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Tseng YT, Chang YL, Chiu YS. Assessment of Language Function in Older Mandarin-Speaking Adults with Mild Cognitive Impairment using Multifaceted Language Tests. J Alzheimers Dis 2024; 97:1189-1209. [PMID: 38217600 PMCID: PMC10836557 DOI: 10.3233/jad-230871] [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] [Accepted: 11/15/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Individuals with amnestic mild cognitive impairment (aMCI), especially for those with multidomain cognitive deficits, should be clinically examined for determining risk of developing Alzheimer's disease. English-speakers with aMCI exhibit language impairments mostly at the lexical-semantic level. Given that the language processing of Mandarin Chinese is different from that of alphabetic languages, whether previous findings for English-speakers with aMCI can be generalized to Mandarin Chinese speakers with aMCI remains unclear. OBJECTIVE This study examined the multifaceted language functions of Mandarin Chinese speakers with aMCI and compared them with those without cognitive impairment by using a newly developed language test battery. METHODS Twenty-three individuals with aMCI and 29 individuals without cognitive impairment were recruited. The new language test battery comprises five language domains (oral production, auditory and reading comprehension, reading aloud, repetition, and writing). RESULTS Compared with the controls, the individuals with aMCI exhibited poorer performance in the oral production and auditory and reading comprehension domains, especially on tests involving effortful lexical and semantic processing. Moreover, the aMCI group made more semantic naming errors compared with their counterparts and tended to experience difficulty in processing items belonging to the categories of living objects. CONCLUSIONS The pattern identified in the present study is similar to that of English-speaking individuals with aMCI across multiple language domains. Incorporating language tests involving lexical and semantic processing into clinical practice is essential and can help identify early language dysfunction in Mandarin Chinese speakers with aMCI.
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Affiliation(s)
- Yun-Ting Tseng
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
- Department of Neurology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, Taiwan
| | - Yen-Shiang Chiu
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
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Fisher MN, Casenhiser DM, Paek EJ. Objective and Subjective Clustering Methods for Verb Fluency Responses From Individuals With Alzheimer's Dementia and Cognitively Healthy Older Adults. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2589-2601. [PMID: 37722380 PMCID: PMC10721246 DOI: 10.1044/2023_ajslp-22-00290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 03/13/2023] [Accepted: 06/27/2023] [Indexed: 09/20/2023]
Abstract
PURPOSE The verb fluency task has been researched using a variety of analysis methods and shown its sensitivity to declines in executive functioning and lexical retrieval abilities in various neurogenic populations. Few studies to date, however, have analyzed clusters and switches in the task, and there is a lack of robust analysis methods that preclude subjectivity and potential rater bias. The purpose of this study was to investigate the reliability when using subjective clustering methods and to determine the feasibility of using an objective clustering method to determine verb fluency performance in individuals with Alzheimer's dementia (IwDs) and cognitively healthy older adults (CHOAs). METHOD Responses from a verb fluency task were obtained from IwDs and CHOAs. Group differences were examined using an objective clustering method for multiple variables regarding clustering and switching. We also calculated the intrarater, interrater, and intermethod reliability using intraclass coefficients. RESULTS Significant group differences were found when utilizing the objective clustering method in all variables except the average cluster size, with IwDs performing poorer than CHOAs. Intrarater reliability was excellent. Interrater reliability between two authors and intermethod reliability between the objective and subjective methods were variable ranging from moderate to good. CONCLUSIONS The results from using the objective clustering method in this study are consistent with the previous literature, making it a viable option for clustering analyses on the verb fluency task, which naturally minimizes subjectivity and rater bias. Alternatively, employing a thoroughly validated and reliable subjective approach can also mitigate potential rater bias and improve replicability across studies. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24061017.
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Affiliation(s)
- Madison N. Fisher
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville
| | - Devin M. Casenhiser
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville
| | - Eun Jin Paek
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville
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Wright LM, De Marco M, Venneri A. Current Understanding of Verbal Fluency in Alzheimer's Disease: Evidence to Date. Psychol Res Behav Manag 2023; 16:1691-1705. [PMID: 37179686 PMCID: PMC10167999 DOI: 10.2147/prbm.s284645] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/05/2023] [Indexed: 05/15/2023] Open
Abstract
Since their development, verbal fluency tests (VFTs) have been used extensively throughout research and in clinical settings to assess a variety of cognitive functions in diverse populations. In Alzheimer's disease (AD), these tasks have proven particularly valuable in identifying the earliest forms of cognitive decline in semantic processing and have been shown to relate specifically to brain regions associated with the initial stages of pathological change. In recent years, researchers have developed more nuanced techniques to evaluate verbal fluency performance, extracting a wide range of cognitive metrics from these simple neuropsychological tests. Such novel techniques allow for a more detailed exploration of the cognitive processes underlying successful task performance beyond the raw test score. The versatility of VFTs and the richness of data they may provide, in light of their low cost and speed of administration, therefore, highlight their potential value both in future research as outcome measures for clinical trials and in a clinical setting as a screening measure for early detection of neurodegenerative diseases.
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Affiliation(s)
- Laura M Wright
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Matteo De Marco
- Department of Life Sciences, Brunel University London, London, UK
| | - Annalena Venneri
- Department of Life Sciences, Brunel University London, London, UK
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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Wu H, Song Y, Yang X, Chen S, Ge H, Yan Z, Qi W, Yuan Q, Liang X, Lin X, Chen J. Functional and structural alterations of dorsal attention network in preclinical and early-stage Alzheimer's disease. CNS Neurosci Ther 2023; 29:1512-1524. [PMID: 36942514 PMCID: PMC10173716 DOI: 10.1111/cns.14092] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES Subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI) are known as the preclinical and early stage of Alzheimer's disease (AD). The dorsal attention network (DAN) is mainly responsible for the "top-down" attention process. However, previous studies mainly focused on single functional modality and limited structure. This study aimed to investigate the multimodal alterations of DAN in SCD and aMCI to assess their diagnostic value in preclinical and early-stage AD. METHODS Resting-state functional magnetic resonance imaging (MRI) was carried out to measure the fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and functional connectivity (FC). Structural MRI was used to calculate the gray matter volume (GMV) and cortical thickness. Moreover, receiver-operating characteristic (ROC) analysis was used to distinguish these alterations in SCD and aMCI. RESULTS The SCD and aMCI groups showed both decreased ReHo in the right middle temporal gyrus (MTG) and decreased GMV compared to healthy controls (HCs). Especially in the SCD group, there were increased fALFF and increased ReHo in the left inferior occipital gyrus (IOG), decreased fALFF and increased FC in the left inferior parietal lobule (IPL), and reduced cortical thickness in the right inferior temporal gyrus (ITG). Furthermore, functional and structural alterations in the SCD and aMCI groups were closely related to episodic memory (EM), executive function (EF), and information processing speed (IPS). The combination of multiple indicators of DAN had a high accuracy in differentiating clinical stages. CONCLUSIONS Our current study demonstrated functional and structural alterations of DAN in SCD and aMCI, especially in the MTG, IPL, and SPL. Furthermore, cognitive performance was closely related to these significant alterations. Our study further suggested that the combined multiple indicators of DAN could be acted as the latent neuroimaging markers of preclinical and early-stage AD for their high diagnostic value.
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Affiliation(s)
- Huimin Wu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Song
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xinyi Yang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shanshan Chen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Honglin Ge
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Zheng Yan
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qianqian Yuan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xuhong Liang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xingjian Lin
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Department of Radiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
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Design and Verbal Fluency in Alzheimer's Disease and Frontotemporal Dementia: Clinical and Metabolic Correlates. J Int Neuropsychol Soc 2022; 28:947-962. [PMID: 34569460 DOI: 10.1017/s1355617721001144] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Cognitive processes underlying verbal and design fluency, and their neural correlates in patients with Alzheimer's disease (AD) and behavioural variant Frontotemporal Dementia (bvFTD) remain unclear. We hypothesised that verbal and design fluency may be associated with distinct neuropsychological processes in AD and FTD, showing different patterns of impairment and neural basis. METHODS We enrolled 142 participants including patients with AD (n = 80, mean age = 74.71), bvFTD (n = 34, mean age = 68.18), and healthy controls (HCs) (n = 28, mean age = 71.14), that underwent cognitive assessment and 18F-fluorodeoxyglucose positron emission tomography imaging. RESULTS Semantic and phonemic fluency showed the largest effect sizes between groups, showing lower scores in bvFTD than AD and HCs, and lower scores in AD than HC. Both AD and bvFTD showed a lower number of unique designs in design fluency in comparison to HC. Semantic fluency was correlated with left frontotemporal lobe in AD, and with left frontal, caudate, and thalamus in bvFTD. Percentage of unique designs in design fluency was associated with the metabolism of the bilateral fronto-temporo-parietal cortex in AD, and the bilateral frontal cortex with right predominance in bvFTD. Repetitions in AD were correlated with bilateral frontal, temporal, and parietal lobes, and with left prefrontal cortex in bvFTD. CONCLUSIONS Our findings demonstrate differential underlying cognitive processes in verbal and design fluency in AD and bvFTD. While memory and executive functioning associated with fronto-temporo-parietal regions were key in AD, attention and executive functions correlated with the frontal cortex and played a more significant role in bvFTD during fluency tasks.
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López-Higes R, Rubio-Valdehita S, Llorente-Morales C, Sánchez-Beato A, Delgado-Lima AH, Delgado-Losada ML. Animals in multidimensional space: Interpreting coordinates throughout lexical-semantic features in mild cognitive impairment and control subjects. J Clin Exp Neuropsychol 2022; 43:1018-1031. [PMID: 35341460 DOI: 10.1080/13803395.2022.2057443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Semantic verbal fluency is a useful neuropsychological tool since it involves language and executive abilities that can be impaired in patients with neurodegenerative diseases in comparison to healthy controls. The present study explores retrieve and executive control processes using traditional quantitative and qualitative raw scores and examines the utility of multidimensional scaling combined with linear regression to provide new insights about the underlying semantic network in mild cognitive impairment and in healthy older adults. METHOD A total of 165 Spanish older adults, 81 patients and 84 controls, were assessed in different cognitive domains and evoked animal names in one minute. Group differences on fluency raw scores were first explored. Regressions using tests to predict groups' fluency scores were also performed. The 12 animals that had been produced more frequently were selected to perform a multidimensional scaling analysis for each group. Four features related to animal names were extracted from normative studies and then were used as predictors in linear regression to provide an interpretation of the resulting dimensions' coordinates. RESULTS Patients performed worse on memory and naming and produced a shorter list of animals than controls. In controls, naming and visual memory explained a small part of variance related to the total of animals produced and to the number of switches. Both groups exhibited similar semantic maps. CONCLUSIONS Results suggest that patients' map is influenced by words with a dense associative neighborhood that were acquired at an early age, whereas in controls none of the predictors explained dimensions.
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Affiliation(s)
- Ramón López-Higes
- Department of Experimental Psychology, Universidad Complutense de Madrid, Spain
| | - Susana Rubio-Valdehita
- Department of Social, Work and Differential Psychology, Universidad Complutense de Madrid, Campus de Somosaguas S/n, Pozuelo de Alarcón, Spain
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A Comparison Between the Performances of Verbal and Nonverbal Fluency Tests in Discriminating Between Mild Cognitive Impairments and Alzheimer’s Disease Patients and Their Brain Morphological Correlates. Dement Neurocogn Disord 2022; 21:17-29. [PMID: 35154337 PMCID: PMC8811206 DOI: 10.12779/dnd.2022.21.1.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose Methods Results Conclusions
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8
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Ahn H, Yi D, Chu K, Joung H, Lee Y, Jung G, Sung K, Han D, Lee JH, Byun MS, Lee DY. Functional Neural Correlates of Semantic Fluency Task Performance in Mild Cognitive Impairment and Alzheimer's Disease: An FDG-PET Study. J Alzheimers Dis 2022; 85:1689-1700. [PMID: 34958036 PMCID: PMC9210291 DOI: 10.3233/jad-215292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Total score (TS) of semantic verbal fluency test (SVFT) is generally used to interpret results, but it is ambiguous as to specific neural functions it reflects. Different SVFT strategy scores reflecting qualitative aspects are proposed to identify specific cognitive functions to overcome limitations of using the TS. OBJECTIVE Functional neural correlates of the TS as well as the other strategy scores in subjects with mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia using Fluorine-18-Fluorodeoxyglucose positron emission tomography (FDG-PET). METHODS Correlations between various SVFT scores (i.e., TS, mean cluster size, switching (SW), hard switching, cluster switching (CSW)) and cerebral glucose metabolism were explored using voxelwise whole-brain approach. Subgroup analyses were also performed based on the diagnosis and investigated the effects of disease severity on the associations. RESULTS Significant positive correlation between TS and cerebral glucose metabolism was found in prefrontal, parietal, cingulate, temporal cortex, and subcortical regions. Significantly increased glucose metabolism associated with the SW were found in similar but smaller regions, mainly in the fronto-parieto-temporal regions. CSW was only correlated with the caudate. In the subgroup analysis conducted to assess different contribution of clinical severity, differential associations between the strategy scores and regional glucose metabolism were found. CONCLUSION SW and CSW may reflect specific language and executive functions better than the TS. The SVFT is influenced by brain dysfunction due to the progression of AD, as demonstrated by the SW with larger involvement of temporal lobe for the AD, and CSW with significant association only for the MCI.
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Affiliation(s)
- Hyejin Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dahyun Yi
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea,Correspondence to: Dong Young Lee, MD, PhD, Department of Neuropsychiatry, Seoul National University Hospital & Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Tel.: +82 2 2072 2205; Fax: +82 2 744 7241; and Dahyun Yi, PhD, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Tel.: +82 2 2072 1722;
| | - Kyungjin Chu
- Korea Counseling Center for Fertility and Depression, National Medical Center, Seoul, Republic of Korea
| | - Haejung Joung
- Interdisciplinary Program of Cognitive Science, Seoul National University, Seoul, Republic of Korea
| | - Younghwa Lee
- Interdisciplinary Program of Cognitive Science, Seoul National University, Seoul, Republic of Korea
| | - Gijung Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kiyoung Sung
- Department of Psychiatry, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Dongkyun Han
- Jamsil Forest Neuropsychiatric Clinic, Seoul, Republic of Korea
| | - Jun Ho Lee
- Mind Lab The Place Psychiatric Clinic, Seoul, Republic of Korea
| | - Min Soo Byun
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea,Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea,Correspondence to: Dong Young Lee, MD, PhD, Department of Neuropsychiatry, Seoul National University Hospital & Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Tel.: +82 2 2072 2205; Fax: +82 2 744 7241; and Dahyun Yi, PhD, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Tel.: +82 2 2072 1722;
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Hemrungrojn S, Tangwongchai S, Charoenboon T, Panasawat M, Supasitthumrong T, Chaipresertsud P, Maleevach P, Likitjaroen Y, Phanthumchinda K, Maes M. Use of the Montreal Cognitive Assessment Thai Version to Discriminate Amnestic Mild Cognitive Impairment from Alzheimer's Disease and Healthy Controls: Machine Learning Results. Dement Geriatr Cogn Disord 2021; 50:183-194. [PMID: 34325427 DOI: 10.1159/000517822] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/11/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Montreal Cognitive Assessment (MoCA) is an effective and applicable screening instrument to confirm the diagnosis of amnestic mild cognitive impairment (aMCI) from patients with Alzheimer's disease (AD) and healthy controls (HCs). OBJECTIVES This study aimed to determine the reliability and validity of the following: (a) Thai translation of the MoCA (MoCA-Thai) and (b) delineate the key features of aMCI based on the MoCA subdomains. METHODS This study included 60 HCs, 61 aMCI patients, and 60 AD patients. The MoCA-Thai shows adequate psychometric properties including internal consistency, concurrent validity, test-retest validity, and inter-rater reliability. RESULTS The MoCA-Thai may be employed as a diagnostic criterion to make the diagnosis of aMCI, whereby aMCI patients are discriminated from HC with an area under the receiver-operating characteristic (AUC-ROC) curve of 0.813 and from AD patients with an AUC-ROC curve of 0.938. The best cutoff scores of the MoCA-Thai to discriminate aMCI from HC is ≤24 and from AD > 16. Neural network analysis showed that (a) aberrations in recall was the most important feature of aMCI versus HC with impairments in language and orientation being the second and third most important features and (b) aberrations in visuospatial skills and executive functions were the most important features of AD versus aMCI and that impairments in recall, language, and orientation but not attention, concentration, and working memory, further discriminated AD from aMCI. CONCLUSIONS The MoCA-Thai is an appropriate cognitive assessment tool to be used in the Thai population for the diagnosis of aMCI and AD.
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Affiliation(s)
- Solaphat Hemrungrojn
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, .,Cognitive Fitness Research Group, Chulalongkorn University, Bangkok, Thailand,
| | | | - Thammanard Charoenboon
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Prathumthani, Thailand
| | - Muthita Panasawat
- Department of Psychiatry, Faculty of Medicine, Thammasat University, Prathumthani, Thailand
| | | | | | | | - Yuttachai Likitjaroen
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kammant Phanthumchinda
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Psychiatry, Medical University of Plovdiv and Technological Center for Emergency Medicine, Plovdiv, Bulgaria.,IMPACT Strategic Research Centre, Deakin University, Geelong, Victoria, Australia
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Duarte-Abritta B, Sánchez SM, Abulafia C, Gustafson DR, Vázquez S, Sevlever G, Castro MN, Fiorentini L, Villarreal MF, Guinjoan SM. Amyloid and anatomical correlates of executive functioning in middle-aged offspring of patients with late-onset Alzheimer's disease. Psychiatry Res Neuroimaging 2021; 316:111342. [PMID: 34365076 DOI: 10.1016/j.pscychresns.2021.111342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/02/2021] [Accepted: 06/18/2021] [Indexed: 12/13/2022]
Abstract
A traditional hallmark of cognitive impairment associated with late-onset Alzheimer´s disease (LOAD) is episodic memory impairment. However, early alterations have been identified in brain regions associated with executive function in asymptomatic, middle-age offspring of patients with LOAD (O-LOAD) compared to those with no family history. We hypothesized that executive function among O-LOAD would correlate with structural and amyloid brain imaging differently from those without a family history of LOAD (control subjects, CS). Executive function, cortical thickness, and in-vivo Aβ deposits were quantified in 30 O-LOAD and 25 CS. Associations were observed among O-LOAD only. Cortical thickness in the left lateral orbitofrontal cortex was positively associated with Design Fluency. The Stroop Color and Word Test, correlated positively with right rostral mid-frontal cortex thickness. Trails Making Test-B was inversely related to left medial orbitofrontal thickness. Tower of London total time was positively associated with β-amyloid deposition in the right precuneus. These results support previous evidence that early executive dysfunction might reflect subtle, early changes in persons at risk of LOAD and suggests that executive function alterations deserve further exploration in the LOAD literature.
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Affiliation(s)
- Bárbara Duarte-Abritta
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta, Instituto de Neurociencias FLENI-CONICET, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Stella-Maris Sánchez
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta, Instituto de Neurociencias FLENI-CONICET, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Departamento de Física, Facultad de Cs. Exactas y Naturales, Universidad de Buenos Aires, Argentina
| | - Carolina Abulafia
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta, Instituto de Neurociencias FLENI-CONICET, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Institute for Biomedical Research (BIOMED), Pontifical Catholic University of Argentina, Buenos Aires, Argentina
| | - Deborah R Gustafson
- Department of Neurology, State University of New York University Downstate Health Sciences University, United States
| | - Silvia Vázquez
- Centro de imágenes moleculares (CIM), Fundación FLENI, Argentina
| | - Gustavo Sevlever
- Departamento de Neuropatología y Biología Molecular, Fundación FLENI, Buenos Aires, Argentina
| | - Mariana N Castro
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta, Instituto de Neurociencias FLENI-CONICET, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina; Servicio de Psiquiatría, Fundación FLENI, Buenos Aires, Argentina
| | - Leticia Fiorentini
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta, Instituto de Neurociencias FLENI-CONICET, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Servicio de Psiquiatría, Fundación FLENI, Buenos Aires, Argentina
| | - Mirta F Villarreal
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta, Instituto de Neurociencias FLENI-CONICET, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Departamento de Física, Facultad de Cs. Exactas y Naturales, Universidad de Buenos Aires, Argentina
| | - Salvador M Guinjoan
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta, Instituto de Neurociencias FLENI-CONICET, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Argentina; Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina; Neurofisiología I, Facultad de Psicología, Universidad de Buenos Aires, Argentina; Laureate Institute for Brain Research, OK, United States.
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11
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Preserved semantic categorical organization in mild cognitive impairment: A network analysis of verbal fluency. Neuropsychologia 2021; 157:107875. [PMID: 33930387 DOI: 10.1016/j.neuropsychologia.2021.107875] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/15/2020] [Accepted: 04/21/2021] [Indexed: 11/21/2022]
Abstract
The decline in semantic verbal fluency as we age may originate from both semantic memory degradation and executive function deficits. We investigated to what extent semantic memory is organized into categories in older adults with mild cognitive impairment (n = 81) and healthy controls (n = 83). We obtained the semantic networks automatically from the probability of co-occurrence of words in a verbal fluency test and characterized them with graph-theory tools. We found that the degree of categorical organization was similar for both diagnostic groups, but there was a higher tendency to transition to other categories during word production in the patient group. These results suggest that the semantic network is preserved in mild cognitive impairment, but also that the existing associations are exploited less efficiently during long-term memory search, possibly because of deficits in executive function.
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12
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Matias-Guiu JA, Pytel V, Delgado-Álvarez A, Delgado-Alonso C, Cortés-Martínez A, Fernández-Oliveira A, Matías-Guiu J. The Five-Point Test: Normative data for middle-aged and elderly Spaniards. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1323-1331. [PMID: 33470870 DOI: 10.1080/23279095.2021.1873137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The Five-Point Test (5PT) is a neuropsychological tool for examining design or figural fluency. In this study, we aimed to provide normative data for the 5PT in Spain. Also, we aimed to compare the norms collected in our research with other normative studies from other populations to evaluate a potential cross-cultural application of 5PT. One hundred and ninety-two healthy subjects aged were enrolled. The mean age was 68.48 ± 9.68 years old (range 50-89), and mean years of education were 10.65 ± 5.22. There were 117 (60.9%) women. The overlapping interval strategy was used to maximize the sample size. Age- and education-adjusted scores were estimated using linear regression analysis. Intraclass correlation coefficient was used to calculate agreement with norms from other countries. Age and years of formal education showed moderate correlations with the scores, while the influence of sex was non-significant. Intraclass correlation coefficient (absolute agreement) between Spanish and German norms was 0.956 (95% confidence interval 0.906-0.978). Norms for unique designs at 1, 2, and 3 minutes are provided. Our study confirms the influence of age and education on design fluency and provides normative data for people older than 50 years old. We hypothesize that 5PT might be a useful test in cross-cultural settings.
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Affiliation(s)
- Jordi A Matias-Guiu
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - Vanesa Pytel
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - Alfonso Delgado-Álvarez
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - Cristina Delgado-Alonso
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | - Ana Cortés-Martínez
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
| | | | - Jorge Matías-Guiu
- Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Madrid, Spain
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13
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Anderson ND, Beana E, Yang H, Köhler S. Deficits in recent but not lifetime familiarity in amnestic mild cognitive impairment. Neuropsychologia 2020; 151:107735. [PMID: 33359882 DOI: 10.1016/j.neuropsychologia.2020.107735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/16/2020] [Accepted: 12/20/2020] [Indexed: 11/30/2022]
Abstract
People with amnestic mild cognitive impairment (aMCI) repeat questions, seemingly without any sense of familiarity (i.e., recognition of prior occurrence without recollection of episodic context). Accumulation of neurofibrillary tau in preclinical Alzheimer's disease begins in perirhinal cortex, a medial temporal lobe region linked to familiarity. Both observations would predict impaired familiarity assessment in aMCI; however, the extant evidence is mixed. To reveal familiarity impairments, it may be necessary to minimize the influence of recollection. In the current study, older adults with aMCI and healthy controls were administered two tasks on which a well-characterized patient (NB) with selective familiarity impairments due to surgical left temporal lobe excision sparing the hippocampus showed abnormal performance: frequency judgments for words exposed to in a recent study phase and judgments of cumulative lifetime familiarity for object concepts denoted by words. We also administered a process dissociation procedure (PDP) task that previously revealed spared familiarity in aMCI. We predicted that familiarity would be spared in aMCI on the PDP task, but impaired when assessed by frequency judgments for recent laboratory exposures and lifetime familiarity judgments. Familiarity was spared on the PDP task, but was impaired when probed with frequency judgments for recently exposed words in aMCI. Lifetime familiarity was also not impaired in aMCI. These results highlight the benefits of studying familiarity under conditions that minimize recollection and the value of frequency judgments in revealing familiarity deficits, and suggest that perirhinal cortex may not be necessary for accessing familiarity accumulated over a lifetime of experience.
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Affiliation(s)
- Nicole D Anderson
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada; Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada.
| | - Elsa Beana
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
| | - Haopei Yang
- Brain & Mind Institute and Department of Psychology, Western University, Ontario, Canada
| | - Stefan Köhler
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada; Brain & Mind Institute and Department of Psychology, Western University, Ontario, Canada
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14
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Battista P, Griseta C, Tortelli R, Guida P, Castellana F, Rivolta D, Logroscino G. The Modified Five-Point Test (MFPT): normative data for a sample of Italian elderly. Neurol Sci 2020; 42:2431-2440. [PMID: 33074452 DOI: 10.1007/s10072-020-04818-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Non-verbal figural fluency is related to executive functions and specifically to the ability to create as many unique designs as possible, while minimizing their repetitions. An Italian version of figural fluency is the Modified Five-Point Test (MFPT), which is highly employed in the clinical practice of neuropsychologists. To date, reference data of Italian population are limited to a sample aged between 16 and 60 years old. Thus, the current study aims to provide normative data of the MFPT in the context of a population-based setting, conducted in Southern Italy. MATERIAL AND METHODS We collected N = 340 Italian healthy subjects, aged over 65 years old (range: 65-91), pooled across subgroups for age, sex, and education. Multiple regression analyses were performed to estimate the effect of age, education, and sex on the participant's performance. Equivalent scores and cut-off scores were also defined for the number of unique designs (UDs) and the number of strategies (CSs). RESULTS Multiple regression analyses revealed that UDs increase with decreasing age and increasing educational level. CSs are influenced by higher educational levels but neither by age nor sex. A significant inverse correlation between the UDs and percentage of errors occurred, suggesting that a higher number of UDs are associated with a fewer number of errors and higher CSs employed. CONCLUSION The MFPT provides a measure of cognitive functioning in terms of the ability to initiate and realize designs, affording useful hints for clinical settings. The MFPT may represent a handy and useful tool with a specific focus in the differentiation of healthy versus pathological aging.
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Affiliation(s)
- Petronilla Battista
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, 94518, USA. .,Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Pavia, Italy.
| | - Chiara Griseta
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, 70013, Bari, Italy
| | - Rosanna Tortelli
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G Panico, Tricase, Italy. .,Institute of Neurology, University College London (UCL), London, UK.
| | - Pietro Guida
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Pavia, Italy
| | - Fabio Castellana
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, 70013, Bari, Italy
| | - Davide Rivolta
- Department of Education, Psychology and Communication, University of Bari Aldo Moro, Bari, Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G Panico, Tricase, Italy.,Department of Basic Medical Sciences Neurosciences and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
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15
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Junquera A, García-Zamora E, Olazarán J, Parra MA, Fernández-Guinea S. Role of Executive Functions in the Conversion from Mild Cognitive Impairment to Dementia. J Alzheimers Dis 2020; 77:641-653. [DOI: 10.3233/jad-200586] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Recent research pointed to executive dysfunction as a potential early predictor of the progression of mild cognitive impairment (MCI) to dementia in Alzheimer’s clinical syndrome (ACS). Such cognitive impairments account for functional impairments in instrumental activities of daily living (IADL). Objective: The present study analyzes the contributions of executive functions to predict MCI–dementia progression in ACS. Methods: We assessed 145 participants, 51 cognitively unimpaired and 94 MCI. The latter were divided using the traditional, memory-based MCI classification (single domain amnestic, multidomain amnestic, and non-amnestic). Eight tests assessing executive functions were administered at baseline and at 1-year follow-up, together with cognitive screening tools and IADL measures. MCI patients were reclassified based on the outcomes from a K-mean cluster analysis which identified three groups. A simple lineal regression model was used to examine whether the classification based on executive functioning could more accurately predict progression to dementia a year later. Results: Clusters based on executive function deficits explained a significant proportion of the variance linked to MCI–dementia conversion, even after controlling for the severity of MCI at baseline (F(1, 68) = 116.25, p = 0.000, R2 = 0.63). Classical memory-based MCI classification failed to predict such a conversion (F(1, 68) = 5.09, p = 0.955, R2 = 0.07). Switching, categories generation, and planning were the executive functions that best distinguished between MCI converters and stable. Conclusion: MCI with a dysexecutive phenotype significantly predicts conversion to dementia in ACS a year later. Switching abilities and verbal fluency (categories) must be evaluated in MCI patients to assess risk of future dementia.
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Affiliation(s)
- Almudena Junquera
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Facultad de Psicología, Universidad Complutense de Madrid, España
| | - Estefanía García-Zamora
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Facultad de Psicología, Universidad Complutense de Madrid, España
| | - Javier Olazarán
- Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Mario A. Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
- Neuroprogressive and Dementia Network, NHS Scotland, UK
- Universidad Autónoma del Caribe, Barranquilla, Colombia
| | - Sara Fernández-Guinea
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Facultad de Psicología, Universidad Complutense de Madrid, España
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16
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Tubi MA, Feingold FW, Kothapalli D, Hare ET, King KS, Thompson PM, Braskie MN. White matter hyperintensities and their relationship to cognition: Effects of segmentation algorithm. Neuroimage 2020; 206:116327. [PMID: 31682983 PMCID: PMC6981030 DOI: 10.1016/j.neuroimage.2019.116327] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 12/31/2022] Open
Abstract
White matter hyperintensities (WMHs) are brain white matter lesions that are hyperintense on fluid attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) scans. Larger WMH volumes have been associated with Alzheimer's disease (AD) and with cognitive decline. However, the relationship between WMH volumes and cross-sectional cognitive measures has been inconsistent. We hypothesize that this inconsistency may arise from 1) the presence of AD-specific neuropathology that may obscure any WMH effects on cognition, and 2) varying criteria for creating a WMH segmentation. Manual and automated programs are typically used to determine segmentation boundaries, but criteria for those boundaries can differ. It remains unclear whether WMH volumes are associated with cognitive deficits, and which segmentation criteria influence the relationships between WMH volumes and clinical outcomes. In a sample of 260 non-demented participants (ages 55-90, 141 males, 119 females) from the Alzheimer's Disease Neuroimaging Initiative (ADNI), we compared the performance of five WMH segmentation methods, by relating the WMH volumes derived using each method to both clinical diagnosis and composite measures of executive function and memory. To separate WMH effects on cognition from effects related to AD-specific processes, we performed analyses separately in people with and without abnormal cerebrospinal fluid amyloid levels. WMH volume estimates that excluded more diffuse, lower-intensity lesions were more strongly correlated with clinical diagnosis and cognitive performance, and only in those without abnormal amyloid levels. These findings may inform best practices for WMH segmentation, and suggest that AD neuropathology may mask WMH effects on clinical diagnosis and cognition.
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Affiliation(s)
- Meral A Tubi
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Franklin W Feingold
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, 90292, USA; Stanford University, Stanford, CA, 94305, USA
| | - Deydeep Kothapalli
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Evan T Hare
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Kevin S King
- Huntington Medical Research Institute, Imaging Division, Pasadena, CA, 91105, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, 90292, USA
| | - Meredith N Braskie
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, 90292, USA.
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17
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Minkova L, Peter J, Abdulkadir A, Schumacher LV, Kaller CP, Nissen C, Klöppel S, Lahr J. Determinants of Inter-Individual Variability in Corticomotor Excitability Induced by Paired Associative Stimulation. Front Neurosci 2019; 13:841. [PMID: 31474818 PMCID: PMC6702284 DOI: 10.3389/fnins.2019.00841] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/26/2019] [Indexed: 12/23/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is a well-established tool in probing cortical plasticity in vivo. Changes in corticomotor excitability can be induced using paired associative stimulation (PAS) protocol, in which TMS over the primary motor cortex is conditioned with an electrical peripheral nerve stimulation of the contralateral hand. PAS with an inter-stimulus interval of 25 ms induces long-term potentiation (LTP)-like effects in cortical excitability. However, the response to a PAS protocol tends to vary substantially across individuals. In this study, we used univariate and multivariate data-driven methods to investigate various previously proposed determinants of inter-individual variability in PAS efficacy, such as demographic, cognitive, clinical, neurophysiological, and neuroimaging measures. Forty-one right-handed participants, comprising 22 patients with amnestic mild cognitive impairment (MCI) and 19 healthy controls (HC), underwent the PAS protocol. Prior to stimulation, demographic, genetic, clinical, as well as structural and resting-state functional MRI data were acquired. The two groups did not differ in any of the variables, except by global cognitive status. Univariate analysis showed that only 61% of all participants were classified as PAS responders, irrespective of group membership. Higher PAS response was associated with lower TMS intensity and with higher resting-state connectivity within the sensorimotor network, but only in responders, as opposed to non-responders. We also found an overall positive correlation between PAS response and structural connectivity within the corticospinal tract, which did not differ between groups. A multivariate random forest (RF) model identified age, gender, education, IQ, global cognitive status, sleep quality, alertness, TMS intensity, genetic factors, and neuroimaging measures (functional and structural connectivity, gray matter (GM) volume, and cortical thickness as poor predictors of PAS response. The model resulted in low accuracy of the RF classifier (58%; 95% CI: 42 - 74%), with a higher relative importance of brain connectivity measures compared to the other variables. We conclude that PAS variability in our sample was not well explained by factors known to influence PAS efficacy, emphasizing the need for future replication studies.
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Affiliation(s)
- Lora Minkova
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany
| | - Jessica Peter
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ahmed Abdulkadir
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lena V Schumacher
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph P Kaller
- Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany.,Department of Neuroradiology, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Nissen
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,University Hospital of Psychiatry and Psychotherapy, University Psychiatric Services, University of Bern, Bern, Switzerland.,Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Center for Geriatrics and Gerontology Freiburg, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jacob Lahr
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany
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18
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Tröger J, Linz N, König A, Robert P, Alexandersson J, Peter J, Kray J. Exploitation vs. exploration—computational temporal and semantic analysis explains semantic verbal fluency impairment in Alzheimer's disease. Neuropsychologia 2019; 131:53-61. [DOI: 10.1016/j.neuropsychologia.2019.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 04/12/2019] [Accepted: 05/08/2019] [Indexed: 10/26/2022]
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19
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Massimo L, Xie SX, Rennert L, Fick DM, Halpin A, Placek K, Williams A, Rascovsky K, Irwin DJ, Grossman M, McMillan CT. Occupational attainment influences longitudinal decline in behavioral variant frontotemporal degeneration. Brain Imaging Behav 2019. [PMID: 29542053 DOI: 10.1007/s11682-018-9852-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
To evaluate whether occupational attainment influences the trajectory of longitudinal cognitive decline in behavioral variant frontotemporal degeneration (bvFTD). Single-center, retrospective, longitudinal study. Sixty-three patients meeting consensus criteria for bvFTD underwent evaluation at the University of Pennsylvania Frontotemporal Degeneration Center. All patients were studied longitudinally on letter-guided fluency, category-naming fluency and Boston Naming Test (BNT). Occupational attainment was defined categorically by assigning each individual's occupation to a professional or non-professional category. Linear mixed-effects models evaluated the interaction of neuropsychological performance change with occupational status. Regression analyses were used to relate longitudinal decline in executive function to baseline MRI grey matter atrophy. Higher occupational status was associated with a more severe slope of cognitive decline on letter-guided fluency and category-naming fluency, but not BNT. Faster rates of longitudinal decline on letter-guided and category-naming fluency were associated with more severe baseline grey matter atrophy in right dorsolateral and inferior frontal regions. Our longitudinal findings suggest that bvFTD individuals with higher lifetime cognitive experience demonstrate more rapid decline on measures of executive function. This finding converges with cross-sectional evidence suggesting that lifetime cognitive experiences contribute to heterogeneity in clinical progression in bvFTD.
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Affiliation(s)
- Lauren Massimo
- Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 West Gates, Philadelphia, PA, 19104, USA.
- The Pennsylvania State University, College of Nursing, University Park, PA, USA.
| | - Sharon X Xie
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lior Rennert
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Donna M Fick
- The Pennsylvania State University, College of Nursing, University Park, PA, USA
| | - Amy Halpin
- Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 West Gates, Philadelphia, PA, 19104, USA
| | - Katerina Placek
- Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 West Gates, Philadelphia, PA, 19104, USA
| | - Andrew Williams
- Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 West Gates, Philadelphia, PA, 19104, USA
| | - Katya Rascovsky
- Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 West Gates, Philadelphia, PA, 19104, USA
| | - David J Irwin
- Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 West Gates, Philadelphia, PA, 19104, USA
| | - Murray Grossman
- Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 West Gates, Philadelphia, PA, 19104, USA
| | - Corey T McMillan
- Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 West Gates, Philadelphia, PA, 19104, USA
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20
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König A, Linz N, Tröger J, Wolters M, Alexandersson J, Robert P. Fully Automatic Speech-Based Analysis of the Semantic Verbal Fluency Task. Dement Geriatr Cogn Disord 2018; 45:198-209. [PMID: 29886493 DOI: 10.1159/000487852] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 02/20/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Semantic verbal fluency (SVF) tests are routinely used in screening for mild cognitive impairment (MCI). In this task, participants name as many items as possible of a semantic category under a time constraint. Clinicians measure task performance manually by summing the number of correct words and errors. More fine-grained variables add valuable information to clinical assessment, but are time-consuming. Therefore, the aim of this study is to investigate whether automatic analysis of the SVF could provide these as accurate as manual and thus, support qualitative screening of neurocognitive impairment. METHODS SVF data were collected from 95 older people with MCI (n = 47), Alzheimer's or related dementias (ADRD; n = 24), and healthy controls (HC; n = 24). All data were annotated manually and automatically with clusters and switches. The obtained metrics were validated using a classifier to distinguish HC, MCI, and ADRD. RESULTS Automatically extracted clusters and switches were highly correlated (r = 0.9) with manually established values, and performed as well on the classification task separating HC from persons with ADRD (area under curve [AUC] = 0.939) and MCI (AUC = 0.758). CONCLUSION The results show that it is possible to automate fine-grained analyses of SVF data for the assessment of cognitive decline.
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Affiliation(s)
- Alexandra König
- Memory Clinic, Association IA, CoBTek Lab, CHU Université Côte d'Azur, Nice, France
| | - Nicklas Linz
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | - Johannes Tröger
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | - Maria Wolters
- School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Jan Alexandersson
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | - Phillipe Robert
- Memory Clinic, Association IA, CoBTek Lab, CHU Université Côte d'Azur, Nice, France
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21
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Hawks ZW, Strube MJ, Johnson NX, Grange DK, White DA. Developmental Trajectories of Executive and Verbal Processes in Children with Phenylketonuria. Dev Neuropsychol 2018; 43:207-218. [PMID: 29432026 DOI: 10.1080/87565641.2018.1438439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Phenylketonuria (PKU) is a hereditary disorder characterized by disrupted phenylalanine metabolism and cognitive impairment. However, the precise nature and developmental trajectory of this cognitive impairment remains unclear. The present study used a verbal fluency task to dissociate executive and verbal processes in children with PKU (n = 23; 7-18 years) and controls (n = 44; 7-19 years). Data were collected at three longitudinal timepoints over a three-year period, and the contributions of age, group, and their interaction to fluency performance were evaluated. Results indicated impairments in executive processes in children with PKU, which were exacerbated by declining metabolic control.
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Affiliation(s)
- Zoë W Hawks
- a Department of Psychological & Brain Sciences , Washington University , St. Louis , Missouri , United States of America
| | - Michael J Strube
- a Department of Psychological & Brain Sciences , Washington University , St. Louis , Missouri , United States of America
| | - Neco X Johnson
- a Department of Psychological & Brain Sciences , Washington University , St. Louis , Missouri , United States of America
| | - Dorothy K Grange
- b Department of Pediatrics , Washington University School of Medicine , St. Louis , Missouri , United States of America
| | - Desirée A White
- a Department of Psychological & Brain Sciences , Washington University , St. Louis , Missouri , United States of America.,b Department of Pediatrics , Washington University School of Medicine , St. Louis , Missouri , United States of America
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22
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Ilhan Algin D, Dagli Atalay S, Ozkan S, Ozbabalik Adapinar D, Ak Sivrioz I. Memantine improves semantic memory in patients with amnestic mild cognitive impairment: A single-photon emission computed tomography study. J Int Med Res 2017; 45:2053-2064. [PMID: 28661262 PMCID: PMC5805216 DOI: 10.1177/0300060517715166] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 05/23/2017] [Indexed: 12/20/2022] Open
Abstract
Objective This study was performed to assess the efficacy of memantine in patients with amnestic mild cognitive impairment (aMCI). Methods Thirty healthy controls and 45 patients diagnosed with aMCI based on the Petersen criteria were classified into 3 groups. Group 1 comprised patients who received a single memantine dose following examination (n = 25), Group 2 comprised patients who did not receive memantine treatment following examination (n = 20), and Group 3 comprised healthy age-matched volunteers (n = 30). Neuropsychological testing was performed, and the response to memantine was examined at baseline and at 12, 24, and 48 weeks. Single-photon emission computed tomography was performed at baseline and at 48 weeks in patients who received memantine treatment. Results Memantine treatment significantly improved the symptoms of aMCI according to the Wechsler Adult Intelligence Scale-Revised vocabulary subtest, backward digit span, and Blessed Dementia Rating Scale, all of which were recorded for the duration of the study. Conclusion These data indicate that patients with aMCI receiving memantine develop an improved semantic memory compared with no treatment. Further studies including larger patient cohorts are necessary to validate these findings.
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Affiliation(s)
- Demet Ilhan Algin
- Assistant Professor, Eskişehir Osmangazi
University Faculty of Medicine Department of Neurology, Eskişehir, Turkey
| | - Suna Dagli Atalay
- Assistant Professor, Eskişehir Osmangazi
University Faculty of Medicine Department of Neurology, Eskişehir, Turkey
| | - Serhat Ozkan
- Assistant Professor, Eskişehir Osmangazi
University Faculty of Medicine Department of Neurology, Eskişehir, Turkey
| | - Demet Ozbabalik Adapinar
- Assistant Professor, Eskişehir Osmangazi
University Faculty of Medicine Department of Neurology, Eskişehir, Turkey
| | - Ilknur Ak Sivrioz
- Professor, Eskişehir Osmangazi
University Faculty of Medicine Department of Nuclear Medicine, Eskişehir,
Turkey
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Toledo CM, Aluísio SM, Dos Santos LB, Brucki SMD, Trés ES, de Oliveira MO, Mansur LL. Analysis of macrolinguistic aspects of narratives from individuals with Alzheimer's disease, mild cognitive impairment, and no cognitive impairment. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2017; 10:31-40. [PMID: 29159266 PMCID: PMC5675715 DOI: 10.1016/j.dadm.2017.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Introduction The depiction of features in discourse production promotes accurate diagnosis and helps to establish the therapeutic intervention in cognitive impairment and dementia. We aimed to identify alterations in the macrolinguistic aspects of discourse using a new computational tool. Methods Sixty individuals, aged 60 years and older, were distributed in three different groups: mild Alzheimer's disease (mAD), amnestic mild cognitive impairment, and healthy controls. A narrative created by individuals was analyzed through the Coh-Metrix-Dementia program, extracting the features of interest automatically. Results mAD showed worse overall performance compared to the other groups: less informative discourse, greater impairment in global coherence, greater modalization, and inferior narrative structure. It was not possible to discriminate between amnestic mild cognitive impairment and healthy controls. Discussion Our results are in line with the literature, verifying a pathological change in the macrostructure of discourse in mAD.
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Affiliation(s)
- Cíntia Matsuda Toledo
- Centro de Referência em Distúrbios Cognitivos, School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Sandra Maria Aluísio
- Núcleo Interinstitucional de Linguística Computacional (NILC), Instituto de Ciências Matemáticas e de Computação, University of São Paulo, São Carlos, São Paulo, Brazil
| | - Leandro Borges Dos Santos
- Núcleo Interinstitucional de Linguística Computacional (NILC), Instituto de Ciências Matemáticas e de Computação, University of São Paulo, São Carlos, São Paulo, Brazil
| | - Sonia Maria Dozzi Brucki
- Centro de Referência em Distúrbios Cognitivos, School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Eduardo Sturzeneker Trés
- Centro de Referência em Distúrbios Cognitivos, School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Maira Okada de Oliveira
- Centro de Referência em Distúrbios Cognitivos, School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Letícia Lessa Mansur
- Centro de Referência em Distúrbios Cognitivos, School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
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