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VandeBunte AM, Fonseca C, Paolillo EW, Gontrum E, Lee SY, Kramer JH, Casaletto KB. Regional Vulnerability of the Corpus Callosum in the Context of Cardiovascular Risk. J Geriatr Psychiatry Neurol 2023; 36:397-406. [PMID: 36710073 PMCID: PMC10441555 DOI: 10.1177/08919887231154931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Many factors outside of cardiovascular health can impact the structure of white matter. Identification of reliable and clinically meaningful biomarkers of the neural effects of systemic and cardiovascular health are needed to refine etiologic predictions. We examined whether the corpus callosum demonstrates regional vulnerability to systemic cardiovascular risk factors. Three hundred and ninety-four older adults without dementia completed brain MRI, neurobehavioral evaluations, and blood draws. A subset (n = 126, n = 128) of individuals had blood plasma analyzed for inflammatory markers of interest (IL-6 and TNF-alpha). Considering diffusion tensor imaging (DTI) is a particularly reliable measure of white matter integrity, we utilized DTI to examine fractional anisotropy (FA) of anterior and posterior regions of the corpus callosum. Using multiple linear regression models, we simultaneously examined FA of the genu and the splenium to compare their associations with systemic and cardiovascular risk factors. Lower FA of the genu but not splenium was associated with greater systemic and cardiovascular risk, including higher systolic blood pressure (β = -0.17, p = .020), hemoglobin A1C (β = -0.21, p = .016) and IL-6 (β = -0.34, p = .005). FA of the genu was uniquely associated with cognitive processing speed (β = 0.20, p = .0015) and executive functioning (β = 0.15, p = .012), but not memory performances (β = 0.05, p = .357). Our results demonstrated differential vulnerability of the corpus callosum, such that frontal regions showed stronger, independent associations with biomarkers of systemic and cardiovascular health in comparison to posterior regions. Posterior white matter integrity may not reflect cardiovascular health. Clinically, these findings support the utility of examining the anterior corpus callosum as an indicator of cerebrovascular health.
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Affiliation(s)
- Anna M. VandeBunte
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
- Palo Alto University, CA, USA
| | - Corrina Fonseca
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Emily W. Paolillo
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Eva Gontrum
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Shannon Y. Lee
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Joel H. Kramer
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Kaitlin B. Casaletto
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA
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2
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Sharp FR, DeCarli CS, Jin LW, Zhan X. White matter injury, cholesterol dysmetabolism, and APP/Abeta dysmetabolism interact to produce Alzheimer's disease (AD) neuropathology: A hypothesis and review. Front Aging Neurosci 2023; 15:1096206. [PMID: 36845656 PMCID: PMC9950279 DOI: 10.3389/fnagi.2023.1096206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/30/2023] [Indexed: 02/12/2023] Open
Abstract
We postulate that myelin injury contributes to cholesterol release from myelin and cholesterol dysmetabolism which contributes to Abeta dysmetabolism, and combined with genetic and AD risk factors, leads to increased Abeta and amyloid plaques. Increased Abeta damages myelin to form a vicious injury cycle. Thus, white matter injury, cholesterol dysmetabolism and Abeta dysmetabolism interact to produce or worsen AD neuropathology. The amyloid cascade is the leading hypothesis for the cause of Alzheimer's disease (AD). The failure of clinical trials based on this hypothesis has raised other possibilities. Even with a possible new success (Lecanemab), it is not clear whether this is a cause or a result of the disease. With the discovery in 1993 that the apolipoprotein E type 4 allele (APOE4) was the major risk factor for sporadic, late-onset AD (LOAD), there has been increasing interest in cholesterol in AD since APOE is a major cholesterol transporter. Recent studies show that cholesterol metabolism is intricately involved with Abeta (Aβ)/amyloid transport and metabolism, with cholesterol down-regulating the Aβ LRP1 transporter and upregulating the Aβ RAGE receptor, both of which would increase brain Aβ. Moreover, manipulating cholesterol transport and metabolism in rodent AD models can ameliorate pathology and cognitive deficits, or worsen them depending upon the manipulation. Though white matter (WM) injury has been noted in AD brain since Alzheimer's initial observations, recent studies have shown abnormal white matter in every AD brain. Moreover, there is age-related WM injury in normal individuals that occurs earlier and is worse with the APOE4 genotype. Moreover, WM injury precedes formation of plaques and tangles in human Familial Alzheimer's disease (FAD) and precedes plaque formation in rodent AD models. Restoring WM in rodent AD models improves cognition without affecting AD pathology. Thus, we postulate that the amyloid cascade, cholesterol dysmetabolism and white matter injury interact to produce and/or worsen AD pathology. We further postulate that the primary initiating event could be related to any of the three, with age a major factor for WM injury, diet and APOE4 and other genes a factor for cholesterol dysmetabolism, and FAD and other genes for Abeta dysmetabolism.
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Affiliation(s)
| | - Charles S. DeCarli
- Department of Neurology, The MIND Institute, University of California at Davis Medical Center, Sacramento, CA, United States
| | - Lee-Way Jin
- Department of Neurology, The MIND Institute, University of California at Davis Medical Center, Sacramento, CA, United States
| | - Xinhua Zhan
- Department of Neurology, The MIND Institute, University of California at Davis Medical Center, Sacramento, CA, United States
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3
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White matter microstructural correlates of associative learning in the oldest-old. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:114-124. [PMID: 36163584 DOI: 10.3758/s13415-022-01035-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 11/08/2022]
Abstract
The ability to learn associations between events is critical for everyday functioning (e.g., decision making, social interactions) and has been attributed to structural differences in white matter tracts connecting cortical regions to the hippocampus (e.g., fornix) and striatum (e.g., internal capsule) in younger-old adults (ages 65-85 years). However, evidence of associative learning has not been assessed within oldest-old adults (ages 90+ years), despite its relevance to other extensively characterized cognitive abilities in the oldest-old and the relatively large effect of advanced age on the microstructural composition of these white matter tracts. We acquired multicompartment diffusion-weighted magnetic resonance imaging data from 22 oldest-old adults without dementia (mean age = 92.91 ± 1.44 years) who also completed an associative learning task. Behavioral results revealed significantly better associative learning performance during later task stages, as expected if participants incidentally learned the cue-cue-target associations for frequently occurring event triplets. Moreover, better learning performance was significantly predicted by better microstructure of cortico-striatal white matter (posterior limb of the internal capsule). Finding that associative learning abilities in the 10th decade of life are supported by better microstructure of white matter tracts connecting the cortex to the striatum underscores their importance to learning performance across the entire lifespan.
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4
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Caçoilo A, Rusinek H, Weickenmeier J. 3D finite-element brain modeling of lateral ventricular wall loading to rationalize periventricular white matter hyperintensity locations. ENGINEERING WITH COMPUTERS 2022; 38:3939-3955. [PMID: 37485473 PMCID: PMC10361695 DOI: 10.1007/s00366-022-01700-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/19/2022] [Indexed: 07/25/2023]
Abstract
Aging-related periventricular white matter hyperintensities (pvWMHs) are a common observation in medical images of the aging brain. The underlying tissue damage is part of the complex pathophysiology associated with age-related microstructural changes and cognitive decline. PvWMH formation is linked to blood-brain barrier dysfunction from cerebral small vessel disease as well as the accumulation of cerebrospinal fluid in periventricular tissue due to progressive denudation of the ventricular wall. In need of a unifying theory for pvWMH etiology, image-based finite-element modeling is used to demonstrate that ventricular expansion from age-related cerebral atrophy and hemodynamic loading leads to maximum mechanical loading of the ventricular wall in the same locations that show pvWMHs. Ventricular inflation, induced via pressurization of the ventricular wall, creates significant ventricular wall stretch and stress on the ependymal cells lining the wall, that are linked to cerebrospinal fluid leaking from the lateral ventricles into periventricular white matter tissue. Eight anatomically accurate 3D brain models of cognitively healthy subjects with a wide range of ventricular shapes are created. For all models, our simulations show that mechanomarkers of mechanical wall loading are consistently highest in pvWMHs locations (p < 0.05). Maximum principal strain, the ependymal cell thinning ratio, and wall curvature are on average 14%, 8%, and 24% higher in pvWMH regions compared to the remaining ventricular wall, respectively. Computational modeling provides a powerful framework to systematically study pvWMH formation and growth with the goal to develop pharmacological interventions in the future.
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Affiliation(s)
- Andreia Caçoilo
- Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, NJ 07030, USA
| | - Henry Rusinek
- Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Johannes Weickenmeier
- Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, NJ 07030, USA
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5
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Zhao H, Wen W, Cheng J, Jiang J, Kochan N, Niu H, Brodaty H, Sachdev P, Liu T. An accelerated degeneration of white matter microstructure and networks in the nondemented old-old. Cereb Cortex 2022; 33:4688-4698. [PMID: 36178117 DOI: 10.1093/cercor/bhac372] [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: 07/15/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/12/2022] Open
Abstract
The nondemented old-old over the age of 80 comprise a rapidly increasing population group; they can be regarded as exemplars of successful aging. However, our current understanding of successful aging in advanced age and its neural underpinnings is limited. In this study, we measured the microstructural and network-based topological properties of brain white matter using diffusion-weighted imaging scans of 419 community-dwelling nondemented older participants. The participants were further divided into 230 young-old (between 72 and 79, mean = 76.25 ± 2.00) and 219 old-old (between 80 and 92, mean = 83.98 ± 2.97). Results showed that white matter connectivity in microstructure and brain networks significantly declined with increased age and that the declined rates were faster in the old-old compared with young-old. Mediation models indicated that cognitive decline was in part through the age effect on the white matter connectivity in the old-old but not in the young-old. Machine learning predictive models further supported the crucial role of declines in white matter connectivity as a neural substrate of cognitive aging in the nondemented older population. Our findings shed new light on white matter connectivity in the nondemented aging brains and may contribute to uncovering the neural substrates of successful brain aging.
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Affiliation(s)
- Haichao Zhao
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Jian Cheng
- School of Computer Science and Engineering, Beihang University, Beijing, China
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Haijun Niu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), University of New South Wales, Sydney, NSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Tao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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6
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Gómez-Ramírez J, Fernández-Blázquez MA, González-Rosa JJ. Prediction of Chronological Age in Healthy Elderly Subjects with Machine Learning from MRI Brain Segmentation and Cortical Parcellation. Brain Sci 2022; 12:brainsci12050579. [PMID: 35624966 PMCID: PMC9139275 DOI: 10.3390/brainsci12050579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 01/11/2023] Open
Abstract
Normal aging is associated with changes in volumetric indices of brain atrophy. A quantitative understanding of age-related brain changes can shed light on successful aging. To investigate the effect of age on global and regional brain volumes and cortical thickness, 3514 magnetic resonance imaging scans were analyzed using automated brain segmentation and parcellation methods in elderly healthy individuals (69–88 years of age). The machine learning algorithm extreme gradient boosting (XGBoost) achieved a mean absolute error of 2 years in predicting the age of new subjects. Feature importance analysis showed that the brain-to-intracranial-volume ratio is the most important feature in predicting age, followed by the hippocampi volumes. The cortical thickness in temporal and parietal lobes showed a superior predictive value than frontal and occipital lobes. Insights from this approach that integrate model prediction and interpretation may help to shorten the current explanatory gap between chronological age and biological brain age.
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Affiliation(s)
- Jaime Gómez-Ramírez
- Institute of Biomedical Research Cadiz (INiBICA), Universidad de Cádiz, 11003 Cádiz, Spain;
- Correspondence:
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7
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Merenstein JL, Bennett IJ. Bridging patterns of neurocognitive aging across the older adult lifespan. Neurosci Biobehav Rev 2022; 135:104594. [PMID: 35227712 PMCID: PMC9888009 DOI: 10.1016/j.neubiorev.2022.104594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/27/2022] [Accepted: 02/23/2022] [Indexed: 02/02/2023]
Abstract
Magnetic resonance imaging (MRI) studies of brain and neurocognitive aging rarely include oldest-old adults (ages 80 +). But predictions of neurocognitive aging theories derived from MRI findings in younger-old adults (ages ~55-80) may not generalize into advanced age, particularly given the increased prevalence of cognitive impairment/dementia in the oldest-old. Here, we reviewed the MRI literature in oldest-old adults and interpreted findings within the context of regional variation, compensation, brain maintenance, and reserve theories. Structural MRI studies revealed regional variation in brain aging as larger age effects on medial temporal and posterior regions for oldest-old than younger-old adults. They also revealed that brain maintenance explained preserved cognitive functioning into the tenth decade of life. Very few functional MRI studies examined compensatory activity in oldest-old adults who perform as well as younger groups, although there was evidence that higher brain reserve in oldest-old adults may mediate effects of brain aging on cognition. Despite some continuity, different cognitive and neural profiles across the older adult lifespan should be addressed in modern neurocognitive aging theories.
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8
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The Relations Between Physical Activity Level, Executive Function, and White Matter Microstructure in Older Adults. J Phys Act Health 2021; 18:1286-1298. [PMID: 34433700 DOI: 10.1123/jpah.2021-0012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/23/2021] [Accepted: 06/12/2021] [Indexed: 11/18/2022]
Abstract
The population of older adults is increasing, indicating a need to examine factors that may prevent or mitigate age-related cognitive decline. The current study examined whether microstructural white matter characteristics mediated the relation between physical activity and executive function in older adults without any self-reported psychiatric and neurological disorders or cognitive impairment (N = 43, mean age = 73 y). Physical activity was measured by average intensity and number of steps via accelerometry. Diffusion tensor imaging was used to examine microstructural white matter characteristics, and neuropsychological testing was used to examine executive functioning. Parallel mediation models were analyzed using microstructural white matter regions of interest as mediators of the association between physical activity and executive function. Results indicated that average steps was significantly related to executive function (β = 0.0003, t = 2.829, P = .007), while moderate to vigorous physical activity was not (β = 0.0007, t = 1.772, P = .08). White matter metrics did not mediate any associations. This suggests that microstructural white matter characteristics alone may not be the mechanism by which physical activity impacts executive function in aging.
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9
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Porcu M, Cocco L, Puig J, Mannelli L, Yang Q, Suri JS, Defazio G, Saba L. Global Fractional Anisotropy: Effect on Resting-state Neural Activity and Brain Networking in Healthy Participants. Neuroscience 2021; 472:103-115. [PMID: 34364954 DOI: 10.1016/j.neuroscience.2021.07.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022]
Abstract
The global fractional anisotropy (gFA) is a structural marker of white matter myelination and integrity. Previous studies already evidenced that aging-related reduced integrity of specific white matter tracts is associated with decreased functional connectivity in several hubs. However, the correlations between gFA and functional brain connectivity remain unknown. In this cross-sectional study, we analyzed structural and functional MR datasets of 79 healthy participants from the Leipzig Study for Mind-Body-Emotion Interactions. DTI model-based method was used to quantify gFA values. We tested associations between gFA, age, and gender. The fractional amplitude of low-frequency fluctuations (fALFF) and ROI-to-ROI connectivity were analyzed in a regression model for evaluating the effects of gFA on brain activity and networking, respectively. A negative correlation was found between gFA and age (ρ = -0.343; p = 0.002). No statistically significant correlation as found between gFA and gender (p = 0.229). Higher values of gFA were associated with increased brain regional activity, including areas of the default mode network. There was a higher degree of correlation between some regions, particularly those that conform to the limbic system. Our study demonstrates that gFA influences regional neural activity and brain networking on resting, particularly the limbic system.
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Affiliation(s)
- Michele Porcu
- Department of Radiology, AOU Cagliari, University of Cagliari, Italy.
| | - Luigi Cocco
- Department of Radiology, AOU Cagliari, University of Cagliari, Italy
| | - Josep Puig
- Department of Radiology (IDI) and Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain
| | | | - Qi Yang
- Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, China
| | - Jasjit S Suri
- Stroke Diagnosis and Monitoring Division, AtheroPoint™, Roseville, CA, USA
| | - Giovanni Defazio
- Department of Neurology, University of Cagliari, Cagliari, Italy
| | - Luca Saba
- Department of Radiology, AOU Cagliari, University of Cagliari, Italy
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10
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Merenstein JL, Corrada MM, Kawas CH, Bennett IJ. Age affects white matter microstructure and episodic memory across the older adult lifespan. Neurobiol Aging 2021; 106:282-291. [PMID: 34332220 DOI: 10.1016/j.neurobiolaging.2021.06.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023]
Abstract
Diffusion imaging studies have observed age-related degradation of white matter that contributes to cognitive deficits separately in younger-old (ages 65-89) and oldest-old (ages 90+) adults. But it remains unclear whether these age effects are magnified in advanced age groups, which may reflect disease-related pathology. Here, we tested whether age-related differences in white matter microstructure followed linear or nonlinear patterns across the entire older adult lifespan (65-98 years), these patterns were influenced by oldest-old adults at increased risk of dementia (cognitive impairment no dementia, CIND), and they explained age effects on episodic memory. Results revealed nonlinear microstructure declines across fiber classes (medial temporal, callosal, association, projection and/or thalamic) that were largest for medial temporal fibers. These patterns remained after excluding oldest-old participants with CIND, indicating that aging of white matter microstructure cannot solely be explained by pathology associated with early cognitive impairment. Moreover, finding that the effect of age on episodic memory was mediated by medial temporal fiber microstructure suggests it is essential for facilitating memory-related neural signals across the older adult lifespan.
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Affiliation(s)
| | - María M Corrada
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Neurology, University of California, Irvine, CA, USA; Department of Epidemiology, University of California, Irvine, CA, USA
| | - Claudia H Kawas
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Neurology, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Ilana J Bennett
- Department of Psychology, University of California, Riverside, CA, USA
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11
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Woodworth DC, Scambray KA, Corrada MM, Kawas CH, Sajjadi SA. Neuroimaging in the Oldest-Old: A Review of the Literature. J Alzheimers Dis 2021; 82:129-147. [PMID: 33998539 DOI: 10.3233/jad-201578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The oldest-old, those 85 years and older, are the fastest growing segment of the population and present with the highest prevalence of dementia. Given the importance of neuroimaging measures to understand aging and dementia, the objective of this study was to review neuroimaging studies performed in oldest-old participants. We used PubMed, Google Scholar, and Web of Science search engines to identify in vivo CT, MRI, and PET neuroimaging studies either performed in the oldest-old or that addressed the oldest-old as a distinct group in analyses. We identified 60 studies and summarized the main group characteristics and findings. Generally, oldest-old participants presented with greater atrophy compared to younger old participants, with most studies reporting a relatively stable constant decline in brain volumes over time. Oldest-old participants with greater global atrophy and atrophy in key brain structures such as the medial temporal lobe were more likely to have dementia or cognitive impairment. The oldest-old presented with a high burden of white matter lesions, which were associated with various lifestyle factors and some cognitive measures. Amyloid burden as assessed by PET, while high in the oldest-old compared to younger age groups, was still predictive of transition from normal to impaired cognition, especially when other adverse neuroimaging measures (atrophy and white matter lesions) were also present. While this review highlights past neuroimaging research in the oldest-old, it also highlights the dearth of studies in this important population. It is imperative to perform more neuroimaging studies in the oldest-old to better understand aging and dementia.
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Affiliation(s)
- Davis C Woodworth
- Department of Neurology, University of California, Irvine, CA, USA.,Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Kiana A Scambray
- Department of Neurology, University of California, Irvine, CA, USA.,Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - María M Corrada
- Department of Neurology, University of California, Irvine, CA, USA.,Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.,Department of Epidemiology, University of California, Irvine, CA, USA
| | - Claudia H Kawas
- Department of Neurology, University of California, Irvine, CA, USA.,Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.,Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - S Ahmad Sajjadi
- Department of Neurology, University of California, Irvine, CA, USA.,Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
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12
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Tang H, Liu T, Liu H, Jiang J, Cheng J, Niu H, Li S, Brodaty H, Sachdev P, Wen W. A slower rate of sulcal widening in the brains of the nondemented oldest old. Neuroimage 2021; 229:117740. [PMID: 33460796 DOI: 10.1016/j.neuroimage.2021.117740] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/09/2021] [Indexed: 11/15/2022] Open
Abstract
The relationships between aging and brain morphology have been reported in many previous structural brain studies. However, the trajectories of successful brain aging in the extremely old remain underexplored. In the limited research on the oldest old, covering individuals aged 85 years and older, there are very few studies that have focused on the cortical morphology, especially cortical sulcal features. In this paper, we measured sulcal width and depth as well as cortical thickness from T1-weighted scans of 290 nondemented community-dwelling participants aged between 76 and 103 years. We divided the participants into young old (between 76 and 84; mean = 80.35±2.44; male/female = 76/88) and oldest old (between 85 and 103; mean = 91.74±5.11; male/female = 60/66) groups. The results showed that most of the examined sulci significantly widened with increased age and that the rates of sulcal widening were lower in the oldest old. The spatial pattern of the cortical thinning partly corresponded with that of sulcal widening. Compared to females, males had significantly wider sulci, especially in the oldest old. This study builds a foundation for future investigations of neurocognitive disorders and neurodegenerative diseases in the oldest old, including centenarians.
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Affiliation(s)
- Hui Tang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, International Research Institute for Multidisciplinary Science, Beihang University, Beijing 100191, China
| | - Tao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, International Research Institute for Multidisciplinary Science, Beihang University, Beijing 100191, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beijing, China.
| | - Hao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, International Research Institute for Multidisciplinary Science, Beihang University, Beijing 100191, China
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney, NSW 2052, Australia
| | - Jian Cheng
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beijing, China
| | - Haijun Niu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, International Research Institute for Multidisciplinary Science, Beihang University, Beijing 100191, China
| | - Shuyu Li
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, International Research Institute for Multidisciplinary Science, Beihang University, Beijing 100191, China
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney, NSW 2052, Australia; Dementia Centre for Research Collaboration, School of Psychiatry, UNSW Sydney, NSW 2052, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney, NSW 2052, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney, NSW 2052, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
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13
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Morand A, Segobin S, Lecouvey G, Gonneaud J, Eustache F, Rauchs G, Desgranges B. Brain Substrates of Time-Based Prospective Memory Decline in Aging: A Voxel-Based Morphometry and Diffusion Tensor Imaging Study. Cereb Cortex 2021; 31:396-409. [PMID: 32935836 DOI: 10.1093/cercor/bhaa232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/29/2020] [Accepted: 07/28/2020] [Indexed: 11/14/2022] Open
Abstract
Time-based prospective memory (TBPM) allows us to remember to perform intended actions at a specific time in the future. TBPM is sensitive to the effects of age, but the neural substrates of this decline are still poorly understood. The aim of the present study was thus to better characterize the brain substrates of the age-related decline in TBPM, focusing on macrostructural gray matter and microstructural white matter integrity. We administered a TBPM task to 22 healthy young (26 ± 5.2 years) and 23 older (63 ± 5.9 years) participants, who also underwent volumetric magnetic resonance imaging and diffusion tensor imaging scans. Neuroimaging analyses revealed lower gray matter volumes in several brain areas in older participants, but these did not correlate with TBPM performance. By contrast, an age-related decline in fractional anisotropy in several white-matter tracts connecting frontal and occipital regions did correlate with TBPM performance, whereas there was no significant correlation in healthy young subjects. According to the literature, these tracts are connected to the anterior prefrontal cortex and the thalamus, 2 structures involved in TBPM. These results confirm the view that a disconnection process occurs in aging and contributes to cognitive decline.
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Affiliation(s)
| | | | - Grégory Lecouvey
- Normandie Université, UNICAEN, PSL Université Paris, 14000 Caen, France
| | - Julie Gonneaud
- Normandie Université, UNICAEN, PSL Université Paris, 14000 Caen, France
| | - Francis Eustache
- Normandie Université, UNICAEN, PSL Université Paris, 14000 Caen, France
| | - Géraldine Rauchs
- Normandie Université, UNICAEN, PSL Université Paris, 14000 Caen, France
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14
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Edde M, Theaud G, Rheault F, Dilharreguy B, Helmer C, Dartigues JF, Amieva H, Allard M, Descoteaux M, Catheline G. Free water: A marker of age-related modifications of the cingulum white matter and its association with cognitive decline. PLoS One 2020; 15:e0242696. [PMID: 33216815 PMCID: PMC7678997 DOI: 10.1371/journal.pone.0242696] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/08/2020] [Indexed: 11/19/2022] Open
Abstract
Diffusion MRI is extensively used to investigate changes in white matter microstructure. However, diffusion measures within white matter tissue can be affected by partial volume effects due to cerebrospinal fluid and white matter hyperintensities, especially in the aging brain. In previous aging studies, the cingulum bundle that plays a central role in the architecture of the brain networks supporting cognitive functions has been associated with cognitive deficits. However, most of these studies did not consider the partial volume effects on diffusion measures. The aim of this study was to evaluate the effect of free water elimination on diffusion measures of the cingulum in a group of 68 healthy elderly individuals. We first determined the effect of free water elimination on conventional DTI measures and then examined the effect of free water elimination on verbal fluency performance over 12 years. The cingulum bundle was reconstructed with a tractography pipeline including a white matter hyperintensities mask to limit the negative impact of hyperintensities on fiber tracking algorithms. We observed that free water elimination increased the ability of conventional DTI measures to detect associations between tissue diffusion measures of the cingulum and changes in verbal fluency in older individuals. Moreover, free water content and mean diffusivity measured along the cingulum were independently associated with changes in verbal fluency. This suggests that both tissue modifications and an increase in interstitial isotropic water would contribute to cognitive decline. These observations reinforce the importance of using free water elimination when studying brain aging and indicate that free water itself could be a relevant marker for age-related cingulum white matter modifications and cognitive decline.
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Affiliation(s)
- Manon Edde
- EPHE, PSL, Bordeaux, France
- CNRS, INCIA, UMR 5287, Bordeaux, France
| | - Guillaume Theaud
- Sherbrooke Connectivity Imaging Lab, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - François Rheault
- Sherbrooke Connectivity Imaging Lab, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Catherine Helmer
- Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Jean-François Dartigues
- Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
- CHU de Bordeaux, Bordeaux, France
| | - Hélène Amieva
- Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Michèle Allard
- EPHE, PSL, Bordeaux, France
- CNRS, INCIA, UMR 5287, Bordeaux, France
- CHU de Bordeaux, Bordeaux, France
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Lab, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Gwénaëlle Catheline
- EPHE, PSL, Bordeaux, France
- CNRS, INCIA, UMR 5287, Bordeaux, France
- Université de Bordeaux, INCIA, UMR 5287, Bordeaux, France
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15
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Rajan S, Brettschneider J, Collingwood JF. Regional segmentation strategy for DTI analysis of human corpus callosum indicates motor function deficit in mild cognitive impairment. J Neurosci Methods 2020; 345:108870. [PMID: 32687851 DOI: 10.1016/j.jneumeth.2020.108870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The corpus callosum is the largest white matter tract in the human brain, involved in inter-hemispheric transfer and integration of lateralised visual, sensory-motor, language, and cognitive information. Microstructural alterations are implicated in ageing as well as various neurological conditions. NEW METHOD Cross-sectional diffusion-weighted images of 107 healthy adults were used to create a linear regression model of the ageing corpus callosum and its sub-regions to evaluate the impact of analysis by sub-region, and to test for deviations from healthy ageing parameters in 28 subjects with mild cognitive impairment (MCI). Alterations in diffusion properties including fractional anisotropy, mean, radial and axial diffusivities were investigated as a function of age. RESULTS Changes in DTI parameters showed age-dependent regional differences, likely arising from axonal diameter variation across cross-sectional regions of interest in the corpus callosum. Patterns suggestive of degeneration with healthy ageing were observed in all regions. Diffusion parameters in sub-regions projecting to pre-motor, primary, and supplementary motor areas of the brain differed for MCI versus healthy controls, and MCI subjects were more likely than healthy controls to experience a reduction in motor skills. COMPARISON WITH EXISTING METHODS Statistical analyses of the corpus callosum by five manually-defined sub-regions, instead of a single manually-defined region of interest, revealed region-specific changes in microstructure in healthy ageing and MCI, and accounted for clinically-evaluated differences in motor skills between cohorts. CONCLUSION This method will support future studies of corpus callosum, enabling identification and measurement of white matter changes that are undetectable with the single ROI approach.
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Affiliation(s)
- Surya Rajan
- School of Engineering, University of Warwick, Coventry, UK
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16
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de Boer L, Garzón B, Axelsson J, Riklund K, Nyberg L, Bäckman L, Guitart-Masip M. Corticostriatal White Matter Integrity and Dopamine D1 Receptor Availability Predict Age Differences in Prefrontal Value Signaling during Reward Learning. Cereb Cortex 2020; 30:5270-5280. [PMID: 32484215 PMCID: PMC7472214 DOI: 10.1093/cercor/bhaa104] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 12/25/2022] Open
Abstract
Probabilistic reward learning reflects the ability to adapt choices based on probabilistic feedback. The dopaminergically innervated corticostriatal circuit in the brain plays an important role in supporting successful probabilistic reward learning. Several components of the corticostriatal circuit deteriorate with age, as it does probabilistic reward learning. We showed previously that D1 receptor availability in NAcc predicts the strength of anticipatory value signaling in vmPFC, a neural correlate of probabilistic learning that is attenuated in older participants and predicts probabilistic reward learning performance. We investigated how white matter integrity in the pathway between nucleus accumbens (NAcc) and ventromedial prefrontal cortex (vmPFC) relates to the strength of anticipatory value signaling in vmPFC in younger and older participants. We found that in a sample of 22 old and 23 young participants, fractional anisotropy in the pathway between NAcc and vmPFC predicted the strength of value signaling in vmPFC independently from D1 receptor availability in NAcc. These findings provide tentative evidence that integrity in the dopaminergic and white matter pathways of corticostriatal circuitry supports the expression of value signaling in vmPFC which supports reward learning, however, the limited sample size calls for independent replication. These and future findings could add to the improved understanding of how corticostriatal integrity contributes to reward learning ability.
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Affiliation(s)
- Lieke de Boer
- Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm 171 65, Sweden
| | - Benjamín Garzón
- Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm 171 65, Sweden
| | - Jan Axelsson
- Department of Radiation Sciences, Diagnostic Radiology, University Hospital, Umeå University, Umeå SE-901 87, Sweden.,Department of Integrative Medical Biology, Physiology, Umeå University, Umeå SE-901 87, Sweden
| | - Katrine Riklund
- Department of Radiation Sciences, Diagnostic Radiology, University Hospital, Umeå University, Umeå SE-901 87, Sweden.,Department of Integrative Medical Biology, Physiology, Umeå University, Umeå SE-901 87, Sweden
| | - Lars Nyberg
- Department of Radiation Sciences, Diagnostic Radiology, University Hospital, Umeå University, Umeå SE-901 87, Sweden.,Department of Integrative Medical Biology, Physiology, Umeå University, Umeå SE-901 87, Sweden.,Umeå Center for Functional Brain Imaging, Umeå University, Umeå 907 36, Sweden
| | - Lars Bäckman
- Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm 171 65, Sweden
| | - Marc Guitart-Masip
- Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm 171 65, Sweden.,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London WC1B 5EH, UK
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17
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Lau WL, Fisher M, Greenia D, Floriolli D, Fletcher E, Singh B, Sajjadi SA, Corrada MM, Whittle C, Kawas C, Paganini-Hill A. Cystatin C, cognition, and brain MRI findings in 90+-year-olds. Neurobiol Aging 2020; 93:78-84. [PMID: 32473464 DOI: 10.1016/j.neurobiolaging.2020.04.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 01/08/2023]
Abstract
Chronic kidney disease is emerging as a novel risk factor for cerebrovascular disease, but this association remains largely unexplored in older adults. Cystatin C is a more accurate measure than creatinine of kidney function in the elderly. We evaluated cystatin C, cognitive function, and brain imaging in 193 participants from The 90+ Study neuroimaging component. The mean age was 93.9 years; 61% were women. Mean cystatin C was 1.62 mg/L with estimated glomerular filtration rate 39.2 mL/min/1.73 m2. Performance on measures of global cognition, executive function, and visual-spatial ability declined at higher tertiles of cystatin C (lower kidney function). Higher cystatin C was significantly associated with infratentorial microbleeds and lower gray matter volume. Adjusted risk of incident dementia was increased in the middle and high cystatin C tertile groups compared with the low group (hazard ratio in highest tertile 3.81 [95% confidence interval 1.14-12.7]), which appeared to be explained in part by the presence of cerebral microbleeds. Overall, cystatin C was associated with cognitive performance, brain imaging pathology, and decline to dementia in this oldest-old cohort.
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Affiliation(s)
- Wei Ling Lau
- Division of Nephrology and Hypertension, University of California Irvine School of Medicine, Orange, CA, USA.
| | - Mark Fisher
- Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA; Department of Anatomy & Neurobiology, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Dana Greenia
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - David Floriolli
- Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Evan Fletcher
- Imaging of Dementia and Agng Laboratory, Department of Neurology, Center for Neuroscience, University of California, Davis, CA, USA
| | - Baljeet Singh
- Imaging of Dementia and Agng Laboratory, Department of Neurology, Center for Neuroscience, University of California, Davis, CA, USA
| | - Seyed Ahmad Sajjadi
- Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Maria M Corrada
- Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Epidemiology, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Christina Whittle
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Claudia Kawas
- Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Neurobiology & Behavior, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Annlia Paganini-Hill
- Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA
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18
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Faizy TD, Thaler C, Broocks G, Flottmann F, Leischner H, Kniep H, Nawabi J, Schön G, Stellmann JP, Kemmling A, Reddy R, Heit JJ, Fiehler J, Kumar D, Hanning U. The Myelin Water Fraction Serves as a Marker for Age-Related Myelin Alterations in the Cerebral White Matter - A Multiparametric MRI Aging Study. Front Neurosci 2020; 14:136. [PMID: 32153358 PMCID: PMC7050496 DOI: 10.3389/fnins.2020.00136] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/03/2020] [Indexed: 12/13/2022] Open
Abstract
Quantitative MRI modalities, such as diffusion tensor imaging (DTI) or magnetization transfer imaging (MTI) are sensitive to the neuronal effects of aging of the cerebral white matter (WM), but lack the specificity for myelin content. Myelin water imaging (MWI) is highly specific for myelin and may be more sensitive for the detection of changes in myelin content inside the cerebral WM microstructure. In this multiparametric imaging study, we evaluated the performance of myelin water fraction (MWF) estimates as a marker for myelin alterations during normal-aging. Multiparametric MRI data derived from DTI, MTI and a novel, recently-proposed MWF-map processing and reconstruction algorithm were acquired from 54 healthy subjects (aged 18-79 years) and region-based multivariate regression analysis was performed. MWFs significantly decreased with age in most WM regions (except corticospinal tract) and changes of MWFs were associated with changes of radial diffusivity, indicating either substantial alterations or preservation of myelin content in these regions. Decreases of fractional anisotropy and magnetization transfer ratio were associated with lower MWFs in commissural fiber tracts only. Mean diffusivity had no regional effects on MWF. We conclude that MWF estimates are sensitive for the assessment of age-related myelin alterations in the cerebral WM of normal-aging brains.
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Affiliation(s)
- Tobias D Faizy
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Thaler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriel Broocks
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fabian Flottmann
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hannes Leischner
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Helge Kniep
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jawed Nawabi
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Schön
- Institute of Applied Biometrics and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan-Patrick Stellmann
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Kemmling
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Muenster, Münster, Germany
| | - Ravinder Reddy
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Jeremy J Heit
- Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dushyant Kumar
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Uta Hanning
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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19
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Caunca MR, De Leon-Benedetti A, Latour L, Leigh R, Wright CB. Neuroimaging of Cerebral Small Vessel Disease and Age-Related Cognitive Changes. Front Aging Neurosci 2019; 11:145. [PMID: 31316367 PMCID: PMC6610261 DOI: 10.3389/fnagi.2019.00145] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/31/2019] [Indexed: 01/04/2023] Open
Abstract
Subclinical cerebrovascular disease is frequently identified in neuroimaging studies and is thought to play a role in the pathogenesis of cognitive disorders. Identifying the etiologies of different types of lesions may help investigators differentiate between age-related and pathological cerebrovascular damage in cognitive aging. In this review article, we aim to describe the epidemiology and etiology of various brain magnetic resonance imaging (MRI) measures of vascular damage in cognitively normal, older adult populations. We focus here on population-based prospective cohort studies of cognitively unimpaired older adults, as well as discuss the heterogeneity of MRI findings and their relationships with cognition. This review article emphasizes the need for a better understanding of subclinical cerebrovascular disease in cognitively normal populations, in order to more effectively identify and prevent cognitive decline in our rapidly aging population.
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Affiliation(s)
- Michelle R Caunca
- Division of Epidemiology and Population Health Sciences, Department of Public Health Sciences, Leonard M. Miller School of Medicine, Evelyn F. McKnight Brain Institute, University of Miami, Miami, FL, United States.,Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Andres De Leon-Benedetti
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Lawrence Latour
- National Institute of Neurological Diseases and Stroke (NINDS), National Institutes of Health, Bethesda, MD, United States
| | - Richard Leigh
- National Institute of Neurological Diseases and Stroke (NINDS), National Institutes of Health, Bethesda, MD, United States
| | - Clinton B Wright
- National Institute of Neurological Diseases and Stroke (NINDS), National Institutes of Health, Bethesda, MD, United States
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20
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Zamboni G, Griffanti L, Mazzucco S, Pendlebury ST, Rothwell PM. Age-dependent association of white matter abnormality with cognition after TIA or minor stroke. Neurology 2019; 93:e272-e282. [PMID: 31201296 PMCID: PMC6656647 DOI: 10.1212/wnl.0000000000007772] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/04/2019] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To investigate if the association between MRI-detectable white matter hyperintensity (WMH) and cognitive status reported in previous studies persists at older ages (>80 years), when some white matter abnormality is almost universally reported in clinical practice. METHODS Consecutive eligible patients from a population-based cohort of all TIA/nondisabling stroke (Oxford Vascular Study) underwent multimodal MRI, including fluid-attenuated inversion recovery and diffusion-weighted imaging, allowing automated measurement of WMH volume, mean diffusivity (MD), and fractional anisotropy (FA) in normal-appearing white matter using FSL tools. These measures were related to cognitive status (Montreal Cognitive Assessment) at age ≤80 vs >80 years. RESULTS Of 566 patients (mean [range] age 66.7 [20-102] years), 107 were aged >80 years. WMH volumes and MD/FA were strongly associated with cognitive status in patients aged ≤80 years (all p < 0.001 for WMH, MD, and FA) but not in patients aged >80 years (not significant for WMH, MD, and FA), with age interactions for WMH volume (p interaction = 0.016) and MD (p interaction = 0.037). Voxel-wise analyses also showed that lower Montreal Cognitive Assessment scores were associated with frontal WMH in patients ≤80 years, but not >80 years. CONCLUSION MRI markers of white matter damage are strongly related to cognition in patients with TIA/minor stroke at younger ages, but not at age >80 years. Clinicians and patients should not overinterpret the significance of these abnormalities at older ages.
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Affiliation(s)
- Giovanna Zamboni
- From the Centre for Prevention of Stroke and Dementia (G.Z., L.G., S.M., S.T.P., P.M.R.) and Wellcome Centre for Integrative Neuroimaging, FMRIB (G.Z., L.G.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford; and Department of Biomedical, Metabolic and Neural Sciences and Centre for Neurosciences and Neurotechnology (G.Z.), University of Modena and Reggio Emilia, Italy.
| | - Ludovica Griffanti
- From the Centre for Prevention of Stroke and Dementia (G.Z., L.G., S.M., S.T.P., P.M.R.) and Wellcome Centre for Integrative Neuroimaging, FMRIB (G.Z., L.G.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford; and Department of Biomedical, Metabolic and Neural Sciences and Centre for Neurosciences and Neurotechnology (G.Z.), University of Modena and Reggio Emilia, Italy
| | - Sara Mazzucco
- From the Centre for Prevention of Stroke and Dementia (G.Z., L.G., S.M., S.T.P., P.M.R.) and Wellcome Centre for Integrative Neuroimaging, FMRIB (G.Z., L.G.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford; and Department of Biomedical, Metabolic and Neural Sciences and Centre for Neurosciences and Neurotechnology (G.Z.), University of Modena and Reggio Emilia, Italy
| | - Sarah T Pendlebury
- From the Centre for Prevention of Stroke and Dementia (G.Z., L.G., S.M., S.T.P., P.M.R.) and Wellcome Centre for Integrative Neuroimaging, FMRIB (G.Z., L.G.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford; and Department of Biomedical, Metabolic and Neural Sciences and Centre for Neurosciences and Neurotechnology (G.Z.), University of Modena and Reggio Emilia, Italy
| | - Peter M Rothwell
- From the Centre for Prevention of Stroke and Dementia (G.Z., L.G., S.M., S.T.P., P.M.R.) and Wellcome Centre for Integrative Neuroimaging, FMRIB (G.Z., L.G.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford; and Department of Biomedical, Metabolic and Neural Sciences and Centre for Neurosciences and Neurotechnology (G.Z.), University of Modena and Reggio Emilia, Italy
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21
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Márquez F, Yassa MA. Neuroimaging Biomarkers for Alzheimer's Disease. Mol Neurodegener 2019; 14:21. [PMID: 31174557 PMCID: PMC6555939 DOI: 10.1186/s13024-019-0325-5] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 05/28/2019] [Indexed: 12/11/2022] Open
Abstract
Currently, over five million Americans suffer with Alzheimer's disease (AD). In the absence of a cure, this number could increase to 13.8 million by 2050. A critical goal of biomedical research is to establish indicators of AD during the preclinical stage (i.e. biomarkers) allowing for early diagnosis and intervention. Numerous advances have been made in developing biomarkers for AD using neuroimaging approaches. These approaches offer tremendous versatility in terms of targeting distinct age-related and pathophysiological mechanisms such as structural decline (e.g. volumetry, cortical thinning), functional decline (e.g. fMRI activity, network correlations), connectivity decline (e.g. diffusion anisotropy), and pathological aggregates (e.g. amyloid and tau PET). In this review, we survey the state of the literature on neuroimaging approaches to developing novel biomarkers for the amnestic form of AD, with an emphasis on combining approaches into multimodal biomarkers. We also discuss emerging methods including imaging epigenetics, neuroinflammation, and synaptic integrity using PET tracers. Finally, we review the complementary information that neuroimaging biomarkers provide, which highlights the potential utility of composite biomarkers as suitable outcome measures for proof-of-concept clinical trials with experimental therapeutics.
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Affiliation(s)
- Freddie Márquez
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA, 92697, USA.
| | - Michael A Yassa
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA, 92697, USA.
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22
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Paganini-Hill A, Bryant N, Corrada MM, Greenia DE, Fletcher E, Singh B, Floriolli D, Kawas CH, Fisher MJ. Blood Pressure Circadian Variation, Cognition and Brain Imaging in 90+ Year-Olds. Front Aging Neurosci 2019; 11:54. [PMID: 31057391 PMCID: PMC6478755 DOI: 10.3389/fnagi.2019.00054] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 02/22/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: To analyze the relationship between blood pressure (BP) variables, including circadian pattern, and cognition in 90+ year-olds. Methods: Twenty-four hour ambulatory BP monitoring was completed on 121 participants drawn from a longitudinal study of aging and dementia in the oldest-old. Various measures of BP and its variability, including nocturnal dipping, were calculated. Each person was given both a neuropsychological test battery covering different cognitive domains and a neurological examination to determine cognitive status. Seventy-one participants had a brain magnetic resonance imaging (MRI) scan. Results: Participants ranged in age from 90 to 102 years (mean = 93), about two-thirds were female, and nearly 80% had at least some college education. Mean nocturnal dips differed significantly between cognitively normal (n = 97) and impaired individuals (n = 24), with cognitively normal participants having on average greater nocturnal dips [6.6% vs. 1.3%, p = 0.006 for systolic BP (SBP); 11% vs. 4.4%, p = 0.002 for diastolic BP (DBP)]. Nocturnal dips were also related to performance on select cognitive test scores (especially those related to language, recent memory and visual-spatial ability), with individuals who performed below previously established median norms having significantly smaller nocturnal dips (both SBP and DBP) than those above the median. DBP reverse dippers had larger mean white matter hyperintensities (WMH as percent of total brain volume; 1.7% vs. 1.2%, 1.1% and 1.0% in extreme dippers, dippers, non-dippers) and a greater proportion had lobar cerebral microbleeds (CMBs; 44% vs. 0%, 7%, 16%, p < 0.05). Impaired participants had higher mean WMH than those with normal cognition (1.6% vs. 1.0% p = 0.03) and more tended to have CMB (31% vs. 20%, p = n.s.). Conclusion: These findings suggest that cognitive dysfunction is associated with dysregulation in the normal circadian BP pattern. Further study is warranted of the potential role of WHM and CMB as mediators of this association.
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Affiliation(s)
- Annlia Paganini-Hill
- Department of Neurology, School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Natalie Bryant
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Maria M Corrada
- Department of Neurology, School of Medicine, University of California, Irvine, Irvine, CA, United States.,Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States.,Department of Epidemiology, School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Dana E Greenia
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Evan Fletcher
- Department of Neurology, Center for Neuroscience, University of California, Davis, Davis, CA, United States
| | - Baljeet Singh
- Department of Neurology, Center for Neuroscience, University of California, Davis, Davis, CA, United States
| | - David Floriolli
- Department of Radiological Sciences, School of Medicince, University of California, Irvine, Irvine, CA, United States
| | - Claudia H Kawas
- Department of Neurology, School of Medicine, University of California, Irvine, Irvine, CA, United States.,Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States.,Department of Neurobiology & Behavior, School of Biological Sciences, University of California, Irvine, Irvine, CA, United States
| | - Mark J Fisher
- Department of Neurology, School of Medicine, University of California, Irvine, Irvine, CA, United States
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23
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The many ages of man: diverse approaches to assessing ageing-related biological and psychological measures and their relationship to chronological age. Curr Opin Psychiatry 2019; 32:130-137. [PMID: 30461440 DOI: 10.1097/yco.0000000000000473] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Chronological age is a crude measure and may not be the best indicator of the ageing process. Establishing valid and reliable biomarkers to understand the true effect of ageing is of great interest. We provide an overview of biological and psychological characteristics that change with age and can potentially serve as markers of the ageing process, and discuss if an integration of these characteristics may more accurately measure the true age of a person. We also describe the clinicopathological continuum of these ageing-related changes. RECENT FINDINGS Ageing-related changes in the biological and psychological systems of the body have been studied to varying degrees and with differing emphases. Despite the development of ageing indices, there is no single indicator that can holistically estimate the ageing process. Differential ageing of bodily systems remains poorly understood, and valid methods have not been developed for composite markers of biological and psychological processes. SUMMARY The ageing process is complex and heterogeneous. Incorporating biological and psychological measures may improve accuracy in reflecting an individual's 'true age,' and elucidate why some people age successfully, whereas others show ageing-related decline and disease.
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24
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Sabisz A, Naumczyk P, Marcinkowska A, Graff B, Gąsecki D, Glińska A, Witkowska M, Jankowska A, Konarzewska A, Kwela J, Jodzio K, Szurowska E, Narkiewicz K. Aging and Hypertension - Independent or Intertwined White Matter Impairing Factors? Insights From the Quantitative Diffusion Tensor Imaging. Front Aging Neurosci 2019; 11:35. [PMID: 30837864 PMCID: PMC6389787 DOI: 10.3389/fnagi.2019.00035] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 02/05/2019] [Indexed: 01/17/2023] Open
Abstract
Aging disrupts white matter integrity, and so does continuous elevated blood pressure that accompanies hypertension (HTN). Yet, our understanding of the interrelationship between these factors is still limited. The study aimed at evaluating patterns of changes in diffusion parameters (as assessed by quantitative diffusion fiber tracking - qDTI) following both aging, and hypertension, as well as the nature of their linkage. 146 participants took part in the study: the control group (N = 61) and the patients with hypertension (N = 85), and were divided into three age subgroups (25-47, 48-56, 57-71 years). qDTI was used to calculate the values of fractional anisotropy, mean, radial and axial diffusivity in 20 main tracts of the brain. The effects of factors (aging and hypertension) on diffusion parameters of tracts were tested with a two-way ANOVA. In the right hemisphere there was no clear effect of the HTN, nor an interaction between the factors, though some age-related effects were observed. Contrary, in the left hemisphere both aging and hypertension contributed to the white matter decline, following a functional pattern. In the projection pathways and the fornix, HTN and aging played part independent of each other, whereas in association fibers and the corpus callosum if the hypertension effect was significant, an interaction was observed. HTN patients manifested faster decline of diffusion parameters but also reached a plateau earlier, with highest between-group differences noted in the middle-aged subgroup. Healthy and hypertensive participants have different brain aging patterns. The HTN is associated with acceleration of white matter integrity decline, observed mainly in association fibers of the left hemisphere.
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Affiliation(s)
- Agnieszka Sabisz
- Second Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Anna Marcinkowska
- Second Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Beata Graff
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
| | - Dariusz Gąsecki
- Department of Neurology of Adults, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Glińska
- Second Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marta Witkowska
- Institute of Psychology, University of Gdańsk, Gdańsk, Poland
| | - Anna Jankowska
- Second Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Jerzy Kwela
- Institute of Experimental Physics, University of Gdańsk, Gdańsk, Poland
| | | | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
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25
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Legdeur N, Badissi M, Carter SF, de Crom S, van de Kreeke A, Vreeswijk R, Trappenburg MC, Oudega ML, Koek HL, van Campen JP, Keijsers CJPW, Amadi C, Hinz R, Gordon MF, Novak G, Podhorna J, Serné E, Verbraak F, Yaqub M, Hillebrand A, Griffa A, Pendleton N, Kramer SE, Teunissen CE, Lammertsma A, Barkhof F, van Berckel BNM, Scheltens P, Muller M, Maier AB, Herholz K, Visser PJ. Resilience to cognitive impairment in the oldest-old: design of the EMIF-AD 90+ study. BMC Geriatr 2018; 18:289. [PMID: 30477432 PMCID: PMC6258163 DOI: 10.1186/s12877-018-0984-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 11/15/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The oldest-old (subjects aged 90 years and older) population represents the fastest growing segment of society and shows a high dementia prevalence rate of up to 40%. Only a few studies have investigated protective factors for cognitive impairment in the oldest-old. The EMIF-AD 90+ Study aims to identify factors associated with resilience to cognitive impairment in the oldest-old. In this paper we reviewed previous studies on cognitive resilience in the oldest-old and described the design of the EMIF-AD 90+ Study. METHODS The EMIF-AD 90+ Study aimed to enroll 80 cognitively normal subjects and 40 subjects with cognitive impairment aged 90 years or older. Cognitive impairment was operationalized as amnestic mild cognitive impairment (aMCI), or possible or probable Alzheimer's Disease (AD). The study was part of the European Medical Information Framework for AD (EMIF-AD) and was conducted at the Amsterdam University Medical Centers (UMC) and at the University of Manchester. We will test whether cognitive resilience is associated with cognitive reserve, vascular comorbidities, mood, sleep, sensory system capacity, physical performance and capacity, genetic risk factors, hallmarks of ageing, and markers of neurodegeneration. Markers of neurodegeneration included an amyloid positron emission tomography, amyloid β and tau in cerebrospinal fluid/blood and neurophysiological measures. DISCUSSION The EMIF-AD 90+ Study will extend our knowledge on resilience to cognitive impairment in the oldest-old by extensive phenotyping of the subjects and the measurement of a wide range of potential protective factors, hallmarks of aging and markers of neurodegeneration. TRIAL REGISTRATION Nederlands Trial Register NTR5867 . Registered 20 May 2016.
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Affiliation(s)
- Nienke Legdeur
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, PO Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Maryam Badissi
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, PO Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Stephen F. Carter
- Wolfson Molecular Imaging Centre, Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | - Sophie de Crom
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, PO Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Aleid van de Kreeke
- Department of Ophthalmology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ralph Vreeswijk
- Department of Geriatric Medicine, Spaarne Gasthuis, Haarlem, The Netherlands
| | | | - Mardien L. Oudega
- Department of Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Huiberdina L. Koek
- Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jos P. van Campen
- Department of Geriatric Medicine, MC Slotervaart Hospital, Amsterdam, The Netherlands
| | | | - Chinenye Amadi
- Wolfson Molecular Imaging Centre, Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | - Rainer Hinz
- Wolfson Molecular Imaging Centre, Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | | | - Gerald Novak
- Janssen Pharmaceutical Research and Development, Titusville, NJ USA
| | - Jana Podhorna
- Boehringer Ingelheim International GmbH, Ingelheim/Rhein, Germany
| | - Erik Serné
- Department of Internal Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Frank Verbraak
- Department of Ophthalmology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Maqsood Yaqub
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Arjan Hillebrand
- Department of Clinical Neurophysiology and MEG Center, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Alessandra Griffa
- Dutch Connectome Lab, Department of Complex Trait Genetics, Center for Neuroscience and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Neil Pendleton
- Wolfson Molecular Imaging Centre, Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | - Sophia E. Kramer
- Department of Otolaryngology-Head and Neck Surgery, Section Ear & Hearing, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory, Department of Clinical chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Adriaan Lammertsma
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Bart N. M. van Berckel
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, PO Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Majon Muller
- Department of Internal Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Andrea B. Maier
- Department of Medicine and Aged Care, @AgeMelbourne, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Karl Herholz
- Wolfson Molecular Imaging Centre, Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, PO Box 7057, 1007 MB Amsterdam, the Netherlands
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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26
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Boban JM, Kozic DB, Brkic SV, Lendak DF, Thurnher MM. Early Introduction of cART Reverses Brain Aging Pattern in Well-Controlled HIV Infection: A Comparative MR Spectroscopy Study. Front Aging Neurosci 2018; 10:329. [PMID: 30405398 PMCID: PMC6200868 DOI: 10.3389/fnagi.2018.00329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/28/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: The aim of this study was to compare age-related changes in chronically infected, asymptomatic HIV-positive patients under combination antiretroviral therapy (cART), with age-, gender-, and educational-level-matched healthy subjects, using multi-voxel magnetic-resonance spectroscopy (MRS). Methods: There were 66 chronically infected HIV-positive subjects and 65 age-, gender-, and educational-level-matched control subjects, divided into four groups according to the age: group 1 (20–29 years old), group 2 (30–39), group 3 (40–49) and group 4 (50–59). MRS was performed and ratios of N-acetyl-aspartate (NAA)/creatine (Cr) were analyzed in ten locations of the supracallosal gray matter. For the comparison of NAA/Cr ratios in healthy and HIV-positive subjects, ANCOVA with age and education as covariates was performed. Correlations of NAA/Cr ratios with duration of cART were performed using Pearson’s correlation test. Statistical significance was set at p < 0.05. Results: The NAA/Cr ratios were decreased in the 20–29-year-old HIV-positive subjects in 8/10 locations (p < 0.005) compared to the healthy controls, while in the 50–59-year-old groups they were significiantly lower only in one location (p = 0.004). There were significant positive correlations of NAA/Cr levels with the duration of cART in the oldest group of HIV-positive subjects, while in the youngest group there were no significant correlations. Conclusion: The aging pattern in chronic HIV infection under cART is accentuated rather than accelerated. There is an initial HIV-related neuronal damage with a significant decline in NAA/Cr ratios; after the initiation of cART, however, NAA/Cr ratios increase continuously to become similar to healthy aging individuals, probably due to beneficial effect of long-standing cART. Summary: Brain aging in chronic HIV infection under cART is accentuated, with an initial HIV-related neuronal damage followed by a subtle NAA/Cr increase after the initiation of cART. Under cART, in advanced age, NAA/Cr ratios become similar to healthy aging individuals.
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Affiliation(s)
- Jasmina M Boban
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Center for Diagnostic Imaging, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
| | - Dusko B Kozic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Center for Diagnostic Imaging, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
| | - Snezana V Brkic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Clinic for Infectious Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Dajana F Lendak
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Clinic for Infectious Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Majda M Thurnher
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
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27
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Borelli WV, Carmona KC, Studart-Neto A, Nitrini R, Caramelli P, da Costa JC. Operationalized definition of older adults with high cognitive performance. Dement Neuropsychol 2018; 12:221-227. [PMID: 30425784 PMCID: PMC6200160 DOI: 10.1590/1980-57642018dn12-030001] [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: 03/01/2018] [Accepted: 07/04/2018] [Indexed: 11/21/2022] Open
Abstract
Recently, there has been an increasing number of studies on exceptional cognitive aging. Herein, we aim to objectively provide the operationalized characterization of older adults with unusually high memory ability. Some authors have defined them as "SuperAgers", individuals aged 80 years or older with memory ability similar or superior to middle-aged subjects. On the other hand, the terminology "high-performing older adults" (HPOA) seems to appropriately conceptualize these individuals without exaggeration. A threshold for age is not a reliable criterion, but may be defined as 75 and 80 years of age for developing and developed countries, respectively. We propose that HPOA may exhibit episodic memory test scores equal to or greater than those of individuals aged 50-60 years, according to the validated tables for the respective country. This group must also have global cognition scores within expected average values for age and education. Executive functioning may play a central role in the exceptional memory performance of this group. Further studies are essential to confirm existing findings and may provide important evidence for cognitive aging theory and the neurobiology of dementia.
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Affiliation(s)
- Wyllians Vendramini Borelli
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre RS, Brazil
| | - Karoline Carvalho Carmona
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Faculdade de Medicina de Universidade Federal de Minas Gerais, Belo Horizonte MG, Brazil
| | - Adalberto Studart-Neto
- Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo USP, Brazil
| | - Ricardo Nitrini
- Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo USP, Brazil
| | - Paulo Caramelli
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Faculdade de Medicina de Universidade Federal de Minas Gerais, Belo Horizonte MG, Brazil
| | - Jaderson Costa da Costa
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre RS, Brazil
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