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Fleischman DA, Arfanakis K, Leurgans SE, Arvanitakis Z, Lamar M, Han SD, Poole VN, Bennett DA, Barnes LL. Cerebral arteriolosclerosis, lacunar infarcts, and cognition in older Black adults. Alzheimers Dement 2024. [PMID: 38988020 DOI: 10.1002/alz.13917] [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: 02/12/2024] [Revised: 04/05/2024] [Accepted: 05/01/2024] [Indexed: 07/12/2024]
Abstract
INTRODUCTION Older Black adults are at risk of cerebral small vessel disease (CSVD), which contributes to dementia risk. Two subtypes of CSVD, arteriolosclerosis and ischemic lacunar infarcts, have been independently linked to lower cognition and higher dementia risk, but their combined effects on cognition in older Black adults are unclear. METHODS Mixed models were used to examine the associations of in vivo measures of arteriolosclerosis (ARTS) and ischemic lacunar infarcts to cognitive level and change in 370 older Black adults without dementia. RESULTS: Modeled together, higher ARTS load accounted for lower levels of global cognition, episodic memory, semantic memory, and perceptual speed, whereas higher infarct load accounted for lower levels of working memory. There were no associations with rate of cognitive change. DISCUSSION Both arteriolosclerosis and ischemic infarcts impact the cognitive health of older Black adults, but arteriolosclerosis affects cognition more broadly and offers promise as an in vivo biomarker of dementia risk. HIGHLIGHTS Older Black adults are at risk of cerebral small vessel disease (CSVD) and dementia. Examined magnetic resonance imaging-derived measure of arteriolosclerosis (ARTS), infarcts, and cognition. ARTS load was widely associated with lower cognition after adjusting for infarct load. Infarct load was specifically associated with lower complex attention. More within-Black in vivo studies of CSVD subtypes and cognition are needed.
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Affiliation(s)
- Debra A Fleischman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, Illinois, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
- Department of Family & Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Zoe Arvanitakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - S Duke Han
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Victoria N Poole
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
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Peterson A, Sathe A, Zaras D, Yang Y, Durant A, Deters KD, Shashikumar N, Pechman KR, Kim ME, Gao C, Khairi NM, Li Z, Yao T, Huo Y, Dumitrescu L, Gifford KA, Wilson JE, Cambronero F, Risacher SL, Beason-Held LL, An Y, Arfanakis K, Erus G, Davatzikos C, Tosun D, Toga AW, Thompson PM, Mormino EC, Zhang P, Schilling K, Albert M, Kukull W, Biber SA, Landman BA, Johnson SC, Schneider J, Barnes LL, Bennett DA, Jefferson AL, Resnick SM, Saykin AJ, Hohman TJ, Archer DB. Sex, racial, and APOE-ε4 allele differences in longitudinal white matter microstructure in multiple cohorts of aging and Alzheimer's disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.10.598357. [PMID: 38915636 PMCID: PMC11195046 DOI: 10.1101/2024.06.10.598357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
INTRODUCTION The effects of sex, race, and Apolipoprotein E (APOE) - Alzheimer's disease (AD) risk factors - on white matter integrity are not well characterized. METHODS Diffusion MRI data from nine well-established longitudinal cohorts of aging were free-water (FW)-corrected and harmonized. This dataset included 4,702 participants (age=73.06 ± 9.75) with 9,671 imaging sessions over time. FW and FW-corrected fractional anisotropy (FAFWcorr) were used to assess differences in white matter microstructure by sex, race, and APOE-ε4 carrier status. RESULTS Sex differences in FAFWcorr in association and projection tracts, racial differences in FAFWcorr in projection tracts, and APOE-ε4 differences in FW limbic and occipital transcallosal tracts were most pronounced. DISCUSSION There are prominent differences in white matter microstructure by sex, race, and APOE-ε4 carrier status. This work adds to our understanding of disparities in AD. Additional work to understand the etiology of these differences is warranted.
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Affiliation(s)
- Amalia Peterson
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
| | - Aditi Sathe
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Dimitrios Zaras
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Yisu Yang
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Alaina Durant
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Kacie D. Deters
- Department of Integrative Biology and Physiology, University of California, Los Angeles
| | - Niranjana Shashikumar
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Kimberly R. Pechman
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Michael E. Kim
- Department of Computer Science, Vanderbilt University, Nashville, TN
| | - Chenyu Gao
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN
| | - Nazirah Mohd Khairi
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN
| | - Zhiyuan Li
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN
| | - Tianyuan Yao
- Department of Computer Science, Vanderbilt University, Nashville, TN
| | - Yuankai Huo
- Department of Computer Science, Vanderbilt University, Nashville, TN
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN
| | - Logan Dumitrescu
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Katherine A. Gifford
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
| | - Jo Ellen Wilson
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
- Veteran‘s Affairs, Geriatric Research, Education and Clinical Center, Tennessee Valley Healthcare System
| | - Francis Cambronero
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Shannon L. Risacher
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN
- Indiana Alzheimer’s Disease Research Center, Indiana University School of Medicine, Indianapolis, IN
| | - Lori L. Beason-Held
- Laboratory for Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD
| | - Yang An
- Laboratory for Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Department of Diagnostic Radiology, Rush University Medical Center, Chicago, IL
| | - Guray Erus
- Department of Radiology, University of Pennsylvania, Philadelphia, PA
| | | | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Arthur W. Toga
- Laboratory of Neuroimaging, USC Stevens Institute of Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
| | - Elizabeth C. Mormino
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA
| | - Panpan Zhang
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Kurt Schilling
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN2
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | - Marilyn Albert
- Department of Neurology, Johns Hopkins School of Medicine Baltimore, MD
| | - Walter Kukull
- National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Sarah A. Biber
- National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Bennett A. Landman
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
- Department of Computer Science, Vanderbilt University, Nashville, TN
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, TN
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN2
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Julie Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | - Angela L. Jefferson
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
- Department of Computer Science, Vanderbilt University, Nashville, TN
| | - Susan M. Resnick
- Laboratory for Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD
| | - Andrew J. Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN
- Indiana Alzheimer’s Disease Research Center, Indiana University School of Medicine, Indianapolis, IN
| | - Timothy J. Hohman
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Derek B. Archer
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University School of Medicine, Nashville, TN
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, TN
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Biesbroek JM, Coenen M, DeCarli C, Fletcher EM, Maillard PM, Barkhof F, Barnes J, Benke T, Chen CPLH, Dal‐Bianco P, Dewenter A, Duering M, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Hilal S, Hofer E, Koek HL, Maier AB, McCreary CR, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Sudre CH, Steketee RME, Teunissen CE, van den Berg E, van der Flier WM, Venketasubramanian N, Venkatraghavan V, Vernooij MW, Wolters FJ, Xin X, Kuijf HJ, Biessels GJ. Amyloid pathology and vascular risk are associated with distinct patterns of cerebral white matter hyperintensities: A multicenter study in 3132 memory clinic patients. Alzheimers Dement 2024; 20:2980-2989. [PMID: 38477469 PMCID: PMC11032573 DOI: 10.1002/alz.13765] [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: 10/30/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION White matter hyperintensities (WMH) are associated with key dementia etiologies, in particular arteriolosclerosis and amyloid pathology. We aimed to identify WMH locations associated with vascular risk or cerebral amyloid-β1-42 (Aβ42)-positive status. METHODS Individual patient data (n = 3,132; mean age 71.5 ± 9 years; 49.3% female) from 11 memory clinic cohorts were harmonized. WMH volumes in 28 regions were related to a vascular risk compound score (VRCS) and Aß42 status (based on cerebrospinal fluid or amyloid positron emission tomography), correcting for age, sex, study site, and total WMH volume. RESULTS VRCS was associated with WMH in anterior/superior corona radiata (B = 0.034/0.038, p < 0.001), external capsule (B = 0.052, p < 0.001), and middle cerebellar peduncle (B = 0.067, p < 0.001), and Aß42-positive status with WMH in posterior thalamic radiation (B = 0.097, p < 0.001) and splenium (B = 0.103, p < 0.001). DISCUSSION Vascular risk factors and Aß42 pathology have distinct signature WMH patterns. This regional vulnerability may incite future studies into how arteriolosclerosis and Aß42 pathology affect the brain's white matter. HIGHLIGHTS Key dementia etiologies may be associated with specific patterns of white matter hyperintensities (WMH). We related WMH locations to vascular risk and cerebral Aβ42 status in 11 memory clinic cohorts. Aβ42 positive status was associated with posterior WMH in splenium and posterior thalamic radiation. Vascular risk was associated with anterior and infratentorial WMH. Amyloid pathology and vascular risk have distinct signature WMH patterns.
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Lamar M, Arfanakis K, Evia A, Makkinejad N, Capuano AW, Kim N, Leurgans SE, Fleischman DA, Duke Han S, Poole V, Barnes LL. Changes in an in-vivo classifier of ARTerioloSclerosis (ARTS) with simultaneous change in cognition for older African Americans. Neurobiol Aging 2024; 134:21-27. [PMID: 37979249 PMCID: PMC10845033 DOI: 10.1016/j.neurobiolaging.2023.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/20/2023]
Abstract
At autopsy, African American decedents often have mixed Alzheimer's and cerebrovascular brain pathologies including arteriolosclerosis. We applied a novel in-vivo classifier of ARTerioloSclerosis (ARTS) in 167 older African Americans (∼75y of age) with > 2 biennial 3 T MRI scans and > 3 years of associated cognitive follow-up to determine if ARTS scores (higher score=higher likelihood of arteriolosclerosis) changed over time and if this change associated with changes in cognition in the same individuals. Mixed effects regression models tested whether ARTS scores increased over time, while simultaneous mixed effects regression models estimated the simultaneous rates of change in both ARTS and cognition and the correlation of these changes. ARTS scores increased over time (estimate=0.030, SE=0.002, p < 0.0001). Faster increases in ARTS were associated with faster rates of global cognitive decline (r = -0.447, p = 0.006) and domain-specific cognitive functions. Applying an in-vivo marker of arteriolosclerosis in an African American cohort revealed that the likelihood of arteriolosclerosis increases over time, and participants whose ARTS scores increased more rapidly tended to have faster than average rates of cognitive decline.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer's Disease Center, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, USA; Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA; Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
| | | | - Nazanin Makkinejad
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Ana W Capuano
- Rush Alzheimer's Disease Center, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Namhee Kim
- Rush Alzheimer's Disease Center, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Debra A Fleischman
- Rush Alzheimer's Disease Center, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - S Duke Han
- Rush Alzheimer's Disease Center, USA; Department of Family Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Victoria Poole
- Rush Alzheimer's Disease Center, USA; Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Abdolahi F, Yu V, Varma R, Zhou X, Wang RK, D'Orazio LM, Zhao C, Jann K, Wang DJ, Kashani AH, Jiang X. Retinal perfusion is linked to cognition and brain MRI biomarkers in Black Americans. Alzheimers Dement 2024; 20:858-868. [PMID: 37800578 PMCID: PMC10917050 DOI: 10.1002/alz.13469] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION We investigated whether retinal capillary perfusion is a biomarker of cerebral small vessel disease and impaired cognition among Black Americans, an understudied group at higher risk for dementia. METHODS We enrolled 96 Black Americans without known cognitive impairment. Four retinal perfusion measures were derived using optical coherence tomography angiography. Neurocognitive assessment and brain magnetic resonance imaging (MRI) were performed. Multiple linear regression analyses were performed. RESULTS Lower retinal capillary perfusion was correlated with worse Oral Symbol Digit Test (P < = 0.005) and Fluid Cognition Composite scores (P < = 0.02), but not with the Crystallized Cognition Composite score (P > = 0.41). Lower retinal perfusion was also correlated with higher free water and peak width of skeletonized mean diffusivity, and lower fractional anisotropy (all P < 0.05) on MRI (N = 35). DISCUSSION Lower retinal capillary perfusion is associated with worse information processing, fluid cognition, and MRI biomarkers of cerebral small vessel disease, but is not related to crystallized cognition.
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Affiliation(s)
- Farzan Abdolahi
- Department of OphthalmologyUniversity of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | - Victoria Yu
- Department of OphthalmologyUniversity of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | - Rohit Varma
- Southern California Eye InstituteCHA Hollywood Presbyterian Medical CenterLos AngelesCaliforniaUSA
| | - Xiao Zhou
- Department of BioengineeringUniversity of WashingtonSeattleWashingtonUSA
| | - Ruikang K. Wang
- Department of BioengineeringUniversity of WashingtonSeattleWashingtonUSA
- Department of OphthalmologyUniversity of WashingtonSeattleWashingtonUSA
| | - Lina M. D'Orazio
- Department of NeurologyUniversity of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | - Chenyang Zhao
- Laboratory of FMRI TechnologyStevens Neuroimaging and Informatics InstituteUniversity of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | - Kay Jann
- Laboratory of FMRI TechnologyStevens Neuroimaging and Informatics InstituteUniversity of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | - Danny J. Wang
- Department of NeurologyUniversity of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
- Laboratory of FMRI TechnologyStevens Neuroimaging and Informatics InstituteUniversity of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
| | - Amir H. Kashani
- Department of OphthalmologyWilmer Eye InstituteJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Xuejuan Jiang
- Department of OphthalmologyUniversity of Southern California Keck School of MedicineLos AngelesCaliforniaUSA
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Zammit AR, Bennett DA, Buchman AS. From theory to practice: translating the concept of cognitive resilience to novel therapeutic targets that maintain cognition in aging adults. Front Aging Neurosci 2024; 15:1303912. [PMID: 38283067 PMCID: PMC10811007 DOI: 10.3389/fnagi.2023.1303912] [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: 09/28/2023] [Accepted: 12/06/2023] [Indexed: 01/30/2024] Open
Abstract
While the concept of cognitive resilience is well-established it has not been defined in a way that can be measured. This has been an impediment to studying its underlying biology and to developing instruments for its clinical assessment. This perspective highlights recent work that has quantified the expression of cortical proteins associated with cognitive resilience, thus facilitating studies of its complex underlying biology and the full range of its clinical effects in aging adults. These initial studies provide empirical support for the conceptualization of resilience as a continuum. Like other conventional risk factors, some individuals manifest higher-than-average cognitive resilience and other individuals manifest lower-than-average cognitive resilience. These novel approaches for advancing studies of cognitive resilience can be generalized to other aging phenotypes and can set the stage for the development of clinical tools that might have the potential to measure other mechanisms of resilience in aging adults. These advances also have the potential to catalyze a complementary therapeutic approach that focuses on augmenting resilience via lifestyle changes or therapies targeting its underlying molecular mechanisms to maintain cognition and brain health even in the presence of untreatable stressors like brain pathologies that accumulate in aging adults.
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Affiliation(s)
- Andrea R. Zammit
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Aron S. Buchman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
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Lamar M, Arfanakis K, Yu L, Kapasi A, Duke Han S, Fleischman DA, Bennett DA, Boyle P. The Relationship of MRI-Derived Alzheimer's and Cerebrovascular-Related Signatures With Level of and Change in Health and Financial Literacy. Am J Geriatr Psychiatry 2023; 31:1129-1139. [PMID: 37541932 PMCID: PMC10800641 DOI: 10.1016/j.jagp.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE The cortical thickness "signature" of Alzheimer's disease (AD-CT) and white matter hyperintensity (WMH) burden have each been associated with cognitive aging and incident AD and related dementias. Less is known about how these structural neuroimaging markers associate with other critical behaviors. We investigated associations of AD-CT and WMH volumes with a composite index of health and financial literacy given that the ability to access, understand, and utilize health and financial information significantly influences older adults' health outcomes. DESIGN, SETTING, PARTICIPANTS Participants were 303 adults without dementia (age∼80 years; 74% women) from the Rush Memory and Aging Project. MEASUREMENTS Baseline 3T MRI T1-weighted structural and T2-weighted FLAIR data were used to assess AD-CT and WMH volumes, respectively. Literacy was measured using questions designed to assess comprehension of health and financial information and concepts, yielding a total literacy score. Multivariable linear mixed effects regression models determined the relationship of each neuroimaging marker, first separately and then combined, with the level of and change in literacy. RESULTS Reduced AD-CT and higher WMH at baseline were each associated with lower levels of literacy; only AD-CT was associated with the rate of decline in literacy over time. The association of AD-CT with change in literacy persisted when both neuroimaging markers were included in the same model. CONCLUSIONS The cortical thickness signature of AD predicts changes in health and financial literacy in nondemented older adults suggesting that the multidimensional construct of health and financial literacy relies on specific brain networks implicated in AD.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Psychiatry and Behavioral Sciences (ML, DAF, PB), Rush University Medical Center, Chicago, IL.
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Diagnostic Radiology and Nuclear Medicine (KA, AK), Rush University Medical Center, Chicago, IL; Department of Biomedical Engineering (KA), Illinois Institute of Technology, Chicago, IL
| | - Lei Yu
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Neurological Sciences (LY, DAF, DAB), Rush University Medical Center, Chicago, IL
| | - Alifiya Kapasi
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Diagnostic Radiology and Nuclear Medicine (KA, AK), Rush University Medical Center, Chicago, IL
| | - S Duke Han
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Family Medicine (SDH), Keck School of Medicine of University of Southern California, Los Angeles, CA
| | - Debra A Fleischman
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Psychiatry and Behavioral Sciences (ML, DAF, PB), Rush University Medical Center, Chicago, IL; Department of Neurological Sciences (LY, DAF, DAB), Rush University Medical Center, Chicago, IL
| | - David A Bennett
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Neurological Sciences (LY, DAF, DAB), Rush University Medical Center, Chicago, IL
| | - Patricia Boyle
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Psychiatry and Behavioral Sciences (ML, DAF, PB), Rush University Medical Center, Chicago, IL
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Tap L, Vernooij MW, Wolters F, van den Berg E, Mattace-Raso FUS. New horizons in cognitive and functional impairment as a consequence of cerebral small vessel disease. Age Ageing 2023; 52:afad148. [PMID: 37585592 PMCID: PMC10431695 DOI: 10.1093/ageing/afad148] [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: 03/21/2023] [Revised: 06/06/2023] [Indexed: 08/18/2023] Open
Abstract
Cerebral small vessel disease (cSVD) is a frequent finding in imaging of the brain in older adults, especially in the concomitance of cardiovascular disease risk factors. Despite the well-established link between cSVD and (vascular) cognitive impairment (VCI), it remains uncertain how and when these vascular alterations lead to cognitive decline. The extent of acknowledged markers of cSVD is at best modestly associated with the severity of clinical symptoms, but technological advances increasingly allow to identify and quantify the extent and perhaps also the functional impact of cSVD more accurately. This will facilitate a more accurate diagnosis of VCI, against the backdrop of concomitant other neurodegenerative pathology, and help to identify persons with the greatest risk of cognitive and functional deterioration. In this study, we discuss how better assessment of cSVD using refined neuropsychological and comprehensive geriatric assessment as well as modern image analysis techniques may improve diagnosis and possibly the prognosis of VCI. Finally, we discuss new avenues in the treatment of cSVD and outline how these contemporary insights into cSVD can contribute to optimise screening and treatment strategies in older adults with cognitive impairment and multimorbidity.
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Affiliation(s)
- Lisanne Tap
- Department of Internal Medicine, Section of Geriatric Medicine and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Radiology and Nuclear Medicine and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Frank Wolters
- Department of Epidemiology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Esther van den Berg
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Francesco U S Mattace-Raso
- Department of Internal Medicine, Section of Geriatric Medicine and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Oveisgharan S, Kim N, Agrawal S, Yu L, Leurgans S, Kapasi A, Arfanakis K, Bennett DA, Schneider JA, Buchman AS. Brain and spinal cord arteriolosclerosis and its associations with cerebrovascular disease risk factors in community-dwelling older adults. Acta Neuropathol 2023; 145:219-233. [PMID: 36469116 PMCID: PMC10183107 DOI: 10.1007/s00401-022-02527-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Arteriolosclerosis is common in older brains and related to cognitive and motor impairment. We compared the severity of arteriolosclerosis and its associations with cerebrovascular disease risk factors (CVD-RFs) in multiple locations in the brain and spinal cord. Participants (n = 390) were recruited in the context of a longitudinal community-based clinical-pathological study, the Rush Memory and Aging Project. CVD-RFs were assessed annually for an average of 8.7 (SD = 4.3) years before death. The annual assessments included systolic (SBP) and diastolic (DBP) blood pressure, diabetes mellitus (DM), low- and high-density lipoprotein cholesterol, triglyceride, body mass index, and smoking. Postmortem pathological assessments included assessment of arteriolosclerosis severity using the same rating scale in three brain locations (basal ganglia, frontal, and parietal white matter regions) and four spinal cord levels (cervical, thoracic, lumbar and sacral levels). A single measure was used to summarize the severity of spinal arteriolosclerosis assessments at the four levels due to their high correlations. Average age at death was 91.5 (SD = 6.2) years, and 73% were women. Half showed arteriolosclerosis in frontal white matter and spinal cord followed by parietal white matter (38%) and basal ganglia (27%). The severity of arteriolosclerosis in all three brain locations showed mild-to-moderate correlations. By contrast, spinal arteriolosclerosis was associated with brain arteriolosclerosis only in frontal white matter. Higher DBP was associated with more severe arteriolosclerosis in all three brain locations. DM was associated with more severe arteriolosclerosis only in frontal white matter. Controlling for DBP, higher SBP was inversely associated with arteriolosclerosis in parietal white matter. Blood cholesterol and triglyceride, high body mass index, or smoking were not related to the severity of arteriolosclerosis in any brain region. None of the CVD-RFs were associated with the severity of spinal arteriolosclerosis. These data indicate that severity of arteriolosclerosis and its associations with CVD-RFs may vary in different CNS locations.
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Affiliation(s)
- Shahram Oveisgharan
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA.
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
| | - Namhee Kim
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sonal Agrawal
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sue Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Alifiya Kapasi
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Biesbroek JM, Biessels GJ. Diagnosing vascular cognitive impairment: Current challenges and future perspectives. Int J Stroke 2023; 18:36-43. [PMID: 35098817 PMCID: PMC9806474 DOI: 10.1177/17474930211073387] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Cerebrovascular disease is a major cause of cognitive decline and dementia. This is referred to as vascular cognitive impairment (VCI). Diagnosing VCI is important, among others to optimize treatment to prevent further vascular injury. This narrative review addresses challenges in current diagnostic approaches to VCI and potential future developments. First we summarize how diagnostic criteria for VCI evolved over time. We then highlight challenges in diagnosing VCI in clinical practice: assessment of severity of vascular brain injury on brain imaging is often imprecise and the relation between vascular lesion burden and cognitive functioning shows high intersubject variability. This can make it difficult to establish causality in individual patients. Moreover, because VCI is essentially an umbrella term, it lacks specificity on disease mechanisms, prognosis, and treatment. We see the need for a fundamentally different approach to diagnosing VCI, which should be more dimensional, including multimodal quantitative assessment of injury, with more accurate estimation of cognitive impact, and include biological definitions of disease that can support further development of targeted treatment. Recent developments in the field that can form the basis of such an approach are discussed.
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Affiliation(s)
- J Matthijs Biesbroek
- Department of Neurology, UMC Utrecht
Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands,Department of Neurology,
Diakonessenhuis Hospital, Utrecht, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht
Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands,Geert Jan Biessels, Department of
Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, G03.232,
PO Box 85500, 3508 GA Utrecht, The Netherlands.
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11
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Maillard P, Hillmer LJ, Lu H, Arfanakis K, Gold BT, Bauer CE, Kramer JH, Staffaroni AM, Stables L, Wang DJ, Seshadri S, Satizabal CL, Beiser A, Habes M, Fornage M, Mosley TH, Rosenberg GA, Singh B, Singh H, Schwab K, Helmer KG, Greenberg SM, DeCarli C, Caprihan A. MRI free water as a biomarker for cognitive performance: Validation in the MarkVCID consortium. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12362. [PMID: 36523847 PMCID: PMC9745638 DOI: 10.1002/dad2.12362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/11/2022] [Accepted: 08/29/2022] [Indexed: 12/15/2022]
Abstract
Introduction To evaluate the clinical validity of free water (FW), a diffusion tensor imaging-based biomarker kit proposed by the MarkVCID consortium, by investigating the association between mean FW (mFW) and executive function. Methods Baseline mFW was related to a baseline composite measure of executive function (EFC), adjusting for relevant covariates, in three MarkVCID sub-cohorts, and replicated in five, large, independent legacy cohorts. In addition, we tested whether baseline mFW predicted accelerated EFC score decline (mean follow-up time: 1.29 years). Results Higher mFW was found to be associated with lower EFC scores in MarkVCID legacy and sub-cohorts (p-values < 0.05). In addition, higher baseline mFW was associated significantly with accelerated decline in EFC scores (p = 0.0026). Discussion mFW is a sensitive biomarker of cognitive decline, providing a strong clinical rational for its use as a marker of white matter (WM) injury in multi-site observational studies and clinical trials of vascular cognitive impairment and dementia (VCID).
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Affiliation(s)
- Pauline Maillard
- Department of NeurologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Laura J. Hillmer
- Department of NeurologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Hanzhang Lu
- Department of RadiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Konstantinos Arfanakis
- Department of Biomedical EngineeringIllinois Institute of TechnologyChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterDepartment of Diagnostic Radiology and Nuclear MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Brian T. Gold
- Department of NeuroscienceUniversity of KentuckyLexingtonKentuckyUSA
| | | | - Joel H. Kramer
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Adam M. Staffaroni
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Lara Stables
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Danny J.J. Wang
- Laboratory of FMRI Technology (LOFT)Stevens Neuroimaging and Informatics InstituteKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Sudha Seshadri
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | - Claudia L. Satizabal
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health San AntonioSan AntonioTexasUSA
- Department of Population Health SciencesUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | - Alexa Beiser
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Mohamad Habes
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular MedicineMcGovern Medical SchoolSchool of Public HealthThe University of Texas Health Science Center at HoustonHoustonTexasUSA
- Human Genetics CenterSchool of Public HealthThe University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Thomas H. Mosley
- MIND CenterUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Gary A. Rosenberg
- Department of NeurologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Baljeet Singh
- Department of NeurologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Herpreet Singh
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Kristin Schwab
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Karl G. Helmer
- Department of RadiologyHarvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
| | | | - Charles DeCarli
- Department of NeurologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Arvind Caprihan
- The Mind Research NetworkAlbuquerqueNew MexicoAlbuquerqueNew MexicoUSA
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12
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Abdelhak A, Solomon I, Montes SC, Saias A, Cordano C, Asken B, Fonseca C, Oertel FC, Arfanakis K, Staffaroni AM, Kramer JH, Geschwind M, Miller BL, Elahi FM, Green AJ. Retinal arteriolar parameters as a surrogate marker of intracranial vascular pathology. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12338. [PMID: 35814617 PMCID: PMC9257197 DOI: 10.1002/dad2.12338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/10/2022]
Abstract
Introduction Development of novel diagnostic tools is a top research priority in vascular dementia. A major obstacle is the lack of a simple, non-invasive method to visualize cerebral arteriolar walls in vivo. Retinal arterioles offer a window into the cerebral circulation. Methods Intensity-based retinal arteriolar visualization in optical coherence tomography (I-bRAVO) was applied to evaluate mean wall thickness (MWT) and wall-to-lumen ratio (WLR) in 250 subjects with sporadic and genetic cerebral small vessel disease (CSVD), non-vascular neurodegenerative diseases (NVND), and healthy controls (HC) in association with imaging and cognitive markers. Results MWT and WLR were higher in CSVD, associated with severity of vascular white matter lesions, and correlated with magnetic resonance imaging-based intracranial arteriolosclerosis score. WLR correlated with gray and white matter volume and differentiated asymptomatic sporadic CSVD from HC (area under the curve = 0.82). Discussion I-bRAVO is a rapid, non-invasive tool. MWT and WLR were associated with imaging markers of CSVD and could contribute to early identification of sporadic CSVD.
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Affiliation(s)
- Ahmed Abdelhak
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Isaac Solomon
- San Diego School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Shivany Condor Montes
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Alexandra Saias
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Christian Cordano
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Breton Asken
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Corrina Fonseca
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Frederike Cosima Oertel
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Konstantinos Arfanakis
- Department of Biomedical EngineeringIllinois Institute of TechnologyChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Adam M. Staffaroni
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Joel H. Kramer
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Michael Geschwind
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Bruce L. Miller
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Fanny M. Elahi
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
- San Francisco Veterans Affairs Health Care System
| | - Ari J. Green
- Weill Institute for NeurosciencesDepartment of NeurologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
- Department of OphthalmologyUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
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