Association of quality of life with structural, functional and molecular brain imaging in community-dwelling older adults

Poor self-rated health is associated with faster cognitive decline and greater small vessel disease in older adults with type 2 diabetes

OBJECTIVE

Self-rated health (SRH) is a predictor for poor health outcomes and cognition. Older adults with type 2 diabetes mellitus (T2D) have multi-morbidity and greater cognitive impairment. In the present study we investigated the association of SRH with cognitive decline and brain pathology in older adults with T2D.

METHODS

Participants (n = 1122) were from the Israel Diabetes and Cognitive Decline study, and SRH was categorised as low (n = 202), moderate (n = 400) or high (n = 520). Cognition was measured by four cognitive domains: episodic memory, executive functions, language, and attention/working memory. Global cognition was the average of the cognitive domains. Statistical models adjusted for sociodemographic, cardiovascular, and clinical variables. In a randomly selected subsample (n = 230) that had magnetic resonance imaging, we examined relationships between baseline SRH and brain characteristics (white matter hyperintensities [WMHs], hippocampal, and total grey matter [GM] volumes).

RESULTS

Low SRH was associated with a decline in executive functions, which accelerated over time when compared to high SRH (est = -0.0036; p = <0.001). Compared to high SRH, low SRH was associated with a faster decline in global cognition (est = -0.0024; p = 0.009). Low SRH at baseline was associated with higher volumes of WMHs (est = 9.8420; p < 0.0008). SRH was not associated with other cognitive domains, or with hippocampal and total GM.

CONCLUSIONS

Low SRH is associated with cognitive decline in T2D older adults and may serve as a risk assessment. WMHs may represent an underlying mechanism.

The Association Between Intrapersonal Resilience Resources and Quality of Life Among Older Persons Living With HIV: A Systematic Review

ABSTRACT

Despite positive improvements in health care, older persons living with HIV (PWH) still face psychosocial challenges and medical issues that affect their overall quality of life (QoL). Intrapersonal resilience resources may serve as a protective factor allowing PWH to better cope with adversity, thereby improving their well-being. In our systematic review, we examined intrapersonal resilience resources and their association with QoL outcomes among middle-aged and older PWH (≥40 years). Four databases (CINAHL, PubMed, PsycINFO, and Embase) were searched, and 1,400 articles were yielded. Following screening and full-text review, 19 studies met full criteria and were included. Based on our findings from these studies, trait resilience, spirituality, and self-efficacy were the most common resilience resources investigated. Resilience resources were positively associated with QoL outcomes and mediated the association between various psychosocial factors (e.g., stigma) and QoL. Future studies should explore resilience resources and QoL over time among diverse populations of PWH.

A systematic review of the neural correlates of well-being reveals no consistent associations

Findings from behavioral and genetic studies indicate a potential role for the involvement of brain structures and brain functioning in well-being. We performed a systematic review on the association between brain structures or brain functioning and well-being, including 56 studies. The 11 electroencephalography (EEG) studies suggest a larger alpha asymmetry (more left than right brain activation) to be related to higher well-being. The 18 Magnetic Resonance Imaging (MRI) studies, 26 resting-state functional MRI studies and two functional near-infrared spectroscopy (fNIRS) studies identified a wide range of brain regions involved in well-being, but replication across studies was scarce, both in direction and strength of the associations. The inconsistency could result from small sample sizes of most studies and a possible wide-spread network of brain regions with small effects involved in well-being. Future directions include well-powered brain-wide association studies and innovative methods to more reliably measure brain activity in daily life.

The Personal Trait of Spiritual Growth Is Correlated With the White Matter Integrity of the Brain

Determining the relationship between the entire brain structure and individual differences is important in extending healthy life expectancy, which can be affected by brain atrophy. The entire brain structure has been gradually known to be correlated not only with age but also with individual differences, such as quality of life, general intelligence, and lifestyle. However, little attention has been paid to the relationship between the entire brain structure and personal traits. We herein focused on one personal trait, namely spiritual growth, and examined its relationship with the entire brain structure using two neuroimaging-derived measures, namely the gray matter Brain Healthcare Quotient (GM-BHQ), a measure of GM volume, and the fractional anisotropy Brain Healthcare Quotient (FA-BHQ), a measure of white matter (WM) integrity, in 229 healthy participants (53 female, 176 male). The results indicated no significant relationship between the GM-BHQ and spiritual growth, but there was a significant positive correlation between the FA-BHQ and spiritual growth after controlling for age, sex, and body mass index (BMI) with partial correlation analysis. Furthermore, multiple regression analysis revealed a significant positive correlation between the FA-BHQ and spiritual growth after controlling for physical characteristics, such as age, sex, and BMI, as well as other variables related to lifestyle that were collected using the Health-Promoting Lifestyle Profile. These results support the idea that there is a relationship between the entire WM brain structure and spiritual growth. Further studies are required to clarify the causal relationship between the entire WM brain structure and spiritual growth with some interventions to improve spiritual growth. Such studies will help extend healthy life expectancy from a new perspective of personal trait.

Gray matter volume reduction with different disease duration in trigeminal neuralgia

PURPOSE

Structural magnetic resonance imaging is widely used to explore brain gray and white matter structure in trigeminal neuralgia (TN) but has yielded conflicting findings. This study investigated the relationship between disease duration as a clinical feature of TN and changes in brain structure.

METHODS

We divided 49 TN patients into three groups (TN1-TN3) based on disease duration (TN1 = 1.1 ± 0.7 (0-2) years, TN2 = 4.8 ± 1.5 (3-7) years, TN3 = 15.1 ± 5.5 (10-30) years). We used voxel-based morphometry (VBM) to compare the gray matter volume (GMV) across groups and between TN patients and 18 matched healthy control subjects.

RESULTS

The TN1 group showed reduced GMV of pain-related regions in the cerebellum; the TN2 group showed reduced GMV in the thalamus and the motor/sensory cortex; and the TN3 group showed reduced GMV in the emotional and reward circuits compared with healthy controls. Similar brain regions, including bilateral hippocampi, caudate, left insular cortex, and medial superior frontal cortex, were affected in TN2 and TN3 compared with TN1.

CONCLUSION

Disease duration can explain differences in structural alterations-especially in pain-related brain regions-in TN. These results highlight the advanced structural neuroimaging method that are valuable tools to assess the trigeminal system in TN and may further our current understanding of TN pathology.

Frontoinsular cortical microstructure is linked to life satisfaction in young adulthood

Life satisfaction is a component of subjective well-being that reflects a global judgement of the quality of life according to an individual's own needs and expectations. As a psychological construct, it has attracted attention due to its relationship to mental health, resilience to stress, and other factors. Neuroimaging studies have identified neurobiological correlates of life satisfaction; however, they are limited to functional connectivity and gray matter morphometry. We explored features of gray matter microstructure obtained through compartmental modeling of multi-shell diffusion MRI data, and we examined cortical microstructure in frontoinsular cortex in a cohort of 807 typical young adults scanned as part of the Human Connectome Project. Our experiments identified the orientation dispersion index (ODI), and analogously fractional anisotropy (FA), of frontoinsular cortex as a robust set of anatomically-specific lateralized diffusion MRI microstructure features that are linked to life satisfaction, independent of other demographic, socioeconomic, and behavioral factors. We further validated our findings in a secondary test-retest dataset and found high reliability of our imaging metrics and reproducibility of outcomes. In our analysis of twin and non-twin siblings, we found basic microstructure in frontoinsular cortex to be strongly genetically determined. We also found a more moderate but still very significant genetic role in determining microstructure as it relates to life satisfaction in frontoinsular cortex. Our findings suggest a potential linkage between well-being and microscopic features of frontoinsular cortex, which may reflect cellular morphology and architecture and may more broadly implicate the integrity of the homeostatic processing performed by frontoinsular cortex as an important component of an individual's judgements of life satisfaction.