| | - Michael Kutner
- Department of Biostatistics, Rollins School of Public Health, Emory University
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute and the Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Arshed Quyyumi
- Mazankowski Alberta Heart Institute and the Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, and the Departments
- Division of Cardiology, Department of Medicine, Emory University School of Medicine
| | - J. Douglas Bremner
- Atlanta Veterans Affairs Medical Center, Decatur, GA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| |
Collapse
|
23
|
McDonald AP, D'Arcy RCN, Song X. Functional MRI on executive functioning in aging and dementia: A scoping review of cognitive tasks. Aging Med (Milton) 2018; 1:209-219. [PMID: 31942499 PMCID: PMC6880681 DOI: 10.1002/agm2.12037] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 08/14/2018] [Indexed: 12/23/2022] Open
Abstract
Cognitive decline with aging and dementia is especially poignant with regard to the executive functioning that is necessary for activities of daily independent living. The relationship between age-related neurodegeneration in the prefrontal cortex and executive functioning has been uniquely investigated using task-phase functional magnetic resonance imaging (fMRI) to detect brain activity in response to stimuli; however, a comprehensive list of task designs that have been implemented to task-phase fMRI is absent in the literature. The purpose of this review was to recognize what methods have been used to study executive functions with aging and dementia in fMRI tasks, and to describe and categorize them. The following cognitive subdomains were emphasized: cognitive flexibility, planning and decision-making, working memory, cognitive control/inhibition, semantic processing, attention and concentration, emotional functioning, and multitasking. Over 30 different task-phase fMRI designs were found to have been implemented in the literature, all adopted from standard neuropsychological assessments. Cognitive set-shifting and decision-making tasks were particularly well studied in regard to age-related neurodegeneration, while emotional functioning and multitasking designs were found to be the least utilized. Summarizing the information on which tasks have shown the greatest usability will assist in the future design and implementation of effective fMRI experiments targeting executive functioning.
Collapse
Affiliation(s)
- Andrew P. McDonald
- Health Sciences and InnovationFraser Health AuthoritySurreyBritish ColumbiaCanada
- Department of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Ryan C. N. D'Arcy
- Health Sciences and InnovationFraser Health AuthoritySurreyBritish ColumbiaCanada
- ImageTech LaboratorySimon Fraser UniversitySurreyBritish ColumbiaCanada
| | - Xiaowei Song
- Health Sciences and InnovationFraser Health AuthoritySurreyBritish ColumbiaCanada
- ImageTech LaboratorySimon Fraser UniversitySurreyBritish ColumbiaCanada
| |
Collapse
|
24
|
Kharabian Masouleh S, Beyer F, Lampe L, Loeffler M, Luck T, Riedel-Heller SG, Schroeter ML, Stumvoll M, Villringer A, Witte AV. Gray matter structural networks are associated with cardiovascular risk factors in healthy older adults. J Cereb Blood Flow Metab 2018; 38:360-372. [PMID: 28857651 PMCID: PMC5951018 DOI: 10.1177/0271678x17729111] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
While recent 'big data' analyses discovered structural brain networks that alter with age and relate to cognitive decline, identifying modifiable factors that prevent these changes remains a major challenge. We therefore aimed to determine the effects of common cardiovascular risk factors on vulnerable gray matter (GM) networks in a large and well-characterized population-based cohort. In 616 healthy elderly (258 women, 60-80 years) of the LIFE-Adult-Study, we assessed the effects of obesity, smoking, blood pressure, markers of glucose and lipid metabolism as well as physical activity on major GM-networks derived using linked independent component analysis. Age, sex, hypertension, diabetes, white matter hyperintensities, education and depression were considered as confounders. Results showed that smoking, higher blood pressure, and higher glycated hemoglobin (HbA1c) were independently associated with lower GM volume and thickness in GM-networks that covered most areas of the neocortex. Higher waist-to-hip ratio was independently associated with lower GM volume in a network of multimodal regions that correlated negatively with age and memory performance. In this large cross-sectional study, we found selective negative associations of smoking, higher blood pressure, higher glucose, and visceral obesity with structural covariance networks, suggesting that reducing these factors could help to delay late-life trajectories of GM aging.
Collapse
Affiliation(s)
| | - Frauke Beyer
- 1 Department of Neurology, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany
| | - Leonie Lampe
- 1 Department of Neurology, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, 9180 University of Leipzig , Leipzig, Germany
| | - Markus Loeffler
- 2 LIFE - Leipzig Research Center for Civilization Diseases, 9180 University of Leipzig , Leipzig, Germany.,3 Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), 9180 University of Leipzig , Leipzig, Germany
| | - Tobias Luck
- 2 LIFE - Leipzig Research Center for Civilization Diseases, 9180 University of Leipzig , Leipzig, Germany.,4 Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, 9180 University of Leipzig , Leipzig, Germany
| | - Steffi G Riedel-Heller
- 4 Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, 9180 University of Leipzig , Leipzig, Germany
| | - Matthias L Schroeter
- 1 Department of Neurology, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, 9180 University of Leipzig , Leipzig, Germany.,5 Clinic for Cognitive Neurology, 9180 University of Leipzig , Leipzig, Germany
| | - Michael Stumvoll
- 6 IFB Adiposity Diseases Faculty of Medicine, 9180 University of Leipzig , Leipzig, Germany
| | - Arno Villringer
- 1 Department of Neurology, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany.,5 Clinic for Cognitive Neurology, 9180 University of Leipzig , Leipzig, Germany
| | - A Veronica Witte
- 1 Department of Neurology, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany
| |
Collapse
|
25
|
Palta P, Carlson MC, Crum RM, Colantuoni E, Sharrett AR, Yasar S, Nahin RL, DeKosky ST, Snitz B, Lopez O, Williamson JD, Furberg CD, Rapp SR, Golden SH. Diabetes and Cognitive Decline in Older Adults: The Ginkgo Evaluation of Memory Study. J Gerontol A Biol Sci Med Sci 2017; 73:123-130. [PMID: 28510619 PMCID: PMC5861864 DOI: 10.1093/gerona/glx076] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 05/05/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Previous studies have shown that individuals with diabetes exhibit accelerated cognitive decline. However, methodological limitations have limited the quality of this evidence. Heterogeneity in study design, cognitive test administration, and methods of analysis of cognitive data have made it difficult to synthesize and translate findings to practice. We analyzed longitudinal data from the Ginkgo Evaluation of Memory Study to test our hypothesis that older adults with diabetes have greater test-specific and domain-specific cognitive declines compared to older adults without diabetes. METHODS Tests of memory, visuo-spatial construction, language, psychomotor speed, and executive function were administered. Test scores were standardized to z-scores and averaged to yield domain scores. Linear random effects models were used to compare baseline differences and changes over time in test and domain scores among individuals with and without diabetes. RESULTS Among the 3,069 adults, aged 72-96 years, 9.3% reported diabetes. Over a median follow-up of 6.1 years, participants with diabetes exhibited greater baseline differences in a test of executive function (trail making test, Part B) and greater declines in a test of language (phonemic verbal fluency). For the composite cognitive domain scores, participants with diabetes exhibited lower baseline executive function and global cognition domain scores, but no significant differences in the rate of decline. CONCLUSIONS Identifying cognitive domains most affected by diabetes can lead to targeted risk modification, possibly in the form of lifestyle interventions such as diet and physical activity, which we know to be beneficial for improving vascular risk factors, such as diabetes, and therefore may reduce the risk of executive dysfunction and possible dementia.
Collapse
Affiliation(s)
- Priya Palta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, University of North Carolina at Chapel Hill
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Rosa M Crum
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | - Elizabeth Colantuoni
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | - Sevil Yasar
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Richard L Nahin
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland
| | - Steven T DeKosky
- Department of Neurology, University of Florida College of Medicine, Gainesville
| | - Beth Snitz
- Department of Neurology, University of Pittsburgh, Pennsylvania
| | - Oscar Lopez
- Department of Neurology, University of Pittsburgh, Pennsylvania
| | - Jeff D Williamson
- Division of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Curt D Furberg
- Division of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Stephen R Rapp
- Division of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Sherita Hill Golden
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
26
|
Compensatory functional reorganization may precede hypertension-related brain damage and cognitive decline: a functional magnetic resonance imaging study. J Hypertens 2017; 35:1252-1262. [PMID: 28169883 PMCID: PMC5404398 DOI: 10.1097/hjh.0000000000001293] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Supplemental Digital Content is available in the text Objectives: Our study aimed at exploring structural and functional differences in the brain during higher cognitive processing between middle-aged hypertensive patients and controls matched for sex, age and years of education. Methods: Two groups of 20 patients took part in MRI examinations. This article reports the results of functional MRI during a Stroop color interference task and structural evaluations based on a modified Fazekas scale. Results: No intergroup differences were found in regards to the severity of white matter lesions (Mann–Whitney U test = 150.5, P > 0.1), nor from the task performance in the scanner (t(35) = 0.2, P > 0.1). However, brain activation patterns between patients and controls varied. Hypertensive patients involved significantly more cerebral areas during the processing, regardless of the task difficulty. Differences were found in 26 diverse regions of both primary and associative cortices (with a peak voxel located in the cuneus, Z = 6.94, P < 0.05 family-wise error corrected at voxel level). Conclusion: Our findings provide an insight into the brain mechanisms related to essential hypertension and suggest a functional reorganization (neuroplasticity) early in the course of the disease.
Collapse
|
27
|
Ren W, Ma J, Li J, Zhang Z, Wang M. Repetitive Transcranial Magnetic Stimulation (rTMS) Modulates Lipid Metabolism in Aging Adults. Front Aging Neurosci 2017; 9:334. [PMID: 29089885 PMCID: PMC5650987 DOI: 10.3389/fnagi.2017.00334] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 09/29/2017] [Indexed: 12/15/2022] Open
Abstract
Hyperlipidemia, one of the cardiovascular (CV) risk factors, is associated with an increase in the risk for dementia. Repetitive transcranial magnetic stimulation (rTMS) was applied over the right dorsolateral prefrontal cortex (DLPFC) to modulate serum lipid levels in older adults. Participants received 10 sessions of rTMS or sham stimulation intervention within 2 weeks. The serum lipid and thyroid hormone-related endocrine levels were assessed before and after the treatment. We found that rTMS significantly decreased serum lipid levels, including the total cholesterol (CHO) and triglyceride (TG); meanwhile, it also increased the thyroid-stimulating hormone (TSH) as well as thyroxine (T4) levels. This suggests that rTMS modulated the serum lipid metabolism by altering activity in the hypothalamo-pituitary-thyroid (HPT) axis. The trial was registered on the website of Chinese Clinical Trial Registry (http://www.chictr.org.cn).
Collapse
Affiliation(s)
- Weicong Ren
- Department of Psychology, Hebei Normal University, Shijiazhuang, China.,Key Laboratory of Brain Aging and Cognitive Neuroscience of Hebei Province, Hebei Medical University, Shijiazhuang, China.,Center on Aging Psychology, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jiang Ma
- Department of Rehabilitation, First Hospital of Shijiazhuang, Shijiazhuang, China
| | - Juan Li
- Center on Aging Psychology, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Zhijie Zhang
- Department of Psychology, Hebei Normal University, Shijiazhuang, China.,Key Laboratory of Brain Aging and Cognitive Neuroscience of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Mingwei Wang
- Key Laboratory of Brain Aging and Cognitive Neuroscience of Hebei Province, Hebei Medical University, Shijiazhuang, China.,Department of Neurology, First Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
28
|
Robertson AD, Marzolini S, Middleton LE, Basile VS, Oh PI, MacIntosh BJ. Exercise Training Increases Parietal Lobe Cerebral Blood Flow in Chronic Stroke: An Observational Study. Front Aging Neurosci 2017; 9:318. [PMID: 29033829 PMCID: PMC5626868 DOI: 10.3389/fnagi.2017.00318] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/15/2017] [Indexed: 02/01/2023] Open
Abstract
Exercise is increasingly recommended as an essential component of stroke rehabilitation, yet uncertainty remains with respect to its direct effect on the cerebral vasculature. The current study first demonstrated the repeatability of pseudo-continuous arterial spin labeling (ASL) magnetic resonance imaging (MRI) in older adults with stroke, and then investigated the change in cerebrovascular function following a 6-month cardiovascular rehabilitation program. In the repeatability study, 12 participants at least 3 months post-stroke underwent two ASL imaging scans 1 month apart. In the prospective observational study, eight individuals underwent ASL imaging and aerobic fitness testing before and after a 6-month cardiovascular rehabilitation program. Cerebral blood flow (CBF) and the spatial coefficient of variation of CBF (sCoV) were quantified to characterize tissue-level perfusion and large cerebral artery transit time properties, respectively. In repeat scanning, intraclass correlation (ICC) indicated moderate test-retest reliability for global gray matter CBF (ICC = 0.73) and excellent reliability for sCoV (ICC = 0.94). In the observational study, gray matter CBF increased after training (baseline: 40 ± 13 vs. 6-month: 46 ± 12 ml·100 g−1·min−1, P = 0.036). The greatest change occurred in the parietal lobe (+18 ± 12%). Gray matter sCoV, however, did not change following training (P = 0.31). This study provides preliminary evidence that exercise-based rehabilitation in chronic stroke enhances tissue-level perfusion, without changing the relative hemodynamic properties of the large cerebral arteries.
Collapse
Affiliation(s)
- Andrew D Robertson
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Susan Marzolini
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Toronto Rehab, University Health Network, Toronto, ON, Canada
| | - Laura E Middleton
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | | | - Paul I Oh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Toronto Rehab, University Health Network, Toronto, ON, Canada.,Peter Munk Cardiac Centre, University of Toronto, Toronto, ON, Canada
| | - Bradley J MacIntosh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
29
|
Dao E, Hsiung GYR, Liu-Ambrose T. The role of exercise in mitigating subcortical ischemic vascular cognitive impairment. J Neurochem 2017; 144:582-594. [PMID: 28833160 DOI: 10.1111/jnc.14153] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/09/2017] [Accepted: 08/11/2017] [Indexed: 12/14/2022]
Abstract
Subcortical ischemic vascular cognitive impairment (SIVCI) is the most preventable form of cognitive dysfunction. There is converging evidence from animal and human studies that indicate vascular injury as the primary cause of SIVCI. Currently, there are no curative pharmaceutical treatments for vascular dementia; however, exercise may be a promising strategy to combat SIVCI. This review will focus on the role of exercise as a strategy to prevent or slow the progression of SIVCI, with particular emphasis on the mechanisms by which exercise may improve cerebrovascular function. We propose that exercise may be an effective strategy to combat SIVCI by improving cognitive function, increasing the bioavailability of neurotrophins, stimulating endothelial function, and controlling vascular risk factors. This article is part of the Special Issue "Vascular Dementia".
Collapse
Affiliation(s)
- Elizabeth Dao
- Department of Physical Therapy, University of British Columbia (UBC), Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, Canada
| | - Ging-Yuek Robin Hsiung
- Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, Canada.,Department of Medicine, Division of Neurology, UBC, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia (UBC), Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| |
Collapse
|
30
|
Gregory MA, Boa Sorte Silva NC, Gill DP, McGowan CL, Liu-Ambrose T, Shoemaker JK, Hachinski V, Holmes J, Petrella RJ. Combined Dual-Task Gait Training and Aerobic Exercise to Improve Cognition, Mobility, and Vascular Health in Community-Dwelling Older Adults at Risk for Future Cognitive Decline1. J Alzheimers Dis 2017; 57:747-763. [PMID: 28304305 DOI: 10.3233/jad-161240] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This 6-month experimental case series study investigated the effects of a dual-task gait training and aerobic exercise intervention on cognition, mobility, and cardiovascular health in community-dwelling older adults without dementia. Participants exercised 40 min/day, 3 days/week for 26 weeks on a Biodex GaitTrainer2 treadmill. Participants were assessed at baseline (V0), interim (V1: 12-weeks), intervention endpoint (V2: 26-weeks), and study endpoint (V3: 52-weeks). The study outcomes included: cognition [executive function (EF), processing speed, verbal fluency, and memory]; mobility: usual & dual-task gait (speed, step length, and stride time variability); and vascular health: ambulatory blood pressure, carotid arterial compliance, and intima-media thickness (cIMT). Fifty-six participants [age: 70(6) years; 61% female] were included in this study. Significant improvements following the exercise program (V2) were observed in cognition: EF (p = 0.002), processing speed (p < 0.001), verbal fluency [digit symbol coding (p < 0.001), phonemic verbal fluency (p < 0.001)], and memory [immediate recall (p < 0.001) and delayed recall (p < 0.001)]; mobility: usual & dual-task gait speed (p = 0.002 and p < 0.001, respectively) and step length (p = 0.001 and p = 0.003, respectively); and vascular health: cIMT (p = 0.002). No changes were seen in the remaining outcomes. In conclusion, 26 weeks of dual-task gait training and aerobic exercise improved performance on a number of cognitive outcomes, while increasing usual & dual-task gait speed and step length in a sample of older adults without dementia.
Collapse
Affiliation(s)
- Michael A Gregory
- Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Narlon C Boa Sorte Silva
- Lawson Health Research Institute, London, ON, Canada.,School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Dawn P Gill
- Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Cheri L McGowan
- Lawson Health Research Institute, London, ON, Canada.,Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Kinesiology, University of Windsor, Windsor, ON, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, Canada
| | - J Kevin Shoemaker
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Vladimir Hachinski
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada
| | - Jeff Holmes
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Robert J Petrella
- Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada.,Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| |
Collapse
|
31
|
Hsu CL, Best JR, Wang S, Voss MW, Hsiung RGY, Munkacsy M, Cheung W, Handy TC, Liu-Ambrose T. The Impact of Aerobic Exercise on Fronto-Parietal Network Connectivity and Its Relation to Mobility: An Exploratory Analysis of a 6-Month Randomized Controlled Trial. Front Hum Neurosci 2017; 11:344. [PMID: 28713255 PMCID: PMC5492161 DOI: 10.3389/fnhum.2017.00344] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 06/14/2017] [Indexed: 12/12/2022] Open
Abstract
Impaired mobility is a major concern for older adults and has significant consequences. While the widely accepted belief is that improved physical function underlies the effectiveness of targeted exercise training in improving mobility and reducing falls, recent evidence suggests cognitive and neural benefits gained through exercise may also play an important role in promoting mobility. However, the underlying neural mechanisms of this relationship are currently unclear. Thus, we hypothesize that 6 months of progressive aerobic exercise training would alter frontoparietal network (FPN) connectivity during a motor task among older adults with mild subcortical ischemic vascular cognitive impairment (SIVCI)—and exercise-induced changes in FPN connectivity would correlate with changes in mobility. We focused on the FPN as it is involved in top-down attentional control as well as motor planning and motor execution. Participants were randomized either to usual-care (CON), which included monthly educational materials about VCI and healthy diet; or thrice-weekly aerobic training (AT), which was walking outdoors with progressive intensity. Functional magnetic resonance imaging was acquired at baseline and trial completion, where the participants were instructed to perform bilateral finger tapping task. At trial completion, compared with AT, CON showed significantly increased FPN connectivity strength during right finger tapping (p < 0.05). Across the participants, reduced FPN connectivity was associated with greater cardiovascular capacity (p = 0.05). In the AT group, reduced FPN connectivity was significantly associated with improved mobility performance, as measured by the Timed-Up-and-Go test (r = 0.67, p = 0.02). These results suggest progressive AT may improve mobility in older adults with SIVCI via maintaining intra-network connectivity of the FPN.
Collapse
Affiliation(s)
- Chun L Hsu
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| | - Shirley Wang
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| | - Michelle W Voss
- Health, Brain, and Cognition Lab, University of Iowa, Iowa CityIA, United States.,Department of Psychology, University of Iowa, Iowa CityIA, United States
| | - Robin G Y Hsiung
- Department of Medicine, University of British Columbia, VancouverBC, Canada
| | - Michelle Munkacsy
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| | - Winnie Cheung
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| | - Todd C Handy
- Department of Psychology, University of British Columbia, VancouverBC, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, VancouverBC, Canada.,Department of Physical Therapy, University of British Columbia, VancouverBC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, VancouverBC, Canada.,Center for Hip Health and Mobility, VancouverBC, Canada
| |
Collapse
|
32
|
Hsu CL, Best JR, Davis JC, Nagamatsu LS, Wang S, Boyd LA, Hsiung GR, Voss MW, Eng JJ, Liu-Ambrose T. Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment. Br J Sports Med 2017; 52:184-191. [PMID: 28432077 DOI: 10.1136/bjsports-2016-096846] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Vascular cognitive impairment (VCI) results from cerebrovascular disease, and worldwide, it is the second most common type of cognitive dysfunction. While targeted aerobic training is a promising approach to delay the progression of VCI by reducing cardiometabolic risk factors, few randomised controlled trials to date have specifically assessed the efficacy of aerobic training on cognitive and brain outcomes in this group at risk for functional decline. AIM To examine the effect of moderate-intensity aerobic training on executive functions and functional neural activity among older adults with mild subcortical ischaemic VCI (SIVCI). METHODS Older adults with mild SIVCI were randomly assigned to: (1) 6-month, 3×/week aerobic training (n=10) or (2) usual care (control; n=11). Participants completed functional MRI (fMRI) at baseline and trial completion. During the fMRI sessions, behavioural performance on the Eriksen flanker task and task-evoked neural activity were assessed. RESULTS At trial completion, after adjusting for baseline general cognition, total white matter lesion volume and flanker performance, compared with the control group, the aerobic training group significantly improved flanker task reaction time. Moreover, compared with the controls, the aerobic training group demonstrated reduced activation in the left lateral occipital cortex and right superior temporal gyrus. Reduced activity in these brain regions was significantly associated with improved (ie, faster) flanker task performance at trial completion. SUMMARY Aerobic training among older adults with mild SIVCI can improve executive functions and neural efficiency of associated brain areas. Future studies with greater sample size should be completed to replicate and extend these findings.
Collapse
Affiliation(s)
- Chun Liang Hsu
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Jennifer C Davis
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | | | - Shirley Wang
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Lara A Boyd
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gy Robin Hsiung
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michelle W Voss
- Department of Psychology, University of Iowa, Iowa City, Iowa, USA.,Health, Brain, & Cognition Lab, University of Iowa, Iowa City, Iowa, USA
| | - Janice Jennifer Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.,Center for Hip Health and Mobility, Vancouver, British Columbia, Canada
| |
Collapse
|
33
|
Meusel LAC, Anderson ND, Parrott MD, Yuen W, Tchistiakova E, MacIntosh BJ, Feldman S, Greenwood CE. Brain Function Is Linked to LDL Cholesterol in Older Adults with Cardiovascular Risk. J Am Geriatr Soc 2016; 65:e51-e55. [DOI: 10.1111/jgs.14663] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Nicole D. Anderson
- Rotman Research Institute; Baycrest Health Sciences; Toronto Ontario Canada
- Departments of Psychology and Psychiatry; University of Toronto; Toronto Ontario Canada
| | - Matthew D. Parrott
- Rotman Research Institute; Baycrest Health Sciences; Toronto Ontario Canada
- Department of Nutritional Sciences; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - William Yuen
- Rotman Research Institute; Baycrest Health Sciences; Toronto Ontario Canada
| | - Ekaterina Tchistiakova
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery; Sunnybrook Research Institute; Toronto Ontario Canada
- Department of Medical Biophysics; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - Bradley J. MacIntosh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery; Sunnybrook Research Institute; Toronto Ontario Canada
- Department of Medical Biophysics; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - Sid Feldman
- Baycrest Health Sciences; Toronto Ontario Canada
- Department of Family and Community Medicine; University of Toronto; Toronto Ontario Canada
| | - Carol E. Greenwood
- Rotman Research Institute; Baycrest Health Sciences; Toronto Ontario Canada
- Department of Nutritional Sciences; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| |
Collapse
|
34
|
Education is associated with sub-regions of the hippocampus and the amygdala vulnerable to neuropathologies of Alzheimer's disease. Brain Struct Funct 2016; 222:1469-1479. [PMID: 27535407 DOI: 10.1007/s00429-016-1287-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 08/11/2016] [Indexed: 01/18/2023]
Abstract
We evaluated the correlation of educational attainment with structural volume and shape morphometry of the bilateral hippocampi and amygdalae in a sample of 110 non-demented, older adults at elevated sociodemographic risk for cognitive and functional declines. In both men and women, no significant education-volume correlation was detected for either structure. However, when performing shape analysis, we observed regionally specific associations with education after adjusting for age, intracranial volume, and race. By sub-dividing the hippocampus and the amygdala into compatible subregions, we found that education was positively associated with size variations in the CA1 and subiculum subregions of the hippocampus and the basolateral subregion of the amygdala (p < 0.05). In addition, we detected a greater left versus right asymmetric pattern in the shape-education correlation for the hippocampus but not the amygdala. This asymmetric association was largely observed in men versus women. These findings suggest that education in youth may exert direct and indirect influences on brain reserve in regions that are most vulnerable to the neuropathologies of aging, dementia, and specifically, Alzheimer disease.
Collapse
|
35
|
Foo H, Mak E, Yong TT, Wen MC, Chander RJ, Au WL, Tan L, Kandiah N. Progression of small vessel disease correlates with cortical thinning in Parkinson's disease. Parkinsonism Relat Disord 2016; 31:34-40. [PMID: 27397577 DOI: 10.1016/j.parkreldis.2016.06.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 06/26/2016] [Accepted: 06/28/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Cerebral small-vessel disease (SVD) is a risk factor for dementia in Parkinson's disease (PD), however the pathophysiological role of SVD in PD-dementia is unclear. We investigated the impact of baseline and progression of SVD on cortical thickness and the correlation to cognition. METHODS Seventy-three mild PD patients with baseline and follow-up structural MRI scans, serial clinical and neuropsychological assessments were studied. SVD included the load of white matter hyperintensities (WMH), lacunes and perivascular spaces (PVS). WMH progression was assessed using the modified Rotterdam Progression scale, while for lacunes and PVS, development of new lesions was considered as lesion progression. Patients were classified as having SVD-progression and SVD-no-progression based on the longitudinal changes in their SVD measures. Freesurfer was used to measure baseline and follow-up regional cortical thickness and subcortical volumes and correlated to cognitive performance. RESULTS Fourteen patients were classified as SVD-progression and 59 as SVD-no-progression. Over 18 months, PD SVD-progression demonstrated significant cortical thinning in the left frontal and bilateral parietal regions with associated decline in memory, executive function, and motor functions. PD SVD-progression also had reduced volumes in the nucleus accumbens and amygdala at baseline and greater atrophy in the caudate nucleus over 18 months. DISCUSSION The extent and progression of SVD is associated with focal cerebral atrophy and domain-specific cognitive dysfunction. Measures to retard SVD may be potentially useful in preventing dementia in PD.
Collapse
Affiliation(s)
- Heidi Foo
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Elijah Mak
- Department of Psychiatry, University of Cambridge, UK
| | - Ting Ting Yong
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Ming-Ching Wen
- Department of Neurology, National Neuroscience Institute, Singapore
| | | | - Wing Lok Au
- Department of Neurology, National Neuroscience Institute, Singapore; Duke-NUS, Graduate Medical School, Singapore
| | - Louis Tan
- Department of Neurology, National Neuroscience Institute, Singapore; Duke-NUS, Graduate Medical School, Singapore
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Singapore; Duke-NUS, Graduate Medical School, Singapore.
| |
Collapse
|
36
|
Varma VR, Tang X, Carlson MC. Hippocampal sub-regional shape and physical activity in older adults. Hippocampus 2016; 26:1051-60. [PMID: 27009597 DOI: 10.1002/hipo.22586] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2016] [Indexed: 01/18/2023]
Abstract
Hippocampal atrophy is a hallmark of Alzheimer's disease pathology, and a target biomarker region for testing intervention efficacy. Over the last few decades, a growing body of evidence from animal and human models suggests that physical activity (PA) is associated with structural benefits to the hippocampus in older adults. Very few human studies, however have explored hippocampal sub-regional specificity of PA; this is significant considering that sub-regions of the hippocampus are associated with distinct cognitive tasks and are differentially affected by disease pathology. This study used objective and self-reported measures of daily walking activity and exercise, and surface-based regional shape analysis using high-field hippocampal sub-regional partitions to explore sub-region specific hippocampal associations in a sample of nondemented, community-dwelling older adults at elevated sociodemographic risk for cognitive decline. Vertex-wise surface areas, which may be more sensitive than global volume measures, were calculated using shape diffeomorphometry, and PA was assessed using step activity monitors and PA questionnaires. We found that daily walking activity in a participant's environment was associated in cross-section mainly with larger surface areas of the subiculum in women. Associations remained significant when controlling for self-reported exercise. Prior studies have found that PA related to exercise and aerobic fitness may be most closely associated with the anterior hippocampus, particularly the dentate gyrus of the hippocampus. These novel findings are the first, to our knowledge, in human models to suggest that PA related to navigation that may not reach the level of moderate-intensity exercise may be associated with specific sub-regions of the hippocampus. These findings underscore the importance of better understanding the independent and related biological mechanisms and pathways by which increasing exercise as well as non-exercise, lifestyle PA may influence structural brain health. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Vijay R Varma
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland.,Clinical and Translational Neuroscience Unit, Laboratory of Behavioral Neuroscience, National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, MD, USA
| | - Xiaoying Tang
- Joint Institute of Engineering, Sun Yat-Sen University-Carnegie Mellon University (SYSU-CMU), Pittsburgh, Pennsylvania, Guangzhou, Guangdong, China.,Shunde International Joint Research Institute, Sun Yat-Sen University-Carnegie Mellon University (SYSU-CMU), Pittsburgh, Pennsylvania, Shunde, Guangdong, China
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
37
|
Apathy and noradrenaline: silent partners to mild cognitive impairment in Parkinson's disease? Curr Opin Neurol 2016; 28:344-50. [PMID: 26110801 DOI: 10.1097/wco.0000000000000218] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE OF REVIEW Mild cognitive impairment (MCI) is a comorbid factor in Parkinson's disease. The aim of this review is to examine the recent neuroimaging findings in the search for Parkinson's disease MCI (PD-MCI) biomarkers to gain insight on whether MCI and specific cognitive deficits in Parkinson's disease implicate striatal dopamine or another system. RECENT FINDINGS The evidence implicates a diffuse pathophysiology in PD-MCI rather than acute dopaminergic involvement. On the one hand, performance in specific cognitive domains, notably in set-shifting and learning, appears to vary with dopaminergic status. On the other hand, motivational states in Parkinson's disease along with their behavioral and physiological indices suggest a noradrenergic contribution to cognitive deficits in Parkinson's disease. Finally, Parkinson's disease's pattern of neurodegeneration offers an avenue for continued research in nigrostriatal dopamine's role in distinct behaviors, as well as the specification of dorsal and ventral striatal functions. SUMMARY The search for PD-MCI biomarkers has employed an array of neuroimaging techniques, but still yields divergent findings. This may be due in part to MCI's broad definition, encompassing heterogeneous cognitive domains, only some of which are affected in Parkinson's disease. Most domains falling under the MCI umbrella include fronto-dependent executive functions, whereas others, notably learning, rely on the basal ganglia. Given the deterioration of the nigrostriatal dopaminergic system in Parkinson's disease, it has been the prime target of PD-MCI investigation. By testing well defined cognitive deficits in Parkinson's disease, distinct functions can be attributed to specific neural systems, overcoming conflicting results on PD-MCI. Apart from dopamine, other systems such as the neurovascular or noradrenergic systems are affected in Parkinson's disease. These factors may be at the basis of specific facets of PD-MCI for which dopaminergic involvement has not been conclusive. Finally, the impact of both dopaminergic and noradrenergic deficiency on motivational states in Parkinson's disease is examined in light of a plausible link between apathy and cognitive deficits.
Collapse
|
38
|
McFall GP, Sapkota S, McDermott KL, Dixon RA. Risk-reducing Apolipoprotein E and Clusterin genotypes protect against the consequences of poor vascular health on executive function performance and change in nondemented older adults. Neurobiol Aging 2016; 42:91-100. [PMID: 27143425 DOI: 10.1016/j.neurobiolaging.2016.02.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/24/2016] [Accepted: 02/29/2016] [Indexed: 02/06/2023]
Abstract
We examined independent and cumulative effects of 2 Alzheimer's-related genetic polymorphisms, Apolipoprotein E (APOE) and Clusterin (CLU), in relation to the deleterious effects of poor vascular health (pulse pressure [PP]) on executive function (EF) performance and change in nondemented older adults. Using a sample (n = 593; age range = 53-95 years) from the Victoria Longitudinal Study, we applied latent growth modeling to test the effect of PP, as moderated by APOE and CLU, on an EF latent variable. EF was affected by higher levels of PP but differentially less so for carriers of low-risk alleles (APOE ɛ2+; CLU TT) than for moderate- or high-risk alleles (APOE ɛ2-; CLU C+). The cumulative genetic risk of APOE plus CLU provided similar moderation of PP level effects on EF. Future research may focus on how APOE and CLU might provide different but complementary contributions to predicting EF level and change. Vascular health risk in synergistic association with risk-related polymorphisms can elucidate the neurobiological underpinnings of cognitive trajectories in nondemented aging.
Collapse
Affiliation(s)
- G Peggy McFall
- Department of Psychology, University of Alberta, Edmonton, Canada; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Shraddha Sapkota
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Kirstie L McDermott
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Roger A Dixon
- Department of Psychology, University of Alberta, Edmonton, Canada; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada.
| |
Collapse
|
39
|
Bhat G, Yost G, Mahoney E. Cognitive function and left ventricular assist device implantation. J Heart Lung Transplant 2015; 34:1398-405. [DOI: 10.1016/j.healun.2015.05.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/27/2015] [Accepted: 05/28/2015] [Indexed: 11/26/2022] Open
|
40
|
Alosco ML, Hayes SM. Structural brain alterations in heart failure: a review of the literature and implications for risk of Alzheimer's disease. Heart Fail Rev 2015; 20:561-71. [PMID: 25896528 PMCID: PMC5543407 DOI: 10.1007/s10741-015-9488-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cardiovascular disease is a recognized contributor to the pathogenesis of Alzheimer's disease (AD). Heart failure (HF) is a cardiovascular subtype that can be used to model the contribution of cardiovascular disease to AD. Neuroimaging research indicates that HF patients exhibit a diverse range of structural brain alterations and epidemiological studies suggest HF may be an important risk factor for AD. The neural alterations observed in HF may overlap with those observed in AD and contribute to increased risk of AD in HF patients. To examine this possibility, we reviewed structural MRI studies in persons with HF. We examined subcortical brain regions affected in the early stages of AD (medial temporal lobes), as well as cortical alterations that typically occur in the later stages of AD. Our review indicates that patients with HF exhibit greater neural atrophy and white matter microstructural alterations of nearly every region of the Papez circuit (e.g., hippocampus, cingulate gyrus, thalamus, mammillary bodies, and fornix), as well-significant alterations in cortical and cerebellar regions. Based on animal research and past work in AD patients, the mechanisms for structural brain changes in HF may stem from reductions in cerebral blood flow subsequent to cardiac deficiency. This review supports the hypothesis that HF may contribute to AD risk via widespread structural brain changes, including many of the same regions affected by AD. Case-controlled prospective neuroimaging studies with long-term follow-ups are needed to clarify the risk of AD in HF and elucidate the neural underpinnings of AD risk in HF.
Collapse
Affiliation(s)
- Michael L Alosco
- Memory Disorders Research Center, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA,
| | | |
Collapse
|
41
|
Nishiguchi S, Yamada M, Tanigawa T, Sekiyama K, Kawagoe T, Suzuki M, Yoshikawa S, Abe N, Otsuka Y, Nakai R, Aoyama T, Tsuboyama T. A 12-Week Physical and Cognitive Exercise Program Can Improve Cognitive Function and Neural Efficiency in Community-Dwelling Older Adults: A Randomized Controlled Trial. J Am Geriatr Soc 2015; 63:1355-63. [DOI: 10.1111/jgs.13481] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Shu Nishiguchi
- Department of Physical Therapy, Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
- Japan Society for the Promotion of Science; Tokyo Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences; University of Tsukuba; Tokyo Japan
| | - Takanori Tanigawa
- Department of Physical Therapy, Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Kaoru Sekiyama
- Graduate School of Social and Cultural Sciences; Kumamoto University; Kumamoto Japan
| | - Toshikazu Kawagoe
- Japan Society for the Promotion of Science; Tokyo Japan
- Graduate School of Social and Cultural Sciences; Kumamoto University; Kumamoto Japan
| | - Maki Suzuki
- Graduate School of Social and Cultural Sciences; Kumamoto University; Kumamoto Japan
| | | | - Nobuhito Abe
- Kokoro Research Center; Kyoto University; Kyoto Japan
| | - Yuki Otsuka
- Kokoro Research Center; Kyoto University; Kyoto Japan
| | - Ryusuke Nakai
- Kokoro Research Center; Kyoto University; Kyoto Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Tadao Tsuboyama
- Department of Physical Therapy, Human Health Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
| |
Collapse
|
42
|
Impact of the Baltimore Experience Corps Trial on cortical and hippocampal volumes. Alzheimers Dement 2015; 11:1340-8. [PMID: 25835516 DOI: 10.1016/j.jalz.2014.12.005] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 12/07/2014] [Accepted: 12/10/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION There is a substantial interest in identifying interventions that can protect and buffer older adults from atrophy in the cortex and particularly, the hippocampus, a region important to memory. We report the 2-year effects of a randomized controlled trial of an intergenerational social health promotion program on older men's and women's brain volumes. METHODS The Brain Health Study simultaneously enrolled, evaluated, and randomized 111 men and women (58 interventions; 53 controls) within the Baltimore Experience Corps Trial to evaluate the intervention impact on biomarkers of brain health at baseline and annual follow-ups during the 2-year trial exposure. RESULTS Intention-to-treat analyses on cortical and hippocampal volumes for full and sex-stratified samples revealed program-specific increases in volumes that reached significance in men only (P's ≤ .04). Although men in the control arm exhibited age-related declines for 2 years, men in the Experience Corps arm showed a 0.7% to 1.6% increase in brain volumes. Women also exhibited modest intervention-specific gains of 0.3% to 0.54% by the second year of exposure that contrasted with declines of about 1% among women in the control group. DISCUSSION These findings showed that purposeful activity embedded within a social health promotion program halted and, in men, reversed declines in brain volume in regions vulnerable to dementia. CLINICAL TRIAL REGISTRATION NCT0038.
Collapse
|
43
|
Varma VR, Chuang YF, Harris GC, Tan EJ, Carlson MC. Low-intensity daily walking activity is associated with hippocampal volume in older adults. Hippocampus 2014; 25:605-15. [PMID: 25483019 DOI: 10.1002/hipo.22397] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2014] [Indexed: 01/12/2023]
Abstract
Hippocampal atrophy is associated with memory impairment and dementia and serves as a key biomarker in the preclinical stages of Alzheimer's disease. Physical activity, one of the most promising behavioral interventions to prevent or delay cognitive decline, has been shown to be associated with hippocampal volume; specifically increased aerobic activity and fitness may have a positive effect on the size of the hippocampus. The majority of older adults, however, are sedentary and have difficulty initiating and maintaining exercise programs. A modestly more active lifestyle may nonetheless be beneficial. This study explored whether greater objectively measured daily walking activity was associated with larger hippocampal volume. We additionally explored whether greater low-intensity walking activity, which may be related to leisure-time physical, functional, and social activities, was associated with larger hippocampal volume independent of exercise and higher-intensity walking activity. Segmentation of hippocampal volumes was performed using Functional Magnetic Resonance Imaging of the Brain's Software Library (FSL), and daily walking activity was assessed using a step activity monitor on 92, nondemented, older adult participants. After controlling for age, education, body mass index, cardiovascular disease risk factors, and the Mini Mental State Exam, we found that a greater amount, duration, and frequency of total daily walking activity were each associated with larger hippocampal volume among older women, but not among men. These relationships were specific to hippocampal volume, compared with the thalamus, used as a control brain region, and remained significant for low-intensity walking activity, independent of moderate- to vigorous-intensity activity and self-reported exercise. This is the first study, to our knowledge, to explore the relationship between objectively measured daily walking activity and hippocampal volume in an older adult population. Findings suggest the importance of examining whether increasing nonexercise, lifestyle physical activities may produce measurable cognitive benefits and affect hippocampal volume through molecular pathways unique to those related to moderate-intensity exercise.
Collapse
Affiliation(s)
- Vijay R Varma
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | | | | | | | | |
Collapse
|
44
|
Hayes SM, Alosco ML, Forman DE. The Effects of Aerobic Exercise on Cognitive and Neural Decline in Aging and Cardiovascular Disease. CURRENT GERIATRICS REPORTS 2014; 3:282-290. [PMID: 25750853 DOI: 10.1007/s13670-014-0101-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Aging is characterized by a decline in cognitive functions, particularly in the domains of executive function, processing speed and episodic memory. These age-related declines are exacerbated by cardiovascular disease (CVD) and cardiovascular risk factors (hypertension, diabetes, obesity, elevated total cholesterol). Structural and functional alterations in brain regions, including the fronto-parietal and medial temporal lobes, have been linked to age- and CVD-related cognitive decline. Multiple recent studies indicate that aerobic exercise programs may slow the progression of age-related neural changes and reduce the risk for mild cognitive impairment as well as dementia. We review age- and CVD-related decline in cognition and the underlying changes in brain morphology and function, and then clarify the impact of aerobic exercise on moderating these patterns.
Collapse
Affiliation(s)
- Scott M Hayes
- Memory Disorders Research Center (151A), VA Boston Healthcare System and Boston University School of Medicine, 150 South Huntington Ave, Boston, MA 02130, USA; Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA
| | - Michael L Alosco
- Memory Disorders Research Center (151A), VA Boston Healthcare System and Boston University School of Medicine, 150 South Huntington Ave, Boston, MA 02130, USA; Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Daniel E Forman
- Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Geriatric Cardiology Section, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| |
Collapse
|