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Jiménez-Balado J, Habeck C, Stern Y, Eich T. The relationship between cortical thickness and white matter hyperintensities in mid to late life. Neurobiol Aging 2024; 141:129-139. [PMID: 38909430 DOI: 10.1016/j.neurobiolaging.2024.05.014] [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: 08/30/2023] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/25/2024]
Abstract
White matter hyperintensities (WMH) are associated with cortical thinning. Although they are primarily detected in older participants, these lesions can appear in younger and midlife individuals. Here, we tested whether WMH are associated with cortical thinning in relatively younger (26-50 years) and relatively older (58-84) participants who were free of dementia, and how these associations are moderated by WMH localization. WMH were automatically quantified and categorized according to the localization of three classes of white matter tracts: association, commissural and projection fibers. Mediation analyses were used to infer whether differences in cortical thickness between younger and older participants were explained by WMH. Our results revealed that total WMH explained between 20.6 % and 65.5 % of the effect of age on cortical thickness in AD-signature regions including the lateral temporal lobes and supramarginal gyrus, among others. This mediation was slightly stronger for projection WMH, although it was still significant for association and commissural WMH. These results suggest that there is an interplay between vascular and AD causes of cognitive impairment that starts at younger ages.
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Affiliation(s)
- Joan Jiménez-Balado
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA USA; Neurovascular Research Group, IMIM-Hospital del Mar Medical Research Institute, Carrer del Dr. Aiguader, 88, Barcelona 08003, Spain
| | - Christian Habeck
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Yaakov Stern
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Teal Eich
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
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Van Etten EJ, Bharadwaj PK, Grilli MD, Raichlen DA, Hishaw GA, Huentelman MJ, Trouard TP, Alexander GE. Regional covariance of white matter hyperintensity volume patterns associated with hippocampal volume in healthy aging. Front Aging Neurosci 2024; 16:1349449. [PMID: 38524117 PMCID: PMC10957632 DOI: 10.3389/fnagi.2024.1349449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Hippocampal volume is particularly sensitive to the accumulation of total brain white matter hyperintensity volume (WMH) in aging, but how the regional distribution of WMH volume differentially impacts the hippocampus has been less studied. In a cohort of 194 healthy older adults ages 50-89, we used a multivariate statistical method, the Scaled Subprofile Model (SSM), to (1) identify patterns of regional WMH differences related to left and right hippocampal volumes, (2) examine associations between the multimodal neuroimaging covariance patterns and demographic characteristics, and (3) investigate the relation of the patterns to subjective and objective memory in healthy aging. We established network covariance patterns of regional WMH volume differences associated with greater left and right hippocampal volumes, which were characterized by reductions in left temporal and right parietal WMH volumes and relative increases in bilateral occipital WMH volumes. Additionally, we observed lower expression of these hippocampal-related regional WMH patterns were significantly associated with increasing age and greater subjective memory complaints, but not objective memory performance in this healthy older adult cohort. Our findings indicate that, in cognitively healthy older adults, left and right hippocampal volume reductions were associated with differences in the regional distribution of WMH volumes, which were exacerbated by advancing age and related to greater subjective memory complaints. Multivariate network analyses, like SSM, may help elucidate important early effects of regional WMH volume on brain and cognitive aging in healthy older adults.
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Affiliation(s)
- Emily J. Van Etten
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Pradyumna K. Bharadwaj
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Matthew D. Grilli
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - David A. Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, CA, United States
- Department of Anthropology, University of Southern California, Los Angeles, CA, United States
| | - Georg A. Hishaw
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - Matthew J. Huentelman
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Theodore P. Trouard
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States
| | - Gene E. Alexander
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
- Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, United States
- Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, United States
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Youn C, Caillaud ML, Li Y, Gallagher IA, Strasser B, Fuchs D, Tanaka H, Haley AP. Association between Large Neutral Amino Acids and Brain Integrity in Middle-Aged Adults at Metabolic Risk. RESEARCH SQUARE 2024:rs.3.rs-3951968. [PMID: 38410466 PMCID: PMC10896396 DOI: 10.21203/rs.3.rs-3951968/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
This investigation delves into the interplay between large neutral amino acids (LNAA) and metabolic syndrome (MetS) in midlife adults, examining their collective influence on brain structure and cognitive function. While LNAA, such as tryptophan and phenylalanine, are known to bolster cognition in youth, our study hypothesizes a reversal of these benefits in older adults with MetS, potentially signaling premature cognitive aging. Eighty participants between 40-61 years underwent MetS component quantification, LNAA measurement via high-performance liquid chromatography, and brain imaging to evaluate white matter hyperintensity (WMH) volume and medial temporal lobe (MTL) cortical thickness. Our linear regression analysis, adjusting for sex, age, and education, revealed that phenylalanine levels moderated the relationship between MetS and WMH volume (F(6, 69) = 3.134, p < 0.05, R2 = 0.214), suggesting that MetS's cognitive impact may be partly due to phenylalanine catabolism byproducts. However, LNAA metabolites did not significantly modulate the MetS-MTL cortical thickness relationship. The findings suggest that LNAA metabolic dysregulation, marked by elevated levels in the presence of MetS, could correlate with brain structural compromises, particularly in the form of MTL cortical thinning and increased WMH load, detectable in midlife. This nuanced understanding of LNAA's role in cognitive health amid cardiovascular risk factors is pivotal, proposing a potential biomarker for early intervention. Further research is crucial to elucidate the longitudinal influence of LNAA and MetS on brain health, thereby informing strategies to mitigate cognitive decline.
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Affiliation(s)
- Cherry Youn
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Marie L. Caillaud
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Yanrong Li
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | | | - Barbara Strasser
- Medical Faculty, Sigmund Freud Private University Vienna, Vienna, Austria
| | - Dietmar Fuchs
- Institute of Biological Chemistry, Biocentre, Medical University of Innsbruck, Innsbruck, Austria
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Andreana P. Haley
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
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Iandolo R, Avci E, Bommarito G, Sandvig I, Rohweder G, Sandvig A. Characterizing upper extremity fine motor function in the presence of white matter hyperintensities: A 7 T MRI cross-sectional study in older adults. Neuroimage Clin 2024; 41:103569. [PMID: 38281363 PMCID: PMC10839532 DOI: 10.1016/j.nicl.2024.103569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND White matter hyperintensities (WMH) are a prevalent radiographic finding in the aging brain studies. Research on WMH association with motor impairment is mostly focused on the lower-extremity function and further investigation on the upper-extremity is needed. How different degrees of WMH burden impact the network of activation recruited during upper limb motor performance could provide further insight on the complex mechanisms of WMH pathophysiology and its interaction with aging and neurological disease processes. METHODS 40 healthy elderly subjects without a neurological/psychiatric diagnosis were included in the study (16F, mean age 69.3 years). All subjects underwent ultra-high field 7 T MRI including structural and finger tapping task-fMRI. First, we quantified the WMH lesion load and its spatial distribution. Secondly, we performed a data-driven stratification of the subjects according to their periventricular and deep WMH burdens. Thirdly, we investigated the distribution of neural recruitment and the corresponding activity assessed through BOLD signal changes among different brain regions for groups of subjects. We clustered the degree of WMH based on location, numbers, and volume into three categories; ranging from mild, moderate, and severe. Finally, we explored how the spatial distribution of WMH, and activity elicited during task-fMRI relate to motor function, measured with the 9-Hole Peg Test. RESULTS Within our population, we found three subgroups of subjects, partitioned according to their periventricular and deep WMH lesion load. We found decreased activity in several frontal and cingulate cortex areas in subjects with a severe WMH burden. No statistically significant associations were found when performing the brain-behavior statistical analysis for structural or functional data. CONCLUSION WMH burden has an effect on brain activity during fine motor control and the activity changes are associated with varying degrees of the total burden and distributions of WMH lesions. Collectively, our results shed new light on the potential impact of WMH on motor function in the context of aging and neurodegeneration.
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Affiliation(s)
- Riccardo Iandolo
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Esin Avci
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Giulia Bommarito
- Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ioanna Sandvig
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Gitta Rohweder
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Stroke Unit, Department of Medicine, St Olav's University Hospital, Trondheim, Norway
| | - Axel Sandvig
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurology and Clinical Neurophysiology, St. Olav's University Hospital, Trondheim, Norway; Department of Clinical Neurosciences, Division of Neuro, Head and Neck, Umeå University Hospital, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Umeå University Hospital, Umeå, Sweden.
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Luna MG, Pahlen S, Corley RP, Wadsworth SJ, Reynolds CA. Frailty and Processing Speed Performance at the Cusp of Midlife in CATSLife. J Gerontol B Psychol Sci Soc Sci 2023; 78:1834-1842. [PMID: 37480567 PMCID: PMC10645312 DOI: 10.1093/geronb/gbad102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVES Frailty is not an end state of aging, but rather represents physiological vulnerability across multiple systems that unfolds across adulthood. However, examinations of frailty at the midlife transition, and how frailty may impact other age-sensitive traits, such as processing speed (PS), remain scarce. Our research aims were to examine frailty and frailty-speed associations before midlife, a ripe developmental period for healthy aging interventions. METHODS Using data from the Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (N = 1,215; Mage = 33.23 years; standard deviation = 4.98), we constructed 25-item (FI25) and 30-item (FI30) frailty indices. PS was measured using the Colorado Perceptual Speed task and WAIS-III Digit Symbol (DS) subtest. Multilevel models accounted for clustering among siblings and adjusted for sex, race, ethnicity, adoption status, educational attainment, and age. RESULTS Reliability of FI measures was apparent from strong intraclass correlations (ICCs) among identical twin siblings, although ICC patterns across all siblings suggested that FI variability may include nonadditive genetic contributions. Higher FI was associated with poorer PS performance but was significant for DS only (BFI25 = -1.17, p = .001, d = -0.12; BFI30 = -1.21, p = .001, d = -0.12). Furthermore, the negative frailty-DS association was moderated by age (BFI25×age = -0.14, p = .042; BFI30×age=-0.19, p = .008) where increasingly worse performance with higher frailty emerged at older ages. DISCUSSION Frailty is evident before midlife and associated with poorer PS, an association that magnifies with age. These findings help elucidate the interrelationship between indicators of frailty and cognitive performance for adults approaching midlife, an understudied period within life-span development.
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Affiliation(s)
- Maria G Luna
- Department of Psychology, University of California, Riverside, Riverside, California, USA
| | - Shandell Pahlen
- Department of Psychology, University of California, Riverside, Riverside, California, USA
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, Boulder, Colorado, USA
| | - Sally J Wadsworth
- Institute for Behavioral Genetics, University of Colorado, Boulder, Boulder, Colorado, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California, Riverside, Riverside, California, USA
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Membreno R, Thomas KR, Calcetas AT, Edwards L, Bordyug M, Showell M, Stanfill M, Brenner EK, Walker KS, Rotblatt LJ, Brickman AM, Edmonds EC, Bangen KJ. Regional White Matter Hyperintensities Relate to Specific Cognitive Abilities in Older Adults Without Dementia. Alzheimer Dis Assoc Disord 2023; 37:303-309. [PMID: 38015423 PMCID: PMC10664788 DOI: 10.1097/wad.0000000000000585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/06/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION White matter hyperintensities (WMHs) are magnetic resonance imaging markers of small vessel cerebrovascular disease that are associated with cognitive decline and clinical Alzheimer disease. Previous studies have often focused on global or total WMH; less is known about associations of regional WMHs and cognitive abilities among older adults without dementia. METHODS A total of 610 older adults with normal cognition (n=302) or mild cognitive impairment (n=308) from the Alzheimer's Disease Neuroimaging Initiative underwent neuropsychological testing and magnetic resonance imaging. Linear regression models examined associations between regional WMH volumes and cognition, adjusting for age, sex, education, apolipoprotein E ε4 allele frequency, and pulse pressure. RESULTS Among all participants, greater regional WMH volume in all lobes was associated with poorer performance on memory and speed/executive functioning. Among participants with normal cognition, greater temporal and occipital WMH volumes were associated with poorer memory, whereas no regional WMH volumes were associated with speed/executive function. DISCUSSION Results show that greater regional WMH volume relates to poorer cognitive functioning-even among those with normal cognition. Together with results from previous studies, our findings raise the possibility that WMH may be a useful therapeutic target and/or important effect modifier in treatment or prevention dementia trials.
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Affiliation(s)
| | - Kelsey R. Thomas
- Research Service, VA San Diego Healthcare System
- Department of Psychiatry, University of California San Diego
| | | | - Lauren Edwards
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA
| | - Maria Bordyug
- Department of Psychiatry, University of California San Diego
| | - Maya Showell
- Research Service, VA San Diego Healthcare System
| | | | | | | | - Lindsay J. Rotblatt
- Psychology Service, VA San Diego Healthcare System
- Department of Psychiatry, University of California San Diego
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University
- Gertrude H. Sergievsky Center, Columbia University
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Emily C. Edmonds
- Banner Alzheimer’s Institute
- Department of Psychology, University of Arizona, Tucson, AZ
| | - Katherine J. Bangen
- Research Service, VA San Diego Healthcare System
- Department of Psychiatry, University of California San Diego
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Mathewson KJ, Beaton EA, Hobbs D, Hall GBC, Schulkin J, Van Lieshout RJ, Saigal S, Schmidt LA. Brain structure and function in the fourth decade of life after extremely low birth weight: An MRI and EEG study. Clin Neurophysiol 2023; 154:85-99. [PMID: 37595482 DOI: 10.1016/j.clinph.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/27/2023] [Accepted: 06/03/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE To examine potential long-term effects of extremely low birth weight (ELBW; ≤ 1000 g) on adult brain structure, brain function, and cognitive-behavioral performance. METHODS A subset of survivors from the prospectively-followed McMaster ELBW Cohort (n = 23, MBW = 816 g) and their peers born at normal birth weight (NBW; ≥ 2500 g; n = 14, MBW = 3361 g) provided T1-weighted magnetic resonance imaging (MRI) brain scans, resting electroencephalographic (EEG) recordings, and behavioral responses to a face-processing task in their early thirties. RESULTS Visual discrimination accuracy for human faces, resting EEG alpha power, and long-distance alpha coherence were lower in ELBW survivors than NBW adults, and volumes of white matter hypointensities (WMH) were higher. Across groups, face-processing performance was correlated positively with posterior EEG spectral power and long-distance alpha and theta coherence, and negatively with WMH. The associations between face-processing scores and parietal alpha power and theta coherence were reduced after adjustment for WMH. CONCLUSIONS Electrocortical activity, brain functional connectivity, and higher-order processing ability may be negatively affected by WMH burden, which is greater in adults born extremely preterm. SIGNIFICANCE Decrements in electrocortical activity and behavioral performance in adult ELBW survivors may be partly explained by increased WMH volumes in this vulnerable population.
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Affiliation(s)
- Karen J Mathewson
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada.
| | - Elliott A Beaton
- Department of Psychology, University of New Orleans, New Orleans, LA, USA
| | - Diana Hobbs
- Department of Psychology, University of New Orleans, New Orleans, LA, USA; Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Geoffrey B C Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Jay Schulkin
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA; Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, USA
| | - Ryan J Van Lieshout
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Saroj Saigal
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Louis A Schmidt
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
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Blackman G, Neri G, Al-Doori O, Teixeira-Dias M, Mazumder A, Pollak TA, Hird EJ, Koutsouleris N, Bell V, Kempton MJ, McGuire P. Prevalence of Neuroradiological Abnormalities in First-Episode Psychosis: A Systematic Review and Meta-analysis. JAMA Psychiatry 2023; 80:1047-1054. [PMID: 37436735 PMCID: PMC10339221 DOI: 10.1001/jamapsychiatry.2023.2225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/08/2023] [Indexed: 07/13/2023]
Abstract
Importance Individuals presenting with first-episode psychosis (FEP) may have a secondary ("organic") etiology to their symptoms that can be identified using neuroimaging. Because failure to detect such cases at an early stage can have serious clinical consequences, it has been suggested that brain magnetic resonance imaging (MRI) should be mandatory for all patients presenting with FEP. However, this remains a controversial issue, partly because the prevalence of clinically relevant MRI abnormalities in this group is unclear. Objective To derive a meta-analytic estimate of the prevalence of clinically relevant neuroradiological abnormalities in FEP. Data Sources Electronic databases Ovid, MEDLINE, PubMed, Embase, PsychINFO, and Global Health were searched up to July 2021. References and citations of included articles and review articles were also searched. Study Selection Magnetic resonance imaging studies of patients with FEP were included if they reported the frequency of intracranial radiological abnormalities. Data Extraction and Synthesis Independent extraction was undertaken by 3 researchers and a random-effects meta-analysis of pooled proportions was calculated. Moderators were tested using subgroup and meta-regression analyses. Heterogeneity was evaluated using the I2 index. The robustness of results was evaluated using sensitivity analyses. Publication bias was assessed using funnel plots and Egger tests. Main Outcomes and Measures Proportion of patients with a clinically relevant radiological abnormality (defined as a change in clinical management or diagnosis); number of patients needed to scan to detect 1 such abnormality (number needed to assess [NNA]). Results Twelve independent studies (13 samples) comprising 1613 patients with FEP were included. Of these patients, 26.4% (95% CI, 16.3%-37.9%; NNA of 4) had an intracranial radiological abnormality, and 5.9% (95% CI, 3.2%-9.0%) had a clinically relevant abnormality, yielding an NNA of 18. There were high degrees of heterogeneity among the studies for these outcomes, 95% to 73%, respectively. The most common type of clinically relevant finding was white matter abnormalities, with a prevalence of 0.9% (95% CI, 0%-2.8%), followed by cysts, with a prevalence of 0.5% (95% CI, 0%-1.4%). Conclusions and Relevance This systematic review and meta-analysis found that 5.9% of patients presenting with a first episode of psychosis had a clinically relevant finding on MRI. Because the consequences of not detecting these abnormalities can be serious, these findings support the use of MRI as part of the initial clinical assessment of all patients with FEP.
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Affiliation(s)
- Graham Blackman
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Giulia Neri
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Omar Al-Doori
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Maria Teixeira-Dias
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Asif Mazumder
- Department of Neuroradiology, King’s College Hospital NHS Foundation Trust, London, United Kingdom
- Department of Radiology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Thomas A. Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Emily J. Hird
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Nikolaos Koutsouleris
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Max-Planck Institute of Psychiatry, Munich, Germany
| | - Vaughan Bell
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Matthew J. Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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Tsapanou A, Gacheru M, Lee S, Mourtzi N, Gazes Y, Habeck C, Belsky DW, Stern Y. Association of Cognitive Polygenic Index and Cognitive Performance with Age in Cognitively Healthy Adults. Genes (Basel) 2023; 14:1814. [PMID: 37761954 PMCID: PMC10531331 DOI: 10.3390/genes14091814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Genome-wide association studies have discovered common genetic variants associated with cognitive performance. Polygenic scores that summarize these discoveries explain up to 10% of the variance in cognitive test performance in samples of adults. However, the role these genetics play in cognitive aging is not well understood. We analyzed data from 168 cognitively healthy participants aged 23-77 years old, with data on genetics, neuropsychological assessment, and brain-imaging measurements from two large ongoing studies, the Reference Abilities Neural Networks, and the Cognitive Reserve study. We tested whether a polygenic index previously related to cognition (Cog PGI) would moderate the relationship between age and measurements of the cognitive domains extracted from a neuropsychological evaluation: fluid reasoning, memory, vocabulary, and speed of processing. We further explored the relationship of Cog PGI and age on cognition using Johnson-Neyman intervals for two-way interactions. Sex, education, and brain measures of cortical thickness, total gray matter volume, and white matter hyperintensity were considered covariates. The analysis controlled for population structure-ancestry. There was a significant interaction effect of Cog PGI on the association between age and the domains of memory (Standardized coefficient = -0.158, p-value = 0.022), fluid reasoning (Standardized coefficient = -0.146, p-value = 0.020), and vocabulary (Standardized coefficient = -0.191, p-value = 0.001). Higher PGI strengthened the negative relationship between age and the domains of memory and fluid reasoning while PGI weakened the positive relationship between age and vocabulary. Based on the Johnson-Neyman intervals, Cog PGI was significantly associated with domains of memory, reasoning, and vocabulary for younger adults. There is a significant moderation effect of genetic predisposition for cognition for the association between age and cognitive performance. Genetics discovered in genome-wide association studies of cognitive performance show a stronger association in young and midlife older adults.
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Affiliation(s)
- Angeliki Tsapanou
- Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA; (A.T.); (C.H.)
| | - Margaret Gacheru
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY 10032, USA;
| | - Seonjoo Lee
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Niki Mourtzi
- Department of Neurology, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Yunglin Gazes
- Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA; (A.T.); (C.H.)
| | - Christian Habeck
- Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA; (A.T.); (C.H.)
| | - Daniel W. Belsky
- Department of Epidemiology and Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Yaakov Stern
- Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA; (A.T.); (C.H.)
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Argiris G, Stern Y, Lee S, Ryu H, Habeck C. Simple topological task-based functional connectivity features predict longitudinal behavioral change of fluid reasoning in the RANN cohort. Neuroimage 2023; 277:120237. [PMID: 37343735 PMCID: PMC10999229 DOI: 10.1016/j.neuroimage.2023.120237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/18/2023] [Indexed: 06/23/2023] Open
Abstract
Recent attention has been given to topological data analysis (TDA), and more specifically persistent homology (PH), to identify the underlying shape of brain network connectivity beyond simple edge pairings by computing connective components across different connectivity thresholds (see Sizemore et al., 2019). In the present study, we applied PH to task-based functional connectivity, computing 0-dimension Betti (B0) curves and calculating the area under these curves (AUC); AUC indicates how quickly a single connected component is formed across correlation filtration thresholds, with lower values interpreted as potentially analogous to lower whole-brain system segregation (e.g., Gracia-Tabuenca et al., 2020). One hundred sixty-three participants from the Reference Ability Neural Network (RANN) longitudinal lifespan cohort (age 20-80 years) were tested in-scanner at baseline and five-year follow-up on a battery of tests comprising four domains of cognition (i.e., Stern et al., 2014). We tested for 1.) age-related change in the AUC of the B0 curve over time, 2.) the predictive utility of AUC in accounting for longitudinal change in behavioral performance and 3.) compared system segregation to the PH approach. Results demonstrated longitudinal age-related decreases in AUC for Fluid Reasoning, with these decreases predicting longitudinal declines in cognition, even after controlling for demographic and brain integrity factors; moreover, change in AUC partially mediated the effect of age on change in cognitive performance. System segregation also significantly decreased with age in three of the four cognitive domains but did not predict change in cognition. These results argue for greater application of TDA to the study of aging.
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Affiliation(s)
- Georgette Argiris
- Cognitive Neuroscience Division, Department of Neurology, Columbia University Irving Medical Center, 710 West 168th Street, 3rd floor, New York, NY 10032, United States
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology, Columbia University Irving Medical Center, 710 West 168th Street, 3rd floor, New York, NY 10032, United States
| | - Seonjoo Lee
- Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States; Department of Biostatistics, Mailman School of Public Health, New York, NY, United States; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Hyunnam Ryu
- Cognitive Neuroscience Division, Department of Neurology, Columbia University Irving Medical Center, 710 West 168th Street, 3rd floor, New York, NY 10032, United States; Taub Institute, Columbia University, New York, NY, United States; Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States
| | - Christian Habeck
- Cognitive Neuroscience Division, Department of Neurology, Columbia University Irving Medical Center, 710 West 168th Street, 3rd floor, New York, NY 10032, United States; Taub Institute, Columbia University, New York, NY, United States.
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11
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Zhou L, Li Y, Sweeney EM, Wang XH, Kuceyeski A, Chiang GC, Ivanidze J, Wang Y, Gauthier SA, de Leon MJ, Nguyen TD. Association of brain tissue cerebrospinal fluid fraction with age in healthy cognitively normal adults. Front Aging Neurosci 2023; 15:1162001. [PMID: 37396667 PMCID: PMC10312090 DOI: 10.3389/fnagi.2023.1162001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
Background and purpose Our objective was to apply multi-compartment T2 relaxometry in cognitively normal individuals aged 20-80 years to study the effect of aging on the parenchymal CSF fraction (CSFF), a potential measure of the subvoxel CSF space. Materials and methods A total of 60 volunteers (age range, 22-80 years) were enrolled. Voxel-wise maps of short-T2 myelin water fraction (MWF), intermediate-T2 intra/extra-cellular water fraction (IEWF), and long-T2 CSFF were obtained using fast acquisition with spiral trajectory and adiabatic T2prep (FAST-T2) sequence and three-pool non-linear least squares fitting. Multiple linear regression analyses were performed to study the association between age and regional MWF, IEWF, and CSFF measurements, adjusting for sex and region of interest (ROI) volume. ROIs include the cerebral white matter (WM), cerebral cortex, and subcortical deep gray matter (GM). In each model, a quadratic term for age was tested using an ANOVA test. A Spearman's correlation between the normalized lateral ventricle volume, a measure of organ-level CSF space, and the regional CSFF, a measure of tissue-level CSF space, was computed. Results Regression analyses showed that there was a statistically significant quadratic relationship with age for CSFF in the cortex (p = 0.018), MWF in the cerebral WM (p = 0.033), deep GM (p = 0.017) and cortex (p = 0.029); and IEWF in the deep GM (p = 0.033). There was a statistically highly significant positive linear relationship between age and regional CSFF in the cerebral WM (p < 0.001) and deep GM (p < 0.001). In addition, there was a statistically significant negative linear association between IEWF and age in the cerebral WM (p = 0.017) and cortex (p < 0.001). In the univariate correlation analysis, the normalized lateral ventricle volume correlated with the regional CSFF measurement in the cerebral WM (ρ = 0.64, p < 0.001), cortex (ρ = 0.62, p < 0.001), and deep GM (ρ = 0.66, p < 0.001). Conclusion Our cross-sectional data demonstrate that brain tissue water in different compartments shows complex age-dependent patterns. Parenchymal CSFF, a measure of subvoxel CSF-like water in the brain tissue, is quadratically associated with age in the cerebral cortex and linearly associated with age in the cerebral deep GM and WM.
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Affiliation(s)
- Liangdong Zhou
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Yi Li
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Elizabeth M. Sweeney
- Penn Statistics in Imaging and Visualization Endeavor (PennSIVE), Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Xiuyuan H. Wang
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
- Department of Statistics and Data Science, Cornell University, Ithaca, NY, United States
| | - Gloria C. Chiang
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Jana Ivanidze
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Yi Wang
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States
| | - Susan A. Gauthier
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Mony J. de Leon
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Thanh D. Nguyen
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
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12
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Jiang M, Lee S, O’Malley AJ, Stern Y, Li Z. A novel causal mediation analysis approach for zero-inflated mediators. Stat Med 2023; 42:2061-2081. [PMID: 37071977 PMCID: PMC10686235 DOI: 10.1002/sim.9689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 01/29/2023] [Accepted: 02/09/2023] [Indexed: 04/20/2023]
Abstract
Mediation analyses play important roles in making causal inference in biomedical research to examine causal pathways that may be mediated by one or more intermediate variables (ie, mediators). Although mediation frameworks have been well established such as counterfactual-outcomes (ie, potential-outcomes) models and traditional linear mediation models, little effort has been devoted to dealing with mediators with zero-inflated structures due to challenges associated with excessive zeros. We develop a novel mediation modeling approach to address zero-inflated mediators containing true zeros and false zeros. The new approach can decompose the total mediation effect into two components induced by zero-inflated structures: the first component is attributable to the change in the mediator on its numerical scale which is a sum of two causal pathways and the second component is attributable only to its binary change from zero to a non-zero status. An extensive simulation study is conducted to assess the performance and it shows that the proposed approach outperforms existing standard causal mediation analysis approaches. We also showcase the application of the proposed approach to a real study in comparison with a standard causal mediation analysis approach.
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Affiliation(s)
- Meilin Jiang
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Seonjoo Lee
- Mental Health Data Science, New York State Psychiatric Institute, New York, New York
- Departments of Biostatistics and Psychiatry, Columbia University, New York, New York
| | - A. James O’Malley
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
- The Dartmouth Institute, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Yaakov Stern
- Department of Neurology, Columbia University, New York, New York
| | - Zhigang Li
- Department of Biostatistics, University of Florida, Gainesville, Florida
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13
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Zheng K, Wang Z, Chen X, Chen J, Fu Y, Chen Q. Analysis of Risk Factors for White Matter Hyperintensity in Older Adults without Stroke. Brain Sci 2023; 13:brainsci13050835. [PMID: 37239307 DOI: 10.3390/brainsci13050835] [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: 03/25/2023] [Revised: 05/11/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND White matter hyperintensity (WMH) is prevalent in older adults aged 60 and above. A large proportion of people with WMH have not experienced stroke and little has been reported in the literature. METHODS The case data of patients aged ≥60 years without stroke in Wuhan Tongji Hospital from January 2015 to December 2019 were retrospectively analyzed. It was a cross-sectional study. Univariate analysis and logistic regression were used to analyze independent risk factors for WMH. The severity of WMH was assessed using the Fazekas scores. The participants with WMH were divided into periventricular white matter hyperintensity (PWMH) group and deep white matter hyperintensity (DWMH) group, then the risk factors of WMH severity were explored separately. RESULTS Eventually, 655 patients were included; among the patients, 574 (87.6%) were diagnosed with WMH. Binary logistic regression showed that age and hypertension were associated with the prevalence of WMH. Ordinal logistic regression showed that age, homocysteine, and proteinuria were associated with the severity of WMH. Age and proteinuria were associated with the severity of PWMH. Age and proteinuria were associated with the severity of DWMH. CONCLUSIONS The present study showed that in patients aged ≥60 years without stroke, age and hypertension were independent risk factors for the prevalence of WMH; while the increasing of age, homocysteine, and proteinuria were associated with greater WMH burden.
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Affiliation(s)
- Kai Zheng
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Zheng Wang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Xi Chen
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Jiajie Chen
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Yu Fu
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Qin Chen
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
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14
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Thams F, Brassen S. The need to change: Is there a critical role of midlife adaptation in mental health later in life? eLife 2023; 12:82390. [PMID: 37141113 PMCID: PMC10159621 DOI: 10.7554/elife.82390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 04/26/2023] [Indexed: 05/05/2023] Open
Abstract
Although late-life depression (LLD) is a serious health problem and more common than dementia in people over 60, it is underdiagnosed and undertreated. The cognitive-emotional etiology of LLD is particularly poorly understood. This is in contrast to the now extensive literature from psychology and cognitive neuroscience on the characteristics of emotionally healthy aging. This research consistently shows a change in emotional processing in older adults that is modulated by prefrontal regulation. Lifespan theories explain this change in terms of neurocognitive adaptation to limited opportunities and resources that typically occur in the second half of life. Epidemiological data on an increase in well-being after a low point around age 50 suggest that the majority of people seem quite capable of making this adaptation, even though empirical evidence for a causal modulation of this so called 'paradox of aging' and for the role of the midlife dip is still lacking. Intriguingly, LLD is associated with deficits in emotional, cognitive, and prefrontal functions similar to those shown to be crucial for healthy adaptation. Suspected causes of these deficits, such as white matter lesions or affective instability, become apparent as early as midlife when internal and external changes as well as daily challenges set in. Based on these findings, we propose that some individuals who develop depression at older ages may not have been able to successfully implement self-regulatory adaptation at midlife. Here, we review the current evidence and theories on successful aging, the neurobiology of LLD, and well-being across the lifespan. Drawing on recent advances in lifespan theories, emotion regulation research, and cognitive neuroscience, we propose a model of successful versus unsuccessful adaptation that emphasizes the increasing need for implicit habitual control and resource-based regulatory choice during midlife.
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Affiliation(s)
- Friederike Thams
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefanie Brassen
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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15
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Tsapanou A, Mourtzi N, Gu Y, Habeck C, Belsky D, Stern Y. Polygenic indices for cognition in healthy aging; the role of brain measures. NEUROIMAGE: REPORTS 2023; 3. [PMID: 36969093 PMCID: PMC10038095 DOI: 10.1016/j.ynirp.2022.100153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Genome-wide association studies (GWAS) have identified large numbers of genetic variants associated with cognition. However, little is known about how these genetic discoveries impact cognitive aging. Methods We conducted polygenic-index (PGI) analysis of cognitive performance in n = 168 European-ancestry adults aged 20-80. We computed PGIs based on GWAS of cognitive performance in young/middle-aged and older adults. We tested associations of the PGI with cognitive performance, as measured through neuropsychological evaluation. We explored whether these associations were accounted for by magnetic resonance imaging (MRI) measures of brain-aging phenotypes: total gray matter volume (GM), cortical thickness (CT), and white matter hyperintensities burden (WMH). Results Participants with higher PGI values performed better on cognitive tests (B = 0.627, SE = 0.196, p = 0.002) (age, sex, and principal components as covariates). Associations remained significant with inclusion of covariates for MRI measures of brain aging; B = 0.439, SE: 0.198, p = 0.028). PGI associations were stronger in young and middle-aged (age<65) as compared to older adults. For further validation, linear regression for Cog PGI and cognition in the fully adjusted model and adding the interaction between age group and Cog PGI, showed significant results (B = 0.892, SE: 0.325, p = 0.007) driven by young and middle-aged adults (B = -0.403, SE: 0.193, p = 0.039). In ancillary analysis, the Cognitive PGI was not associated with any of the brain measures. Conclusions Genetics discovered in GWAS of cognition are associated with cognitive performance in healthy adults across age, but most strongly in young and middle-aged adults. Associations were not explained by brain-structural markers of brain aging. Genetics uncovered in GWAS of cognitive performance may contribute to individual differences established relatively early in life and may not reflect genetic mechanisms of cognitive aging.
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Affiliation(s)
- A. Tsapanou
- Cognitive Neuroscience Division, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - N. Mourtzi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Y. Gu
- Cognitive Neuroscience Division, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - C. Habeck
- Cognitive Neuroscience Division, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - D. Belsky
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
- Robert N Butler Columbia Aging Center, Columbia University, New York, USA
| | - Y. Stern
- Cognitive Neuroscience Division, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
- Corresponding author. Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, 10032, USA. (Y. Stern)
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16
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James SN, Nicholas JM, Lu K, Keshavan A, Lane CA, Parker T, Buchanan SM, Keuss SE, Murray-Smith H, Wong A, Cash DM, Malone IB, Barnes J, Sudre CH, Coath W, Modat M, Ourselin S, Crutch SJ, Kuh D, Fox NC, Schott JM, Richards M. Adulthood cognitive trajectories over 26 years and brain health at 70 years of age: findings from the 1946 British Birth Cohort. Neurobiol Aging 2023; 122:22-32. [PMID: 36470133 PMCID: PMC10564626 DOI: 10.1016/j.neurobiolaging.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
Few studies can address how adulthood cognitive trajectories relate to brain health in 70-year-olds. Participants (n = 468, 49% female) from the 1946 British birth cohort underwent 18F-Florbetapir PET/MRI. Cognitive function was measured in childhood (age 8 years) and across adulthood (ages 43, 53, 60-64 and 69 years) and was examined in relation to brain health markers of β-amyloid (Aβ) status, whole brain and hippocampal volume, and white matter hyperintensity volume (WMHV). Taking into account key contributors of adult cognitive decline including childhood cognition, those with greater Aβ and WMHV at age 70 years had greater decline in word-list learning memory in the preceding 26 years, particularly after age 60. In contrast, those with smaller whole brain and hippocampal volume at age 70 years had greater decline in processing search speed, subtly manifest from age 50 years. Subtle changes in memory and processing speed spanning 26 years of adulthood were associated with markers of brain health at 70 years of age, consistent with detectable prodromal cognitive effects in early older age.
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Affiliation(s)
- Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK.
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Kirsty Lu
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Ashvini Keshavan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Christopher A Lane
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Thomas Parker
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, UK; Department of Medicine, Division of Brain Sciences, Imperial College London
| | - Sarah M Buchanan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah E Keuss
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Heidi Murray-Smith
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - David M Cash
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute at UCL, University College London, London, UK
| | - Ian B Malone
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - William Coath
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Marc Modat
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Sebastien Ourselin
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute at UCL, University College London, London, UK
| | - Jonathan M Schott
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK; Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute at UCL, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
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Song S, Gaynor AM, Gazes Y, Lee S, Xu Q, Habeck C, Stern Y, Gu Y. Physical activity moderates the association between white matter hyperintensity burden and cognitive change. Front Aging Neurosci 2022; 14:945645. [PMID: 36313016 PMCID: PMC9610117 DOI: 10.3389/fnagi.2022.945645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/20/2022] [Indexed: 01/11/2023] Open
Abstract
Objective Greater physical activity (PA) could delay cognitive decline, yet the underlying mechanisms remain unclear. White matter hyperintensity (WMH) burden is one of the key brain pathologies that have been shown to predict faster cognitive decline at a late age. One possible pathway is that PA may help maintain cognition by mitigating the detrimental effects of brain pathologies, like WMH, on cognitive change. This study aims to examine whether PA moderates the association between WMH burden and cognitive change. Materials and methods This population-based longitudinal study included 198 dementia-free adults aged 20-80 years. Leisure-time physical activity (LTPA) was assessed by a self-reported questionnaire. Occupational physical activity (OPA) was a factor score measuring the physical demands of each job. Total physical activity (TPA) was operationalized as the average of z-scores of LTPA and OPA. Outcome variables included 5-year changes in global cognition and in four reference abilities (fluid reasoning, processing speed, memory, and vocabulary). Multivariable linear regression models were used to estimate the moderation effect of PA on the association between white matter hyperintensities and cognitive change, adjusting for age, sex, education, and baseline cognition. Results Over approximately 5 years, global cognition (p < 0.001), reasoning (p < 0.001), speed (p < 0.001), and memory (p < 0.05) scores declined, and vocabulary (p < 0.001) increased. Higher WMH burden was correlated with more decline in global cognition (Spearman's rho = -0.229, p = 0.001), reasoning (rho = -0.402, p < 0.001), and speed (rho = -0.319, p < 0.001), and less increase in vocabulary (rho = -0.316, p < 0.001). Greater TPA attenuated the association between WMH burden and changes in reasoning (βTPA^*WMH = 0.029, 95% CI = 0.006-0.052, p = 0.013), speed (βTPA^*WMH = 0.035, 95% CI = -0.004-0.065, p = 0.028), and vocabulary (βTPA^*WMH = 0.034, 95% CI = 0.004-0.065, p = 0.029). OPA seemed to be the factor that exerted a stronger moderation on the relationship between WMH burden and cognitive change. Conclusion Physical activity may help maintain reasoning, speed, and vocabulary abilities in face of WMH burden. The cognitive reserve potential of PA warrants further examination.
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Affiliation(s)
- Suhang Song
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States
| | - Alexandra M. Gaynor
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
| | - Yunglin Gazes
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
- Division of Cognitive Neuroscience, Department of Neurology, Columbia University, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
| | - Seonjoo Lee
- Department of Psychiatry and Biostatistics, Columbia University, New York, NY, United States
- Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States
| | - Qianhui Xu
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Christian Habeck
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
- Division of Cognitive Neuroscience, Department of Neurology, Columbia University, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
| | - Yaakov Stern
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
- Division of Cognitive Neuroscience, Department of Neurology, Columbia University, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Yian Gu
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
- Division of Cognitive Neuroscience, Department of Neurology, Columbia University, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, United States
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18
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Song S, Gaynor AM, Cruz E, Lee S, Gazes Y, Habeck C, Stern Y, Gu Y. Mediterranean Diet and White Matter Hyperintensity Change over Time in Cognitively Intact Adults. Nutrients 2022; 14:3664. [PMID: 36079921 PMCID: PMC9460774 DOI: 10.3390/nu14173664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/27/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022] Open
Abstract
Current evidence on the impact of Mediterranean diet (MeDi) on white matter hyperintensity (WMH) trajectory is scarce. This study aims to examine whether greater adherence to MeDi is associated with less accumulation of WMH. This population-based longitudinal study included 183 cognitively intact adults aged 20−80 years. The MeDi score was obtained from a self-reported food frequency questionnaire; WMH was assessed by 3T MRI. Multivariable linear regression was used to estimate the effect of MeDi on WMH change. Covariates included socio-demographic factors and brain markers. Moderation effects by age, gender, and race/ethnicity were examined, followed by stratification analyses. Among all participants, WMH increased from baseline to follow-up (mean difference [follow-up-baseline] [standard deviation] = 0.31 [0.48], p < 0.001). MeDi adherence was negatively associated with the increase in WMH (β = −0.014, 95% CI = −0.026−−0.001, p = 0.034), adjusting for all covariates. The association between MeDi and WMH change was moderated by age (young group = reference, p-interaction[middle-aged × MeDi] = 0.075, p-interaction[older × MeDi] = 0.037). The association between MeDi and WMH change was observed among the young group (β = −0.035, 95% CI = −0.058−−0.013, p = 0.003), but not among other age groups. Moderation effects by gender and race/ethnicity did not reach significance. Greater adherence to MeDi was associated with a lesser increase in WMH over time. Following a healthy diet, especially at younger age, may help to maintain a healthy brain.
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Affiliation(s)
- Suhang Song
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY 10032, USA
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA
| | - Alexandra M. Gaynor
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY 10032, USA
| | - Emily Cruz
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY 10032, USA
| | - Seonjoo Lee
- Department of Psychiatry and Biostatistics, Columbia University, New York, NY 10032, USA
- Mental Health Data Science, New York State Psychiatric Institute, New York, NY 10032, USA
| | - Yunglin Gazes
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY 10032, USA
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY 10032, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032, USA
| | - Christian Habeck
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY 10032, USA
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY 10032, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032, USA
| | - Yaakov Stern
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY 10032, USA
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY 10032, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032, USA
- Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | - Yian Gu
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY 10032, USA
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY 10032, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032, USA
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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19
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Huang CC, Chou KH, Lee WJ, Yang AC, Tsai SJ, Chen LK, Chung CP, Lin CP. Brain white matter hyperintensities-predicted age reflects neurovascular health in middle-to-old aged subjects. Age Ageing 2022; 51:6583203. [PMID: 35536881 DOI: 10.1093/ageing/afac106] [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: 08/07/2021] [Revised: 02/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND age-related neurovascular structural and functional impairment is a major aetiology of dementia and stroke in older people. There is no single marker representative of neurovascular biological age yet. OBJECTIVE this study aims to develop and validate a white matter hyperintensities (WMH)-based model for characterising individuals' neurovascular biological age. METHODS in this prospective single-site study, the WMH-based age-prediction model was constructed based on WMH volumes of 491 healthy participants (21-89 years). In the training dataset, the constructed linear-regression model with log-transformed WMH volumes showed well-balanced complexity and accuracy (root mean squared error, RMSE = 10.20 and mean absolute error, MAE = 7.76 years). This model of neurovascular age estimation was then applied to a middle-to-old aged testing dataset (n = 726, 50-92 years) as the testing dataset for external validation. RESULTS the established age estimator also had comparable generalizability with the testing dataset (RMSE = 7.76 and MAE = 6.38 years). In the testing dataset, the WMH-predicted age difference was negatively associated with visual executive function. Individuals with older predicted-age for their chronological age had greater cardiovascular burden and cardiovascular disease risks than individuals with normal or delayed predicted age. These associations were independent of chronological age. CONCLUSIONS our model is easy to use in clinical practice that helps to evaluate WMH severity objective to chronological age. Current findings support our WMH-based age measurement to reflect neurovascular health and have potential diagnostic and prognostic value for clinical or research purposes in age-related neurovascular disorders.
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Affiliation(s)
- Chu-Chung Huang
- Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Shanghai Changning Mental Health Center, Shanghai, China
| | - Kun-Hsien Chou
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ju Lee
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Family Medicine, Yuanshan Branch, Taipei Veterans General Hospital, Yi-Lan, Taiwan
| | - Albert C Yang
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
- Institute of Brain Science, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Liang-Kung Chen
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan
| | - Chih-Ping Chung
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Jiménez-Balado J, Corlier F, Habeck C, Stern Y, Eich T. Effects of white matter hyperintensities distribution and clustering on late-life cognitive impairment. Sci Rep 2022; 12:1955. [PMID: 35121804 PMCID: PMC8816933 DOI: 10.1038/s41598-022-06019-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/20/2022] [Indexed: 11/29/2022] Open
Abstract
White matter hyperintensities (WMH) are a key hallmark of subclinical cerebrovascular disease and are known to impair cognition. Here, we parcellated WMH using a novel system that segments WMH based on both lobar regions and distance from the ventricles, dividing the brain into a coordinate system composed of 36 distinct parcels (‘bullseye’ parcellation), and then investigated the effect of distribution on cognition using two different analytic approaches. Data from a well characterized sample of healthy older adults (58 to 84 years) who were free of dementia were included. Cognition was evaluated using 12 computerized tasks, factored onto 4 indices representing episodic memory, speed of processing, fluid reasoning and vocabulary. We first assessed the distribution of WMH according to the bullseye parcellation and tested the relationship between WMH parcellations and performance across the four cognitive domains. Then, we used a data-driven approach to derive latent variables within the WMH distribution, and tested the relation between these latent components and cognitive function. We observed that different, well-defined cognitive constructs mapped to specific WMH distributions. Speed of processing was correlated with WMH in the frontal lobe, while in the case of episodic memory, the relationship was more ubiquitous, involving most of the parcellations. A principal components analysis revealed that the 36 bullseye regions factored onto 3 latent components representing the natural aggrupation of WMH: fronto-parietal periventricular (WMH principally in the frontal and parietal lobes and basal ganglia, especially in the periventricular region); occipital; and temporal and juxtacortical WMH (involving WMH in the temporal lobe, and at the juxtacortical region from frontal and parietal lobes). We found that fronto-parietal periventricular and temporal & juxtacortical WMH were independently associated with speed of processing and episodic memory, respectively. These results indicate that different cognitive impairment phenotypes might present with specific WMH distributions. Additionally, our study encourages future research to consider WMH classifications using parcellations systems other than periventricular and deep localizations.
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Affiliation(s)
- Joan Jiménez-Balado
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Fabian Corlier
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Christian Habeck
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Yaakov Stern
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Teal Eich
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
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21
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Dadar M, Mahmoud S, Narayanan S, Collins LD, Arnold DL, Maranzano J. Diffusely abnormal white matter converts to T2 lesion volume in the absence of MRI-detectable acute inflammation. Brain 2021; 145:2008-2017. [DOI: 10.1093/brain/awab448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/28/2021] [Accepted: 11/12/2021] [Indexed: 01/18/2023] Open
Abstract
Abstract
Diffusely abnormal white matter (DAWM), characterised by biochemical changes of myelin in the absence of frank demyelination, has been associated with clinical progression in secondary progressive MS (SPMS). However, little is known about changes of DAWM over time and their relation to focal white matter lesions (FWML).
The objectives of this work were: 1) To characterize the longitudinal evolution of FWML, DAWM, and DAWM that transforms into FWML, and 2) To determine whether gadolinium enhancement, known to be associated with the development of new FWML, is also related to DAWM voxels that transform into FWML.
Our data included 4220 MRI scans of 689 SPMS participants, followed for 156 weeks and 2677 scans of 686 RRMS participants, followed for 96 weeks. FWML and DAWM were segmented using a previously validated, automatic thresholding technique based on normalized T2 intensity values. Using longitudinally registered images, DAWM voxels at each visit that transformed into FWML on the last MRI scan as well as their overlap with gadolinium enhancing lesion masks were identified.
Our results showed that the average yearly rate of conversion of DAWM-to-FWML was 1.27 cc for SPMS and 0.80 cc for RRMS. FWML in SPMS participants significantly increased (t = 3.9; p = 0.0001) while DAWM significantly decreased (t = −4.3 p < 0.0001) and the ratio FWML:DAWM increased (t = 12.7; p < 0.00001). RRMS participants also showed an increase in the FWML:DAWM Ratio (t = 6.9; p < 0.00001) but without a significant change of the individual volumes. Gadolinium enhancement was associated with 7.3% and 18.7% of focal New T2 lesion formation in the infrequent scans of the RRMS and SPMS cohorts, respectively. In comparison, only 0.1% and 0.0% of DAWM-to-FWML voxels overlapped with gadolinium enhancement.
We conclude that DAWM transforms into FWML over time, in both RRMS and SPMS. DAWM appears to represent a form of pre-lesional pathology that contributes to T2 lesion volume increase over time, independent of new focal inflammation and gadolinium enhancement.
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Affiliation(s)
- Mahsa Dadar
- Radiology Department, Faculty of Medicine, Laval University, Quebec, Canada
- Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - Sawsan Mahmoud
- Department of Anatomy, University of Quebec in Trois-Rivieres, Trois-Rivieres, Quebec, Canada
| | - Sridar Narayanan
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Louis D. Collins
- Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Douglas L. Arnold
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Josefina Maranzano
- Department of Anatomy, University of Quebec in Trois-Rivieres, Trois-Rivieres, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
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22
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Wang J, Napoli E, Kim K, McLennan YA, Hagerman RJ, Giulivi C. Brain Atrophy and White Matter Damage Linked to Peripheral Bioenergetic Deficits in the Neurodegenerative Disease FXTAS. Int J Mol Sci 2021; 22:9171. [PMID: 34502080 PMCID: PMC8431233 DOI: 10.3390/ijms22179171] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
Fragile X-associated tremor/ataxia syndrome (FXTAS) is a neurodegenerative disorder affecting subjects (premutation carriers) with a 55-200 CGG-trinucleotide expansion in the 5'UTR of the fragile X mental retardation 1 gene (FMR1) typically after age 50. As both the presence of white matter hyperintensities (WMHs) and atrophied gray matter on magnetic resonance imaging (MRI) are linked to age-dependent decline in cognition, here we tested whether MRI outcomes (WMH volume (WMHV) and brain volume) were correlated with mitochondrial bioenergetics from peripheral blood monocytic cells in 87 carriers with and without FXTAS. As a parameter assessing cumulative damage, WMHV was correlated to both FXTAS stages and age, and brain volume discriminated between carriers and non-carriers. Similarly, mitochondrial mass and ATP production showed an age-dependent decline across all participants, but in contrast to WMHV, only FADH2-linked ATP production was significantly reduced in carriers vs. non-carriers. In carriers, WMHV negatively correlated with ATP production sustained by glucose-glutamine and FADH2-linked substrates, whereas brain volume was positively associated with the latter and mitochondrial mass. The observed correlations between peripheral mitochondrial bioenergetics and MRI findings-and the lack of correlations with FXTAS diagnosis/stages-may stem from early brain bioenergetic deficits even before overt FXTAS symptoms and/or imaging findings.
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Affiliation(s)
- Junyi Wang
- Center for Mind and Brain, University of California Davis, Davis, CA 95618, USA;
| | - Eleonora Napoli
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, Davis, CA 95616, USA;
| | - Kyoungmi Kim
- The MIND Institute, University of California Davis Medical Center, Sacramento, CA 95817, USA; (K.K.); (Y.A.M.)
- Department of Public Health Sciences, School of Medicine, University of California Davis, Sacramento, CA 95817, USA
| | - Yingratana A. McLennan
- The MIND Institute, University of California Davis Medical Center, Sacramento, CA 95817, USA; (K.K.); (Y.A.M.)
- Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA 95817, USA
| | - Randi J. Hagerman
- The MIND Institute, University of California Davis Medical Center, Sacramento, CA 95817, USA; (K.K.); (Y.A.M.)
- Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA 95817, USA
| | - Cecilia Giulivi
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, Davis, CA 95616, USA;
- The MIND Institute, University of California Davis Medical Center, Sacramento, CA 95817, USA; (K.K.); (Y.A.M.)
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23
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Melazzini L, Vitali P, Olivieri E, Bolchini M, Zanardo M, Savoldi F, Di Leo G, Griffanti L, Baselli G, Sardanelli F, Codari M. White Matter Hyperintensities Quantification in Healthy Adults: A Systematic Review and Meta-Analysis. J Magn Reson Imaging 2020; 53:1732-1743. [PMID: 33345393 DOI: 10.1002/jmri.27479] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Although white matter hyperintensities (WMH) volumetric assessment is now customary in research studies, inconsistent WMH measures among homogenous populations may prevent the clinical usability of this biomarker. PURPOSE To determine whether a point estimate and reference standard for WMH volume in the healthy aging population could be determined. STUDY TYPE Systematic review and meta-analysis. POPULATION In all, 9716 adult subjects from 38 studies reporting WMH volume were retrieved following a systematic search on EMBASE. FIELD STRENGTH/SEQUENCE 1.0T, 1.5T, or 3.0T/fluid-attenuated inversion recovery (FLAIR) and/or proton density/T2 -weighted fast spin echo sequences or gradient echo T1 -weighted sequences. ASSESSMENT After a literature search, sample size, demographics, magnetic field strength, MRI sequences, level of automation in WMH assessment, study population, and WMH volume were extracted. STATISTICAL TESTS The pooled WMH volume with 95% confidence interval (CI) was calculated using the random-effect model. The I2 statistic was calculated as a measure of heterogeneity across studies. Meta-regression analysis of WMH volume on age was performed. RESULTS Of the 38 studies analyzed, 17 reported WMH volume as the mean and standard deviation (SD) and were included in the meta-analysis. Mean and SD of age was 66.11 ± 10.92 years (percentage of men 50.45% ± 21.48%). Heterogeneity was very high (I2 = 99%). The pooled WMH volume was 4.70 cm3 (95% CI: 3.88-5.53 cm3 ). At meta-regression analysis, WMH volume was positively associated with subjects' age (β = 0.358 cm3 per year, P < 0.05, R2 = 0.27). DATA CONCLUSION The lack of standardization in the definition of WMH together with the high technical variability in assessment may explain a large component of the observed heterogeneity. Currently, volumes of WMH in healthy subjects are not comparable between studies and an estimate and reference interval could not be determined. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Luca Melazzini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Paolo Vitali
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Emanuele Olivieri
- Medicine and Surgery Medical School, Università degli Studi di Milano, Milano, Italy
| | - Marco Bolchini
- Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy
| | - Moreno Zanardo
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Filippo Savoldi
- Postgraduate School in Radiology, Università degli Studi di Milano, Milano, Italy
| | - Giovanni Di Leo
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Ludovica Griffanti
- Department of Psychiatry, Wellcome Centre for Integrative Neuroimaging (WIN), University of Oxford, Oxford, UK
| | - Giuseppe Baselli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Marina Codari
- Department of Radiology, Stanford University School of Medicine, Stanford, California, USA
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Garnier-Crussard A, Bougacha S, Wirth M, André C, Delarue M, Landeau B, Mézenge F, Kuhn E, Gonneaud J, Chocat A, Quillard A, Ferrand-Devouge E, de La Sayette V, Vivien D, Krolak-Salmon P, Chételat G. White matter hyperintensities across the adult lifespan: relation to age, Aβ load, and cognition. ALZHEIMERS RESEARCH & THERAPY 2020; 12:127. [PMID: 33032654 PMCID: PMC7545576 DOI: 10.1186/s13195-020-00669-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022]
Abstract
Background White matter hyperintensities (WMH) are very frequent in older adults and associated with worse cognitive performance. Little is known about the links between WMH and vascular risk factors, cortical β-amyloid (Aβ) load, and cognition in cognitively unimpaired adults across the entire lifespan, especially in young and middle-aged adults. Methods One hundred and thirty-seven cognitively unimpaired adults from the community were enrolled (IMAP cohort). Participants underwent (i) a comprehensive neuropsychological assessment of episodic memory, processing speed, working memory, and executive functions; (ii) brain structural T1 and FLAIR MRI scans used for the automatic segmentation of total and regional (frontal, parietal, temporal, occipital, and corpus callosum) WMH; and (iii) a Florbetapir-PET scan to measure cortical Aβ. The relationships of total and regional WMH to age, vascular risk factors, cortical Aβ, and cognition were assessed within the whole sample, but also splitting the sample in two age groups (≤ or > 60 years old). Results WMH increased with age across the adult lifespan, i.e., even in young and middle-aged adults. Systolic blood pressure, diastolic blood pressure, and glycated hemoglobin were all associated with higher WMH before, but not after, adjusting for age and the other vascular risk factors. Higher frontal, temporal, and occipital WMH were associated with greater Aβ, but this association was no longer significant when adjusting for age and vascular risk factors. Higher total and frontal WMH were associated with worse performance in executive functions, with no interactive effect of the age group. In contrast, there was a significant interaction of the age group on the link between WMH and working memory, which was significant within the subgroup of young/middle-aged adults only. Adding cortical Aβ load in the models did not alter the results, and there was no interaction between WMH and Aβ on cognition. Conclusion WMH increased with age and were associated with worse executive functions across the adult lifespan and with worse working memory in young/middle-aged adults. Aβ load was weakly associated with WMH and did not change the relationship found between WMH and executive functions. This study argues for the clinical relevance of WMH across the adult lifespan, even in young and middle-aged adults with low WMH.
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Affiliation(s)
- Antoine Garnier-Crussard
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.,Clinical and Research Memory Center of Lyon, Lyon Institute For Elderly, Charpennes Hospital, Hospices Civils de Lyon, Lyon, France.,Claude Bernard University Lyon 1, Lyon, France
| | - Salma Bougacha
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Miranka Wirth
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Claire André
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.,Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen, France
| | - Marion Delarue
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Brigitte Landeau
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Florence Mézenge
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Elizabeth Kuhn
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Julie Gonneaud
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Anne Chocat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Anne Quillard
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Eglantine Ferrand-Devouge
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.,Department of General Practice, Normandie Univ, UNIROUEN, Rouen, France.,Rouen University Hospital, Inserm CIC-CRB 1404, F-76 000, Rouen, France
| | - Vincent de La Sayette
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen, France.,Department of Neurology, CHU de Caen, Caen, France
| | - Denis Vivien
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.,Department of Clinical Research, CHU de Caen, Caen, France
| | - Pierre Krolak-Salmon
- Clinical and Research Memory Center of Lyon, Lyon Institute For Elderly, Charpennes Hospital, Hospices Civils de Lyon, Lyon, France.,Claude Bernard University Lyon 1, Lyon, France.,Lyon Neuroscience Research Centre, INSERM 1028, CNRS 5292, Lyon, France
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.
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Bell V, Wilkinson S, Greco M, Hendrie C, Mills B, Deeley Q. What is the functional/organic distinction actually doing in psychiatry and neurology? Wellcome Open Res 2020; 5:138. [PMID: 32685699 PMCID: PMC7338913 DOI: 10.12688/wellcomeopenres.16022.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2020] [Indexed: 12/16/2022] Open
Abstract
The functional-organic distinction aims to distinguish symptoms, signs, and syndromes that can be explained by diagnosable biological changes, from those that cannot. The distinction is central to clinical practice and is a key organising principle in diagnostic systems. Following a pragmatist approach that examines meaning through use, we examine how the functional-organic distinction is deployed and conceptualised in psychiatry and neurology. We note that the conceptual scope of the terms 'functional' and 'organic' varies considerably by context. Techniques for differentially diagnosing 'functional' and 'organic' diverge in the strength of evidence they produce as a necessary function of the syndrome in question. Clinicians do not agree on the meaning of the terms and report using them strategically. The distinction often relies on an implied model of 'zero sum' causality and encourages classification of syndromes into discrete 'functional' and 'organic' versions. Although this clearly applies in some instances, this is often in contrast to our best scientific understanding of neuropsychiatric disorders as arising from a dynamic interaction between personal, social and neuropathological factors. We also note 'functional' and 'organic' have loaded social meanings, creating the potential for social disempowerment. Given this, we argue for a better understanding of how strategic simplification and complex scientific reality limit each other in neuropsychiatric thinking. We also note that the contribution of people who experience the interaction between 'functional' and 'organic' factors has rarely informed the validity of this distinction and the dilemmas arising from it, and we highlight this as a research priority.
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Affiliation(s)
- Vaughan Bell
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sam Wilkinson
- Department of Sociology, Philosophy and Anthropology, Exeter University, Exeter, UK
| | - Monica Greco
- Department of Sociology, Goldsmiths, University of London, London, UK
| | | | | | - Quinton Deeley
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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