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Yan M, Lin Z, Zheng H, Lai J, Liu Y, Lin Z. Development of an individualized model for predicting postoperative delirium in elderly patients with hepatocellular carcinoma. Sci Rep 2024; 14:11716. [PMID: 38777824 PMCID: PMC11111779 DOI: 10.1038/s41598-024-62593-z] [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: 01/11/2024] [Accepted: 05/20/2024] [Indexed: 05/25/2024] Open
Abstract
Postoperative delirium (POD) is a common complication in older patients with hepatocellular carcinoma (HCC) that adversely impacts clinical outcomes. We aimed to evaluate the risk factors for POD and to construct a predictive nomogram. Data for a total of 1481 older patients (training set: n=1109; validation set: n=372) who received liver resection for HCC were retrospectively retrieved from two prospective databases. The receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis (DCA) were used to evaluate the performance. The rate of POD was 13.3% (148/1109) in the training set and 16.4% (61/372) in the validation set. Multivariate analysis of the training set revealed that factors including age, history of cerebrovascular disease, American Society of Anesthesiologists (ASA) classification, albumin level, and surgical approach had significant effects on POD. The area under the ROC curves (AUC) for the nomogram, incorporating the aforementioned predictors, was 0.798 (95% CI 0.752-0.843) and 0.808 (95% CI 0.754-0.861) for the training and validation sets, respectively. The calibration curves of both sets showed a degree of agreement between the nomogram and the actual probability. DCA demonstrated that the newly established nomogram was highly effective for clinical decision-making. We developed and validated a nomogram with high sensitivity to assist clinicians in estimating the individual risk of POD in older patients with HCC.
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Affiliation(s)
- Mingfang Yan
- Department of Anesthesiology, Clinical Oncology School of Fujian Medical University &, Fujian Cancer Hospital, Fuzhou, 350014, Fujian, China
| | - Zhaoyan Lin
- College of Animal Science, Fujian Agriculture and Forestry University, Fuzhou, 350002, Fujian, China
| | - Huizhe Zheng
- Department of Anesthesiology, Clinical Oncology School of Fujian Medical University &, Fujian Cancer Hospital, Fuzhou, 350014, Fujian, China
| | - Jinglan Lai
- Department of Infectious Diseases, Mengchao Hepatobiliary Hospital of Fujian. Medical University, Fuzhou, 350025, Fujian, China
| | - Yuming Liu
- Department of Anesthesiology, Mengchao Hepatobiliary Hospital of Fujian. Medical University, Fuzhou, 350025, Fujian, China.
| | - Zhenmeng Lin
- Department of Anesthesiology, Clinical Oncology School of Fujian Medical University &, Fujian Cancer Hospital, Fuzhou, 350014, Fujian, China.
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2
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Fan D, Zhao H, Liu H, Niu H, Liu T, Wang Y. Abnormal brain activities of cognitive processes in cerebral small vessel disease: A systematic review of task fMRI studies. J Neuroradiol 2024; 51:155-167. [PMID: 37844660 DOI: 10.1016/j.neurad.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023]
Abstract
Cerebral small vessel disease (CSVD) is characterized by widespread functional changes in the brain, as evident from abnormal brain activations during cognitive tasks. However, the existing findings in this area are not yet conclusive. We systematically reviewed 25 studies reporting task-related fMRI in five cognitive domains in CSVD, namely executive function, working memory, processing speed, motor, and affective processing. The findings highlighted: (1) CSVD affects cognitive processes in a domain-specific manner; (2) Compensatory and regulatory effects were observed simultaneously in CSVD, which may reflect the interplay between the negative impact of brain lesion and the positive impact of cognitive reserve. Combined with behavioral and functional findings in CSVD, we proposed an integrated model to illustrate the relationship between altered activations and behavioral performance in different stages of CSVD: functional brain changes may precede and be more sensitive than behavioral impairments in the early pre-symptomatic stage; Meanwhile, compensatory and regulatory mechanisms often occur in the early stages of the disease, while dysfunction/decompensation and dysregulation often occur in the late stages. Overall, abnormal hyper-/hypo-activations are crucial for understanding the mechanisms of small vessel lesion-induced behavioral dysfunction, identifying potential neuromarker and developing interventions to mitigate the impact of CSVD on cognitive function.
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Affiliation(s)
- Dongqiong Fan
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Haichao Zhao
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China; Faculty of Psychology, MOE Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Hao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Haijun Niu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Tao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
| | - Yilong Wang
- Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; Chinese Institute for Brain Research, Beijing, China; National Center for Neurological Disorders, Beijing, China.
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Hu WT, Nayyar A, Kaluzova M. Charting the Next Road Map for CSF Biomarkers in Alzheimer's Disease and Related Dementias. Neurotherapeutics 2023; 20:955-974. [PMID: 37378862 PMCID: PMC10457281 DOI: 10.1007/s13311-023-01370-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 06/29/2023] Open
Abstract
Clinical prediction of underlying pathologic substrates in people with Alzheimer's disease (AD) dementia or related dementia syndromes (ADRD) has limited accuracy. Etiologic biomarkers - including cerebrospinal fluid (CSF) levels of AD proteins and cerebral amyloid PET imaging - have greatly modernized disease-modifying clinical trials in AD, but their integration into medical practice has been slow. Beyond core CSF AD biomarkers (including beta-amyloid 1-42, total tau, and tau phosphorylated at threonine 181), novel biomarkers have been interrogated in single- and multi-centered studies with uneven rigor. Here, we review early expectations for ideal AD/ADRD biomarkers, assess these goals' future applicability, and propose study designs and performance thresholds for meeting these ideals with a focus on CSF biomarkers. We further propose three new characteristics: equity (oversampling of diverse populations in the design and testing of biomarkers), access (reasonable availability to 80% of people at risk for disease, along with pre- and post-biomarker processes), and reliability (thorough evaluation of pre-analytical and analytical factors influencing measurements and performance). Finally, we urge biomarker scientists to balance the desire and evidence for a biomarker to reflect its namesake function, indulge data- as well as theory-driven associations, re-visit the subset of rigorously measured CSF biomarkers in large datasets (such as Alzheimer's disease neuroimaging initiative), and resist the temptation to favor ease over fail-safe in the development phase. This shift from discovery to application, and from suspended disbelief to cogent ingenuity, should allow the AD/ADRD biomarker field to live up to its billing during the next phase of neurodegenerative disease research.
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Affiliation(s)
- William T Hu
- Department of Neurology, Rutgers Biomedical and Health Sciences, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6200, New Brunswick, NJ, 08901, USA.
- Center for Innovation in Health and Aging Research, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA.
| | - Ashima Nayyar
- Department of Neurology, Rutgers Biomedical and Health Sciences, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6200, New Brunswick, NJ, 08901, USA
| | - Milota Kaluzova
- Department of Neurology, Rutgers Biomedical and Health Sciences, Rutgers-Robert Wood Johnson Medical School, 125 Paterson Street, Suite 6200, New Brunswick, NJ, 08901, USA
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Daigle KM, Pietrzykowski MO, Waters AB, Swenson LP, Gansler DA. Central Executive Network and Executive Function in Patients With Alzheimer's Disease and Healthy Individuals: Meta-Analysis of Structural and Functional MRI. J Neuropsychiatry Clin Neurosci 2022; 34:204-213. [PMID: 35272491 DOI: 10.1176/appi.neuropsych.20110279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The neural architecture of executive function is of interest given its utility as a transdiagnostic predictor of adaptive functioning. However, a gap exists in the meta-analytic literature assessing this relationship in neuropsychiatric populations, concordance between structural and functional architecture, and the relationship with neuropsychological assessment of executive function. Given the importance of the central executive network (CEN) in Alzheimer's disease, this population may be useful in understanding this relationship in Alzheimer's disease pathology. METHODS A meta-analysis of studies (k=21) was conducted to elucidate the relationship between executive function and CEN for structural architecture (k=10; N=1,027) among patients with Alzheimer's disease (k=6; N=250) and healthy control subjects (HCs) (k=4; N=777) and for functional architecture (k=11; N=522) among patients with Alzheimer's disease (k=6; N=306) and HCs (k=5; N=216). Random-effects modeling was used to increase accuracy of conclusions about population means. RESULTS Analyses revealed a positive brain-behavior relationship (pr=0.032, 95% CI=0.07, 0.54), although there was a lack of statistically significant heterogeneity between functional and structural neuroimaging (Q=9.89, p=0.971, I2=0.00%) and between the Alzheimer's and HC groups in functional (Q=8.18, p=0.612, I2=0.00%) and structural (Q=1.60, p=0.996, I2=0.00%) neuroimaging. Similarly, a lack of statistically significant heterogeneity was revealed between functional and structural neuroimaging among patients with Alzheimer's disease (Q=3.59, p=0.980, I2=0.00%) and HCs (Q=3.67, p=0.885, I2=0.00%). CONCLUSIONS Structural and functional imaging in the CEN are predictive of executive function performance among patients with Alzheimer's disease and HCs. Regardless of how the CEN is affected, behavior is correlated to the degree to which the CEN is affected. Findings are significant in the context of methodological decisions in multimodal neuroimaging research.
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Affiliation(s)
- Katrina M Daigle
- Clinical Neuroscience of Cognitive Control Laboratory, Department of Psychology, Suffolk University, Boston (Daigle, Pietrzykowski, Waters, Gansler); and Department of Psychology, Suffolk University, Boston (Swenson)
| | - Malvina O Pietrzykowski
- Clinical Neuroscience of Cognitive Control Laboratory, Department of Psychology, Suffolk University, Boston (Daigle, Pietrzykowski, Waters, Gansler); and Department of Psychology, Suffolk University, Boston (Swenson)
| | - Abigail B Waters
- Clinical Neuroscience of Cognitive Control Laboratory, Department of Psychology, Suffolk University, Boston (Daigle, Pietrzykowski, Waters, Gansler); and Department of Psychology, Suffolk University, Boston (Swenson)
| | - Lance P Swenson
- Clinical Neuroscience of Cognitive Control Laboratory, Department of Psychology, Suffolk University, Boston (Daigle, Pietrzykowski, Waters, Gansler); and Department of Psychology, Suffolk University, Boston (Swenson)
| | - David A Gansler
- Clinical Neuroscience of Cognitive Control Laboratory, Department of Psychology, Suffolk University, Boston (Daigle, Pietrzykowski, Waters, Gansler); and Department of Psychology, Suffolk University, Boston (Swenson)
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Pendlebury ST, Thomson RJ, Welch SJV, Rothwell PM. Cognitive Predictors of Delirium on Long-Term Follow-Up after TIA and Stroke: Population-Based Cohort Study. Cerebrovasc Dis 2021; 51:288-295. [PMID: 34844242 DOI: 10.1159/000519900] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/16/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION TIA and stroke cause cognitive impairment with a typical "vascular" pattern, including prominent frontal/executive deficits. Cognitive impairment is associated with increased delirium risk and the few available data suggest that executive dysfunction is important. We therefore determined the predictive value of both severity and pattern of cognitive deficits for delirium on long-term follow-up after TIA/stroke. METHODS Surviving TIA/stroke participants on October 1, 2013, in the Oxford Vascular Study (OXVASC) were assessed prospectively for delirium during all hospitalizations over the subsequent 6 months. Associations between OXVASC pre-admission mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores, and delirium during hospitalizations on follow-up were determined using logistic regression adjusted for covariates, including demographic factors, history of depression, baseline stroke severity, and admission illness severity. RESULTS Among 1,565 TIA/stroke survivors, 158 patients (mean/SD age = 79.2/11.5 years) had ≥1 admission and 59 (37%) had ≥1 delirium episode. Mean/SD time between baseline TIA/stroke and admission was 4.7/3.6 years and between most recent OXVASC cognitive testing and admission was 1.7/1.8 years. MMSE and MoCA scores were associated with delirium: odds ratio (OR) = 1.16 (95% CI 1.07-1.27, p < 0.0001 per point decrease in MMSE) and OR = 1.20 (1.11-1.30, p < 0.0001 MoCA) and associations were robust to adjustment for all covariates, including stroke severity: OR = 1.11 (1.01-1.22, p = 0.03, MMSE) and OR = 1.15 (1.05-1.25, p = 0.003, MoCA). All 10 subtests on the MoCA and 4/11 on the MMSE were significantly associated with delirium with highest predictive value for frontal/executive and recall domains. CONCLUSIONS Cognitive impairment of increasing severity after TIA/stroke predisposed to delirium particularly deficits in frontal/executive domains and recall. Long-term risk of delirium should be considered as part of the overall cerebrovascular disease burden.
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Affiliation(s)
- Sarah T Pendlebury
- Wolfson Centre for Prevention of Stroke and Dementia, Wolfson Building, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Departments of General (Internal) Medicine and Geratology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ross J Thomson
- Department of Cardiology, Royal Free Hospital, London, UK
| | - Sarah J V Welch
- Wolfson Centre for Prevention of Stroke and Dementia, Wolfson Building, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Peter M Rothwell
- Wolfson Centre for Prevention of Stroke and Dementia, Wolfson Building, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
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The central executive network and executive function in healthy and persons with schizophrenia groups: a meta-analysis of structural and functional MRI. Brain Imaging Behav 2021; 16:1451-1464. [PMID: 34775552 DOI: 10.1007/s11682-021-00589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 10/19/2022]
Abstract
This meta-analysis evaluated the extent to which executive function can be understood with structural and functional magnetic resonance imaging. Studies included structural in schizophrenia (k = 8; n = 241) and healthy controls (k = 12; n = 1660), and functional in schizophrenia (k = 4; n = 104) and healthy controls (k = 12; n = 712). Results revealed a positive association in the brain behavior relationship when pooled across schizophrenia and control samples for structural (pr = 0.27) and functional (pr = 0.29) modalities. Subgroup analyses revealed no significant difference for functional neuroimaging (pr = .43, 95%CI = -.08-.77, p = .088) but with structural neuroimaging (pr = .37, 95%CI = -.08-.69, p = .015) the association to executive functions is lower in the control group. Subgroup analyses also revealed no significant differences in the strength of the brain-behavior relationship in the schizophrenia group (pr = .59, 95%CI = .58-.61, p = .881) or the control group (pr = 0.19, 95%CI = 0.18-0.19, p = 0.920), suggesting concordance.
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Zhuang Y, Shi Y, Zhang J, Kong D, Guo L, Bo G, Feng Y. Neurologic Factors in Patients with Vascular Mild Cognitive Impairment Based on fMRI. World Neurosurg 2020; 149:461-469. [PMID: 33253953 DOI: 10.1016/j.wneu.2020.11.120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 12/12/2022]
Abstract
This study focused on the application of functional magnetic resonance imaging and neuropsychology in diagnosis of vascular mild cognitive impairment (MCI) and the exploration of its relevant factors. The study enrolled 28 patients with vascular MCI in an observation group and 30 healthy individuals in a control group. All patients underwent magnetic resonance imaging. An automatic segmentation algorithm based on graph theory was adopted to process the images. Age, sex, disease course, Montreal Cognitive Assessment score, regional homogeneity, and amplitude of low-frequency fluctuation levels were recorded. There were no significant differences in age, gender, and course of disease between the observation group and the control group (P > 0.05). The level of regional homogeneity in the left posterior cerebellum in the observation group was significantly higher than that in the control group (P < 0.05).The regional homogeneity level of bilateral cingulate cortex was negatively correlated with Montreal Cognitive Assessment score (P < 0.05). The amplitude of low-frequency fluctuation of bilateral inferior parietal lobe, parietal lobe, and prefrontal lobe in the observation group was significantly lower than that in the control group, and the amplitude of low-frequency fluctuation of bilateral anterior cingulate gyrus, superior medial frontal gyrus, orbital frontal gyrus, right middle frontal gyrus, and right auxiliary motor area was higher than that in the control group (P < 0.05). Heart disease, such as myocardial infarction and atrial fibrillation, is a high risk factor for vascular MCI. Functional magnetic resonance imaging combined with an automatic segmentation algorithm can noninvasively observe the changes of a patient's brain tissue, which can be used in the recognition of vascular MCI. The global network attributes of patients with depression tend to be more randomized and have stronger resilience under targeted attacks.
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Affiliation(s)
- Yingying Zhuang
- Department of Medical Imaging, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian City, China
| | - Yuntao Shi
- Department of Digestive, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian City, China
| | - Jiandong Zhang
- Department of Medical Imaging, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian City, China
| | - Dan Kong
- Department of Medical Imaging, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian City, China
| | - Lili Guo
- Department of Medical Imaging, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian City, China
| | - Genji Bo
- Department of Medical Imaging, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian City, China
| | - Yun Feng
- Department of Medical Imaging, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian City, China.
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Gagliardi G, Epelbaum S, Houot M, Bakardjian H, Boukadida L, Revillon M, Dubois B, Dalla Barba G, La Corte V. Which Episodic Memory Performance is Associated with Alzheimer's Disease Biomarkers in Elderly Cognitive Complainers? Evidence from a Longitudinal Observational Study with Four Episodic Memory Tests (Insight-PreAD). J Alzheimers Dis 2020; 70:811-824. [PMID: 31282413 DOI: 10.3233/jad-180966] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) pathology is found in the brain years before symptoms are usually detected. An episodic memory (EM) decline is considered to be the specific cognitive sign indicating a transition from the preclinical to the prodromal stage of AD. However, there is still no consensus on the most sensitive tool to detect it. OBJECTIVE The goal of our study was to determine which EM measures, among three clinically used EM tests and one research EM test, would be optimal to use for detection of early decline in elderly cognitive complainers. METHODS 318 healthy elderly participants with subjective cognitive complaint were followed for two years. We applied generalized linear mixed models to investigate the effect of baseline brain amyloid and metabolism on the longitudinal evolution of four EM tests. RESULTS Our findings show that participants performed significantly worse in two out of four EM tests (i.e., the Memory Binding Test and the Delayed Matched Sample test 48 items) as their level of brain amyloid load increased. However, we did not find an association between EM measures and brain metabolism. An interaction of the two biomarkers was associated with the number of intrusions in the Memory Binding Test over two years. CONCLUSION As most clinical trials in AD are now including patients at its early clinical stage, the precise delineation of the transition phase between the preclinical and prodromal stages of the disease is of crucial importance. Our study indicates that challenging EM tests and intrusions are valuable tools to identify this critical transition.
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Affiliation(s)
- Geoffroy Gagliardi
- Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM) - Hôpital Pitié-Salpêtrière, Paris, France.,Centre de référence pour les maladies d'Alzheimer du sujet jeune et les démences rares, Institut de la mémoire et de la maladie d'Alzheimer, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Stéphane Epelbaum
- Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM) - Hôpital Pitié-Salpêtrière, Paris, France.,Centre de référence pour les maladies d'Alzheimer du sujet jeune et les démences rares, Institut de la mémoire et de la maladie d'Alzheimer, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Inria, Aramis Project Team, Paris, France
| | - Marion Houot
- Centre de référence pour les maladies d'Alzheimer du sujet jeune et les démences rares, Institut de la mémoire et de la maladie d'Alzheimer, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Centre of excellence of neurodegenerative disease (CoEN), ICM, CIC Neurosciences, APHP Department of Neurology, Hopital Pitié-Salpêtrière, University Paris 6, Paris, France
| | - Hovagim Bakardjian
- Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM) - Hôpital Pitié-Salpêtrière, Paris, France.,Centre de référence pour les maladies d'Alzheimer du sujet jeune et les démences rares, Institut de la mémoire et de la maladie d'Alzheimer, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Laurie Boukadida
- Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM) - Hôpital Pitié-Salpêtrière, Paris, France.,Centre de référence pour les maladies d'Alzheimer du sujet jeune et les démences rares, Institut de la mémoire et de la maladie d'Alzheimer, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Marie Revillon
- Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM) - Hôpital Pitié-Salpêtrière, Paris, France.,Centre de référence pour les maladies d'Alzheimer du sujet jeune et les démences rares, Institut de la mémoire et de la maladie d'Alzheimer, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Bruno Dubois
- Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM) - Hôpital Pitié-Salpêtrière, Paris, France.,Centre de référence pour les maladies d'Alzheimer du sujet jeune et les démences rares, Institut de la mémoire et de la maladie d'Alzheimer, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Centre of excellence of neurodegenerative disease (CoEN), ICM, CIC Neurosciences, APHP Department of Neurology, Hopital Pitié-Salpêtrière, University Paris 6, Paris, France
| | - Gianfranco Dalla Barba
- Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM) - Hôpital Pitié-Salpêtrière, Paris, France.,Centre de référence pour les maladies d'Alzheimer du sujet jeune et les démences rares, Institut de la mémoire et de la maladie d'Alzheimer, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Dipartimento di Scienze della Vita, Universitá degli Studi di Trieste, Trieste, Italy
| | - Valentina La Corte
- Centre de référence pour les maladies d'Alzheimer du sujet jeune et les démences rares, Institut de la mémoire et de la maladie d'Alzheimer, Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Memory and Cognition Laboratory, Institute of Psychology, University of Paris Descartes, Paris, France.,Center for Psychiatry & Neuroscience, INSERM U894, Paris, France
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Malek-Ahmadi M, Chen K, Perez SE, Mufson EJ. Cerebral Amyloid Angiopathy and Neuritic Plaque Pathology Correlate with Cognitive Decline in Elderly Non-Demented Individuals. J Alzheimers Dis 2020; 67:411-422. [PMID: 30594928 DOI: 10.3233/jad-180765] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Cerebral amyloid angiopathy (CAA) is a vascular neuropathology commonly reported in non-cognitively impaired (NCI), mild cognitive impairment, and Alzheimer's disease (AD) brains. However, it is unknown whether similar findings are present in non-demented elderly subjects. OBJECTIVE This study determined the association between CAA and cognition among elderly NCI subjects with varying levels of AD pathology. METHODS Data from 182 cases that received a diagnosis of NCI at their first clinical assessment were obtained from the Rush Religious Orders study (RROS). A cognitive composite score was used to measure cognitive decline. CAA was dichotomized as present or absent. Cases were also dichotomized according to CERAD neuropathological diagnosis and Braak staging. A mixed model-repeated measures analysis assessed decline on the cognitive composite score. RESULTS CAA, alone, was not associated with cognitive decline [-0.87 (95% CI: -3.33, 1.58), p = 0.49]. However, among those with CAA, the High CERAD group had significantly greater decline relative to the Low CERAD group [-4.08 (95% CI: -7.10, -1.06), p = 0.008]. The High and Low CERAD groups were not significantly different [-1.77 (95% CI: -6.14, 2.60), p = 0.43] in those without CAA. Composite score decline in the High and Low Braak groups with [-1.32 (95% CI: -4.40, 1.75), p = 0.40] or without [0.27 (95% CI: -4.01, 4.56), p = 0.90] CAA was not significantly different. CONCLUSION The current data shows that an interaction between CAA and plaque load is associated with greater decline on a cognitive composite score used to test non-cognitively impaired elderly participants in AD prevention trials.
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Affiliation(s)
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Sylvia E Perez
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Elliott J Mufson
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA
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10
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Brugulat-Serrat A, Salvadó G, Operto G, Cacciaglia R, Sudre CH, Grau-Rivera O, Suárez-Calvet M, Falcon C, Sánchez-Benavides G, Gramunt N, Minguillon C, Fauria K, Barkhof F, Molinuevo JL, Gispert JD. White matter hyperintensities mediate gray matter volume and processing speed relationship in cognitively unimpaired participants. Hum Brain Mapp 2019; 41:1309-1322. [PMID: 31778002 PMCID: PMC7267988 DOI: 10.1002/hbm.24877] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/25/2019] [Accepted: 11/14/2019] [Indexed: 12/17/2022] Open
Abstract
White matter hyperintensities (WMH) have been extensively associated with cognitive impairment and reductions in gray matter volume (GMv) independently. This study explored whether WMH lesion volume mediates the relationship between cerebral patterns of GMv and cognition in 521 (mean age 57.7 years) cognitively unimpaired middle‐aged individuals. Episodic memory (EM) was measured with the Memory Binding Test and executive functions (EF) using five WAIS‐IV subtests. WMH were automatically determined from T2 and FLAIR sequences and characterized using diffusion‐weighted imaging (DWI) parameters. WMH volume was entered as a mediator in a voxel‐wise mediation analysis relating GMv and cognitive performance (with both EM and EF composites and the individual tests independently). The mediation model was corrected by age, sex, education, number of Apolipoprotein E (APOE)‐ε4 alleles and total intracranial volume. We found that even at very low levels of WMH burden in the cohort (median volume of 3.2 mL), higher WMH lesion volume was significantly associated with a widespread pattern of lower GMv in temporal, frontal, and cerebellar areas. WMH mediated the relationship between GMv and EF, mainly driven by processing speed, but not EM. DWI parameters in these lesions were compatible with incipient demyelination and axonal loss. These findings lead to the reflection on the relevance of the control of cardiovascular risk factors in middle‐aged individuals as a valuable preventive strategy to reduce or delay cognitive decline.
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Affiliation(s)
- Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Grégory Operto
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Carole H Sudre
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Dementia Research Centre, UCL, London, UK.,Centre for Medical Imaging Computing, Faculty of Engineering, University College London, London, UK
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Carolina Minguillon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Frederik Barkhof
- Centre for Medical Imaging Computing, Faculty of Engineering, University College London, London, UK.,Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK.,Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, Netherland
| | - José L Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Juan D Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
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11
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Brown CA, Schmitt FA, Smith CD, Gold BT. Distinct patterns of default mode and executive control network circuitry contribute to present and future executive function in older adults. Neuroimage 2019; 195:320-332. [PMID: 30953834 PMCID: PMC6536351 DOI: 10.1016/j.neuroimage.2019.03.073] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/16/2019] [Accepted: 03/30/2019] [Indexed: 11/26/2022] Open
Abstract
Executive function (EF) performance in older adults has been linked with functional and structural profiles within the executive control network (ECN) and default mode network (DMN), white matter hyperintensities (WMH) burden and levels of Alzheimer's disease (AD) pathology. Here, we simultaneously explored the unique contributions of these factors to baseline and longitudinal EF performance in older adults. Thirty-two cognitively normal (CN) older adults underwent neuropsychological testing at baseline and annually for three years. Neuroimaging and AD pathology measures were collected at baseline. Separate linear regression models were used to determine which of these variables predicted composite EF scores at baseline and/or average annual change in composite ΔEF scores over the three-year follow-up period. Results demonstrated that low DMN deactivation, high ECN activation and WMH burden were the main predictors of EF scores at baseline. In contrast, poor DMN and ECN WM microstructure and higher AD pathology predicted greater annual decline in EF scores. Subsequent mediation analysis demonstrated that DMN WM microstructure uniquely mediated the relationship between AD pathology and ΔEF. These results suggest that functional activation patterns within the DMN and ECN and WMHs contribute to baseline EF while structural connectivity within these networks impact longitudinal EF performance in older adults.
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Affiliation(s)
- Christopher A Brown
- Department of Neuroscience, University of Kentucky, Lexington, KY, 40536, USA
| | - Frederick A Schmitt
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, 40536, USA; Department of Neurology, University of Kentucky, Lexington, KY, 40536, USA; Department of Psychiatry, University of Kentucky, Lexington, KY, 40536, USA
| | - Charles D Smith
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, 40536, USA; Department of Neurology, University of Kentucky, Lexington, KY, 40536, USA; Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY, 40536, USA
| | - Brian T Gold
- Department of Neuroscience, University of Kentucky, Lexington, KY, 40536, USA; Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, 40536, USA; Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY, 40536, USA.
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12
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Chen H, Li Y, Liu Q, Shi Q, Wang J, Shen H, Chen X, Ma J, Ai L, Zhang YM. Abnormal Interactions of the Salience Network, Central Executive Network, and Default-Mode Network in Patients With Different Cognitive Impairment Loads Caused by Leukoaraiosis. Front Neural Circuits 2019; 13:42. [PMID: 31275116 PMCID: PMC6592158 DOI: 10.3389/fncir.2019.00042] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/28/2019] [Indexed: 12/31/2022] Open
Abstract
Leukoaraiosis (LA) is associated with cognitive impairment in the older people which can be demonstrated in functional connectivity (FC) based on resting-state functional magnetic resonance imaging (rs-fMRI). This study is to explore the FC changes in LA patients with different cognitive status by three network models. Fifty-three patients with LA were divided into three groups: the normal cognition (LA-NC; n = 14, six males), mild cognitive impairment (LA-MCI; n = 27, 13 males), and vascular dementia (LA-VD; n = 12, six males), according to the Mini Mental State Exam (MMSE) and Clinical Dementia Rating (CDR). The three groups and 30 matched healthy controls (HCs; 11 males) underwent rs-fMRI. The data of rs-fMRI were analyzed by independent components analysis (ICA) and region of interest (ROI) analysis by the REST toolbox. Then the FC was respectively analyzed by the default-mode network (DMN), salience networks (SNs) and the central executive network (CEN) with their results compared among the different groups. For inter-brain network analysis, there were negative FC between the SN and DMN in LA groups, and the FC decreased when compared with HC group. While there were enhanced inter-brain network FC between the SN and CEN as well as within the SN. The FC in patients with LA can be detected by different network models of rs-fMRI. The multi-model analysis is helpful for the further understanding of the cognitive changes in those patients.
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Affiliation(s)
- Hongyan Chen
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuexiu Li
- Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center of Stroke, National Clinical Research Center for Neurological Diseases, Beijing, China
- Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Beijing Key Laboratory of Central Nervous System Injury, Beijing, China
| | - Qi Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qingli Shi
- Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center of Stroke, National Clinical Research Center for Neurological Diseases, Beijing, China
- Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Beijing Key Laboratory of Central Nervous System Injury, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Pinggu Hospital, Beijing, China
| | - Jingfang Wang
- Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center of Stroke, National Clinical Research Center for Neurological Diseases, Beijing, China
- Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Beijing Key Laboratory of Central Nervous System Injury, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, General Hospital of The Yang Tze River Shipping, Wuhan Brain Hospital, Wuhan, China
| | - Huicong Shen
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xuzhu Chen
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jun Ma
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lin Ai
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yu Mei Zhang
- Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center of Stroke, National Clinical Research Center for Neurological Diseases, Beijing, China
- Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
- Beijing Key Laboratory of Central Nervous System Injury, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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13
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Tanner JJ, Amin M, Hardcastle C, Parvataneni H, Vaillancourt DE, Mareci TH, Price CC. Better Brain and Cognition Prior to Surgery Is Associated With Elevated Postoperative Brain Extracellular Free-Water in Older Adults. Front Aging Neurosci 2019; 11:117. [PMID: 31156423 PMCID: PMC6532420 DOI: 10.3389/fnagi.2019.00117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/01/2019] [Indexed: 12/23/2022] Open
Abstract
For adults age 65 and older, the brain shows acute functional connectivity decreases after total knee arthroplasty with the severity of change predicted by preoperative cognitive function and brain disease burden. The extent of acute structural microstructural brain changes acutely after surgery remains unknown within the literature. For the current study, we report on the severity of acute post-surgery microstructural brain changes as measured by diffusion imaging and free-water analysis. Participants who underwent total knee arthroplasty under general anesthesia and non-surgery peers were part of a federally funded prospective cohort investigation involving participants. Recruitment occurred between 2013 and 2017. Data were collected in outpatient and inpatient settings within a university-affiliated medical center. A total of 232 TKA patients were referred by the study surgeon and contacted for study inclusion. Of these, 78 met inclusion and exclusion criteria and completed assessment. Five participants were excluded due to anesthetic protocol changes (spinal instead of general) with an additional 12 excluded for imaging-related complications. The total included sample size was 61. A total of 127 non-surgery participants were screened with 66 enrolled. One non-surgery participant was excluded for an imaging-related complication. Total knee arthroplasty and general anesthetic protocols were standardized. Participants received preoperative neurocognitive assessment and brain magnetic resonance imaging, with repeat imaging 48 h after surgery or pseudo surgery. Free-water analyses were performed using diffusion weighted images and tract-based spatial statistics with baseline cognitive data used to predict free-water changes. Surgery participants had widespread increases in white matter free-water. Surgery participants with higher cognitive functions as measured by immediate memory and less evidence of brain atrophy and disease (i.e., brain integrity) had greater free-water increase. Non-surgery peers had no free-water change. We interpret the surgery group’s free-water change as indicating widespread brain white matter glial response, with greater change indicative of better brain response to the acute surgery/anesthesia experience.
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Affiliation(s)
- Jared J Tanner
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Manish Amin
- Department of Physics, University of Florida, Gainesville, FL, United States
| | - Cheshire Hardcastle
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Hari Parvataneni
- Department of Orthopedic Surgery, University of Florida, Gainesville, FL, United States
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, Biomedical Engineering, and Neurology, University of Florida, Gainesville, FL, United States
| | - Thomas H Mareci
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, United States
| | - Catherine C Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Anesthesiology, University of Florida, Gainesville, FL, United States
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14
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Atwi S, Metcalfe AWS, Robertson AD, Rezmovitz J, Anderson ND, MacIntosh BJ. Attention-Related Brain Activation Is Altered in Older Adults With White Matter Hyperintensities Using Multi-Echo fMRI. Front Neurosci 2018; 12:748. [PMID: 30405336 PMCID: PMC6200839 DOI: 10.3389/fnins.2018.00748] [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: 02/27/2018] [Accepted: 09/28/2018] [Indexed: 11/19/2022] Open
Abstract
Cognitive decline is often undetectable in the early stages of accelerated vascular aging. Attentional processes are particularly affected in older adults with white matter hyperintensities (WMH), although specific neurovascular mechanisms have not been elucidated. We aimed to identify differences in attention-related neurofunctional activation and behavior between adults with and without WMH. Older adults with moderate to severe WMH (n = 18, mean age = 70 years), age-matched adults (n = 28, mean age = 72), and healthy younger adults (n = 19, mean age = 25) performed a modified flanker task during multi-echo blood oxygenation level dependent functional magnetic resonance imaging. Task-related activation was assessed using a weighted-echo approach. Healthy older adults had more widespread response and higher amplitude of activation compared to WMH adults in fronto-temporal and parietal cortices. Activation associated with processing speed was absent in the WMH group, suggesting attention-related activation deficits that may be a consequence of cerebral small vessel disease. WMH adults had greater executive contrast activation in the precuneous and posterior cingulate gyrus compared to HYA, despite no performance benefits, reinforcing the network dysfunction theory in WMH.
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Affiliation(s)
- Sarah Atwi
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Arron W S Metcalfe
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Centre for Youth Bipolar Disorder, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Andrew D Robertson
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Jeremy Rezmovitz
- Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Nicole D Anderson
- Department of Psychiatry and Psychology, University of Toronto, Toronto, ON, Canada.,Rotman Research Institute, Baycrest Centre, University of Toronto, Toronto, ON, Canada
| | - Bradley J MacIntosh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
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