1
|
Saywell I, Foreman L, Child B, Phillips-Hughes AL, Collins-Praino L, Baetu I. Influence of cognitive reserve on cognitive and motor function in α-synucleinopathies: A systematic review and multilevel meta-analysis. Neurosci Biobehav Rev 2024; 161:105672. [PMID: 38608829 DOI: 10.1016/j.neubiorev.2024.105672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/26/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
Cognitive reserve has shown promise as a justification for neuropathologically unexplainable clinical outcomes in Alzheimer's disease. Recent evidence suggests this effect may be replicated in conditions like Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy. However, the relationships between cognitive reserve and different cognitive abilities, as well as motor outcomes, are still poorly understood in these conditions. Additionally, it is unclear whether the reported effects are confounded by medication. This review analysed studies investigating the relationship between cognitive reserve and clinical outcomes in these α-synucleinopathy cohorts, identified from MEDLINE, Scopus, psycINFO, CINAHL, and Web of Science. 85 records, containing 176 cognition and 31 motor function effect sizes, were pooled using multilevel meta-analysis. There was a significant, positive association between higher cognitive reserve and both better cognition and motor function. Cognition effect sizes differed by disease subtype, cognitive reserve measure, and outcome type; however, no moderators significantly impacted motor function. Review findings highlight the clinical implications of cognitive reserve and importance of engaging in reserve-building behaviours.
Collapse
Affiliation(s)
- Isaac Saywell
- School of Psychology, University of Adelaide, Adelaide 5005, Australia.
| | - Lauren Foreman
- School of Psychology, University of Adelaide, Adelaide 5005, Australia
| | - Brittany Child
- School of Psychology, University of Adelaide, Adelaide 5005, Australia
| | | | | | - Irina Baetu
- School of Psychology, University of Adelaide, Adelaide 5005, Australia.
| |
Collapse
|
2
|
Abo Foul Y, Arkadir D, Demikhovskaya A, Noyman Y, Linetsky E, Abu Snineh M, Aviezer H, Eitan R. Perception of emotionally incongruent cues: evidence for overreliance on body vs. face expressions in Parkinson's disease. Front Psychol 2024; 15:1287952. [PMID: 38770252 PMCID: PMC11103677 DOI: 10.3389/fpsyg.2024.1287952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/08/2024] [Indexed: 05/22/2024] Open
Abstract
Individuals with Parkinson's disease (PD) may exhibit impaired emotion perception. However, research demonstrating this decline has been based almost entirely on the recognition of isolated emotional cues. In real life, emotional cues such as expressive faces are typically encountered alongside expressive bodies. The current study investigated emotion perception in individuals with PD (n = 37) using emotionally incongruent composite displays of facial and body expressions, as well as isolated face and body expressions, and congruent composite displays as a baseline. In addition to a group of healthy controls (HC) (n = 50), we also included control individuals with schizophrenia (SZ) (n = 30), who display, as in PD, similar motor symptomology and decreased emotion perception abilities. The results show that individuals with PD showed an increased tendency to categorize incongruent face-body combinations in line with the body emotion, whereas those with HC showed a tendency to classify them in line with the facial emotion. No consistent pattern for prioritizing the face or body was found in individuals with SZ. These results were not explained by the emotional recognition of the isolated cues, cognitive status, depression, or motor symptoms of individuals with PD and SZ. As real-life expressions may include inconsistent cues in the body and face, these findings may have implications for the way individuals with PD and SZ interpret the emotions of others.
Collapse
Affiliation(s)
- Yasmin Abo Foul
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - David Arkadir
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Anastasia Demikhovskaya
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yehuda Noyman
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eduard Linetsky
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Muneer Abu Snineh
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Hillel Aviezer
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Renana Eitan
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Medical Neurobiology (Physiology), Institute for Medical Research Israel-Canada, Hebrew University-Hadassah Medical School, Jerusalem, Israel
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
3
|
Chang CW, Tan CH, Hong WP, Yu RL. GBA moderates cognitive reserve's effect on cognitive function in patients with Parkinson's disease. J Neurol 2024:10.1007/s00415-024-12374-5. [PMID: 38656622 DOI: 10.1007/s00415-024-12374-5] [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: 12/04/2023] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Cognitive reserve (CR) involves an individual's ability to maintain cognitive vitality over their lifespan. Glucocerebrosidase (GBA) gene mutations contribute to additional effects on cognitive function in Parkinson's disease (PD) patients, but the interplay between GBA mutations and CR remains unclear. We investigated the interactions among CR, GBA, and diseases, aiming to examine whether the CR established at different stages interacts with specific genotypes to affect cognitive function. METHODS Three hundred and eighteen participants' CR indicators (i.e., education, occupation, and social function) and comprehensive neuropsychological function (i.e., tests for executive function, attention/working memory, visuospatial function, memory, and language) were evaluated. RESULTS We found that CR established in a specific life stage influences the individual's cognitive function, particularly in PD, based on their distinct GBA rs9628662 genotypes. Attention/working memory and memory performance are affected by occupational complexity in midlife in PD patients with the GG genotype (q < 0.0001; q < 0.0001) and healthy adults with the T genotype (q = 0.0440; q < 0.0001). Language is influenced by early education and occupation, and the effects of occupation are also observed in PD patients with the GG genotype (q = 0.0040) and in healthy adults carrying the T genotype (q = 0.0040). CONCLUSIONS CR, established at different life stages, can be influenced by the GBA rs9628662 genotype, impacting later-life cognition. Validating genotypes and incorporating genotype information when assessing cognitive reserve effects is crucial and can enhance targeted cognitive training.
Collapse
Affiliation(s)
- Chia-Wen Chang
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Hsiang Tan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Pin Hong
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Rwei-Ling Yu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Office of Strategic Planning, National Cheng Kung University, Tainan, Taiwan.
| |
Collapse
|
4
|
Schwartz CE, Borowiec K, Rapkin BD. Reserve-building as a buffer for depression among individuals living with disability: a longitudinal study of current activities related to brain health. Front Psychol 2024; 15:1330437. [PMID: 38455115 PMCID: PMC10919219 DOI: 10.3389/fpsyg.2024.1330437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/19/2024] [Indexed: 03/09/2024] Open
Abstract
Aims This study examined whether reserve-building activities are associated with attenuated reported depression among people who were disabled from work due to a medical condition as compared to employed, retired, and unemployed participants. Methods This secondary analysis included 771 individuals who provided data at three time points: baseline (late Spring 2020), follow-up 1 (Spring 2021), and follow-up 2 (Fall 2021). The DeltaQuest Reserve-Building Measure assessed current activities related to brain health. An analysis of variance and Pearson correlation coefficients assessed group differences in reserve-building activity scores. Classification and regression tree (CART) modeling investigated factors associated with higher and lower reported depression by employment group. The random effects (RE) models tested two buffering hypotheses: (1) comparing all groups to the employed group and (2) examining within-group effects. Results Engaging in outdoor activities, exercise, and religious/spiritual activities was associated with reduced depression over time in the overall sample. While disabled participants endorsed lower levels of being Active in the World, Outdoor activities, and Exercise and higher levels of Inner Life and Passive Media Consumption than the other employment groups, more reserve-building activities distinguished depression levels in the disabled group's CART models compared to the others. Among the disabled, unemployed, and retired participants, engaging in any reserve-building activities was also associated with lower depression scores, which was distinct from the employed participants. In the RE models that used the employed group as the reference category, only the disabled group's level of depression was buffered by engaging in creative activities. In the within-group RE models, the disabled group's engagement in Religious/Spiritual, Outdoors, and Games was associated with substantially reduced within-group depression, which was different from the other employment groups. In contrast, reserve-building activities were not implicated at all as buffers for employed participants. Conclusion This study revealed a beneficial effect of reserve-building activities on buffering depression over time during the COVID-19 pandemic, particularly for disabled people. It documented that even if such individuals engaged in lesser amounts of such activities as compared to other employment groups, the buffering effect was substantial. Given the low-cost and accessible nature of reserve-building activities, it would be worthwhile to encourage such activities for disabled individuals.
Collapse
Affiliation(s)
- Carolyn E. Schwartz
- DeltaQuest Foundation, Inc., Concord, MA, United States
- Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, United States
| | - Katrina Borowiec
- DeltaQuest Foundation, Inc., Concord, MA, United States
- Department of Measurement, Evaluation, Statistics, and Assessment, Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, United States
| | - Bruce D. Rapkin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| |
Collapse
|
5
|
Di Tella S, Isernia S, Cabinio M, Rossetto F, Borgnis F, Pagliari C, Cazzoli M, Navarro J, Silveri MC, Baglio F. Cognitive Reserve proxies can modulate motor and non-motor basal ganglia circuits in early Parkinson's Disease. Brain Imaging Behav 2024; 18:220-230. [PMID: 37993754 PMCID: PMC10844415 DOI: 10.1007/s11682-023-00829-8] [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] [Accepted: 11/19/2023] [Indexed: 11/24/2023]
Abstract
Parkinson's Disease (PD) is hallmarked by dysfunctional circuitry between the basal ganglia and dorsolateral-prefrontal cortex. Recently progress has been made in understanding factors contributing to differential susceptibility to pathology mitigating disease-related cognitive decline. Cognitive reserve, the brain processing resources accumulated throughout life while engaged in mentally stimulating activities, can play an important protective role in cognitive performance. We tested the hypothesis that Cognitive Reserve proxies may exert an impact on the basal ganglia and dorsolateral-prefrontal atrophy in early PD. Forty-five early patients with PD and 20 age-gender-matched healthy controls (HC) completed the Cognitive Reserve Index questionnaire to quantify Cognitive Reserve proxies by three indexes (CRI-Education, CRI-Working Activity, CRI-Leisure Time) and a structural MRI examination (3T). Morphometrical indexes for basal ganglia (bilateral putamen, caudate, pallidum volume) and dorsolateral-prefrontal cortex (cortical thickness) were computed. Significant differences between HC and PD were tested by direct comparisons in demographics, cognitive level, and cognitive reserve proxies indexes. Then two multiple regression analyses were performed to identify predictors of the basal ganglia and dorsolateral-prefrontal cortex structural integrity. Regression analysis revealed that basal ganglia volume was significantly predicted by CRI-Education (pFDR = 0.029), sex (pFDR = 0.029), and Total Intracranial Volume (pFDR < 0.001). Instead, the dorsolateral-prefrontal thickness was predicted by CRI-Leisure Time (pFDR = 0.030) and age (pFDR = 0.010). Cognitive Reserve proxies, especially education and leisure-time activities, can play a protective role on the structural integrity of the basal ganglia and dorsolateral-prefrontal cortex, respectively, critical regions hallmarking brain status of early phases of PD.
Collapse
Affiliation(s)
- Sonia Di Tella
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Sara Isernia
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
| | - Monia Cabinio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | | | | | - Marta Cazzoli
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Jorge Navarro
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | | | | |
Collapse
|
6
|
Šneidere K, Zdanovskis N, Mondini S, Stepens A. Relationship between lifestyle proxies of cognitive reserve and cortical regions in older adults. Front Psychol 2024; 14:1308434. [PMID: 38250107 PMCID: PMC10797127 DOI: 10.3389/fpsyg.2023.1308434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction With the rapid increase in the population over 65 years old, research on healthy aging has become one of the priorities in the research community, looking for a cost-effective method to prevent or delay symptoms of mild cognitive disorder or dementia. Studies indicate that cognitive reserve theory could be beneficial in this regard. The aim of this study was to investigate the potential relationship between lifestyle socio-behavioral proxies of cognitive reserve and cortical regions in adults with no subjective cognitive decline. Methods Overall, 58 participants, aged 65-85 years, were included in the data analysis (M = 71.83, SD = 5.02, 20.7% male). Cognitive reserve proxies were measured using the Cognitive Reserve Index questionnaire, while cortical volumes were obtained with the Siemens 1.5 T Avanto MRI scanner and further mapped using the Desikan-Killiany-Tourville (DKT) Atlas. Estimated intracranial volume and age were used as covariates. Results The results indicated that higher occupational complexity was associated with larger cortical volume in the left middle temporal gyrus, the left and right inferior temporal gyrus, and the left inferior parietal lobule, while a combined proxy (the total CRI score) showed a positive relationship with the volume of left middle temporal gyrus and inferior parietal lobule, and pars orbitalis in the right hemisphere. Discussion These results might indicate that more complex occupational activities and overall more intellectually and socially active life-style could contribute to better brain health, especially in regions known to be more vulnerable to Alzheimer's disease.
Collapse
Affiliation(s)
- Kristine Šneidere
- Department of Health Psychology and Pedagogy, Riga Stradiņš University, Riga, Latvia
- Military Medicine Research and Study Centre, Riga Stradiņš University, Riga, Latvia
| | - Nauris Zdanovskis
- Military Medicine Research and Study Centre, Riga Stradiņš University, Riga, Latvia
- Department of Radiology, Riga Stradiņš University, Riga, Latvia
- Department of Radiology, Riga East University Hospital, Riga, Latvia
| | - Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Ainars Stepens
- Military Medicine Research and Study Centre, Riga Stradiņš University, Riga, Latvia
| |
Collapse
|
7
|
Paola Caminiti S, Gallo S, Menegon F, Naldi A, Comi C, Tondo G. Lifestyle Modulators of Neuroplasticity in Parkinson's Disease: Evidence in Human Neuroimaging Studies. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:602-613. [PMID: 37326116 DOI: 10.2174/1871527322666230616121213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/25/2023] [Accepted: 05/17/2023] [Indexed: 06/17/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disease characterized by both motor and non-motor symptoms. A progressive neuronal loss and the consequent clinical impairment lead to deleterious effects on daily living and quality of life. Despite effective symptomatic therapeutic approaches, no disease-modifying therapies are currently available. Emerging evidence suggests that adopting a healthy lifestyle can improve the quality of life of PD patients. In addition, modulating lifestyle factors can positively affect the microstructural and macrostructural brain levels, corresponding to clinical improvement. Neuroimaging studies may help to identify the mechanisms through which physical exercise, dietary changes, cognitive enrichment, and exposure to substances modulate neuroprotection. All these factors have been associated with a modified risk of developing PD, with attenuation or exacerbation of motor and non-motor symptomatology, and possibly with structural and molecular changes. In the present work, we review the current knowledge on how lifestyle factors influence PD development and progression and the neuroimaging evidence for the brain structural, functional, and molecular changes induced by the adoption of positive or negative lifestyle behaviours.
Collapse
Affiliation(s)
| | - Silvia Gallo
- Neurology Unit, Department of Translational Medicine, Movement Disorders Centre, University of Piemonte Orientale, 28100 Novara, Italy
| | - Federico Menegon
- Neurology Unit, Department of Translational Medicine, Movement Disorders Centre, University of Piemonte Orientale, 28100 Novara, Italy
| | - Andrea Naldi
- Neurology Unit, San Giovanni Bosco Hospital, 10154 Turin, Italy
| | - Cristoforo Comi
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy
| | - Giacomo Tondo
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy
| |
Collapse
|
8
|
Pinto JO, Peixoto B, Dores AR, Barbosa F. Measures of cognitive reserve: An umbrella review. Clin Neuropsychol 2024; 38:42-115. [PMID: 37073431 DOI: 10.1080/13854046.2023.2200978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/04/2023] [Indexed: 04/20/2023]
Abstract
Objective: Recently, there has been a growing interest in operationalizing and measuring cognitive reserve (CR) for clinical and research purposes. This umbrella review aims to summarize the existing systematic and meta-analytic reviews about measures of CR. Method: A literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the guidelines of Aromataris et al. (2015) to identify the systematic reviews and meta-analysis involving the assessment of CR. The methodological quality of the papers included in this umbrella review was assessed with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) and Specialist Unit for Review Evidence (SURE). Results: Thirty-one reviews were identified, sixteen of which were systematic reviews, and fifteen were meta-analyses. Most of the reviews had a critically low quality, according to AMSTAR-2. The reviews included between two and 135 studies. Most of the papers focused on older adults, mainly those with dementia. CR was measured using one to six proxies, but most considered each proxy separately. The most assessed proxies of CR were education on its own, combined with occupation and/or engagement in activities or combined with parental education, bilingualism, and engagement in activities when four CR proxies were studied. Most of the studies included in higher quality reviews focused on three proxies, with education and engagement in activities being the most evaluated using CR questionnaires. Conclusion: Despite the growing interest in measuring CR, its operationalization did not improve since the last umbrella review in this field.
Collapse
Affiliation(s)
- Joana O Pinto
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- CESPU, University Institute of Health Sciences, Gandra, Portugal
| | - Bruno Peixoto
- CESPU, University Institute of Health Sciences, Gandra, Portugal
- NeuroGen - Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Artemisa R Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- Center for Rehabilitation Research, ESS, Polytechnic of Porto, Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| |
Collapse
|
9
|
Jellinger KA. Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks. Int J Mol Sci 2023; 25:498. [PMID: 38203667 PMCID: PMC10778722 DOI: 10.3390/ijms25010498] [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: 11/23/2023] [Revised: 12/11/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Cognitive impairment (CI) is a characteristic non-motor feature of Parkinson disease (PD) that poses a severe burden on the patients and caregivers, yet relatively little is known about its pathobiology. Cognitive deficits are evident throughout the course of PD, with around 25% of subtle cognitive decline and mild CI (MCI) at the time of diagnosis and up to 83% of patients developing dementia after 20 years. The heterogeneity of cognitive phenotypes suggests that a common neuropathological process, characterized by progressive degeneration of the dopaminergic striatonigral system and of many other neuronal systems, results not only in structural deficits but also extensive changes of functional neuronal network activities and neurotransmitter dysfunctions. Modern neuroimaging studies revealed multilocular cortical and subcortical atrophies and alterations in intrinsic neuronal connectivities. The decreased functional connectivity (FC) of the default mode network (DMN) in the bilateral prefrontal cortex is affected already before the development of clinical CI and in the absence of structural changes. Longitudinal cognitive decline is associated with frontostriatal and limbic affections, white matter microlesions and changes between multiple functional neuronal networks, including thalamo-insular, frontoparietal and attention networks, the cholinergic forebrain and the noradrenergic system. Superimposed Alzheimer-related (and other concomitant) pathologies due to interactions between α-synuclein, tau-protein and β-amyloid contribute to dementia pathogenesis in both PD and dementia with Lewy bodies (DLB). To further elucidate the interaction of the pathomechanisms responsible for CI in PD, well-designed longitudinal clinico-pathological studies are warranted that are supported by fluid and sophisticated imaging biomarkers as a basis for better early diagnosis and future disease-modifying therapies.
Collapse
Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, A-1150 Vienna, Austria
| |
Collapse
|
10
|
Farran N, Darwish H. Validation of the Cognitive Reserve Index Questionnaire (CRIq) in Arabic. Behav Sci (Basel) 2023; 13:1006. [PMID: 38131862 PMCID: PMC10740462 DOI: 10.3390/bs13121006] [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: 10/19/2023] [Revised: 12/02/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
Cognitive reserve is the adaptability of cognitive processes in the face of brain aging and pathology. This study aimed to validate the Arabic version of the Cognitive Reserve Index Questionnaire (CRIq) in a healthy Lebanese sample. CRIq assesses cognitive reserve through three domains: education, working activity, and leisure time. Statistical measures, including descriptive and regression analysis along with structural equation modeling, were utilized to investigate the convergent and discriminant validity of the CRIq, incorporating fluid intelligence (Gf) and measures of cognitive function, long-term memory encoding and retrieval (Glr), and processing speed (Gs). Results from 174 participants revealed that the activities assessed by the CRIq-Arabic were comparable to the original CRIq study, with slight cultural differences. The internal consistency of the CRIq-Arabic was good (Cronbach's α = 0.88), indicating reliability. Convergent validity was confirmed, with moderate to high loadings on the cognitive reserve latent construct. Discriminant validity was supported as correlations between cognitive reserve variables and non-target constructs (Gf, Glr, and Gs) were less than 1. The findings provide an initial psychometric validation of the CRIq-Arabic. Further research of clinical samples is needed to enhance its utility in neuropsychological practice.
Collapse
Affiliation(s)
- Natali Farran
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Hala Darwish
- Hariri School of Nursing, American University of Beirut, Beirut 11-0236, Lebanon
- Department of Systems, Populations and Leadership, School of Nursing and Department of Neurology, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| |
Collapse
|
11
|
Fisher A, Moore DJ, Levine AJ, Masliah E, Gouaux B, Soontornniyomkij V, Letendre S, Sundermann EE. The relationship between synaptodendritic neuropathology and HIV-associated neurocognitive disorders is moderated by cognitive reserve. J Neurovirol 2023; 29:713-722. [PMID: 37943478 DOI: 10.1007/s13365-023-01177-5] [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: 01/26/2023] [Revised: 06/23/2023] [Accepted: 09/21/2023] [Indexed: 11/10/2023]
Abstract
We examined whether cognitive reserve moderated the relationship between neurodegeneration and cognition in 67 postmortem persons with HIV (PWH) who were cognitively assessed within 1 year of death. Cognitive reserve was measured via the Wide Range Achievement Test-4 reading subtest (WRAT4). Synaptodendritic neurodegeneration was based on densities of synaptophysin and microtubule-associated protein 2 immunohistochemical reactivity in frontal cortex, and categorized as minimal, moderate, or severe (tertile-split). T-Scores from 15 cognitive tests were averaged into a global cognitive T-score. Among those with low cognitive reserve (based on WRAT4 median split), the moderate neurodegeneration group showed cognition that was poorer than the minimal neurodegeneration group and comparable to the severe neurodegeneration group. Among those with high cognitive reserve, the moderate neurodegeneration group showed cognition comparable to the minimal neurodegeneration group and better than the severe neurodegeneration group. High cognitive reserve may buffer against cognitive impairment among PWH with moderate, but not severe, neurodegeneration.
Collapse
Affiliation(s)
- Arin Fisher
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92037, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92037, USA
| | - Andrew J Levine
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Ben Gouaux
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92037, USA
| | | | - Scott Letendre
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Erin E Sundermann
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92037, USA.
| |
Collapse
|
12
|
Hoenig MC, Dzialas V, Banwinkler M, Asendorf A, Drzezga A, van Eimeren T. Educational level and its association with dopamine transporter loss in patients with Parkinson's disease. Parkinsonism Relat Disord 2023; 115:105844. [PMID: 37690218 DOI: 10.1016/j.parkreldis.2023.105844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/07/2023] [Accepted: 09/01/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND According to the cognitive-reserve concept, higher educated dementia patients tolerate more brain pathology than lower educated patients with similar impairment. Here, we examined whether higher education is associated with more severe dopamine terminal loss at the diagnosis of Parkinson's disease (PD). METHODS Dopamine transporter (DaT) SPECT information of 352 de novo PD patients and 172 healthy controls (HC) were retrieved from PPMI. Correlation analyses were performed between education years and regional DaT signal (i.e., putamen, caudate, striatum), correcting for UPDRS-III, age, sex and MoCA. Second, using a median split on education (Md = 16 yrs), high and low education groups were determined, which were matched for demographic and/or clinical scores and compared based on regional DaT signals. Finally, moderation analyses were conducted in the PD cohort, assessing the effect of education on the relation between putaminal DaT capacity and UPDRS-III. All analyses were performed across the entire cohorts and separately for three age ranges (sixth, seventh and eighth life decade). RESULTS Only PD patients in their eighth life decade presented a positive association between education and regional dopamine signalling. A significant moderation effect of education on the association between putaminal DaT signal loss and motor symptom severity was observed in this group (B=3.377, t=3.075, p = .003). The remaining analyses did not yield any significant results, neither in the PD nor HC cohort. CONCLUSION Higher education is not related with greater tolerance against dopamine loss in PD, but may nonetheless assert protective effects at more advanced age.
Collapse
Affiliation(s)
- Merle C Hoenig
- Research Center Juelich, Institute of Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany.
| | - Verena Dzialas
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
| | - Magdalena Banwinkler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
| | - Adrian Asendorf
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
| | - Alexander Drzezga
- Research Center Juelich, Institute of Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany; German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany
| | - Thilo van Eimeren
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
| |
Collapse
|
13
|
França M, Parada Lima J, Oliveira A, Rosas MJ, Vicente SG, Sousa C. Visuospatial memory profile of patients with Parkinson's disease. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-9. [PMID: 37695259 DOI: 10.1080/23279095.2023.2256918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND In Parkinson's Disease (PD) cognitive impairment may become evident at an early stage of the disease. Performance in the visuospatial domain has been pointed out as a possible predictor of cognitive decline for dementia. OBJECTIVES The goal was to characterize the visuospatial memory profile, explore the predictive value of a set of visuospatial measures that better distinguish patients from controls, and investigate the relevance of the 10/36 SPART, providing cutoff scores. METHODS A total of 43 PD patients and 45 healthy controls (HC) were recruited from the Centro Hospitalar Universitário de São João and the community, respectively. The protocol included a set of tests assessing global cognitive functioning, visuoperceptive abilities, and visuospatial memory. RESULTS PD patients performed significantly worse than HC, showing difficulties in global cognition, visuospatial learning, and visuoconstructive and perceptive abilities. Through a discriminant analysis, the Clock Drawing Test and ACE-R's visuospatial domain were revealed as good tools to be included in the evaluation protocol. Regarding the 10/36 SPART's performance, four predictors were found (age, sex, education, and emotional distress) and cutoff scores were determined. CONCLUSIONS The visuospatial memory profile found was congruent with that described in the literature. The results were discussed according to their relevance for clinical practice and future research.
Collapse
Affiliation(s)
- Márcia França
- Faculty of Psychology and Educational Sciences of Oporto University, Porto, Portugal
| | - Joana Parada Lima
- Neuropsychology Unit of Psychology Department, São João University Hospital Center, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - Ana Oliveira
- Neurology Service, São João University Hospital Center, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - Maria José Rosas
- Neurology Service, São João University Hospital Center, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - Selene G Vicente
- Faculty of Psychology and Educational Sciences of Oporto University, Porto, Portugal
- Psychology Center, Oporto University, Porto, Portugal
| | - Cláudia Sousa
- Faculty of Psychology and Educational Sciences of Oporto University, Porto, Portugal
- Neuropsychology Unit of Psychology Department, São João University Hospital Center, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| |
Collapse
|
14
|
Di Tella S, De Marco M, Baglio F, Silveri MC, Venneri A. Resting-state functional connectivity is modulated by cognitive reserve in early Parkinson's disease. Front Psychol 2023; 14:1207988. [PMID: 37691780 PMCID: PMC10485267 DOI: 10.3389/fpsyg.2023.1207988] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/28/2023] [Indexed: 09/12/2023] Open
Abstract
Background Fronto-striatal disconnection is thought to be at the basis of dysexecutive symptoms in patients with Parkinson's disease (PD). Multiple reserve-related processes may offer resilience against functional decline. Among these, cognitive reserve (CR) refers to the adaptability of cognitive processes. Objective To test the hypothesis that functional connectivity of pathways associated with executive dysfunction in PD is modulated by CR. Methods Twenty-six PD patients and 24 controls underwent resting-state functional magnetic resonance imaging. Functional connectivity was explored with independent component analysis and seed-based approaches. The following networks were selected from the outcome of the independent component analysis: default-mode (DMN), left and right fronto-parietal (l/rFPN), salience (SalN), sensorimotor (SMN), and occipital visual (OVN). Seed regions were selected in the substantia nigra and in the dorsolateral and ventromedial prefrontal cortex for the assessment of seed-based functional connectivity maps. Educational and occupational attainments were used as CR proxies. Results Compared with their counterparts with high CR, PD individuals with low CR had reduced posterior DMN functional connectivity in the anterior cingulate and basal ganglia, and bilaterally reduced connectivity in fronto-parietal regions within the networks defined by the dorsolateral and ventrolateral prefrontal seeds. Hyper-connectivity was detected within medial prefrontal regions when comparing low-CR PD with low-CR controls. Conclusion CR may exert a modulatory effect on functional connectivity in basal ganglia and executive-attentional fronto-parietal networks. In PD patients with low CR, attentional control networks seem to be downregulated, whereas higher recruitment of medial frontal regions suggests compensation via an upregulation mechanism. This upregulation might contribute to maintaining efficient cognitive functioning when posterior cortical function is progressively reduced.
Collapse
Affiliation(s)
- Sonia Di Tella
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Matteo De Marco
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | | | | | - Annalena Venneri
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| |
Collapse
|
15
|
Batzu L, Urso D, Grothe MJ, Veréb D, Chaudhuri KR, Pereira JB. Increased basal forebrain volumes could prevent cognitive decline in LRRK2 Parkinson's disease. Neurobiol Dis 2023:106182. [PMID: 37286171 DOI: 10.1016/j.nbd.2023.106182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/12/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES It has been recently suggested that LRRK2 mutations are associated with a more benign clinical phenotype and a potentially more preserved cholinergic function in Parkinson's disease (PD). However, to our knowledge, no studies have tested whether the better clinical progression observed in LRRK2-PD patients is associated with more preserved volumes of a cholinergic brain area, the basal forebrain (BF). To address this hypothesis, here we compared BF volumes in LRRK2 carriers with and without PD with respect to idiopathic PD (iPD) patients and controls, and assessed whether they are associated with better clinical progression observed in LRRK2-PD compared to iPD. METHODS Thirty-one symptomatic LRRK2-PD patients and 13 asymptomatic LRRK2 individuals were included from the Parkinson's Progression Markers Initiative. In addition, 31 patients with iPD and 13 healthy controls matched to the previous groups were also included. BF volumes were automatically extracted from baseline T1-weighted MRI scans using a stereotactic atlas of cholinergic nuclei. These volumes were then compared between groups and their relationship with longitudinal cognitive changes was evaluated using linear mixed effects models. Mediation analyses assessed whether BF volumes mediated differences in cognitive trajectories between groups. RESULTS LRRK2-PD patients showed significantly higher BF volumes compared to iPD (P = 0.019) as did asymptomatic LRRK2 subjects compared to controls (P = 0.008). There were no other significant differences in cortical regions or subcortical volumes between these groups. BF volumes predicted longitudinal decline in several cognitive functions in iPD patients but not in LRRK2-PD, who did not show cognitive changes over a 4-year follow-up period. BF volumes were a significant mediator of the different cognitive trajectories between iPD and LRRK2-PD patients (95% CI 0.056-2.955). DISCUSSION Our findings suggest that mutations in LRRK2 are associated with increased BF volumes, potentially reflecting a compensatory hypercholinergic state that could prevent cognitive decline in LRRK2-PD patients.
Collapse
Affiliation(s)
- Lucia Batzu
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom.
| | - Daniele Urso
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom; 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, Lecce, Italy
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Dániel Veréb
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Joana B Pereira
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden; Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
| |
Collapse
|
16
|
Jin Y, Lin L, Xiong M, Sun S, Wu SC. Moderating effects of cognitive reserve on the relationship between brain structure and cognitive abilities in middle-aged and older adults. Neurobiol Aging 2023; 128:49-64. [PMID: 37163923 DOI: 10.1016/j.neurobiolaging.2023.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 05/12/2023]
Abstract
The cognitive reserve (CR) hypothesis is reinforced by negative moderating effects, suggesting that those with higher CR are less reliant on brain structure for cognitive function. Previous research on CR's moderating effects yielded inconsistent results, motivating our 3 studies using UK Biobank data. Study I examined five CR proxies' moderating effects on global, lobar, and regional brain-cognition models; study II extended study I by using a larger sample size; and study III investigated age-related moderating effects on the hippocampal regions. In study I, most moderating effects were negative and none survived the multiple comparison correction, but study II identified 13 global-level models with significant negative moderating effects that survived correction. Study III showed age influenced CR proxies' moderating effects in hippocampal regions. Our findings suggest that the effects of CR proxies on brain integrity and cognition varied depending on the proxy used, brain integrity indicators, cognitive domain, and age group. This study offers significant insights regarding the importance of CR for brain integrity and cognitive outcomes.
Collapse
Affiliation(s)
- Yue Jin
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Lan Lin
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China.
| | - Min Xiong
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Shen Sun
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Shui-Cai Wu
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| |
Collapse
|
17
|
Saywell I, Child B, Foreman L, Collins-Praino L, Baetu I. Influence of cognitive reserve on cognitive and motor function in α-synucleinopathies: A systematic review protocol. Ann N Y Acad Sci 2023; 1522:15-23. [PMID: 36740453 DOI: 10.1111/nyas.14967] [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: 02/07/2023]
Abstract
Cognitive reserve has been used to justify neuropathologically unexplainable mismatches in Alzheimer's disease outcomes. Recent evidence has suggested this effect may be replicable across other conditions. However, it is still unclear whether cognitive reserve applies to α-synucleinopathies or to motor outcomes, or if medication confounds effects. This review protocol follows PRISMA-P guidelines and aims to investigate whether cognitive reserve can predict both cognitive and motor outcomes for α-synucleinopathy patients. MEDLINE (via PubMed), Scopus, psycINFO (via Ovid), CINAHL (via EBSCO), and Web of Science have been searched. Cross-sectional, cohort, case-control, and longitudinal studies investigating the association between cognitive reserve and cognitive and/or motor outcomes for Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy will be included. Reviewers will independently perform screening, while also extracting data, assessing the risk of bias (using a version of the Quality in Prognostic Studies tool), and rating evidence quality (using GRADE). If possible, random-effects meta-analyses will be conducted for each unique outcome variable and α-synucleinopathy; otherwise, a narrative synthesis will be performed. Depending on the number of studies, exploratory analyses may involve meta-regression to assess potential confounding effects. Understanding the broader protective effect of cognitive reserve has significant implications for preventive interventions in the wider population.
Collapse
Affiliation(s)
- Isaac Saywell
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Brittany Child
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Lauren Foreman
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Irina Baetu
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
18
|
Rocha NP, Carreira EX, Prado ACDA, Tavares F, Tavares M, Cardoso F, Jaeger A, Souza LCD, Teixeira AL. Cognitive evaluation in Parkinson's disease: applying the Movement Disorder Society recommendations in a population with a low level of formal education. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:119-127. [PMID: 36948198 PMCID: PMC10033198 DOI: 10.1055/s-0042-1759761] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND The diagnosis of cognitive disorders in Parkinson disease (PD) can be very challenging. Aiming at establishing uniform and reliable diagnostic procedures, the International Parkinson's Disease and Movement Disorder Society (MDS) commissioned task forces to delineate diagnostic criteria for mild cognitive impairment (MCI) and dementia in PD. OBJECTIVES To investigate the applicability of the MDS recommendations for cognitive evaluation in a Brazilian sample of patients with PD with low levels of formal education. METHODS A total of 41 patients with PD were subjected to a comprehensive neuropsychological evaluation based on tests proposed by the MDS, which included the Mini-Mental State Examination, the Mattis Dementia Rating Scale (MDRS), the Trail Making Test (TMT) parts A and B, in addition to language and memory skills assessment. Neuropsychiatric and daily functioning features were also evaluated. Spearman correlation analyses were used to evaluate the association between the scores obtained in the cognitive scales and demographic/clinical variables. RESULTS Although none of the participants had a formal diagnosis of dementia, 50% presented some degree of cognitive impairment when considering the results of the MDRS. Of note, a noticeable number of patients was not able to complete the full neuropsychological assessment. The TMT part B was the most difficult task, being completed by only 22 participants (54%). As expected, the greater the educational level, the better the performance on the cognitive tests. Better motor function was also associated with better scores in cognition. CONCLUSIONS Adopting strict inclusion/exclusion criteria and a comprehensive clinical evaluation, we found remarkable limitations for the MDS recommendations when individuals with low educational levels are considered. A revision of the current guidelines is necessary considering differences among populations, especially related to formal education.
Collapse
Affiliation(s)
- Natalia Pessoa Rocha
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil
- The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Department of Psychiatry and Behavioral Sciences, Neuropsychiatry Program, Texas, United States
| | - Eduarda Xavier Carreira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil
- The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Department of Psychiatry and Behavioral Sciences, Neuropsychiatry Program, Texas, United States
| | - Ana Carolina de Almeida Prado
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Filosofia e Ciências Humanas, Departamento de Psicologia, Belo Horizonte MG, Brazil
| | - Fabíola Tavares
- Universidade Federal de Minas Gerais, Serviço de Neurologia, Unidade de Distúrbios do Movimento, Belo Horizonte MG, Brazil
| | - Mayra Tavares
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Filosofia e Ciências Humanas, Departamento de Psicologia, Belo Horizonte MG, Brazil
| | - Francisco Cardoso
- Universidade Federal de Minas Gerais, Serviço de Neurologia, Unidade de Distúrbios do Movimento, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Medicina Interna, Belo Horizonte MG, Brazil
| | - Antônio Jaeger
- Universidade Federal de Minas Gerais, Faculdade de Filosofia e Ciências Humanas, Departamento de Psicologia, Belo Horizonte MG, Brazil
| | - Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Serviço de Neurologia, Unidade de Distúrbios do Movimento, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Medicina Interna, Belo Horizonte MG, Brazil
| | - Antônio Lucio Teixeira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brazil
- The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Department of Psychiatry and Behavioral Sciences, Neuropsychiatry Program, Texas, United States
| |
Collapse
|
19
|
D’Este G, Berra F, Carli G, Leitner C, Marelli S, Zucconi M, Casoni F, Ferini-Strambi L, Galbiati A. Cognitive Reserve in Isolated Rapid Eye-Movement Sleep Behavior Disorder. Brain Sci 2023; 13:brainsci13020176. [PMID: 36831719 PMCID: PMC9954116 DOI: 10.3390/brainsci13020176] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
Isolated rapid-eye-movement sleep behaviour disorder (RBD) is considered the prodromal stage of α-synucleinopathies (e.g., Parkinson's disease and dementia with Lewy bodies); however, iRBD patients show a wide variety in the progression timing (5-15 years). The model of cognitive reserve (CR) might contribute to explaining this phenomenon. Our exploratory study aimed to evaluate, for the first time, the impact of CR level on cognitive performance in polysomnography-confirmed iRBD patients. Fifty-five iRBD patients (mean age ± SD: 66.38 ± 7.51; M/F 44/11) underwent clinical and neuropsychological evaluations at the time of diagnosis. The CR Index questionnaire was part of the clinical assessment. We found that iRBD patients with high levels of CR showed: (i) the lowest percentage of mild cognitive impairment (10%), and (ii) the best performance in visuo-constructive and verbal memory functions (i.e., the recall of the Rey-Osterrieth complex figure test). Our results suggest that CR might help iRBD patients better cope with the cognitive decline related to the neurodegenerative process, providing the first preliminary findings supporting CR as a possible protective factor in this condition. This might pave the way for future longitudinal studies to evaluate the role of CR as a modulating factor in the timing of iRBD conversion and cognitive deterioration development.
Collapse
Affiliation(s)
- Giada D’Este
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesca Berra
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Giulia Carli
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Caterina Leitner
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Sara Marelli
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Marco Zucconi
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesca Casoni
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Luigi Ferini-Strambi
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Andrea Galbiati
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Correspondence: ; Tel.: +39-022-643-3397
| |
Collapse
|
20
|
Worm MS, Miskowiak KW, Purdon SE, Flachs EM, Thomsen JF, Eller NH, Jensen JH. Do objective and subjective measures of cognitive impairment predict occupational status in patients with work-related stress? A clinical follow-up study. Int Arch Occup Environ Health 2023; 96:121-130. [PMID: 35896841 DOI: 10.1007/s00420-022-01909-w] [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: 04/13/2022] [Accepted: 07/05/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Cognitive impairment is a common complaint in prolonged work-related stress and may contribute to work disability. The objective was to evaluate the longitudinal impacts of objectively and subjectively measured cognitive impairment on occupational status and to evaluate the measurement's predictive properties regarding occupational prognosis in patients with work-related stress. METHODS Patients with work-related stress (n = 82) were assessed with Danish versions of the Screen for Cognitive Impairment in Psychiatry (SCIP-D) and the Cognitive Failure Questionnaire (CFQ), as screeners of objective and subjective cognitive impairments, respectively. Patients were contacted via telephone at 6-month follow-up providing data on occupational status (employment vs. non-employment). Impacts of cognitive impairment on occupational status were evaluated using logistic regression analyses adjusting for other explanatory covariates (sociodemographic factors, comorbidities etc.). The predictive performance of SCIP-D and CFQ were evaluated using non-adjusted logistic regression analysis and receiver-operating-characteristics curves. RESULTS There was a strong association between objective cognitive impairment measured with SCIP-D and non-employment when adjusting for other explanatory factors (OR adjusted 3.25, 95% CI 1.09-9.69). The association was attenuated but remained robust in the non-adjusted analysis (OR non-adjusted 1.74, 95% CI 1.08-2.81). Yet, a cut-score of SCIP-D performed inadequate as a sole predictor of occupational status. Subjective cognitive impairment was unrelated to subsequent occupational status. CONCLUSIONS Objective-but not subjective-cognitive impairment was associated with subsequent non-employment. Our results suggest a predictive potential in objective measurements of cognitive impairment with significant implications for clinical assessment of patients with work-related stress.
Collapse
Affiliation(s)
- Maja Søndergård Worm
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Psychiatric Centre Copenhagen, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Scot E Purdon
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Department of Neuropsychology, Alberta Hospital Edmonton, Edmonton, AB, Canada
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jane Frølund Thomsen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Nanna Hurwitz Eller
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Stress Research Center, Copenhagen, Denmark
| | - Johan Høy Jensen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark. .,Copenhagen Stress Research Center, Copenhagen, Denmark.
| |
Collapse
|
21
|
How Cognitive Reserve should Influence Rehabilitation Choices using Virtual Reality in Parkinson’s Disease. PARKINSON'S DISEASE 2022; 2022:7389658. [PMID: 36160828 PMCID: PMC9507627 DOI: 10.1155/2022/7389658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/08/2022] [Accepted: 08/25/2022] [Indexed: 11/18/2022]
Abstract
Virtual reality (VR) is used in the rehabilitation of patients with Parkinson's disease (PD) in several studies. In VR trials, the motor, physical characteristics, and the degree of the disease are often well defined, while PD cognitive reserve is not. This systematic review was performed to define a cognitive profile for patients with PD who could best benefit from using VR to enhance functional motor aspects during rehabilitation. PubMed, Cochrane Library, Scopus, and Web of Sciences databases were analysed to identify randomized clinical trials (RCT) and randomized pilot trials that addressed the rehabilitation of motor symptoms in subjects with PD using VR. The included studies used Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA) to evaluate the cognitive aspect. Only articles written in English and with full texts were considered. The risk of bias from all included studies was assessed based on the Cochrane risk-of-bias tool and the PRISMA guideline was considered. Eighteen articles were eligible for review, including three randomized pilot trials. All studies aimed to evaluate the effect of VR on the motor aspects typically affected by PD (balance, postural control, risk of falls, walking, and reaching). The most widely adopted approach has been nonimmersive VR, except for one study that used immersive VR. Both the benefits of physical activity on the motor symptoms of patients with PD and the impact of cognitive reserve during the rehabilitation of these patients were highlighted. The analysis of the results allowed us to outline the ideal cognitive profile of patients with PD who can benefit from the effects of rehabilitation using VR.
Collapse
|
22
|
Lifestyle factors in multiple sclerosis disability progression and silent brain damage: A cross-sectional study. Mult Scler Relat Disord 2022; 65:104016. [DOI: 10.1016/j.msard.2022.104016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/02/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022]
|
23
|
Magnante AT, Ord AS, Holland JA, Sautter SW. Neurocognitive functioning of patients with early-stage Parkinson's disease. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-12. [PMID: 35931087 DOI: 10.1080/23279095.2022.2106865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Parkinson's disease (PD) is a neurological disorder commonly associated with motor deficits. However, cognitive impairment is also common in patients with PD. Cognitive concerns in PD may affect multiple domains of neurocognition and vary across different stages of the disease. Extant research has focused mainly on cognitive deficits in middle to late stages of PD, whereas few studies have examined the unique cognitive profiles of patients with early-stage PD. This study addressed this gap in the published literature and examined neurocognitive functioning and functional capacity of patients with de novo PD, focusing on the unique pattern of cognitive deficits specific to the early stage of the disease. Results indicated that the pattern of cognitive deficits in patients with PD (n = 55; mean age = 72.93) was significantly different from healthy controls (n = 59; mean age = 71.88). Specifically, tasks related to executive functioning, attention, and verbal memory demonstrated the most pronounced deficits in patients with early-stage PD. Clinical implications of these findings are discussed.
Collapse
Affiliation(s)
- Anna Theresa Magnante
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Anna Shirokova Ord
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Jamie A Holland
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Scott W Sautter
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
- Hampton Roads Neuropsychology Inc., Virginia Beach, VA, USA
| |
Collapse
|
24
|
Mondini S, Montemurro S, Pucci V, Ravelli A, Signorini M, Arcara G. Global Examination of Mental State: An open tool for the brief evaluation of cognition. Brain Behav 2022; 12:e2710. [PMID: 35861637 PMCID: PMC9392517 DOI: 10.1002/brb3.2710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/02/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The aim of this paper is to present a freely accessible new instrument for the evaluation of cognition: the Global Examination of Mental State (GEMS). METHODS It is made up of 11 items tapping into a range of skills, such as Orientation in time and space, Memory, Working memory, Visuo-spatial, Visuo-constructional and Planning abilities, Perceptual and visual Attention, Language (Naming, Comprehension, and Verbal fluency), and Pragmatics. RESULTS The psychometric strengths of this screening are: (1) extensive and updated normative data on the adult Italian population (from 18 to 100 years old); (2) absence of ceiling effect in healthy individuals, which allows to better detect interindividual variability; (3) comparison of the global scores with normative data taking into account Cognitive Reserve rather than only education, thus increasing diagnostic accuracy; (4) thresholds for significant change over time and the possibility to use parallel versions (GEMS-A/GEMS-B) for test-retest; (5) solid psychometric properties and data on discriminant validity; and (6) free access to all materials (record forms, instructions, and cut-off scores) on the web under a Creative Common License. CONCLUSIONS With all these characteristics, GEMS could be a very useful paper-and-pencil instrument for cognitive screening.
Collapse
Affiliation(s)
- Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology (FISSPA), University of Padua, Padua, Italy.,Human Inspired Technology Research Centre, University of Padua, Padua, Italy
| | | | - Veronica Pucci
- Department of Philosophy, Sociology, Education and Applied Psychology (FISSPA), University of Padua, Padua, Italy.,Human Inspired Technology Research Centre, University of Padua, Padua, Italy
| | - Adele Ravelli
- Department of Philosophy, Sociology, Education and Applied Psychology (FISSPA), University of Padua, Padua, Italy
| | - Matteo Signorini
- Gruppo Veneto di Diagnostica e Riabilitazione (GVDR), Padua, Italy
| | | |
Collapse
|
25
|
Cao T, Zhang S, Yu M, Zhao X, Wan Q. The Chinese Translation Study of the Cognitive Reserve Index Questionnaire. Front Psychol 2022; 13:948740. [PMID: 35936344 PMCID: PMC9353001 DOI: 10.3389/fpsyg.2022.948740] [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: 05/20/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeThe purpose of this study was to perform the translation and adaption of the Cognitive Reserve Index questionnaire into Chinese and assess the reliability of the Chinese version.Materials and MethodsThe Chinese version of the Cognitive Reserve Index questionnaire was created from a standard forward-backward translation. A total of 371 volunteers, aged between 20 and 89 years, participated in this survey. Participants were divided into three age-groups (Young, Middle-aged, and Elderly), and subgroup differences were examined by independent samples t-tests, ANOVA analysis as well as post-hoc analysis. Pearson correlation analysis was applied to test the association between the total scores and each subscore (CRI-Education, CRI-WorkingActivity, and CRI-LeisureTime). The internal consistency and test-retest reliability of the Cognitive Reserve Index questionnaire were assessed. The test-retest reliability was measured among 40 participants with a 2-week interval using intraclass correlation coefficient.ResultsStrong correlations were observed between the total scores and each subscore (CRI-Education, CRI-WorkingActivity, and CRI-LeisureTime: r = 0.65, 0.79, and 0.70, respectively). In contrast, it was found low to moderate correlations among three subscores. The internal consistency was acceptable (Cronbach's alpha coefficient = 0.68). The intraclass correlation coefficient for total scores of the Chinese version of the Cognitive Reserve Index questionnaire was 0.87 (95% CI 0.74–0.93).ConclusionThe Chinese version of the Cognitive Reserve Index questionnaire was a potentially reliable and practical tool for evaluating cognitive reserve accumulated through a person's life span.
Collapse
|
26
|
Ciccarelli N, Colombo B, Pepe F, Magni E, Antonietti A, Silveri MC. Cognitive reserve: a multidimensional protective factor in Parkinson's disease related cognitive impairment. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:687-702. [PMID: 33629649 DOI: 10.1080/13825585.2021.1892026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Abstract
We explored the association between cognitive reserve (CR) and Parkinson' s disease (PD) related cognitive deterioration.Forty PD patients and 12 matched healthy controls (HC) were enrolled. The PD group was balanced for the presence/absence of cognitive impairment. All participants underwent MOCA. CR was measured by the Brief Intelligence Test, and a new comprehensive tool, named Cognitive Reserve Test (CoRe-T), including sections on leisure activities and creativity.Participants with higher CR obtained a better MOCA score irrespective of the group they belonged to. At the same time, irrespective of the CR level, the performance of the HC group was always better in comparison to the PD group. Within the PD group, a higher frequency of leisure activities was associated to be cognitively unimpaired, independently by the severity of motor symptoms and age.CR could help to cope with PD-related cognitive decline. Its multidimensional nature could have important applications in prevention and rehabilitation interventions.
Collapse
Affiliation(s)
| | | | - Fulvio Pepe
- Department of Neuroscience, Poliambulanza Foundation, Brescia, Italy
| | - Eugenio Magni
- Department of Neuroscience, Poliambulanza Foundation, Brescia, Italy
| | | | | |
Collapse
|
27
|
Gu L, Xu H. Effect of cognitive reserve on cognitive function in Parkinson’s disease. Neurol Sci 2022; 43:4185-4192. [DOI: 10.1007/s10072-022-05985-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/25/2022] [Indexed: 11/28/2022]
|
28
|
Morphological basis of Parkinson disease-associated cognitive impairment: an update. J Neural Transm (Vienna) 2022; 129:977-999. [PMID: 35726096 DOI: 10.1007/s00702-022-02522-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/25/2022] [Indexed: 12/15/2022]
Abstract
Cognitive impairment is one of the most salient non-motor symptoms of Parkinson disease (PD) that poses a significant burden on the patients and carers as well as being a risk factor for early mortality. People with PD show a wide spectrum of cognitive dysfunctions ranging from subjective cognitive decline and mild cognitive impairment (MCI) to frank dementia. The mean frequency of PD with MCI (PD-MCI) is 25.8% and the pooled dementia frequency is 26.3% increasing up to 83% 20 years after diagnosis. A better understanding of the underlying pathological processes will aid in directing disease-specific treatment. Modern neuroimaging studies revealed considerable changes in gray and white matter in PD patients with cognitive impairment, cortical atrophy, hypometabolism, dopamine/cholinergic or other neurotransmitter dysfunction and increased amyloid burden, but multiple mechanism are likely involved. Combined analysis of imaging and fluid markers is the most promising method for identifying PD-MCI and Parkinson disease dementia (PDD). Morphological substrates are a combination of Lewy- and Alzheimer-associated and other concomitant pathologies with aggregation of α-synuclein, amyloid, tau and other pathological proteins in cortical and subcortical regions causing destruction of essential neuronal networks. Significant pathological heterogeneity within PD-MCI reflects deficits in various cognitive domains. This review highlights the essential neuroimaging data and neuropathological changes in PD with cognitive impairment, the amount and topographical distribution of pathological protein aggregates and their pathophysiological relevance. Large-scale clinicopathological correlative studies are warranted to further elucidate the exact neuropathological correlates of cognitive impairment in PD and related synucleinopathies as a basis for early diagnosis and future disease-modifying therapies.
Collapse
|
29
|
Filippi M, Balestrino R, Basaia S, Agosta F. Neuroimaging in Glucocerebrosidase-Associated Parkinsonism: A Systematic Review. Mov Disord 2022; 37:1375-1393. [PMID: 35521899 PMCID: PMC9546404 DOI: 10.1002/mds.29047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 12/11/2022] Open
Abstract
Background Mutations in the GBA gene cause Gaucher's disease (GD) and constitute the most frequent genetic risk factor for idiopathic Parkinson's disease (iPD). Nonmanifesting carriers of GBA mutations/variants (GBA‐NMC) constitute a potential PD preclinical population, whereas PD patients carrying some GBA mutations/variants (GBA‐PD) have a higher risk of a more aggressive disease course. Different neuroimaging techniques are emerging as potential biomarkers in PD and have been used to study GBA‐associated parkinsonism. Objective The aim is to critically review studies applying neuroimaging to GBA‐associated parkinsonism. Methods Literature search was performed using PubMed and EMBASE databases (last search February 7, 2022). Studies reporting neuroimaging findings in GBA‐PD, GD with and without parkinsonism, and GBA‐NMC were included. Results Thirty‐five studies were included. In longitudinal studies, GBA‐PD patients show a more aggressive disease than iPD at both structural magnetic resonance imaging and 123‐fluoropropylcarbomethoxyiodophenylnortropane single‐photon emission computed tomography. Fluorodeoxyglucose‐positron emission tomography and brain perfusion studies reported a greater cortical involvement in GBA‐PD compared to iPD. Overall, contrasting evidence is available regarding GBA‐NMC for imaging and clinical findings, although subtle differences have been reported compared with healthy controls with no mutations. Conclusions Although results must be interpreted with caution due to limitations of the studies, in line with previous clinical observations, GBA‐PD showed a more aggressive disease progression in neuroimaging longitudinal studies compared to iPD. Cognitive impairment, a “clinical signature” of GBA‐PD, seems to find its neuroimaging correlate in the greater cortical burden displayed by these patients as compared to iPD. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
Collapse
Affiliation(s)
- Massimo Filippi
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Roberta Balestrino
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Basaia
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Agosta
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| |
Collapse
|
30
|
Ramos AA, Garvey A, Cutfield NJ, Machado L. Forward and backward spatial recall in Parkinson's disease and matched controls: A 1-year follow-up study. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-10. [PMID: 35412882 DOI: 10.1080/23279095.2022.2059372] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Patients with Parkinson's disease (PD) exhibit a domain-general visuospatial dysfunction; however, no previous study has examined changes over time in forward and backward spatial recall in PD against controls. To evaluate changes in short-term (STM) and working memory (WM) dysfunction in PD, the current study assessed performance on a computer-modified version of the Corsi Block-Tapping Test (forward and backward recall) at two-time points 1 year apart, while simultaneously exploring associations with potentially relevant demographic and clinical variables. We enrolled 38 patients with PD and 38 controls matched for age, sex, and Montreal Cognitive Assessment (MoCA) total scores. Linear mixed-effects models analyzed the primary measured variables (forward and backward scores). At baseline, the dysfunction effect sizes were as follows: forward recall (-0.45, 95% CI [-0.90, 0.01]) and backward recall (-0.26, 95% CI [-0.71, 0.19]). At follow-up, patients exhibited substantially greater difficulties in backward recall (-0.65, 95% CI [-1.18, -0.13]) compared to the baseline assessment, whereas the forward dysfunction effect size remained almost the same (-0.43, 95% CI [-0.94, 0.09]). Age (p = .005, f = 0.35) and total scores on MoCA (p = .017, f = 0.18), irrespective of group and recall condition, were significant predictors of spatial block scores. The pattern of dysfunction effect sizes indicates that, in contrast to forward recall, backward recall dysfunction in PD worsened 1-year after the baseline assessment, presumably reflecting the progression of PD-related visuospatial WM dysfunction.
Collapse
Affiliation(s)
- Ari Alex Ramos
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Anthony Garvey
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Liana Machado
- Department of Psychology, University of Otago, Dunedin, New Zealand
| |
Collapse
|
31
|
Fang Y, Dai S, Jin C, Si X, Gu L, Song Z, Gao T, Chen Y, Yan Y, Yin X, Pu J, Zhang B. Aquaporin-4 Polymorphisms Are Associated With Cognitive Performance in Parkinson’s Disease. Front Aging Neurosci 2022; 13:740491. [PMID: 35356146 PMCID: PMC8959914 DOI: 10.3389/fnagi.2021.740491] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/04/2021] [Indexed: 12/29/2022] Open
Abstract
ObjectiveAquaporin-4 (AQP4) facilitates a sleep-enhanced interstitial brain waste clearance system. This study was conducted to determine the clinical implication of AQP4 polymorphisms in Parkinson’s disease (PD).MethodsThree-hundred and eighty-two patients with PD and 180 healthy controls with a mean follow-up time of 66.1 months from the Parkinson’s Progression Marker Initiative study were analyzed. We examined whether AQP4 SNPs were associated with an altered rate of motor or cognitive decline using linear mixed model and Cox regression. We then investigated whether AQP4 SNPs were associated with Aβ burden as measured by 18F Florbetapir standard uptake values. Furthermore, we examined if AQP4 SNPs moderated the association between REM sleep behavior disorder (RBD) and CSF biomarkers.ResultsIn patients with PD, AQP4 rs162009 (AA/AG vs. GG) was associated with slower dementia conversion, better performance in letter-number sequencing and symbol digit modalities, lower Aβ deposition in the putamen, anterior cingulum, and frontotemporal areas. In the subgroup of high RBD screening questionnaire score, rs162009 AA/AG had a higher CSF Aβ42 level. rs162009 AA/AG also had better performance in semantic fluency in healthy controls. Besides, rs68006382 (GG/GA vs. AA) was associated with faster progression to mild cognitive impairment, worse performance in letter-number sequencing, semantic fluency, and symbol digit modalities in patients with PD.InterpretationGenetic variations of AQP4 and subsequent alterations of glymphatic efficacy might contribute to an altered rate of cognitive decline in PD. AQP4 rs162009 is likely a novel genetic prognostic marker of glymphatic function and cognitive decline in PD.
Collapse
Affiliation(s)
- Yi Fang
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shaobing Dai
- Department of Anesthesiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chongyao Jin
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoli Si
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Luyan Gu
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhe Song
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ting Gao
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Chen
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yaping Yan
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xinzhen Yin
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiali Pu
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Baorong Zhang Jiali Pu
| | - Baorong Zhang
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Baorong Zhang Jiali Pu
| |
Collapse
|
32
|
Bock MA, Tanner CM. The epidemiology of cognitive function in Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:3-37. [PMID: 35248199 DOI: 10.1016/bs.pbr.2022.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Epidemiology is the study of the distribution of disease in human populations, which is important in evaluating burden of illness, identifying modifiable risk factors, and planning for current and projected needs of the health care system. Parkinson's disease (PD) is the second most common serious neurodegenerative illness and is expected to further increase in prevalence. Cognitive changes are increasingly viewed as an integral non-motor feature in PD, emerging even in the prodromal phase of the disease. The prevalence of PD-MCI ranges from 20% to 40% depending on the population studied. The incidence of PD-dementia increases with duration of disease, with estimates growing from 3% to 30% of individuals followed for 5 years or less to over 80% after 20 years. There are several challenges in estimating the frequency of cognitive change, including only recently standardized diagnostic criteria, variation depending on exact neuropsychological evaluations performed, and differences in population sampling. Clinical features associated with cognitive decline include older age, increased disease duration and severity, early gait dysfunction, dysautonomia, hallucinations and other neuropsychiatric features, the presence of REM behavior disorder, and posterior predominant dysfunction on neuropsychological testing. There is increasing evidence that genetic risk factors, in particular GBA and MAPT mutations, contribute to cognitive change. Possible protective factors include higher cognitive reserve and regular exercise. Important sequelae of cognitive decline in PD include higher caregiver burden, decreased functional status, and increased risk of institutionalization and mortality. Many remaining uncertainties regarding the epidemiology of cognitive change in PD require future research, with improved biomarkers and more sensitive and convenient outcome measures.
Collapse
Affiliation(s)
- Meredith A Bock
- Movement Disorders and Neuromodulation Center, Department of Neurology, Weill Institute for Neuroscience, University of California, San Francisco, CA, United States; Mental Illness Research, Education, and Clinical Center, San Francisco Veteran's Affairs Health Care System, San Francisco, CA, United States; Parkinson's Disease Research Education and Clinical Center, San Francisco Veteran's Affairs Health Care System, San Francisco, CA, United States
| | - Caroline M Tanner
- Movement Disorders and Neuromodulation Center, Department of Neurology, Weill Institute for Neuroscience, University of California, San Francisco, CA, United States; Parkinson's Disease Research Education and Clinical Center, San Francisco Veteran's Affairs Health Care System, San Francisco, CA, United States.
| |
Collapse
|
33
|
Migliore S, D’Aurizio G, Scaricamazza E, Maffi S, Ceccarelli C, Ristori G, Romano S, Castaldo A, Fichera M, Curcio G, Squitieri F. Cognitive Reserve in Early Manifest Huntington Disease Patients: Leisure Time Is Associated with Lower Cognitive and Functional Impairment. J Pers Med 2022; 12:jpm12010036. [PMID: 35055351 PMCID: PMC8777615 DOI: 10.3390/jpm12010036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/19/2021] [Accepted: 12/30/2021] [Indexed: 12/15/2022] Open
Abstract
We focused on Cognitive Reserve (CR) in patients with early Huntington Disease (HD) and investigated whether clinical outcomes might be influenced by lifetime intellectual enrichment over time. CR was evaluated by means of the Cognitive Reserve Index questionnaire (CRIq), an internationally validated scale which includes three sections: education, working activity, and leisure time. The clinical HD variables were quantified at three different time points (baseline-t0, 1 year follow up-t1 and 2 years follow up-t2) as per the Unified Huntington’s Disease Rating Scale (UHDRS), an internationally standardized and validated scale including motor, cognitive, functional and behavioral assays. Our sample consisted of 75 early manifest patients, withclinical stage scored according to the Total Functional Capacity (TFC) scale. Our correlational analysis highlighted a significant inverse association between CRIq leisure time (CRIq_LA) and longitudinal functional impairment (namely, the differential TFC score between t2 and t0 or ΔTFC) (p < 0.05), and the multidimensional progression of HD as measured by the composite UHDRS (cUHDRS, p < 0.01). CRIq_LA was significantly and positively associated with better cognitive performances at all time points (p < 0.05). Our results suggest that higher is the CRIq_LA, milder is the progression of HD in terms of functional, multidimensional and cognitive outcome.
Collapse
Affiliation(s)
- Simone Migliore
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (S.M.); (E.S.); (S.M.)
| | - Giulia D’Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.D.); (G.C.)
| | - Eugenia Scaricamazza
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (S.M.); (E.S.); (S.M.)
| | - Sabrina Maffi
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (S.M.); (E.S.); (S.M.)
| | - Consuelo Ceccarelli
- Italian League for Research on Huntington and Related Diseases Foundation, 00185 Rome, Italy;
| | - Giovanni Ristori
- Centre for Experimental Neurological Therapies, Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, S. Andrea Hospital, Sapienza University, 00189 Rome, Italy; (G.R.); (S.R.)
| | - Silvia Romano
- Centre for Experimental Neurological Therapies, Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, S. Andrea Hospital, Sapienza University, 00189 Rome, Italy; (G.R.); (S.R.)
| | - Anna Castaldo
- Department of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (A.C.); (M.F.)
| | - Mario Fichera
- Department of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (A.C.); (M.F.)
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.D.); (G.C.)
| | - Ferdinando Squitieri
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (S.M.); (E.S.); (S.M.)
- Correspondence: or
| |
Collapse
|
34
|
Kim J, Kim MS. An Overview of Cognitive Reserve in Aging Based on Keyword Network Analysis. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221139374. [DOI: 10.1177/00469580221139374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Many studies have reported that Cognitive reserve is a critical mechanism affecting cognitive statuses, such as dementia. The purposes of this study were to identify the knowledge structure and the research trend on cognitive reserve by conducting keyword analysis on research papers ranging from the earliest to the most recent studies done on the topic and to suggest directions for future research. The Web of Science (WOS) database was used to search for articles on cognitive reserve in aging from 2001 to 2020. NetMiner version 4 (cyram, KOREA), a social network analysis program, was used for keyword network analysis. Data analysis showed keywords that could be categorized as cognitive reserve related keywords (cognitive reserve related concepts, cognitive reserve related factor, cognitive reserve diagnosis and measurement, cognitive reserve outcomes) and cognitive reserve research keywords (research subject/disease, research method, intervention, research field). Through trend analysis, we found that various keywords appeared, indicating that the research has gradually developed conceptually and methodically. Based on these findings, future CR studies require the development of multimodal interface-based tools by applying modern digital technology that can be used to more accurately diagnose and monitor CR; remotely, in real time. In addition, to improve CR, it is suggested that the development of cognitive stimulation interventions utilizing VR which fuses AI based interaction technology with the subjects. Finally, CR could develop further through a cooperation of multidisciplinary professionals such as psychology, medicine and nursing.
Collapse
Affiliation(s)
- Jihyun Kim
- Sahmyook University, Seoul, Republic of Korea
| | - Mi So Kim
- Shinhan University, Gyeonggi-do, Republic of Korea
| |
Collapse
|
35
|
Scamarcia PG, Agosta F, Spinelli EG, Basaia S, Stojković T, Stankovic I, Sarasso E, Canu E, Markovic V, Petrović I, Stefanova E, Pagani E, Kostic VS, Filippi M. Longitudinal White Matter Damage Evolution in Parkinson's Disease. Mov Disord 2021; 37:315-324. [PMID: 34806799 DOI: 10.1002/mds.28864] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/27/2021] [Accepted: 11/02/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND White matter hyperintensities (WMHs) have a role in cognitive impairment in normal brain aging, while the effect on Parkinson's disease (PD) progression is still controversial. OBJECTIVE To investigate the longitudinal evolution of micro- and macrostructural damage of cerebral white matter (WM) and its relationship with the clinical picture in PD. METHODS A total of 154 PD patients underwent clinical, cognitive, and magnetic resonance imaging (MRI) assessment once a year for up to 4 years. Sixty healthy controls underwent the same protocol at baseline. WMHs were identified and total WMH volume was measured. WMHs were also used as exclusion masks to define normal-appearing white matter (NAWM). Using tract-based spatial statistics, diffusion tensor (DT) MRI metrics of whole-brain WM and NAWM were obtained. Linear mixed-effects models defined the longitudinal evolution and association between variables. WM alterations were tested as risk factors of disease progression using linear regression and Cox proportional hazards models. RESULTS At baseline, PD patients showed alterations of all DT MRI measures compared to controls. Longitudinally, DT MRI measures did not vary significantly and no association with clinical variables was found. WMH volume changed over time and was associated with impairment in global cognition, executive functions, and language. Baseline WMH volume was a moderate risk factor for progression to mild cognitive impairment. CONCLUSIONS Our study suggests an association between WMHs and cognitive deterioration in PD, whereas WM microstructural damage is a negligible contributor to clinical deterioration. WMHs assessed by MRI can provide an important tool for monitoring the development of cognitive impairment in PD patients. © 2021 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Pietro Giuseppe Scamarcia
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Edoardo Gioele Spinelli
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Silvia Basaia
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Tanja Stojković
- Clinic of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Iva Stankovic
- Clinic of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Elisabetta Sarasso
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Vladana Markovic
- Clinic of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Igor Petrović
- Clinic of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Elka Stefanova
- Clinic of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Vladimir S Kostic
- Clinic of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
36
|
Potts C, Richardson J, Bond RB, Price RK, Mulvenna MD, Zvolsky P, Harvey M, Hughes CF, Duffy F. Reliability of Addenbrooke's Cognitive Examination III in differentiating between dementia, mild cognitive impairment and older adults who have not reported cognitive problems. Eur J Ageing 2021; 19:495-507. [PMID: 34566550 PMCID: PMC8456688 DOI: 10.1007/s10433-021-00652-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2021] [Indexed: 11/30/2022] Open
Abstract
Diagnosing dementia can be challenging for clinicians, given the array of factors that contribute to changes in cognitive function. The Addenbrooke’s Cognitive Examination III (ACE-III) is commonly used in dementia assessments, covering the domains of attention, memory, fluency, visuospatial and language. This study aims to (1) assess the reliability of ACE-III to differentiate between dementia, mild cognitive impairment (MCI) and controls and (2) establish whether the ACE-III is useful for diagnosing dementia subtypes. Client records from the Northern Health and Social Care Trust (NHSCT) Memory Service (n = 2,331, 2013–2019) were used in the analysis including people diagnosed with Alzheimer’s disease (n = 637), vascular dementia (n = 252), mixed dementia (n = 490), MCI (n = 920) and controls (n = 32). There were significant differences in total ACE-III and subdomain scores between people with dementia, MCI and controls (p < 0.05 for all), with little overlap between distribution of total ACE-III scores (< 39%) between groups. The distribution of total ACE-III and subdomain scores across all dementias were similar. There were significant differences in scores for attention, memory and fluency between Alzheimer’s disease and mixed dementia, and for visuospatial and language between Alzheimer’s disease–vascular dementia (p < 0.05 for all). However, despite the significant differences across these subdomains, there was a high degree of overlap between these scores (> 73%) and thus the differences are not clinically relevant. The results suggest that ACE-III is a useful tool for discriminating between dementia, MCI and controls, but it is not reliable for discriminating between dementia subtypes. Nonetheless, the ACE-III is still a reliable tool for clinicians that can assist in making a dementia diagnosis in combination with other factors at assessment.
Collapse
Affiliation(s)
- C Potts
- Faculty of Computing, School of Computing, Engineering and the Built Environment, Ulster University, Newtownabbey, Coleraine, UK
| | - J Richardson
- Memory Service, Northern Health and Social Care Trust, Antrim, UK
| | - R B Bond
- Faculty of Computing, School of Computing, Engineering and the Built Environment, Ulster University, Newtownabbey, Coleraine, UK
| | - R K Price
- Faculty of Life and Health Sciences, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - M D Mulvenna
- Faculty of Computing, School of Computing, Engineering and the Built Environment, Ulster University, Newtownabbey, Coleraine, UK
| | - P Zvolsky
- Memory Service, Northern Health and Social Care Trust, Antrim, UK
| | - M Harvey
- Memory Service, Northern Health and Social Care Trust, Antrim, UK
| | - C F Hughes
- Faculty of Life and Health Sciences, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - F Duffy
- Memory Service, Northern Health and Social Care Trust, Antrim, UK
| |
Collapse
|
37
|
Lillig R, Ophey A, Schulz JB, Reetz K, Wojtala J, Storch A, Liepelt-Scarfone I, Becker S, Berg D, Balzer-Geldsetzer M, Kassubek J, Hilker-Roggendorf R, Witt K, Mollenhauer B, Trenkwalder C, Roeske S, Wittchen HU, Riedel O, Dodel R, Kalbe E. A new CERAD total score with equally weighted z-scores and additional executive and non-amnestic "CERAD-Plus" tests enhances cognitive diagnosis in patients with Parkinson's disease: Evidence from the LANDSCAPE study. Parkinsonism Relat Disord 2021; 90:90-97. [PMID: 34418761 DOI: 10.1016/j.parkreldis.2021.07.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/23/2021] [Accepted: 07/31/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) is a renowned cognitive test battery, which has been extended in its German version to the CERAD-Plus including tests of executive functions and processing speed. The most commonly used total score (TS) is based on the restricted CERAD version and reflects the sum of selected raw-values (Chandler et al., 2005). The CERAD-Plus extensions might be of particular diagnostic utility for cognitive assessments in Parkinson's Disease (PD), as executive functions and processing speed belong to the most vulnerable domains in PD. OBJECTIVE The aim was to develop a CERAD-TS based on the extended CERAD-Plus' age-, gender-, and education-corrected z-scores and to evaluate its diagnostic accuracy compared to the established CERAD-Chandler-TS. METHODS Baseline data of n = 679 patients with PD (69% male, n = 277 PD without cognitive impairment, n = 307 PD-MCI, n = 95 PD-D) from the multicenter, prospective DEMPARK/LANDSCAPE study were analyzed. ROC-analyses were conducted for four different TS that were either based on the original CERAD or CERAD-Plus, on raw-values or z-scores, and equally-weighted or based on factor scores. AUC-comparisons were conducted to determine the best yet most parsimonious TS. RESULTS The newly designed CERAD-Plus-TS based on equally-weighted z-scores outperformed both the CERAD-Chandler-TS and cognitive screening instruments when differentiating between individuals with PD of varying cognitive impairment (0.78 ≤ AUC ≤ 0.98). CONCLUSION Results suggest a high relevance of non-amnestic subscales for the cognitive assessment in PD populations. The proposed CERAD-Plus-TS needs further validation. The extensions might offer diagnostic potential for non-PD populations as well.
Collapse
Affiliation(s)
- Robert Lillig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), 50937, Cologne, Germany.
| | - Anja Ophey
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), 50937, Cologne, Germany.
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany.
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany.
| | - Jennifer Wojtala
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany.
| | - Alexander Storch
- Department of Neurology, University of Rostock and German Center for Neurodegenerative Diseases (DZNE) Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany.
| | - Inga Liepelt-Scarfone
- Hertie Institute for Clinical Brain Research Department of Neurodegenerative Diseases, Otfried-Müller-Straße 27, 72076, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076, Tübingen, Germany; IB-Hochschule für Gesundheit und Soziales, Paulinenstraße 45, 70178, Stuttgart, Germany.
| | - Sara Becker
- Hertie Institute for Clinical Brain Research Department of Neurodegenerative Diseases, Otfried-Müller-Straße 27, 72076, Tübingen, Germany.
| | - Daniela Berg
- Hertie Institute for Clinical Brain Research Department of Neurodegenerative Diseases, Otfried-Müller-Straße 27, 72076, Tübingen, Germany; Department of Neurology, Christian-Albrechts-University of Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Monika Balzer-Geldsetzer
- Ethikkommission, Ludwig-Maximilians-Universität München, Pettenkoferstr. 8, 80336, München, Germany.
| | - Jan Kassubek
- Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany.
| | | | - Karsten Witt
- Department of Neurology and Research Centre of Neurosensory Sciences, Carl von Ossietzky University, Carl-von-Ossietzky-Straße 9, 26129, Oldenburg, Germany.
| | - Brit Mollenhauer
- Paracelsus-Elena Klinik, Kassel, Department of Neurosurgery, University Medical Center, Goettingen, Klinikstraße 16, 34128, Kassel, Germany.
| | - Claudia Trenkwalder
- Paracelsus-Elena Klinik, Kassel, Department of Neurosurgery, University Medical Center, Goettingen, Klinikstraße 16, 34128, Kassel, Germany.
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), Department of Clinical Research, Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.
| | - Hans-Ullrich Wittchen
- Department of Psychiatry & Psychotherapy, University Hospital Munich, Ludwig-Maximilians-University Munich, Nußbaumstraße 7, 80336, München, Germany.
| | - Oliver Riedel
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Department of Clinical Epidemiology, Achterstraße 30, 28359, Bremen, Germany.
| | - Richard Dodel
- Department of Neurology, Philipps University Marburg, Baldingerstraße, 35043, Marburg, Germany; Department of Geriatric Medicine, University Hospital Essen, Germaniastrasse 1-3, 45356, Essen, Germany.
| | - Elke Kalbe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), 50937, Cologne, Germany.
| |
Collapse
|
38
|
Requena-Ocaña N, Araos P, Flores M, García-Marchena N, Silva-Peña D, Aranda J, Rivera P, Ruiz JJ, Serrano A, Pavón FJ, Suárez J, Rodríguez de Fonseca F. Evaluation of neurotrophic factors and education level as predictors of cognitive decline in alcohol use disorder. Sci Rep 2021; 11:15583. [PMID: 34341419 PMCID: PMC8328971 DOI: 10.1038/s41598-021-95131-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023] Open
Abstract
Cognitive reserve (CR) is the capability of an individual to cope with a brain pathology through compensatory mechanisms developed through cognitive stimulation by mental and physical activity. Recently, it has been suggested that CR has a protective role against the initiation of substance use, substance consumption patterns and cognitive decline and can improve responses to treatment. However, CR has never been linked to cognitive function and neurotrophic factors in the context of alcohol consumption. The present cross-sectional study aims to evaluate the association between CR (evaluated by educational level), cognitive impairment (assessed using a frontal and memory loss assessment battery) and circulating levels of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) in patients with alcohol use disorder (AUD). Our results indicated that lower educational levels were accompanied by earlier onset of alcohol consumption and earlier development of alcohol dependence, as well as impaired frontal cognitive function. They also suggest that CR, NT-3 and BDNF may act as compensatory mechanisms for cognitive decline in the early stages of AUD, but not in later phases. These parameters allow the identification of patients with AUD who are at risk of cognitive deterioration and the implementation of personalized interventions to preserve cognitive function.
Collapse
Affiliation(s)
- Nerea Requena-Ocaña
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain.
- School of Psychology, Complutense University of Madrid, Madrid, Spain.
- Laboratorio de Investigación, IBIMA, Hospital Universitario Regional de Málaga, Avenida Carlos Haya 82, 29010, Málaga, Spain.
| | - Pedro Araos
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, School of Psychology, University of Málaga, 29010, Málaga, Spain
| | - María Flores
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
| | - Nuria García-Marchena
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
| | - Daniel Silva-Peña
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
| | - Jesús Aranda
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
- School of Medicine, University of Málaga, 29071, Málaga, Spain
| | - Patricia Rivera
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
| | - Juan Jesús Ruiz
- Provincial Drug Addiction Center of Málaga, Provincial Council of Málaga, Málaga, Spain
| | - Antonia Serrano
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
| | - Francisco Javier Pavón
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
- Cardiac Clinical Management Unit, IBIMA, University Hospital Virgen de la Victoria, 29010, Málaga, Spain
| | - Juan Suárez
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain.
- Department of Human Anatomy, Legal Medicine and History of Science, IBIMA, Facultad de Medicina, University of Málaga, Bulevar Louis Pausteur, 29071, Málaga, Spain.
| | - Fernando Rodríguez de Fonseca
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain.
| |
Collapse
|
39
|
Montanaro E, Romagnolo A, Fabbri M, Artusi CA, Imbalzano G, Rizzone MG, Lopiano L, Zibetti M. Association between sleep disorders and cognitive dysfunctions in non-demented patients with advanced Parkinson's disease. J Neurol 2021; 269:1538-1545. [PMID: 34328543 PMCID: PMC8857104 DOI: 10.1007/s00415-021-10726-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/21/2021] [Accepted: 07/24/2021] [Indexed: 11/29/2022]
Abstract
Background Parkinson’s disease (PD) is increasingly recognized as a multidimensional disorder, characterized by several non-motor symptoms, including disturbances of sleep and cognition. Current studies on the relationship between sleep problems and neuropsychological functions, mainly conducted in early to moderate PD patients, outline mixed results. In this study, we analysed the relationship between subjectively reported sleep alterations and cognitive functions in a large cohort of 181 advanced PD patients. Methods All consecutive, non-demented, advanced PD patients candidates for device-aided therapy completed two self-administered sleep questionnaires—the Parkinson’s Disease Sleep Scale (PDSS-2) and the Epworth Sleepiness Scale (ESS)—and underwent a comprehensive battery of neuropsychological tests encompassing five cognitive domains (reasoning, memory, attention, frontal executive functions, and language). Results Patients showed mild to moderate sleep problems (PDSS-2 score: 23.4 ± 1.2) and mild daytime sleepiness (ESS 8.6 ± 5.1). A significant correlation was found between PDSS-2 total score and non-verbal reasoning, as well as attentive skills, executive functions, and language abilities. No correlations were found between sleep measures and memory tests scores. Patients with clinically relevant sleep disturbances performed worse on attention, executive functions, and language. No significant correlations were found between daytime sleepiness and any neuropsychological test. Conclusions In advanced PD patients, sleep disturbances selectively correlate with specific neuropsychological functions and not with short-term memory and consolidation. Even if confirmations by means of longitudinal studies are needed, our observations suggest the importance of considering treatment of sleep disturbances to minimize their potential impact on cognition.
Collapse
Affiliation(s)
- Elisa Montanaro
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.,Neurology 2 Unit, A.O.U. Città della Salute e della Scienza di Torino, Corso Bramante 88, 10126, Torino, Italy
| | - Alberto Romagnolo
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy. .,Neurology 2 Unit, A.O.U. Città della Salute e della Scienza di Torino, Corso Bramante 88, 10126, Torino, Italy.
| | - Margherita Fabbri
- Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Center, NS-Park/FCRIN Network and NeuroToul COEN Center, Toulouse University Hospital, INSERM, University of Toulouse 3, Toulouse, France
| | - Carlo Alberto Artusi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.,Neurology 2 Unit, A.O.U. Città della Salute e della Scienza di Torino, Corso Bramante 88, 10126, Torino, Italy
| | - Gabriele Imbalzano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.,Neurology 2 Unit, A.O.U. Città della Salute e della Scienza di Torino, Corso Bramante 88, 10126, Torino, Italy
| | - Mario Giorgio Rizzone
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.,Neurology 2 Unit, A.O.U. Città della Salute e della Scienza di Torino, Corso Bramante 88, 10126, Torino, Italy
| | - Leonardo Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.,Neurology 2 Unit, A.O.U. Città della Salute e della Scienza di Torino, Corso Bramante 88, 10126, Torino, Italy
| | - Maurizio Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.,Neurology 2 Unit, A.O.U. Città della Salute e della Scienza di Torino, Corso Bramante 88, 10126, Torino, Italy
| |
Collapse
|
40
|
Cognitive Reserve, Executive Function, and Memory in Parkinson's Disease. Brain Sci 2021; 11:brainsci11080992. [PMID: 34439609 PMCID: PMC8391924 DOI: 10.3390/brainsci11080992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 11/20/2022] Open
Abstract
Cognitive impairment is acknowledged as a feature of Parkinson’s disease (PD), and the most common cognitive declines are in executive function (EF) and memory. Cognitive reserve (CR) may offer some protection against cognitive dysfunction in PD. The present study used two proxies of CR (years of education, premorbid IQ) to examine the relationship between CR and (i) EF (ii) memory in a large PD sample (n = 334). Two aspects of EF were examined, including verbal fluency and planning skills. Two aspects of verbal memory were examined, including immediate recall and delayed recall. For EF, both CR proxies significantly predicted verbal fluency, but only years of education predicted planning skills. Years of education significantly predicted immediate recall, but premorbid IQ did not. Neither CR proxy predicted delayed recall. These findings suggest that CR, in particular years of education, may contribute to EF and memory function in those with PD. A key finding of this study is the varying contribution of CR proxies to different aspects of the same cognitive domain. The findings indicate that using only one proxy has the potential to be misleading and suggest that when testing the relationship between CR and cognition, studies should include tasks that measure different aspects of the cognitive domain(s) of interest.
Collapse
|
41
|
Busch RM, Hogue O, Miller M, Ferguson L, McAndrews MP, Hamberger M, Kim M, McDonald CR, Reyes A, Drane DL, Hermann BP, Bingaman W, Najm IM, Kattan MW, Jehi L. Nomograms to Predict Verbal Memory Decline After Temporal Lobe Resection in Adults With Epilepsy. Neurology 2021; 97:e263-e274. [PMID: 34011574 PMCID: PMC8302146 DOI: 10.1212/wnl.0000000000012221] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 04/14/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To develop and externally validate models to predict the probability of postoperative verbal memory decline in adults after temporal lobe resection (TLR) for epilepsy using easily accessible preoperative clinical predictors. METHODS Multivariable models were developed to predict delayed verbal memory outcome on 3 commonly used measures: Rey Auditory Verbal Learning Test (RAVLT) and Logical Memory (LM) and Verbal Paired Associates (VPA) subtests from Wechsler Memory Scale-Third Edition. With the use of the Harrell step-down procedure for variable selection, models were developed in 359 adults who underwent TLR at the Cleveland Clinic and validated in 290 adults at 1 of 5 epilepsy surgery centers in the United States or Canada. RESULTS Twenty-nine percent of the development cohort and 26% of the validation cohort demonstrated significant decline on at least 1 verbal memory measure. Initial models had good to excellent predictive accuracy (calibration [c] statistic range 0.77-0.80) in identifying patients with memory decline; however, models slightly underestimated decline in the validation cohort. Model coefficients were updated with data from both cohorts to improve stability. The model for RAVLT included surgery side, baseline memory score, and hippocampal resection. The models for LM and VPA included surgery side, baseline score, and education. Updated model performance was good to excellent (RAVLT c = 0.81, LM c = 0.76, VPA c = 0.78). Model calibration was very good, indicating no systematic overestimation or underestimation of risk. CONCLUSIONS Nomograms are provided in 2 easy-to-use formats to assist clinicians in estimating the probability of verbal memory decline in adults considering TLR for treatment of epilepsy. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that multivariable prediction models accurately predict verbal memory decline after TLR for epilepsy in adults.
Collapse
Affiliation(s)
- Robyn M Busch
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison.
| | - Olivia Hogue
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Margaret Miller
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Lisa Ferguson
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Mary Pat McAndrews
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Marla Hamberger
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Michelle Kim
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Carrie R McDonald
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Anny Reyes
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Daniel L Drane
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Bruce P Hermann
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - William Bingaman
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Imad M Najm
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Michael W Kattan
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Lara Jehi
- From the Epilepsy Center (R.M.B., L.F., W.B., I.M.N., L.J.) and Department of Neurology (R.M.B., M.M., I.M.N., L.J.), Neurological Institute, and Department of Quantitative Health Sciences (O.H., M.W.K.), Lerner Research Institute, Cleveland Clinic, OH; Department of Psychology (M.P.M.), University of Toronto; Krembil Brain Institute (M.P.M.), University Health Network, Toronto, Ontario, Canada; Department of Neurology (M.H.), Columbia University, New York, NY; Department of Neurology (M.K., D.L.D.), University of Washington School of Medicine, Seattle; Department of Psychiatry (C.R.M., A.R.), University of California, San Diego; Departments of Neurology and Pediatrics (D.L.D.), Emory University School of Medicine, Atlanta, GA; and Department of Neurology (B.P.H.), University of Wisconsin School of Medicine and Public Health, Madison
| |
Collapse
|
42
|
D'Iorio A, Guida P, Maggi G, Redgrave P, Santangelo G, Obeso I. Neuropsychological spectrum in early PD: Insights from controlled and automatic behavioural regulation. Neurosci Biobehav Rev 2021; 126:465-480. [PMID: 33836213 DOI: 10.1016/j.neubiorev.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/05/2021] [Accepted: 04/02/2021] [Indexed: 11/15/2022]
Abstract
Initial changes in Parkinson's disease (PD) are marked by loss of automatic movements and decline of some cognitive functions. Yet, the exact profile and extent of cognitive impairments in early stages of PD as well as their mechanisms related to automatic motor dysfunction remain unclear. Our objective was to examine the neuropsychological changes in early PD and their association to automatic and controlled modes of behavioural control. Significant relationships between early PD and cognitive dysfunction in set-shifting, abstraction ability/concept formation, processing speed, visuospatial/constructional abilities and verbal-visual memory was found. We also noted that tests with a strong effortful and controlled component were similarly affected as automatic tests by early PD, particularly those testing verbal memory, processing speed and visuospatial/constructional functions. Our findings indicate that initial stages of PD sets constraints over most of the cognitive domains normally assessed and are not easily explained in terms of either automatic or controlled mechanisms, as both appear similarly altered in early PD.
Collapse
Affiliation(s)
- Alfonsina D'Iorio
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Pasqualina Guida
- HM CINAC. Centro Integral de Neurociencias AC. HM Hospitales CEU San Pablo University, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain
| | - Gianpaolo Maggi
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Peter Redgrave
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Gabriella Santangelo
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Ignacio Obeso
- HM CINAC. Centro Integral de Neurociencias AC. HM Hospitales CEU San Pablo University, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain.
| |
Collapse
|
43
|
Cognitive Reserve in Individuals Aging With Traumatic Brain Injury: Independent and Interactive Effects on Cognitive Functioning. J Head Trauma Rehabil 2021; 37:E196-E205. [PMID: 34145164 DOI: 10.1097/htr.0000000000000697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the influence of 2 temporal factors-age and injury chronicity-on the relationship between cognitive reserve (CR) and cognitive functioning in older adults with chronic traumatic brain injury (TBI). SETTING Outpatient research laboratory. PARTICIPANTS Adults, 50 years or older, with a 1- to 45-year history of moderate or severe TBI (N = 108). DESIGN Cross-sectional observational study. MAIN MEASURES CR was estimated using demographically corrected performance on a word-reading test (an approximation of premorbid IQ). Injury chronicity was operationalized as number of years since the date of injury. Composite cognitive scores were computed from performances on neuropsychological tests of processing speed, executive functioning, and memory. RESULTS CR was positively and significantly related to all cognitive performances independent of age, injury chronicity, and injury severity. Greater injury chronicity significantly attenuated the effect of CR on processing speed such that individuals more distal from their injury date evidenced a weaker positive relationship between CR and performance. CONCLUSION Temporal factors may modify associations between CR and cognition. Findings suggest that the protective effects of CR are temporally delimited, potentially contending with declines in brain reserve. The prognostic value of traditional outcome determinants should be considered in the context of injury chronicity.
Collapse
|
44
|
Parkinson's disease and virtual reality rehabilitation: cognitive reserve influences the walking and balance outcome. Neurol Sci 2021; 42:4615-4621. [PMID: 33661481 DOI: 10.1007/s10072-021-05123-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Parkinson's disease (PD) is a neurodegenerative pathology characterized by motor and non-motor symptoms that often lead to several impairments. Many studies show the efficacy of different rehabilitation protocols aimed to improve balance and gait functions in PD patients. However, multiple factors may influence rehabilitation outcome. Recently, it has been observed as the cognitive reserve (CR) may influence the rehabilitation outcome, helping to address the patient toward technological or conventional rehabilitation. Our study investigated how CR may affect motor rehabilitation outcomes in PD patients who undergo virtual reality (VR) rehabilitation, aimed at improving walking and balance. MATERIALS AND METHODS Thirty patients affected by idiopathic PD were enrolled. Patients underwent 12 sessions VR training, over 6 weeks (45 min). Six-Minute Walk Test (6MWT) and Berg Balance Scale (BBS) were used to assess walking and balance, respectively. CR was assessed by Cognitive Reserve Index questionnaire (CRIq). RESULTS Significant correlations between CR and change from baseline in walking and balance measures were found, with a significant positive correlation between CRIq and 6MWT (r=0.50, p=0.01) and between CRIq and BBS (r=0.41, p=0.04). DISCUSSION Our results showed that PD patients with higher CR treated with VR improved significantly more in their balance and walking distance than those with lower CR. The current study suggests that VR when aimed to improve balance and walking in PD patients is more effective in patients with higher CR.
Collapse
|
45
|
Crowley SJ, Banan G, Amin M, Tanner JJ, Hizel L, Nguyen P, Brumback B, Rodriguez K, McFarland N, Bowers D, Ding M, Mareci TA, Price CC. Statistically Defined Parkinson's Disease Executive and Memory Cognitive Phenotypes: Demographic, Behavioral, and Structural Neuroimaging Comparisons. JOURNAL OF PARKINSONS DISEASE 2021; 11:283-297. [PMID: 33216042 DOI: 10.3233/jpd-202166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Some individuals with Parkinson's disease (PD) experience working memory and inhibitory difficulties, others learning and memory difficulties, while some only minimal to no cognitive deficits for many years. OBJECTIVE To statistically derive PD executive and memory phenotypes, and compare PD phenotypes on disease and demographic variables, vascular risk factors, and specific neuroimaging variables with known associations to executive and memory function relative to non-PD peers. METHODS Non-demented individuals with PD (n = 116) and non-PD peers (n = 62) were recruited to complete neuropsychology measures, blood draw, and structural magnetic resonance imaging. Tests representing the cognitive domains of interest (4 executive function, 3 memory) were included in a k-means cluster analysis comprised of the PD participants. Resulting clusters were compared demographic and disease-related variables, vascular risk markers, gray/white regions of interest, and white matter connectivity between known regions involved in executive and memory functions (dorsolateral prefrontal cortices to caudate nuclei; entorhinal cortices to hippocampi). RESULTS Clusters showed: 1) PD Executive, n = 25; 2) PD Memory, n = 35; 3) PD Cognitively Well; n = 56. Even after disease variable corrections, PD Executive had less subcortical gray matter, white matter, and fewer bilateral dorsolateral-prefrontal cortex to caudate nucleus connections; PD Memory showed bilaterally reduced entorhinal-hippocampal connections. PD Cognitively Well showed only reduced putamen volume and right entorhinal cortex to hippocampi connections relative to non-PD peers. Groups did not statistically differ on cortical integrity measures or cerebrovascular disease markers. CONCLUSION PD cognitive phenotypes showed different structural gray and white matter patterns. We discuss data relative to phenotype demographics, cognitive patterns, and structural brain profiles.
Collapse
Affiliation(s)
- Samuel J Crowley
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Guita Banan
- Department of Biochemistry and Molecular Biology, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Manish Amin
- Department of Biochemistry and Molecular Biology, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Jared J Tanner
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Loren Hizel
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Peter Nguyen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Babette Brumback
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Katie Rodriguez
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Nikolaus McFarland
- Department of Neurology, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Dawn Bowers
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Mingzhou Ding
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Thomas A Mareci
- Department of Biochemistry and Molecular Biology, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Catherine C Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| |
Collapse
|
46
|
A Comprehensive Meta-analysis on Short-term and Working Memory Dysfunction in Parkinson's Disease. Neuropsychol Rev 2021; 31:288-311. [PMID: 33523408 DOI: 10.1007/s11065-021-09480-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/05/2021] [Indexed: 12/29/2022]
Abstract
A previous meta-analysis demonstrated short-term memory (STM) and working memory (WM) dysfunction in patients with Parkinson's disease (PD). However, considerable research on the topic that calls into question the extent of such impairments in PD has since been published. The aim of the present quantitative review was to provide the largest statistical overview on STM and WM dysfunction in Parkinson's disease (PD), while simultaneously providing novel insights on moderating factors of effect size heterogeneity in PD. The systematic literature search in PubMed, PsycINFO, PsycArticles, Scopus and Web of Science databases allowed us to estimate 350 effect sizes from 145 empirical studies that reported STM and WM scores for patients with PD against healthy controls. The outcomes indicated general dysfunction in the visuospatial domain and poor verbal WM in PD. Subgroup analyses suggested that mild cognitive impairment is associated with STM and WM difficulties in PD. Furthermore, meta-regression analyses revealed that disease duration accounted for more than 80% of the visuospatial STM effect size variance (β = 0.136, p < .001, R2 = .8272), larger daily levodopa equivalent dose was associated with WM dysfunction (verbal: β = -0.001, p = .016, R2 = .1812; visuospatial: β = 0.003, p = .069, R2 = .2340), and years of education partially explained the verbal STM effect size variance (β = -0.027, p = .040, R2 = .1171). Collectively, these findings advance our understanding of underlying factors that influence STM and WM functioning in PD, while at the same time providing novel directions for future research.
Collapse
|
47
|
Xing Y, Fu S, Li M, Ma X, Liu M, Liu X, Huang Y, Xu G, Jiao Y, Wu H, Jiang G, Tian J. Regional Neural Activity Changes in Parkinson's Disease-Associated Mild Cognitive Impairment and Cognitively Normal Patients. Neuropsychiatr Dis Treat 2021; 17:2697-2706. [PMID: 34429605 PMCID: PMC8380131 DOI: 10.2147/ndt.s323127] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 07/27/2021] [Indexed: 01/21/2023] Open
Abstract
PURPOSE The aim of this study was to compare regional homogeneity (ReHo) changes in Parkinson's disease mild cognitive impairment (PD-MCI) patients with respect to normal controls (NC) and those with cognitively normal PD (PD-CN). Further, the study investigated the relationship between ReHo changes in PD patients and neuropsychological variation. PATIENTS AND METHODS Thirty PD-MCI, 19 PD-CN, and 21 NC subjects were enrolled. Resting state functional magnetic resonance imaging data of all subjects were collected, and regional brain activity was measured for ReHo. Analysis of covariance for ReHo was determined between the PD-MCI, PD-CN, and NC groups. Spearman rank correlations were assessed using the ReHo maps and data from the neuropsychological tests. RESULTS In comparison with NC, PD-CN patients showed significantly higher ReHo values in the right middle frontal gyrus (MFG) and lower ReHo values in the left supramarginal gyrus, bilateral inferior parietal lobule (IPL), and the right postcentral gyrus (PCG). In comparison with PD-CN patients, PD-MCI patients displayed significantly higher ReHo values in the right PCG, left middle occipital gyrus (MOG) and IPL. No significant correlation between ReHo indices and the neuropsychological scales was observed. CONCLUSION Our finding revealed that decreases in ReHo in the default mode network (DMN) may appear before PD-related cognitive impairment. In order to preserve executive attention capacity, ReHo in the right MFG in PD patients lacking cognition impairment increased for compensation. PD-MCI showed increased ReHo in the left MOG, which might have been caused by visual and visual-spatial dysfunction, and increased ReHo in the left IPL, which might reflect network disturbance and induce cognition deficits.
Collapse
Affiliation(s)
- Yilan Xing
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Shishun Fu
- Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Meng Li
- Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Xiaofen Ma
- Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Mengchen Liu
- Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Xintong Liu
- Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Yan Huang
- Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Guang Xu
- Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Yonggang Jiao
- Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Hong Wu
- Department of Neurology of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Guihua Jiang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Junzhang Tian
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.,Department of Medical Imaging of Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| |
Collapse
|
48
|
Liu B, Li W. Association between education level and HIV-associated neurocognitive disorder: a systematic review and meta-analysis. Sex Health 2020; 17:SH20057. [PMID: 33342460 DOI: 10.1071/sh20057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/23/2020] [Indexed: 01/09/2023]
Abstract
In the era of antiretroviral treatment, human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) is common in HIV-positive (HIV+) patients, with an incidence of 30-50%. The relationship between education level and HAND has been evaluated in some studies, however, the results were inconsistent. The aim of this meta-analysis was to provide compelling evidence on the association between education level and the risk of HAND. Reports were searched for in the databases of Medline, Embase and PsyclNFO. Studies evaluating the relationship between education level and HAND in adult HIV+ patients were included. The pooled odds ratio/risk ratio was analysed by using the random-effects model. Two subgroup analyses were performed according to the adjustment of educational level in the neurocognitive impairment assessment and the income level. In total, 18 studies were included. Six studies and 12 studies reported education level as the continuous variable and categorical variable, respectively. The methods used for the assessment of neurocognitive impairment in included studies were neuropsychological battery tests (n = 10), HIV Dementia Scale (n = 1), the International HIV Dementia Scale (n = 6) and the Chinese version of the Montreal Cognitive Assessment (n = 1). The result showed that the risk of HAND in HIV+ patients who have lower education attainment was significantly higher than that in HIV+ patients who have higher education attainment. In conclusion, this meta-analysis demonstrated that HIV+ patients who have low education attainment carry higher risk of developing HAND compared with HIV+ patients who have high education attainment. This study highlighted the importance of early neurological screening for HIV+ patients who have low education level.
Collapse
|
49
|
Consonni M, Dalla Bella E, Bersano E, Telesca A, Lauria G. Cognitive reserve is associated with altered clinical expression in amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2020; 22:237-247. [PMID: 33263428 DOI: 10.1080/21678421.2020.1849306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective: Long-term life experiences, such as education, occupational attainment, leisure activities, and bilingualism, have been considered proxies of cognitive reserve (CR). In neurodegenerative disease, CR is considered as a modulator of a more favorable cognitive trajectory and motor functions. Our study investigated the role of CR on cognitive and motor involvement in a large cohort of incident patients with amyotrophic lateral sclerosis (ALS). Methods: Cognition assessment and clinical and demographic information were obtained in 101 incident ALS patients. CR was measured based on years of education, occupational attainment, amount of leisure activities, and bilingualism. Correlation and regression analyses were performed to test the association between CR and the clinical expression of ALS. Results: We found that all proxies of CR were positively associated with executive functions, verbal fluency, and memory domains. Motor impairment was inversely related to educational level and occupational attainment. Regression analysis documented the association between CR and cognitive performances in all patients and the predictive role of CR in modulating motor functional disability in patients with bulbar-onset. Conclusion: Our findings showed that CR mediates the extent of cognitive decline and that of functional bulbar impairment, suggesting that the concept of reserve applied to ALS should encompass cognitive and motor domains.
Collapse
Affiliation(s)
- Monica Consonni
- 3rd Neurology Unit and Motor Neuron Diseases Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy and
| | - Eleonora Dalla Bella
- 3rd Neurology Unit and Motor Neuron Diseases Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy and
| | - Enrica Bersano
- 3rd Neurology Unit and Motor Neuron Diseases Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy and
| | - Alessandra Telesca
- 3rd Neurology Unit and Motor Neuron Diseases Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy and
| | - Giuseppe Lauria
- 3rd Neurology Unit and Motor Neuron Diseases Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy and.,Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| |
Collapse
|
50
|
Perrier J, Viard A, Levy C, Morel N, Allouache D, Noal S, Joly F, Eustache F, Giffard B. Longitudinal investigation of cognitive deficits in breast cancer patients and their gray matter correlates: impact of education level. Brain Imaging Behav 2020; 14:226-241. [PMID: 30406352 DOI: 10.1007/s11682-018-9991-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cognitive deficits are a major complaint in breast cancer patients, even before chemotherapy. Comprehension of the cerebral mechanisms related to cognitive impairment in breast cancer patients remains difficult due to the scarcity of studies investigating both cognitive and anatomical imaging changes. Furthermore, only some of the patients experienced cognitive decline following chemotherapy, yet few studies have identified risk factors for cognitive deficits in these patients. It has been shown that education level could impact cognitive abilities during the recovery phase following chemotherapy. Our main aim was to longitudinally evaluate cognitive and anatomical changes associated with cancer and chemotherapy in breast cancer patients. Our secondary aim was to assess the impact of education level on cognitive performances and gray matter (GM) atrophy in these patients. Twenty patients were included before chemotherapy (T1), 1 month (T2) and 1 year (T3) after chemotherapy. Twenty-seven controls without a history of cancer were assessed at T1 and T3 only. Cluster groups based on education level were defined for both groups and were further compared. Comparison between patients and controls revealed deficits in patients on verbal episodic memory retrieval at T1 and T3 and on executive functions at T3. After chemotherapy, breast cancer patients had GM atrophy that persisted or recovered 1 year after chemotherapy depending on the cortical areas. Increase in GM volumes from T1 to T3 were also found in both groups. At T2, patients with a higher level of education compared to lower level exhibited higher episodic memory retrieval and state anxiety scores, both correlating with cerebellar volume. This higher level of education group exhibited hippocampal atrophy. Our results suggest that, before chemotherapy, cancer-related processes impact cognitive functioning and that this impact seems exacerbated by the effect of chemotherapy on certain brain regions. Increase in GM volumes after chemotherapy were unexpected and warrant further investigations. Higher education level was associated, 1 month after the end of chemotherapy, with greater anxiety and hippocampal atrophy despite a lack of cognitive deficits. These results suggest, for the first time, the occurrence of compensation mechanisms that may be linked to cognitive reserve in relationship to state anxiety. This identification of factors, which may compensate cognitive impairment following chemotherapy, is critical for patient care and quality of life.
Collapse
Affiliation(s)
- Joy Perrier
- Normandie Univ, UNICAEN, PSL University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France.
| | - Armelle Viard
- Normandie Univ, UNICAEN, PSL University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Christelle Levy
- Breast Committee Department, Centre François Baclesse, Caen, France
| | - Nastassja Morel
- Normandie Univ, UNICAEN, PSL University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | | | - Sabine Noal
- Breast Committee Department, Centre François Baclesse, Caen, France
| | - Florence Joly
- Clinical Research Department, Caen, France.,Medical Oncology Department, CHU de Caen, Caen, France.,INSERM, U1086, ANTICIPE, Caen, France.,Cancer & Cognition, Platform, Ligue Contre le Cancer, CHU de Caen, Caen, France
| | - Francis Eustache
- Normandie Univ, UNICAEN, PSL University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Bénédicte Giffard
- Normandie Univ, UNICAEN, PSL University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France.,Cancer & Cognition, Platform, Ligue Contre le Cancer, CHU de Caen, Caen, France
| |
Collapse
|