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Schroyen G, Sleurs C, Ottenbourgs T, Leenaerts N, Nevelsteen I, Melis M, Smeets A, Deprez S, Sunaert S. Changes in leukoencephalopathy and serum neurofilament after (neo)adjuvant chemotherapy for breast cancer. Transl Oncol 2023; 37:101769. [PMID: 37651891 PMCID: PMC10480307 DOI: 10.1016/j.tranon.2023.101769] [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: 03/31/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Previous case studies have provided evidence for chemotherapy-induced leukoencephalopathy in patients with breast cancer. However, prospective research is lacking. Hence, we investigated leukoencephalopathy before and after chemotherapy and its association with a serum neuroaxonal damage marker. METHODS This prospective cohort study included 40 patients receiving chemotherapy for breast cancer, and two age- and education-matched control groups, recruited between 2018 and 2021 (31-64 years of age). The latter control groups consisted of 39 chemotherapy-naïve patients and 40 healthy women. Fluid-attenuated inversion-recovery magnetic resonance imaging was used for lesion volumetry (total, juxtacortical, periventricular, infratentorial, and deep white matter) and blood serum to measure neurofilament light chain (NfL) levels. Acquisition took place pre-chemotherapy and three months and one-year post-chemotherapy, or at corresponding intervals. Within/between group differences were compared using robust mixed-effects modeling, and associations between total lesion volume and serum-NfL with linear regression. RESULTS Stronger increases in deep white matter lesion volumes were observed shortly post-chemotherapy, compared with healthy women (ßstandardized=0.09, pFDR<0.001). Increases in total lesion volume could mainly be attributed to enlargement of existing lesions (mean±SD, 0.12±0.16 mL), rather than development of new lesions (0.02±0.02 mL). A stronger increase in serum-NfL concentration was observed shortly post-chemotherapy compared with both control groups (ß>0.70, p<0.004), neither of which showed any changes over time, whereas a decrease was observed compared with healthy women one-year post-chemotherapy (ß=-0.54, p = 0.002). Serum-NfL concentrations were associated with lesion volume one-year post-chemotherapy (or at matched timepoint; ß=0.36, p = 0.010), whereas baseline or short-term post-therapy levels or changes were not. CONCLUSION These results underscore the possibility of chemotherapy-induced leukoencephalopathy months post-treatment, as well as the added value of serum-NfL as a prognostic marker for peripheral/central neurotoxicity. TRANSLATIONAL RELEVANCE Previous case studies have provided evidence of chemotherapy-induced leukoencephalopathy in patients with breast cancer. However, prospective studies to estimate longitudinal changes are currently missing. In this study, we used longitudinal fluid-attenuated inversion-recovery magnetic resonance imaging to assess white matter lesion volumes in patients treated for non-metastatic breast cancer and healthy women. Our findings demonstrate that chemotherapy-treated patients exhibit stronger increases in lesion volumes compared with healthy women, specifically in deep white matter, at three months post-chemotherapy. Increases could mainly be attributed to enlargement of existing lesions, rather than development of new lesions. Last, serum concentrations of neurofilament light chain, a neuroaxonal damage marker, increased shortly after chemotherapy and long-term post-chemotherapy levels were associated with lesion volumes. These findings highlight the potential of this non-invasive serum marker as a prognostic marker for peripheral and/or central neurotoxicity. Implementation in clinical practice could aid in therapeutic decisions, assessing disease activity, or monitoring treatment response.
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Affiliation(s)
- Gwen Schroyen
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium
| | - Charlotte Sleurs
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; Tilburg University, Department of Cognitive Neuropsychology, Tilburg, the Netherlands; KU Leuven, Department of Oncology, Leuven, Belgium
| | - Tine Ottenbourgs
- KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium
| | - Nicolas Leenaerts
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; KU Leuven, Department of Neurosciences, Mind-Body Research, Leuven, Belgium; KU Leuven, University Psychiatric Center, Leuven, Belgium; University Hospitals Leuven, Department of Psychiatry, Leuven, Belgium
| | - Ines Nevelsteen
- University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; KU Leuven, Department of Oncology, Leuven, Belgium; University Hospitals Leuven, Department of Oncology, Surgical Oncology, Leuven, Belgium
| | - Michelle Melis
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium
| | - Ann Smeets
- University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; KU Leuven, Department of Oncology, Leuven, Belgium; University Hospitals Leuven, Department of Oncology, Surgical Oncology, Leuven, Belgium
| | - Sabine Deprez
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium.
| | - Stefan Sunaert
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium; University Hospitals Leuven, Department of Radiology, Leuven, Belgium
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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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Okeke O, Elbasheir A, Carter SE, Powers A, Mekawi Y, Gillespie CF, Schwartz AC, Bradley B, Fani N. Indirect Effects of Racial Discrimination on Health Outcomes Through Prefrontal Cortical White Matter Integrity. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:741-749. [PMID: 35597432 DOI: 10.1016/j.bpsc.2022.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Racial discrimination is consistently associated with adverse health outcomes and has been linked to structural decrements in brain white matter. However, it is unclear whether discrimination-related neuroplastic changes could indirectly affect health outcomes. Our goal was to evaluate indirect associations of racial discrimination on health outcomes through white matter microstructure in a sample of trauma-exposed Black women. METHODS A trauma study in an urban hospital setting recruited 79 Black women who received a history and physical examination to assess medical disorders (compiled into a summed total of disorder types). Participants reported on experiences of racial discrimination and underwent diffusion tensor imaging; fractional anisotropy values were extracted from white matter pathways previously linked to racial discrimination (corpus callosum, including the body and genu; anterior cingulum bundle; and superior longitudinal fasciculus) and entered into mediational models. RESULTS Indirect effects of racial discrimination on medical disorders through left anterior cingulum bundle fractional anisotropy were significant (β = 0.07, SE = 0.04, 95% CI [0.003, 0.14]) after accounting for trauma and economic disadvantage. Indirect effects of racial discrimination on medical disorders through corpus callosum genu fractional anisotropy were also significant (β = 0.08, SE = 0.04, 95% CI [0.01, 0.16]). CONCLUSIONS Racial discrimination may increase risk for medical disorders via neuroplastic effects on microstructural integrity of stress-sensitive prefrontal white matter tracts. Racial discrimination-related changes in these tracts may affect health behaviors, which, in turn, influence vulnerability for medical disorders. These data highlight the connections between racial discrimination, prefrontal white matter connections, and incidence of medical disorders in Black Americans.
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Affiliation(s)
- Onyebuchi Okeke
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Aziz Elbasheir
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Sierra E Carter
- Department of Psychology, Georgia State University, Atlanta, Georgia
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Yara Mekawi
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky
| | - Charles F Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Ann C Schwartz
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia; Atlanta VA Medical Center, Decatur, Georgia
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia.
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King DLO, Henson RN, Kievit R, Wolpe N, Brayne C, Tyler LK, Rowe JB, Tsvetanov KA. Distinct components of cardiovascular health are linked with age-related differences in cognitive abilities. Sci Rep 2023; 13:978. [PMID: 36653428 PMCID: PMC9849401 DOI: 10.1038/s41598-022-27252-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
Cardiovascular ageing contributes to cognitive impairment. However, the unique and synergistic contributions of multiple cardiovascular factors to cognitive function remain unclear because they are often condensed into a single composite score or examined in isolation. We hypothesized that vascular risk factors, electrocardiographic features and blood pressure indices reveal multiple latent vascular factors, with independent contributions to cognition. In a population-based deep-phenotyping study (n = 708, age 18-88), path analysis revealed three latent vascular factors dissociating the autonomic nervous system response from two components of blood pressure. These three factors made unique and additive contributions to the variability in crystallized and fluid intelligence. The discrepancy in fluid relative to crystallized intelligence, indicative of cognitive decline, was associated with a latent vascular factor predominantly expressing pulse pressure. This suggests that higher pulse pressure is associated with cognitive decline from expected performance. The effect was stronger in older adults. Controlling pulse pressure may help to preserve cognition, particularly in older adults. Our findings highlight the need to better understand the multifactorial nature of vascular aging.
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Affiliation(s)
- Deborah L O King
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SP, UK.
- Department of Psychology, Centre for Speech, Language and the Brain, University of Cambridge, Cambridge, CB23 6HT, UK.
| | - Richard N Henson
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 2QQ, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - Rogier Kievit
- Donders Research Institute for Brain, Cognition and Behaviour, Radboud University, 6525 AJ, Nijmegen, The Netherlands
| | - Noham Wolpe
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 2QQ, UK
- Department of Physical Therapy, The Stanley Steer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Carol Brayne
- Cambridge Public Health, Cambridge Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Lorraine K Tyler
- Department of Psychology, Centre for Speech, Language and the Brain, University of Cambridge, Cambridge, CB23 6HT, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SP, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - Kamen A Tsvetanov
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SP, UK
- Department of Psychology, Centre for Speech, Language and the Brain, University of Cambridge, Cambridge, CB23 6HT, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
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Li Y, Laukka EJ, Dekhtyar S, Papenberg G, Speh A, Fratiglioni L, Kalpouzos G, Qiu C. Association Between Behavioral, Biological, and Genetic Markers of Cardiovascular Health and MRI Markers of Brain Aging: A Cohort Study. Neurology 2023; 100:e38-e48. [PMID: 36319110 PMCID: PMC9827130 DOI: 10.1212/wnl.0000000000201346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/19/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The life's simple 7 approach was proposed to define cardiovascular health (CVH) metrics. We sought to investigate the associations between behavioral, biological, and genetic markers for CVH and vascular brain aging in older adults. METHODS This population-based cohort study included participants who had repeated brain MRI measures from 2001 to 2003 to 2007-2010 (i.e., count of perivascular spaces, volumes of white matter hyperintensity [WMH] and gray matter, and lacunes). At baseline, global, behavioral, and biological CVH metrics were defined and scored following the life's simple 7 approach and categorized into unfavorable, intermediate, and favorable profiles according to tertiles. The metabolic genetic risk score was calculated by counting 15 risk alleles associated with hypertension, diabetes, or dyslipidemia. Data were analyzed using linear mixed-effects and Cox proportional hazards models, adjusting for age, sex, and education. RESULTS The study sample consisted of 317 participants (age 60 years or older; 61.8% women). Favorable and intermediate (vs unfavorable) global CVH profiles were related to slower WMH progression, with β-coefficients (95% CI) being -0.019(-0.035-0.002) and -0.018(-0.034-0.001), respectively. Favorable and intermediate (vs unfavorable) biological CVH profiles were significantly related to slower WMH increase only in people aged 60-72 years. CVH profiles were not related to progression of other brain measures. Furthermore, a higher metabolic genetic risk score (range: 6-21) was associated with faster WMH increase (β-coefficient = 0.005; 95% CI: 0.003-0.008). There were statistical interactions of metabolic genetic risk score with global and behavioral CVH profiles on WMH accumulation. A higher metabolic genetic risk score was related to faster WMH accumulation, with β-coefficients being 0.015(0.007-0.023), 0.005(0.001-0.009), and 0.003(-0.001 to 0.006) among people with unfavorable, intermediate, and favorable global CVH profiles, respectively; the corresponding β-coefficients were 0.013(0.006-0.020), 0.006(0.003-0.009), and 0.002(-0.002 to 0.006) among people with unfavorable, intermediate, and favorable behavioral CVH profiles. DISCUSSION Intermediate to favorable global CVH profiles in older adults are associated with slower vascular brain aging. The association of metabolic genetic risk load with accelerated vascular brain aging was evident among people with unfavorable to intermediate, but not favorable, CVH profiles. These findings highlight the importance of adhering to favorable CVH profiles, especially healthy behaviors, in vascular brain health.
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Affiliation(s)
- Yuanjing Li
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Erika J Laukka
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Serhiy Dekhtyar
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Goran Papenberg
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Andreja Speh
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Laura Fratiglioni
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Grégoria Kalpouzos
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia
| | - Chengxuan Qiu
- From the Aging Research Center (Y.L., E.J.L., S.D., G.P., A.S., L.F., G.K., C.Q.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center (E.J.L., L.F.), Stockholm, Sweden; Department of Neurology (A.S.), University Medical Center Ljubljana, Ljubljana, Slovenia; and Medical Faculty (A.S.), University of Ljubljana, Ljubljana, Slovenia.
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Liu X, Tyler LK, Rowe JB, Tsvetanov KA. Multimodal fusion analysis of functional, cerebrovascular and structural neuroimaging in healthy aging subjects. Hum Brain Mapp 2022; 43:5490-5508. [PMID: 35855641 PMCID: PMC9704789 DOI: 10.1002/hbm.26025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/24/2022] [Accepted: 07/07/2022] [Indexed: 01/15/2023] Open
Abstract
Brain aging is a complex process that requires a multimodal approach. Neuroimaging can provide insights into brain morphology, functional organization, and vascular dynamics. However, most neuroimaging studies of aging have focused on each imaging modality separately, limiting the understanding of interrelations between processes identified by different modalities and their relevance to cognitive decline in aging. Here, we used a data-driven multimodal approach, linked independent component analysis (ICA), to jointly analyze magnetic resonance imaging (MRI) of grey matter volume, cerebrovascular, and functional network topographies in relation to measures of fluid intelligence. Neuroimaging and cognitive data from the Cambridge Centre for Ageing and Neuroscience study were used, with healthy participants aged 18-88 years (main dataset n = 215 and secondary dataset n = 433). Using linked ICA, functional network activities were characterized in independent components but not captured in the same component as structural and cerebrovascular patterns. Split-sample (n = 108/107) and out-of-sample (n = 433) validation analyses using linked ICA were also performed. Global grey matter volume with regional cerebrovascular changes and the right frontoparietal network activity were correlated with age-related and individual differences in fluid intelligence. This study presents the insights from linked ICA to bring together measurements from multiple imaging modalities, with independent and additive information. We propose that integrating multiple neuroimaging modalities allows better characterization of brain pattern variability and changes associated with healthy aging.
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Affiliation(s)
- Xulin Liu
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
| | - Lorraine K. Tyler
- The Centre for Speech, Language and the Brain, Department of PsychologyUniversity of CambridgeCambridgeUK
| | - Cam‐CAN
- Cambridge Centre for Ageing and Neuroscience (Cam‐CAN), MRC Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - James B. Rowe
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
- MRC Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Kamen A. Tsvetanov
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
- The Centre for Speech, Language and the Brain, Department of PsychologyUniversity of CambridgeCambridgeUK
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García-García I, Michaud A, Jurado MÁ, Dagher A, Morys F. Mechanisms linking obesity and its metabolic comorbidities with cerebral grey and white matter changes. Rev Endocr Metab Disord 2022; 23:833-843. [PMID: 35059979 DOI: 10.1007/s11154-021-09706-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 02/07/2023]
Abstract
Obesity is a preventable risk factor for cerebrovascular disorders and it is associated with cerebral grey and white matter changes. Specifically, individuals with obesity show diminished grey matter volume and thickness, which seems to be more prominent among fronto-temporal regions in the brain. At the same time, obesity is associated with lower microstructural white matter integrity, and it has been found to precede increases in white matter hyperintensity load. To date, however, it is unclear whether these findings can be attributed solely to obesity or whether they are a consequence of cardiometabolic complications that often co-exist with obesity, such as low-grade systemic inflammation, hypertension, insulin resistance, or dyslipidemia. In this narrative review we aim to provide a comprehensive overview of the potential impact of obesity and a number of its cardiometabolic consequences on brain integrity, both separately and in synergy with each other. We also identify current gaps in knowledge and outline recommendations for future research.
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Affiliation(s)
- Isabel García-García
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain.
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.
| | | | - María Ángeles Jurado
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Alain Dagher
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Filip Morys
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
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Makino K, Lee S, Bae S, Harada K, Chiba I, Katayama O, Tomida K, Morikawa M, Yamashiro Y, Sudo M, Takayanagi N, Shimada H. Light intensity physical activity is beneficially associated with brain volume in older adults with high cardiovascular risk. Front Cardiovasc Med 2022; 9:882562. [PMID: 35911542 PMCID: PMC9326229 DOI: 10.3389/fcvm.2022.882562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundOlder people with high cardiovascular risk, including those without cardiovascular diseases, are an at-risk population for dementia. Regular physical activity is generally recommended to maintain brain health; however, the optimal intensity of physical activity for maintaining brain volume in older adults with cardiovascular risk remains unclear. We examined the associations between intensity-specific physical activity and brain volume stratified by absolute cardiovascular risk level in older adults without cardiovascular diseases.Methods and resultsThis cross-sectional study involved 725 community-dwelling older Japanese adults without cardiovascular diseases. We estimated absolute cardiovascular risk using the World Health Organization risk estimation charts, which include variables such as age, sex, diabetes mellitus, smoking, systolic blood pressure, and total cholesterol, and stratified cardiovascular risk level into three risk categories: low (≤ 9%), moderate (10–14%), and high (≥15%). We measured daily physical activity using a triaxial accelerometer, and calculated the average time spent in moderate-to-vigorous intensity physical activity (MVPA) and light intensity physical activity (LPA). We performed brain T1-weighted magnetic resonance imaging and calculated the volume of the cortical gray matter, subcortical gray matter, and cerebral white matter, using the FreeSurfer software. In the overall sample, multivariable linear regression analysis showed that greater MVPA was significantly associated with greater volume of the cortical gray matter and cerebral white matter, and greater LPA was significantly associated with greater volume of the cerebral white matter. Additionally, in the analysis of the sample stratified by absolute cardiovascular risk level, cerebral white matter volume was significantly associated with both MVPA and LPA in the high cardiovascular risk group.ConclusionsThe association between physical activity and brain volume differed according to cardiovascular risk level in community-dwelling older adults. In a population at high cardiovascular risk, maintaining or increasing LPA might be a practical and achievable strategy for healthy brain aging.
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Affiliation(s)
- Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
- *Correspondence: Keitaro Makino
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ippei Chiba
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | | | - Motoki Sudo
- Tokyo Research Laboratories, Kao Corporation, Tokyo, Japan
| | | | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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9
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Maleki S, Hendrikse J, Chye Y, Caeyenberghs K, Coxon JP, Oldham S, Suo C, Yücel M. Associations of cardiorespiratory fitness and exercise with brain white matter in healthy adults: A systematic review and meta-analysis. Brain Imaging Behav 2022; 16:2402-2425. [PMID: 35773556 PMCID: PMC9581839 DOI: 10.1007/s11682-022-00693-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
Magnetic resonance imaging (MRI) studies have revealed positive associations between brain structure and physical activity, cardiorespiratory fitness, and exercise (referred to here as PACE). While a considerable body of research has investigated the effects of PACE on grey matter, much less is known about effects on white matter (WM). Hence, we conducted a systematic review of peer-reviewed literature published prior to 5th July 2021 using online databases (PubMed and Scopus) and PRISMA guidelines to synthesise what is currently known about the relationship between PACE and WM in healthy adults. A total of 60 studies met inclusion criteria and were included in the review. Heterogeneity across studies was calculated using Qochran's q test, and publication bias was assessed for each meta-analysis using Begg and Mazumdar rank correlation test. A meta-regression was also conducted to explore factors contributing to any observed heterogeneity. Overall, we observed evidence of positive associations between PACE and global WM volume (effect size (Hedges's g) = 0.137, p < 0.001), global WM anomalies (effect size = 0.182, p < 0.001), and local microstructure integrity (i.e., corpus callosum: effect size = 0.345, p < 0.001, and anterior limb of internal capsule: effect size = 0.198, p < 0.001). These findings suggest that higher levels of PACE are associated with improved global WM volume and local integrity. We appraise the quality of evidence, and discuss the implications of these findings for the preservation of WM across the lifespan. We conclude by providing recommendations for future research in order to advance our understanding of the specific PACE parameters and neurobiological mechanisms underlying these effects.
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Affiliation(s)
- Suzan Maleki
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia
| | - Joshua Hendrikse
- Movement and Exercise Neuroscience Laboratory, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Yann Chye
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - James P Coxon
- Movement and Exercise Neuroscience Laboratory, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Stuart Oldham
- Neural Systems and Behaviour, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Chao Suo
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia.
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia.
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Marrie RA, Patel R, Figley CR, Kornelsen J, Bolton JM, Graff LA, Mazerolle EL, Helmick C, Uddin MN, Figley TD, Marriott JJ, Bernstein CN, Fisk JD. Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure. Front Neurol 2022; 13:910014. [PMID: 35685743 PMCID: PMC9170886 DOI: 10.3389/fneur.2022.910014] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/03/2022] [Indexed: 01/09/2023] Open
Abstract
ObjectiveVascular comorbidities are associated with reduced cognitive performance and with changes in brain structure in people with multiple sclerosis (MS). Understanding causal pathways is necessary to support the design of interventions to mitigate the impacts of comorbidities, and to monitor their effectiveness. We assessed the inter-relationships among vascular comorbidity, cognition and brain structure in people with MS.MethodsAdults with neurologist-confirmed MS reported comorbidities, and underwent assessment of their blood pressure, HbA1c, and cognitive functioning (i.e., Symbol Digit Modalities Test, California Verbal Learning Test, Brief Visuospatial Memory Test-Revised, and verbal fluency). Test scores were converted to age-, sex-, and education-adjusted z-scores. Whole brain magnetic resonance imaging (MRI) was completed, from which measures of thalamic and hippocampal volumes, and mean diffusivity of gray matter and normal-appearing white matter were converted to age and sex-adjusted z-scores. Canonical correlation analysis was used to identify linear combinations of cognitive measures (cognitive variate) and MRI measures (MRI variate) that accounted for the most correlation between the cognitive and MRI measures. Regression analyses were used to test whether MRI measures mediated the relationships between the number of vascular comorbidities and cognition measures.ResultsOf 105 participants, most were women (84.8%) with a mean (SD) age of 51.8 (12.8) years and age of symptom onset of 29.4 (10.5) years. Vascular comorbidity was common, with 35.2% of participants reporting one, 15.2% reporting two, and 8.6% reporting three or more. Canonical correlation analysis of the cognitive and MRI variables identified one pair of variates (Pillai's trace = 0.45, p = 0.0035). The biggest contributors to the cognitive variate were the SDMT and CVLT-II, and to the MRI variate were gray matter MD and thalamic volume. The correlation between cognitive and MRI variates was 0.50; these variates were used in regression analyses. On regression analysis, vascular comorbidity was associated with the MRI variate, and with the cognitive variate. After adjusting for the MRI variate, vascular comorbidity was not associated with the cognitive variate.ConclusionVascular comorbidity is associated with lower cognitive function in people with MS and this association is partially mediated via changes in brain macrostructure and microstructure.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- *Correspondence: Ruth Ann Marrie
| | - Ronak Patel
- Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Chase R. Figley
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Division of Diagnostic Imaging, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
| | - Jennifer Kornelsen
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Division of Diagnostic Imaging, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Centre, Winnipeg, MB, Canada
| | - James M. Bolton
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lesley A. Graff
- Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Erin L. Mazerolle
- Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Carl Helmick
- Department of Psychiatry and Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Md Nasir Uddin
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Neurology, University of Rochester, Rochester, New York, NY, United States
| | - Teresa D. Figley
- Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - James J. Marriott
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Charles N. Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - John D. Fisk
- Nova Scotia Health and the Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, NS, Canada
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Schroyen G, Sleurs C, Bartsoen E, Smeets D, van Weehaeghe D, Van Laere K, Smeets A, Deprez S, Sunaert S. Neuroinflammation as potential precursor of leukoencephalopathy in early-stage breast cancer patients: A cross-sectional PET-MRI study. Breast 2022; 62:61-68. [PMID: 35131644 PMCID: PMC8829129 DOI: 10.1016/j.breast.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 12/24/2022] Open
Abstract
Background Although chemotherapy-induced leukoencephalopathy has been described in case and cohort studies, literature remains inconclusive about its prevalence and mechanisms. Therefore, we investigated the presence of leukoencephalopathy after multiagent chemotherapy in women treated for breast cancer and potential underlying neuroinflammatory processes. Methods In this exploratory study, 15 chemotherapy-treated and 15 age-matched chemotherapy-naïve patients with early-stage breast cancer, as well as 15 healthy controls underwent simultaneous PET-MR neuroimaging, including T1-weighted MPRAGE, T2-weighted FLAIR and dynamic PET with the 18-kDA translocator protein (TSPO) radioligand [18F]DPA-714. Total and regional (juxtacortical, periventricular, deep white matter and infratentorial) lesion burden were compared between the groups with one-way ANOVA. With paired t-tests, [18F]DPA-714 volume of distribution [VT, including partial volume correction (PVC)] in lesioned and normal appearing white matter (NAWM) were compared within subjects, to investigate inflammation. Finally, two general linear models were used to examine the predictive values of neurofilament light-chain (NfL) serum levels on (1) total lesion burden or (2) PVC [18F]DPA-714 VT of lesions showing elevated inflammation. Results No significant differences were found in total or localized lesion burden. However, significantly higher (20–45%) TSPO uptake was observed in juxtacortical lesions (p ≤ 0.008, t ≥ 3.90) compared to NAWM in both cancer groups, but only persisted for chemotherapy-treated patients after PVC (p = 0.005, t = 4.30). NfL serum levels were not associated with total lesion volume or tracer uptake in juxtacortical lesions. Conclusion This multimodal neuroimaging study suggests that neuroinflammatory processes could be involved in the development of juxtacortical, but not periventricular or deep white matter, leukoencephalopathy shortly after chemotherapy for early-stage breast cancer. No increased white matter lesion load in breast cancer patients. No differences in TSPO uptake in periventricular or deep white matter lesions. Higher TSPO uptake in juxtacortical lesions in chemotherapy-treated breast cancer patients. TSPO uptake in inflammatory lesions and NfL levels not significantly associated, despite a trend.
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12
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Yuan Y, Li N, Liu Y, Wang M, Heizhati M, Zhu Q, Yao X, Luo Q. Plasma aldosterone concentration is associated with white matter lesions in patients with primary aldosteronism. Endocrine 2022; 75:889-898. [PMID: 34780033 DOI: 10.1007/s12020-021-02920-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Primary aldosteronism (PA) is the most frequent form of secondary hypertension. Hypertension is a risk factor for cognitive decline and dementia. White matter lesions (WMLs) are linked to vascular risk factors, which increase the risk of dementia. We aimed to analyze the association of PA-related parameters and WMLs in patients with PA. METHODS We conducted a retrospective analysis of all patients with PA in the Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region from January 1, 2011 to April 1, 2021. We analyzed the relationship between plasma aldosterone concentration (PAC), plasma renin activity (PRA), aldosterone-renin ratio (ARR), serum potassium, and WMLs. RESULTS We enrolled 138 patients with WMLs and matched these to controls without WMLs at a 1:4 ratio. Among the analytic sample (N = 711) with ages ranging from 30 to 64 years, 69% were male. In the logistic regression analysis, PAC, PRA and serum potassium were treated as continuous variables. The results showed that PAC (OR 1.04, 95% CI 1.01, 1.06, P = 0.008) was positively associated with the risk of WMLs, and serum potassium (OR 0.26, 95% CI 0.16, 0.44, P < 0.001) was inversely associated with the risk of WMLs. PRA (OR 0.86, 95% CI 0.68, 1.08, P = 0.384) was not associated with the risk of WMLs after adjusting for confounders. The results of restricted cubic splines showed the dose-response association between increasing PAC, ARR, decreasing serum potassium, and the risk of WMLs. We also divided PAC, ARR and serum potassium into two groups according to the result of restricted cubic splines. After adjusting for confounders, patients who were in Q2 (≥23.12 ng/dl) of PAC (OR 2.07, 95% CI 1.36, 3.15), Q2 (≥56.81 (ng/dl per ng/ml*h) of ARR (OR 1.82, 95% CI 1.22, 2.72) and Q2 (≤3.58 mmol/l) of serum potassium (OR 2.99, 95% CI 1.95, 4.50) had a significantly higher risk of WMLs than their counterparts. In stratified analyses, there was no evidence of subgroup heterogeneity regarding the change in the risk of WMLs (P > 0.05 for interaction for all). CONCLUSION Our results suggested that the PAC and serum potassium were related to the risk of WMLs in patients with PA. In particular, PAC ≥23.12 ng/dl significantly increased the risk of WMLs in patients with PA.
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Affiliation(s)
- Yujuan Yuan
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
- Xinjiang Medical University, Urumqi, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China.
| | - Yan Liu
- Radiography Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Menghui Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Qing Zhu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Xiaoguang Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Qin Luo
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
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13
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Neurophysiological and Brain Structural Markers of Cognitive Frailty Differ from Alzheimer's Disease. J Neurosci 2022; 42:1362-1373. [PMID: 35012965 PMCID: PMC8883844 DOI: 10.1523/jneurosci.0697-21.2021] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/29/2021] [Accepted: 11/03/2021] [Indexed: 02/02/2023] Open
Abstract
With increasing life span and prevalence of dementia, it is important to understand the mechanisms of cognitive aging. Here, we focus on a subgroup of the population we term "cognitively frail," defined by reduced cognitive function in the absence of subjective memory complaints, or a clinical diagnosis of dementia. Cognitive frailty is distinct from cognitive impairment caused by physical frailty. It has been proposed to be a precursor to Alzheimer's disease, but may alternatively represent one end of a nonpathologic spectrum of cognitive aging. We test these hypotheses in humans of both sexes, by comparing the structural and neurophysiological properties of a community-based cohort of cognitive frail adults, to people presenting clinically with diagnoses of Alzheimer's disease or mild cognitive impairment, and community-based cognitively typical older adults. Cognitive performance of the cognitively frail was similar to those with mild cognitive impairment. We used a novel cross-modal paired-associates task that presented images followed by sounds, to induce physiological responses of novelty and associative mismatch, recorded by EEG/MEG. Both controls and cognitively frail showed stronger mismatch responses and larger temporal gray matter volume, compared with people with mild cognitive impairment and Alzheimer's disease. Our results suggest that community-based cognitively frail represents a spectrum of normal aging rather than incipient Alzheimer's disease, despite similar cognitive function. Lower lifelong cognitive reserve, hearing impairment, and cardiovascular comorbidities might contribute to the etiology of the cognitive frailty. Critically, community-based cohorts of older adults with low cognitive performance should not be interpreted as representing undiagnosed Alzheimer's disease.SIGNIFICANCE STATEMENT The current study investigates the neural signatures of cognitive frailty in relation to healthy aging and Alzheimer's disease. We focus on the cognitive aspect of frailty and show that, despite performing similarly to the patients with mild cognitive impairment, a cohort of community-based adults with poor cognitive performance do not show structural atrophy or neurophysiological signatures of Alzheimer's disease. Our results call for caution before assuming that cognitive frailty represents latent Alzheimer's disease. Instead, the cognitive underperformance of cognitively frail adults could result in cumulative effects of multiple psychosocial risk factors over the lifespan, and medical comorbidities.
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Beck D, de Lange AG, Pedersen ML, Alnæs D, Maximov II, Voldsbekk I, Richard G, Sanders A, Ulrichsen KM, Dørum ES, Kolskår KK, Høgestøl EA, Steen NE, Djurovic S, Andreassen OA, Nordvik JE, Kaufmann T, Westlye LT. Cardiometabolic risk factors associated with brain age and accelerate brain ageing. Hum Brain Mapp 2022; 43:700-720. [PMID: 34626047 PMCID: PMC8720200 DOI: 10.1002/hbm.25680] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 09/02/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022] Open
Abstract
The structure and integrity of the ageing brain is interchangeably linked to physical health, and cardiometabolic risk factors (CMRs) are associated with dementia and other brain disorders. In this mixed cross-sectional and longitudinal study (interval mean = 19.7 months), including 790 healthy individuals (mean age = 46.7 years, 53% women), we investigated CMRs and health indicators including anthropometric measures, lifestyle factors, and blood biomarkers in relation to brain structure using MRI-based morphometry and diffusion tensor imaging (DTI). We performed tissue specific brain age prediction using machine learning and performed Bayesian multilevel modeling to assess changes in each CMR over time, their respective association with brain age gap (BAG), and their interaction effects with time and age on the tissue-specific BAGs. The results showed credible associations between DTI-based BAG and blood levels of phosphate and mean cell volume (MCV), and between T1-based BAG and systolic blood pressure, smoking, pulse, and C-reactive protein (CRP), indicating older-appearing brains in people with higher cardiometabolic risk (smoking, higher blood pressure and pulse, low-grade inflammation). Longitudinal evidence supported interactions between both BAGs and waist-to-hip ratio (WHR), and between DTI-based BAG and systolic blood pressure and smoking, indicating accelerated ageing in people with higher cardiometabolic risk (smoking, higher blood pressure, and WHR). The results demonstrate that cardiometabolic risk factors are associated with brain ageing. While randomized controlled trials are needed to establish causality, our results indicate that public health initiatives and treatment strategies targeting modifiable cardiometabolic risk factors may also improve risk trajectories and delay brain ageing.
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Affiliation(s)
- Dani Beck
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Ann‐Marie G. de Lange
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- LREN, Centre for Research in Neurosciences‐Department of Clinical NeurosciencesCHUV and University of LausanneLausanneSwitzerland
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Mads L. Pedersen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Dag Alnæs
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Bjørknes CollegeOsloNorway
| | - Ivan I. Maximov
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Department of Health and FunctioningWestern Norway University of Applied SciencesBergenNorway
| | - Irene Voldsbekk
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Geneviève Richard
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Anne‐Marthe Sanders
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Kristine M. Ulrichsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Erlend S. Dørum
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Knut K. Kolskår
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Einar A. Høgestøl
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Srdjan Djurovic
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- KG Jebsen Centre for Neurodevelopmental DisordersUniversity of OsloOsloNorway
| | | | - Tobias Kaufmann
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of Psychiatry and PsychotherapyUniversity of TübingenTubingenGermany
| | - Lars T. Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- KG Jebsen Centre for Neurodevelopmental DisordersUniversity of OsloOsloNorway
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Morris TP, Ai M, Chaddock-Heyman L, McAuley E, Hillman CH, Kramer AF. Relationships between enriching early life experiences and cognitive function later in life are mediated by educational attainment. JOURNAL OF COGNITIVE ENHANCEMENT 2022; 5:449-458. [PMID: 35005424 DOI: 10.1007/s41465-021-00208-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The study of how engagement in enriching cognitive, physical and social activities in childhood impacts cognitive function decades later will advance our understanding of how modifiable lifestyle activities promote cognition across the lifespan. 88 healthy older adults (aged 60-80 years) returned a retrospective questionnaire regarding their participation in seven lifestyle activities (musical instrument playing, language learning, sport participation, art/dance lessons, scouting, volunteering, family vacations) before age 13 years. After controlling for current age, educational attainment, socioeconomic status of the mother and current engagement in lifestyle activities, a greater number of activities were significantly associated with better vocabulary abilities, episodic memory and fluid intelligence. The relationships with vocabulary and fluid intelligence were mediated by educational attainment. We postulate that engagement in a higher number of enriching early life activities is a reflection of both one's sociocontextual environment and engagement with that environment. This engagement leads to attributes relevant for educational aspirations/attainment, ultimately contributing to factors that have a lifespan impact on cognitive function.
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Affiliation(s)
| | - Meishan Ai
- Department of Psychology, Northeastern University, USA
| | - Laura Chaddock-Heyman
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, USA
| | - Edward McAuley
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, USA.,Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Charles H Hillman
- Department of Psychology, Northeastern University, USA.,Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, United States
| | - Arthur F Kramer
- Department of Psychology, Northeastern University, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, USA
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16
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Predovan D, Gazes Y, Lee S, Li P, Sloan RP, Stern Y. Effect of Aerobic Exercise on White Matter Tract Microstructure in Young and Middle-Aged Healthy Adults. Front Hum Neurosci 2021; 15:681634. [PMID: 34276329 PMCID: PMC8283503 DOI: 10.3389/fnhum.2021.681634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Recent evidence suggests that being physically active can mitigate age-related white matter (WM) changes. In a randomized clinical trial, the effect of 6-month aerobic exercise (AE) or stretching/toning interventions on measures of WM microstructure (WMM) was assessed in a sample of 74 adults aged 20-67 years. Major WM pathways were reconstructed. No significant group-level change in WM tract microstructure following an AE training was observed. Without adjustment for multiple comparisons, an increase in fractional anisotropy (FA) and a decrease in mean diffusivity (MD) of the uncinate fasciculus were observed post-intervention in the AE group in comparison with the stretching group. In the AE group, a significant increase in cardiorespiratory fitness was measured but did not correlate with FA and MD change. The present results of this study are in accordance with similar studies in healthy adults that did not show significant benefit on WMM after participating in an AE program. Clinical Trial Registration: Clinicaltrials.gov identifier, NCT01179958.
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Affiliation(s)
- David Predovan
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
| | - Yunglin Gazes
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
| | - Seonjoo Lee
- Department of Biostatistics, Columbia University, New York, NY, United States.,Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States
| | - Peipei Li
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
| | - Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University, New York, NY, United States
| | - Yaakov Stern
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
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17
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Tsvetanov KA, Henson RNA, Jones PS, Mutsaerts H, Fuhrmann D, Tyler LK, Rowe JB. The effects of age on resting-state BOLD signal variability is explained by cardiovascular and cerebrovascular factors. Psychophysiology 2021; 58:e13714. [PMID: 33210312 PMCID: PMC8244027 DOI: 10.1111/psyp.13714] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 07/27/2020] [Accepted: 09/28/2020] [Indexed: 12/18/2022]
Abstract
Accurate identification of brain function is necessary to understand neurocognitive aging, and thereby promote health and well-being. Many studies of neurocognitive aging have investigated brain function with the blood-oxygen level-dependent (BOLD) signal measured by functional magnetic resonance imaging. However, the BOLD signal is a composite of neural and vascular signals, which are differentially affected by aging. It is, therefore, essential to distinguish the age effects on vascular versus neural function. The BOLD signal variability at rest (known as resting state fluctuation amplitude, RSFA), is a safe, scalable, and robust means to calibrate vascular responsivity, as an alternative to breath-holding and hypercapnia. However, the use of RSFA for normalization of BOLD imaging assumes that age differences in RSFA reflecting only vascular factors, rather than age-related differences in neural function (activity) or neuronal loss (atrophy). Previous studies indicate that two vascular factors, cardiovascular health (CVH) and cerebrovascular function, are insufficient when used alone to fully explain age-related differences in RSFA. It remains possible that their joint consideration is required to fully capture age differences in RSFA. We tested the hypothesis that RSFA no longer varies with age after adjusting for a combination of cardiovascular and cerebrovascular measures. We also tested the hypothesis that RSFA variation with age is not associated with atrophy. We used data from the population-based, lifespan Cam-CAN cohort. After controlling for cardiovascular and cerebrovascular estimates alone, the residual variance in RSFA across individuals was significantly associated with age. However, when controlling for both cardiovascular and cerebrovascular estimates, the variance in RSFA was no longer associated with age. Grey matter volumes did not explain age differences in RSFA, after controlling for CVH. The results were consistent between voxel-level analysis and independent component analysis. Our findings indicate that cardiovascular and cerebrovascular signals are together sufficient predictors of age differences in RSFA. We suggest that RSFA can be used to separate vascular from neuronal factors, to characterize neurocognitive aging. We discuss the implications and make recommendations for the use of RSFA in the research of aging.
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Affiliation(s)
- Kamen A. Tsvetanov
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
- Department of PsychologyCentre for Speech, Language and the BrainUniversity of CambridgeCambridgeUK
| | - Richard N. A. Henson
- Medical Research Council Cognition and Brain Sciences UnitCambridgeUK
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - P. Simon Jones
- Department of PsychologyCentre for Speech, Language and the BrainUniversity of CambridgeCambridgeUK
| | - Henk Mutsaerts
- Department of Radiology and Nuclear MedicineAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Delia Fuhrmann
- Medical Research Council Cognition and Brain Sciences UnitCambridgeUK
| | - Lorraine K. Tyler
- Department of PsychologyCentre for Speech, Language and the BrainUniversity of CambridgeCambridgeUK
| | - Cam‐CAN
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
- Department of PsychologyCentre for Speech, Language and the BrainUniversity of CambridgeCambridgeUK
| | - James B. Rowe
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
- Medical Research Council Cognition and Brain Sciences UnitCambridgeUK
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18
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Friedman BB, Suri S, Solé-Padullés C, Düzel S, Drevon CA, Baaré WFC, Bartrés-Faz D, Fjell AM, Johansen-Berg H, Madsen KS, Nyberg L, Penninx BWJH, Sexton C, Walhovd KB, Zsoldos E, Budin-Ljøsne I. Are People Ready for Personalized Brain Health? Perspectives of Research Participants in the Lifebrain Consortium. THE GERONTOLOGIST 2021; 60:1050-1059. [PMID: 31682729 PMCID: PMC7427479 DOI: 10.1093/geront/gnz155] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives A healthy brain is central to physical and mental well-being. In this multi-site, qualitative study, we investigated views and attitudes of adult participants in brain research studies on the brain and personalized brain health as well as interest in maintaining a healthy brain. Design and Methods We conducted individual interviews with 44 adult participants in brain research cohorts of the Lifebrain consortium in Spain, Norway, Germany, and the United Kingdom. The interviews were audio recorded, transcribed, and coded using a cross-country codebook. The interview data were analyzed using qualitative content analysis. Results Most participants did not focus on their own brain health and expressed uncertainty regarding how to maintain it. Those actively focusing on brain health often picked one specific strategy like diet or memory training. The participants were interested in taking brain health tests to learn about their individual risk of developing brain diseases, and were willing to take measures to maintain their brain health if personalized follow-up was provided and the measures had proven impact. The participants were interested in more information on brain health. No differences in responses were identified between age groups, sex, or countries. Discussion and Implications Concise, practical, personalized, and evidence-based information about the brain may promote brain health. Based on our findings, we have launched an ongoing global brain health survey to acquire more extensive, quantitative, and representative data on public perception of personalized brain health.
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Affiliation(s)
- Barbara Bodorkos Friedman
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway
| | - Sana Suri
- Department of Psychiatry and Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Cristina Solé-Padullés
- Department of Medicine, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Spain
| | - Sandra Düzel
- Max Planck Institute for Human Development, Berlin, Germany
| | - Christian A Drevon
- Vitas AS, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre,Denmark
| | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences and Neuroscience Institute, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway
| | | | - Kathrine S Madsen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Lars Nyberg
- Centre for Functional Brain Imaging, Umeå Universitet, Sweden
| | | | - Claire Sexton
- Department of Psychiatry and Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK.,Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, Oslo, Norway
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway
| | - Enikő Zsoldos
- Department of Psychiatry and Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Isabelle Budin-Ljøsne
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway.,Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
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19
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Matijevic S, Ryan L. Tract Specificity of Age Effects on Diffusion Tensor Imaging Measures of White Matter Health. Front Aging Neurosci 2021; 13:628865. [PMID: 33790778 PMCID: PMC8006297 DOI: 10.3389/fnagi.2021.628865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/11/2021] [Indexed: 11/13/2022] Open
Abstract
Well-established literature indicates that older adults have poorer cerebral white matter integrity, as measured through diffusion tensor imaging (DTI). Age differences in DTI have been observed widely across white matter, although some tracts appear more sensitive to the effects of aging than others. Factors like APOE ε4 status and sex may contribute to individual differences in white matter integrity that also selectively impact certain tracts, and could influence DTI changes in aging. The present study explored the degree to which age, APOE ε4, and sex exerted global vs. tract specific effects on DTI metrics in cognitively healthy late middle-aged to older adults. Data from 49 older adults (ages 54–92) at two time-points separated by approximately 2.7 years were collected. DTI metrics, including fractional anisotropy (FA) and mean diffusivity (MD), were extracted from nine white matter tracts and global white matter. Results showed that across timepoints, FA and MD increased globally, with no tract-specific changes observed. Baseline age had a global influence on both measures, with increasing age associated with lower FA and higher MD. After controlling for global white matter FA, age additionally predicted FA for the genu, callosum body, inferior fronto-occipital fasciculus (IFOF), and both anterior and posterior cingulum. Females exhibited lower global FA on average compared to males. In contrast, MD was selectively elevated in the anterior cingulum and superior longitudinal fasciculus (SLF), for females compared to males. APOE ε4 status was not predictive of either measure. In summary, these results indicate that age and sex are associated with both global and tract-specific alterations to DTI metrics among a healthy older adult cohort. Older women have poorer white matter integrity compared to older men, perhaps related to menopause-induced metabolic changes. While age-related alterations to white matter integrity are global, there is substantial variation in the degree to which tracts are impacted, possibly as a consequence of tract anatomical variability. The present study highlights the importance of accounting for global sources of variation in DTI metrics when attempting to investigate individual differences (due to age, sex, or other factors) in specific white matter tracts.
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Affiliation(s)
- Stephanie Matijevic
- Cognition and Neuroimaging Laboratory, Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Lee Ryan
- Cognition and Neuroimaging Laboratory, Department of Psychology, University of Arizona, Tucson, AZ, United States
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20
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van Kesteren EJ, Kievit RA. Exploratory factor analysis with structured residuals for brain network data. Netw Neurosci 2021; 5:1-27. [PMID: 33688604 PMCID: PMC7935039 DOI: 10.1162/netn_a_00162] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/28/2020] [Indexed: 11/05/2022] Open
Abstract
Dimension reduction is widely used and often necessary to make network analyses and their interpretation tractable by reducing high-dimensional data to a small number of underlying variables. Techniques such as exploratory factor analysis (EFA) are used by neuroscientists to reduce measurements from a large number of brain regions to a tractable number of factors. However, dimension reduction often ignores relevant a priori knowledge about the structure of the data. For example, it is well established that the brain is highly symmetric. In this paper, we (a) show the adverse consequences of ignoring a priori structure in factor analysis, (b) propose a technique to accommodate structure in EFA by using structured residuals (EFAST), and (c) apply this technique to three large and varied brain-imaging network datasets, demonstrating the superior fit and interpretability of our approach. We provide an R software package to enable researchers to apply EFAST to other suitable datasets.
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Affiliation(s)
- Erik-Jan van Kesteren
- Utrecht University, Department of Methodology and Statistics, Utrecht, the Netherlands
| | - Rogier A. Kievit
- University of Cambridge, MRC Cognition and Brain Sciences Unit, Cambridge, UK
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21
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Poulakis K, Reid RI, Przybelski SA, Knopman DS, Graff-Radford J, Lowe VJ, Mielke MM, Machulda MM, Jack CR, Petersen RC, Westman E, Vemuri P. Longitudinal deterioration of white-matter integrity: heterogeneity in the ageing population. Brain Commun 2021; 3:fcaa238. [PMID: 33615218 PMCID: PMC7884606 DOI: 10.1093/braincomms/fcaa238] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 02/07/2023] Open
Abstract
Deterioration in white-matter health plays a role in cognitive ageing. Our goal was to discern heterogeneity of white-matter tract vulnerability in ageing using longitudinal imaging data (two to five imaging and cognitive assessments per participant) from a population-based sample of 553 elderly participants (age ≥60 years). We found that different clusters (healthy white matter, fast white-matter decliners and intermediate white-matter group) were heterogeneous in the spatial distribution of white-matter integrity, systemic health and cognitive trajectories. White-matter health of specific tracts (genu of corpus callosum, posterior corona radiata and anterior internal capsule) informed about cluster assignments. Not surprisingly, brain amyloidosis was not significantly different between clusters. Clusters had differential white-matter tract vulnerability to ageing (commissural fibres > association/brainstem fibres). Identification of vulnerable white-matter tracts is a valuable approach to assessing risk for cognitive decline.
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Affiliation(s)
- Konstantinos Poulakis
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm 141 52, Sweden
| | - Robert I Reid
- Department of Radiology, Mayo Clinic, Rochester, MN 559 05, USA
| | | | - David S Knopman
- Department of Radiology, Mayo Clinic, Rochester, MN 559 05, USA
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN 559 05, USA
| | | | - Mary M Machulda
- Department of Radiology, Mayo Clinic, Rochester, MN 559 05, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN 559 05, USA
| | | | - Eric Westman
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm 141 52, Sweden
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22
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Polymeris AA, Coslovksy M, Aeschbacher S, Sinnecker T, Benkert P, Kobza R, Beer J, Rodondi N, Fischer U, Moschovitis G, Monsch AU, Springer A, Schwenkglenks M, Wuerfel J, De Marchis GM, Lyrer PA, Kühne M, Osswald S, Conen D, Kuhle J, Bonati LH. Serum neurofilament light in atrial fibrillation: clinical, neuroimaging and cognitive correlates. Brain Commun 2021; 2:fcaa166. [PMID: 33381755 PMCID: PMC7753055 DOI: 10.1093/braincomms/fcaa166] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/09/2020] [Accepted: 09/14/2020] [Indexed: 12/12/2022] Open
Abstract
Emerging evidence suggests that atrial fibrillation is associated with cognitive dysfunction independently of stroke, but the underlying mechanisms remain unclear. In this cross-sectional analysis from the Swiss-atrial fibrillation Study (NCT02105844), we investigated the association of serum neurofilament light protein, a neuronal injury biomarker, with (i) the CHA2DS2-VASc score (congestive heart failure, hypertension, age 65–74 or >75 years, diabetes mellitus, stroke or transient ischaemic attack, vascular disease, sex), clinical and neuroimaging parameters and (ii) cognitive measures in atrial fibrillation patients. We measured neurofilament light in serum using an ultrasensitive single-molecule array assay in a sample of 1379 atrial fibrillation patients (mean age, 72 years; female, 27%). Ischaemic infarcts, small vessel disease markers and normalized brain volume were assessed on brain MRI. Cognitive testing included the Montreal cognitive assessment, trail-making test, semantic verbal fluency and digit symbol substitution test, which were summarized using principal component analysis. Results were analysed using univariable and multivariable linear regression. Neurofilament light was associated with the CHA2DS2-VASc score, with an average 19.2% [95% confidence interval (17.2%, 21.3%)] higher neurofilament per unit CHA2DS2-VASc increase. This association persisted after adjustment for age and MRI characteristics. In multivariable analyses, clinical parameters associated with neurofilament light were higher age [32.5% (27.2%, 38%) neurofilament increase per 10 years], diabetes mellitus, heart failure and peripheral artery disease [26.8% (16.8%, 37.6%), 15.7% (8.1%, 23.9%) and 19.5% (6.8%, 33.7%) higher neurofilament, respectively]. Mean arterial pressure showed a curvilinear association with neurofilament, with evidence for both an inverse linear and a U-shaped association. MRI characteristics associated with neurofilament were white matter lesion volume and volume of large non-cortical or cortical infarcts [4.3% (1.8%, 6.8%) and 5.5% (2.5%, 8.7%) neurofilament increase per unit increase in log-volume of the respective lesion], as well as normalized brain volume [4.9% (1.7%, 8.1%) higher neurofilament per 100 cm3 smaller brain volume]. Neurofilament light was inversely associated with all cognitive measures in univariable analyses. The effect sizes diminished after adjusting for clinical and MRI variables, but the association with the first principal component was still evident. Our results suggest that in atrial fibrillation patients, neuronal loss measured by serum neurofilament light is associated with age, diabetes mellitus, heart failure, blood pressure and vascular brain lesions, and inversely correlates with normalized brain volume and cognitive function.
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Affiliation(s)
- Alexandros A Polymeris
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Michael Coslovksy
- Clinical Trial Unit, Department of Clinical Research, University Hospital Basel and University of Basel, Switzerland.,Cardiovascular Research Institute Basel (CRIB), Basel, Switzerland
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel (CRIB), Basel, Switzerland.,Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - Tim Sinnecker
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.,Medical Image Analysis Center (MIAC) AG and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Pascal Benkert
- Clinical Trial Unit, Department of Clinical Research, University Hospital Basel and University of Basel, Switzerland
| | - Richard Kobza
- Department of Cardiology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Jürg Beer
- Department of Medicine, Cantonal Hospital Baden, Baden, Switzerland.,Molecular Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Urs Fischer
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Giorgio Moschovitis
- Cardiology Division, Department of Medicine, EOC Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Andreas U Monsch
- Memory Clinic, University Department of Geriatric Medicine Felix Platter and University of Basel, Basel, Switzerland
| | - Anne Springer
- Cardiovascular Research Institute Basel (CRIB), Basel, Switzerland.,Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - Matthias Schwenkglenks
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.,Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
| | - Jens Wuerfel
- Medical Image Analysis Center (MIAC) AG and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Gian Marco De Marchis
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Philippe A Lyrer
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Michael Kühne
- Cardiovascular Research Institute Basel (CRIB), Basel, Switzerland.,Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - Stefan Osswald
- Cardiovascular Research Institute Basel (CRIB), Basel, Switzerland.,Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - David Conen
- Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland.,Population Health Research Institute, McMaster University, Hamilton, Canada
| | - Jens Kuhle
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Leo H Bonati
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
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23
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Tsentidou G, Moraitou D, Tsolaki M. Cognition in Vascular Aging and Mild Cognitive Impairment. J Alzheimers Dis 2020; 72:55-70. [PMID: 31561369 DOI: 10.3233/jad-190638] [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] [Indexed: 12/11/2022]
Abstract
Cardiovascular health declines with age, due to vascular risk factors, and this leads to an increasing risk of cognitive decline. Mild cognitive impairment (MCI) is defined as the negative cognitive changes beyond what is expected in normal aging. The purpose of the study was to compare older adults with vascular risk factors (VRF), MCI patients, and healthy controls (HC) in main dimensions of cognitive control. The sample comprised a total of 109 adults, aged 50 to 85 (M = 66.09, S.D. = 9.02). They were divided into three groups: 1) older adults with VRF, 2) MCI patients, and 3) healthy controls (HC). VRF and MCI did not differ significantly in age, educational level, or gender as was the case with HC. The tests used mainly examine inhibition, cognitive flexibility, and working memory processing. Results showed that the VRF group had more Set Loss Errors in drawing designs indicating deficits in establishing cognitive set and in cognitive shifting. MCI patients displayed lower performance in processing. Hence, different types of specific impairments emerge in vascular aging and MCI, and this may imply that discrete underlying pathologies may play a role in the development of somewhat different profiles of cognitive decline.
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Affiliation(s)
- Glykeria Tsentidou
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, Greece
| | - Despina Moraitou
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki (GAADRD), Greece.,Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, Greece
| | - Magda Tsolaki
- 1st Department of Neurology, Medical School, Aristotle University of Thessaloniki (AUTh), Greece.,Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki (GAADRD), Greece.,Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, Greece
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24
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Veldsman M, Werden E, Egorova N, Khlif MS, Brodtmann A. Microstructural degeneration and cerebrovascular risk burden underlying executive dysfunction after stroke. Sci Rep 2020; 10:17911. [PMID: 33087782 PMCID: PMC7578057 DOI: 10.1038/s41598-020-75074-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/07/2020] [Indexed: 01/12/2023] Open
Abstract
Executive dysfunction affects 40% of stroke patients, but is poorly predicted by characteristics of the stroke itself. Stroke typically occurs on a background of cerebrovascular burden, which impacts cognition and brain network structural integrity. We used structural equation modelling to investigate whether measures of white matter microstructural integrity (fractional anisotropy and mean diffusivity) and cerebrovascular risk factors better explain executive dysfunction than markers of stroke severity. 126 stroke patients (mean age 68.4 years) were scanned three months post-stroke and compared to 40 age- and sex-matched control participants on neuropsychological measures of executive function. Executive function was below what would be expected for age and education level in stroke patients as measured by the organizational components of the Rey Complex Figure Test, F(3,155) = 17, R2 = 0.25, p < 0.001 (group significant predictor at p < 0.001) and the Trail-Making Test (B), F(3,157) = 3.70, R2 = 0.07, p < 0.01 (group significant predictor at p < 0.001). A multivariate structural equation model illustrated the complex relationship between executive function, white matter integrity, stroke characteristics and cerebrovascular risk (root mean square error of approximation = 0.02). Pearson's correlations confirmed a stronger relationship between executive dysfunction and white matter integrity (r = - 0.74, p < 0.001), than executive dysfunction and stroke severity (r = 0.22, p < 0.01). The relationship between executive function and white matter integrity is mediated by cerebrovascular burden. White matter microstructural degeneration of the superior longitudinal fasciculus in the executive control network better explains executive dysfunction than markers of stroke severity. Executive dysfunction and incident stroke can be both considered manifestations of cerebrovascular risk factors.
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Affiliation(s)
- Michele Veldsman
- Department of Experimental Psychology, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK.
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.
| | - Emilio Werden
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Natalia Egorova
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Mohamed Salah Khlif
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Amy Brodtmann
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
- Austin Health, Heidelberg, Melbourne, VIC, Australia
- Eastern Clinical Research Unit, Box Hill Hospital, Melbourne, VIC, Australia
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25
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Archer DB, Moore EE, Shashikumar N, Dumitrescu L, Pechman KR, Landman BA, Gifford KA, Jefferson AL, Hohman TJ. Free-water metrics in medial temporal lobe white matter tract projections relate to longitudinal cognitive decline. Neurobiol Aging 2020; 94:15-23. [PMID: 32502831 PMCID: PMC7483422 DOI: 10.1016/j.neurobiolaging.2020.05.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/24/2020] [Accepted: 05/03/2020] [Indexed: 12/12/2022]
Abstract
Although hippocampal volume has served as a long-standing predictor of cognitive decline, diffusion magnetic resonance imaging studies of white matter have shown similar relationships. Still, it remains unclear if gray matter and white matter interact to predict cognitive impairment and longitudinal decline. Here, we investigate whether free-water (FW) and FW-corrected fractional anisotropy (FAT) within medial temporal lobe white matter tracts provides meaningful contribution to cognition and cognitive decline beyond hippocampal volume. Using data from the Vanderbilt Memory & Aging Project (n = 319), we found that FW was associated with baseline memory and executive function beyond that of hippocampal volume and other comorbidities. Longitudinal analyses demonstrated significant interactions of hippocampal volume and inferior longitudinal fasciculus (p = 0.043) and cingulum bundle (p = 0.025) FAT on memory decline and with fornix FAT (p = 0.025) on decline in executive function. Results suggest that FW metrics of white matter have a unique role in cognitive decline and should be included in theoretical models of aging, cerebrovascular disease, and Alzheimer's disease.
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Affiliation(s)
- Derek B Archer
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA; Department of Neurology, Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Elizabeth E Moore
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Niranjana Shashikumar
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Logan Dumitrescu
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA; Department of Neurology, Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Kimberly R Pechman
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Bennett A Landman
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA; Department of Electrical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Katherine A Gifford
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Angela L Jefferson
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA.
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA; Department of Neurology, Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN, USA
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26
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Conley AC, Karayanidis F, Jolly TAD, Yang MH, Hsieh S. Cerebral Arterial Pulsatility and Global White Matter Microstructure Impact Spatial Working Memory in Older Adults With and Without Cardiovascular Risk Factors. Front Aging Neurosci 2020; 12:245. [PMID: 32848715 PMCID: PMC7427001 DOI: 10.3389/fnagi.2020.00245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/16/2020] [Indexed: 12/27/2022] Open
Abstract
Aging is associated with an increased prevalence of vascular health conditions that are linked to a disruption in the cerebral vasculature and white matter microstructural organization. In people with cardiovascular risk factors, increased cerebral arterial pulsatility is associated with poorer white matter microstructural organization and cognitive functioning. This study examines the relationship among arterial pulsatility, white matter microstructural organization, and cognitive ability in a healthy adult lifespan sample. One hundred and eighty-nine adults were divided into a younger adult (<50 years, n = 97) and older adult (>50 years, n = 92). The latter were further subdivided into two subgroups with (CV+, n = 25) and without (CV−, n = 67) cardiovascular risk factors. Arterial pulsatility was measured using cardiac-gated phase-contrast flow quantification sequence and three indexes of whole-brain white matter microstructural organization [i.e., fractional anisotropy (FA), radial diffusivity (RaD), mean diffusivity (MD)] were derived from diffusion-weighted imaging (DWI). Cognitive ability was assessed using global cognitive functioning (MoCA) and a measure of working memory [sensitivity (d′) from a 2-back task]. Neither the whole group analysis nor the younger adult group showed an association between measures of arterial pulsatility, global white matter microstructural organization, and cognition. In older adults, higher MD and RaD were associated with increased arterial pulsatility and poorer working memory performance. The indirect pathway from arterial pulsatility to working memory performance via both MD and RaD measures was significant in this group. Interestingly, a comparison of CV+ and CV− subgroups showed that this mediating relationship was only evident in older adults with at least one CV risk factor. These findings are consistent with cardiovascular risk factors as underlying arterial, white matter, and cognitive decline in cognitively normal older adults.
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Affiliation(s)
- Alexander C Conley
- Department of Psychiatry, Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Frini Karayanidis
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science, University of Newcastle, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Todd A D Jolly
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science, University of Newcastle, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Meng-Heng Yang
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan.,Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan.,Department and Institute of Public health, National Cheng Kung University, Tainan, Taiwan
| | - Shulan Hsieh
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan.,Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan.,Department and Institute of Public health, National Cheng Kung University, Tainan, Taiwan
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27
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Keage HAD, Feuerriegel D, Greaves D, Tregoweth E, Coussens S, Smith AE. Increasing Objective Cardiometabolic Burden Associated With Attenuations in the P3b Event-Related Potential Component in Older Adults. Front Neurol 2020; 11:643. [PMID: 32903798 PMCID: PMC7438865 DOI: 10.3389/fneur.2020.00643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/29/2020] [Indexed: 11/13/2022] Open
Abstract
Cardiometabolic diseases and risk factors increase the risk of late-life cognitive impairment and dementia and have also been associated with detrimental gray and white matter changes. However, the functional brain changes associated with cardiometabolic health in late-life are unclear. We sought to characterize these functional changes by recording event-related potentials (ERPs) during an n-back working memory task (0, 1, and 2 back) in 85 adults (60% female) between 50 and 80 years of age. Due to a stratified recruitment approach, participants varied widely in relation to cognitive function and cardiometabolic health. Standard and objective cut-offs for high blood glucose, waist to hip ratio (i.e., obesity), high blood cholesterol, and hypertension were employed to generate a summative score for cardiometabolic burden (none, one, or two or more above cut-off). Mixed effects modeling (covarying for age and gender) revealed no statistically significant associations between cardiometabolic burden and visual P1 and N1 component amplitudes. There was a significant effect for the P3b component: as cardiometabolic burden increased, P3b amplitude decreased. We show that cardiometabolic factors related to the development of cognitive impairment and dementia in late-life associate with brain activity, as recorded via ERPs. Findings have relevance for the monitoring of lifestyle interventions (typically targeting cardiometabolic factors) in aging, as ERPs may provide a more sensitive measure of change than cognitive performance. Further, our results raise questions related to the findings of a broad range of ERP studies where the groups compared may differ in their cardiometabolic health status (not only in psychological symptomatology).
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Affiliation(s)
- Hannah A. D. Keage
- Cognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society, University of South Australia, Adelaide, SA, Australia
| | - Daniel Feuerriegel
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Danielle Greaves
- Cognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society, University of South Australia, Adelaide, SA, Australia
| | - Emma Tregoweth
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Scott Coussens
- Cognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society, University of South Australia, Adelaide, SA, Australia
| | - Ashleigh E. Smith
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
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28
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Borgeest GS, Henson RN, Shafto M, Samu D, Kievit RA. Greater lifestyle engagement is associated with better age-adjusted cognitive abilities. PLoS One 2020; 15:e0230077. [PMID: 32437448 PMCID: PMC7241829 DOI: 10.1371/journal.pone.0230077] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/20/2020] [Indexed: 11/17/2022] Open
Abstract
Previous evidence suggests that modifiable lifestyle factors, such as engagement in leisure activities, might slow the age-related decline of cognitive functions. Less is known, however, about which aspects of lifestyle might be particularly beneficial to healthy cognitive ageing, and whether they are associated with distinct cognitive domains (e.g. fluid and crystallized abilities) differentially. We investigated these questions in the cross-sectional Cambridge Centre for Ageing and Neuroscience (Cam-CAN) data (N = 708, age 18-88), using data-driven exploratory structural equation modelling, confirmatory factor analyses, and age-residualized measures of cognitive differences across the lifespan. Specifically, we assessed the relative associations of the following five lifestyle factors on age-related differences of fluid and crystallized age-adjusted abilities: education/SES, physical health, mental health, social engagement, and intellectual engagement. We found that higher education, better physical and mental health, more social engagement and a greater degree of intellectual engagement were each individually correlated with better fluid and crystallized cognitive age-adjusted abilities. A joint path model of all lifestyle factors on crystallized and fluid abilities, which allowed a simultaneous assessment of the lifestyle domains, showed that physical health, social and intellectual engagement and education/SES explained unique, complementary variance, but mental health did not make significant contributions above and beyond the other four lifestyle factors and age. The total variance explained for fluid abilities was 14% and 16% for crystallized abilities. Our results are compatible with the hypothesis that intellectually and physically challenging as well as socially engaging activities are associated with better crystallized and fluid performance across the lifespan.
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Affiliation(s)
- G. Sophia Borgeest
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Richard N. Henson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Meredith Shafto
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - David Samu
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Cam-CAN
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, United Kingdom
| | - Rogier A. Kievit
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
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29
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Foguet-Boreu Q, Guàrdia Sancho A, Santos Lopez JM, Roura Poch P, Palmarola Ginesta J, Puig-Ribera AM, Muñoz Pradós J. Association between cognitive impairment and cardiovascular burden in patients with severe mental disorder. Cogn Neuropsychiatry 2020; 25:1-13. [PMID: 31599190 DOI: 10.1080/13546805.2019.1676709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Cognitive impairment is related to an increase in cardiovascular risk (CVR) in the general population. However, in severe mental disorder (SMD), the evidence is less consistent. Few studies have evaluated the relationship between cognition and vascular burden in SMD. This study determines the relationship between cognition and vascular burden in patients with SMD.Methods: Sixty SMD patients (61% men, mean age: 46) attending a psychosocial rehabilitation centre were included. We evaluated sociodemographic, clinical, laboratory, quality of life and functionality characteristics. And we analysed the association between cognitive performance and vascular burden.Results: SMD diagnoses were: 41.7% schizophrenia, 20.0% bipolar, 5.0% schizoaffective, 21.7% depressive and 11.7% other. Cognitive impairment was present in 55% of the cases. The average vascular burden was 3.2. Patients with cognitive impairment have a significantly higher vascular burden than patients without cognitive impairment (p < 0.05). The speed of processing had a moderate correlation with vascular burden (r = -0.457, p = 0.001).Conclusions: Patients with cognitive impairment had a significantly higher vascular burden than patients without cognitive impairment. There are two practical clinical implications: CVR should be evaluated in all SMD patients; and psychoeducation programmes for CVR should be performed and adapted to the cognitive deficits.
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Affiliation(s)
- Quintí Foguet-Boreu
- Department of Psychiatry, Vic University Hospital, Vic, Spain.,Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Anna Guàrdia Sancho
- Sport and Physical Activity Research Group, Centre for Health and Social Care Research, Department of Physical Activity and Sports Sciences, University of Vic - Central University of Catalonia, Vic, Spain.,Osonament - Osona Psychopedagogical Medical Center, Vic, Spain
| | | | - Pere Roura Poch
- Department of Psychiatry, Vic University Hospital, Vic, Spain.,School of Medicine, University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
| | | | - Anna Maria Puig-Ribera
- Sport and Physical Activity Research Group, Centre for Health and Social Care Research, Department of Physical Activity and Sports Sciences, University of Vic - Central University of Catalonia, Vic, Spain
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30
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Murphy SE, Harmer CJ. Tracking the Brain: White Matter Structure Is Associated With Selective Serotonin Reuptake Inhibitor Treatment Response in Depression. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:856-858. [PMID: 31590723 DOI: 10.1016/j.bpsc.2019.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Susannah E Murphy
- Department of Psychiatry, Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Catherine J Harmer
- Department of Psychiatry, Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, United Kingdom.
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31
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Low A, Mak E, Rowe JB, Markus HS, O'Brien JT. Inflammation and cerebral small vessel disease: A systematic review. Ageing Res Rev 2019; 53:100916. [PMID: 31181331 DOI: 10.1016/j.arr.2019.100916] [Citation(s) in RCA: 203] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/23/2019] [Accepted: 06/05/2019] [Indexed: 12/13/2022]
Abstract
Inflammation is increasingly implicated as a risk factor for dementia, stroke, and small vessel disease (SVD). However, the underlying mechanisms and causative pathways remain unclear. We systematically reviewed the existing literature on the associations between markers of inflammation and SVD (i.e., white matter hyperintensities (WMH), lacunes, enlarged perivascular spaces (EPVS), cerebral microbleeds (CMB)) in cohorts of older people with good health, cerebrovascular disease, or cognitive impairment. Based on distinctions made in the literature, markers of inflammation were classified as systemic inflammation (e.g. C-reactive protein, interleukin-6, fibrinogen) or vascular inflammation/endothelial dysfunction (e.g. homocysteine, von Willebrand factor, Lp-PLA2). Evidence from 82 articles revealed relatively robust associations between SVD and markers of vascular inflammation, especially amongst stroke patients, suggesting that alterations to the endothelium and blood-brain barrier may be a driving force behind SVD. Conversely, cross-sectional findings on systemic inflammation were mixed, although longitudinal investigations demonstrated that elevated levels of systemic inflammatory markers at baseline predicted subsequent SVD severity and progression. Importantly, regional analysis revealed that systemic and vascular inflammation were differentially related to two distinct forms of SVD. Specifically, markers of vascular inflammation tended to be associated with SVD in areas typical of hypertensive arteriopathy (e.g., basal ganglia), while systemic inflammation appeared to be involved in CAA-related vascular damage (e.g., centrum semiovale). Nonetheless, there is insufficient data to establish whether inflammation is causal of, or secondary to, SVD. Findings have important implications on interventions, suggesting the potential utility of treatments targeting the brain endothelium and blood brain barrier to combat SVD and associated neurodegenerative diseases.
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Affiliation(s)
- Audrey Low
- Department of Psychiatry, University of Cambridge, United Kingdom
| | - Elijah Mak
- Department of Psychiatry, University of Cambridge, United Kingdom
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, United Kingdom
| | - Hugh S Markus
- Department of Clinical Neurosciences, University of Cambridge, United Kingdom
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, United Kingdom.
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