1
|
Valter K, Tedford SE, Eells JT, Tedford CE. Photobiomodulation use in ophthalmology - an overview of translational research from bench to bedside. FRONTIERS IN OPHTHALMOLOGY 2024; 4:1388602. [PMID: 39211002 PMCID: PMC11358123 DOI: 10.3389/fopht.2024.1388602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 07/04/2024] [Indexed: 09/04/2024]
Abstract
Photobiomodulation (PBM) refers to the process in which wavelengths of light are absorbed by intracellular photoacceptors, resulting in the activation of signaling pathways that culminate in biological changes within the cell. PBM is the result of low-intensity light-induced reactions in the cell in contrast to thermal photoablation produced by high-intensity lasers. PBM has been effectively used in the clinic to enhance wound healing and mitigate pain and inflammation in musculoskeletal conditions, sports injury, and dental applications for many decades. In the past 20 years, experimental evidence has shown the benefit of PBM in increasing numbers of retinal and ophthalmic conditions. More recently, preclinical findings in ocular models have been translated to the clinic with promising results. This review discusses the preclinical and clinical evidence of the effects of PBM in ophthalmology and provides recommendations of the clinical use of PBM in the management of ocular conditions.
Collapse
Affiliation(s)
- Krisztina Valter
- Clear Vision Laboratory, John Curtin School of Medical Research, Eccles Institute of Neuroscience, Canberra, ACT, Australia
- School of Medicine and Psychology, Australian National University, Canberra, ACT, Australia
| | | | - Janis T. Eells
- College of Health Professions and Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | | |
Collapse
|
2
|
Matynia A, Recio BS, Myers Z, Parikh S, Goit RK, Brecha NC, Pérez de Sevilla Müller L. Preservation of Intrinsically Photosensitive Retinal Ganglion Cells (ipRGCs) in Late Adult Mice: Implications as a Potential Biomarker for Early Onset Ocular Degenerative Diseases. Invest Ophthalmol Vis Sci 2024; 65:28. [PMID: 38224335 PMCID: PMC10793389 DOI: 10.1167/iovs.65.1.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/27/2023] [Indexed: 01/16/2024] Open
Abstract
Purpose Intrinsically photosensitive retinal ganglion cells (ipRGCs) play a crucial role in non-image-forming visual functions. Given their significant loss observed in various ocular degenerative diseases at early stages, this study aimed to assess changes in both the morphology and associated behavioral functions of ipRGCs in mice between 6 (mature) and 12 (late adult) months old. The findings contribute to understanding the preservation of ipRGCs in late adults and their potential as a biomarker for early ocular degenerative diseases. Methods Female and male C57BL/6J mice were used to assess the behavioral consequences of aging to mature and old adults, including pupillary light reflex, light aversion, visual acuity, and contrast sensitivity. Immunohistochemistry on retinal wholemounts from these mice was then conducted to evaluate ipRGC dendritic morphology in the ganglion cell layer (GCL) and inner nuclear layer (INL). Results Morphological analysis showed that ipRGC dendritic field complexity was remarkably stable through 12 months old of age. Similarly, the pupillary light reflex, visual acuity, and contrast sensitivity were stable in mature and old adults. Although alterations were observed in ipRGC-independent light aversion distinct from the pupillary light reflex, aged wild-type mice continuously showed enhanced light aversion with dilation. No effect of sex was observed in any tests. Conclusions The preservation of both ipRGC morphology and function highlights the potential of ipRGC-mediated function as a valuable biomarker for ocular diseases characterized by early ipRGC loss. The consistent stability of ipRGCs in mature and old adult mice suggests that detected changes in ipRGC-mediated functions could serve as early indicators or diagnostic tools for early-onset conditions such as Alzheimer's disease, Parkinson's disease, and diabetes, where ipRGC loss has been documented.
Collapse
Affiliation(s)
- Anna Matynia
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California, United States
| | - Brandy S. Recio
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Zachary Myers
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Sachin Parikh
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California, United States
| | - Rajesh Kumar Goit
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California, United States
| | - Nicholas C. Brecha
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California, United States
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Luis Pérez de Sevilla Müller
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| |
Collapse
|
3
|
Marefat H, Vahabi Z, Afzalian N, Khanbagi M, Karimi H, Ebrahiminia F, Kalafatis C, Modarres MH, Khaligh-Razavi SM. Brain Representation of Animal and Non-Animal Images in Patients with Mild Cognitive Impairment and Alzheimer's Disease. J Alzheimers Dis Rep 2023; 7:1133-1152. [PMID: 38025804 PMCID: PMC10657719 DOI: 10.3233/adr-230132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/06/2023] [Indexed: 12/01/2023] Open
Abstract
Background In early Alzheimer's disease (AD), high-level visual functions and processing speed are impacted. Few functional magnetic resonance imaging (fMRI) studies have investigated high-level visual deficits in AD, yet none have explored brain activity patterns during rapid animal/non-animal categorization tasks. Objective To address this, we utilized the previously known Integrated Cognitive Assessment (ICA) to collect fMRI data and compare healthy controls (HC) to individuals with mild cognitive impairment (MCI) and mild AD. Methods The ICA encompasses a rapid visual categorization task that involves distinguishing between animals and non-animals within natural scenes. To comprehensively explore variations in brain activity levels and patterns, we conducted both univariate and multivariate analyses of fMRI data. Results The ICA task elicited activation across a range of brain regions, encompassing the temporal, parietal, occipital, and frontal lobes. Univariate analysis, which compared responses to animal versus non-animal stimuli, showed no significant differences in the regions of interest (ROIs) across all groups, with the exception of the left anterior supramarginal gyrus in the HC group. In contrast, multivariate analysis revealed that in both HC and MCI groups, several regions could differentiate between animals and non-animals based on distinct patterns of activity. Notably, such differentiation was absent within the mild AD group. Conclusions Our study highlights the ICA task's potential as a valuable cognitive assessment tool designed for MCI and AD. Additionally, our use of fMRI pattern analysis provides valuable insights into the complex changes in brain function associated with AD. This approach holds promise for enhancing our understanding of the disease's progression.
Collapse
Affiliation(s)
- Haniyeh Marefat
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Zahra Vahabi
- Western University, London, Ontario, Canada
- Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Memory and Behavioral Neurology Division, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Afzalian
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Mahdiyeh Khanbagi
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Hamed Karimi
- Department of Psychology and Neuroscience, Boston College, Boston, MA, USA
| | - Fatemeh Ebrahiminia
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Chris Kalafatis
- South London & Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Old Age Psychiatry, King’s College London, London, United Kingdom
- Cognetivity Ltd, London, United Kingdom
| | | | - Seyed-Mahdi Khaligh-Razavi
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
- Cognetivity Ltd, London, United Kingdom
| |
Collapse
|
4
|
Zhang X, Liu L, Yang F, Liu Z, Jin X, Han S, Zhang Y, Cheng J, Wen B. Neurovascular coupling dysfunction in high myopia patients: Evidence from a multi-modal magnetic resonance imaging analysis. J Neuroradiol 2023:S0150-9861(23)00242-0. [PMID: 37777086 DOI: 10.1016/j.neurad.2023.09.005] [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: 05/29/2023] [Revised: 09/09/2023] [Accepted: 09/24/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND AND PURPOSE To investigate neurovascular coupling dysfunction in high myopia (HM) patients. MATERIALS AND METHODS A total of 37 HM patients and 36 healthy controls were included in this study. Degree centrality (DC), regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), and fractional ALFF (fALFF) maps were employed to represent neuronal activity. Cerebral blood perfusion was characterized by cerebral blood flow (CBF). The correlation coefficient was calculated to reflect the relationship between neuronal activity and cerebral blood perfusion. Pearson partial correlation analysis was utilized to evaluate the association between HM dysfunction and clinical indicators. RESULTS HM patients exhibited significant alterations in neurovascular coupling across 37 brain regions compared to healthy controls. The brain regions with marked changes varied among the four neurovascular coupling patterns, including the middle frontal gyrus, superior occipital gyrus, middle occipital gyrus, and fusiform gyrus. Additionally, the superior frontal gyrus orbital part, medial superior frontal gyrus, inferior occipital gyrus, and dorsolateral superior frontal gyrus displayed significant changes in three coupling patterns. In HM patients, the ReHo-CBF changes in the inferior frontal gyrus orbital part were positively correlated with best-corrected visual acuity (BCVA) and refractive diopter changes. Similarly, the ALFF-CBF changes in the inferior frontal gyrus orbital part showed a positive correlation with refractive diopter changes. ReHo-CBF and ALFF-CBF alterations in the paracentral lobule were positively correlated with BCVA and refractive diopter changes. CONCLUSION Our findings underscore the abnormal alterations in neurovascular coupling across multiple brain regions in HM patients. These results suggest that neurovascular dysfunction in HM patients may be associated with an aberrant visual regulation mechanism.
Collapse
Affiliation(s)
- Xiaopan Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of magnetic resonance and brain function, Zhengzhou 450052, China
| | - Liang Liu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Fan Yang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Zijun Liu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Xuemin Jin
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of magnetic resonance and brain function, Zhengzhou 450052, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of magnetic resonance and brain function, Zhengzhou 450052, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Baohong Wen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
| |
Collapse
|
5
|
Wang S, Jiang X, Peng W, Yang S, Pi R, Zhou S. Acrolein Induces Retinal Abnormalities of Alzheimer's Disease in Mice. Int J Mol Sci 2023; 24:13576. [PMID: 37686379 PMCID: PMC10487815 DOI: 10.3390/ijms241713576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/12/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
It is reported that retinal abnormities are related to Alzheimer's disease (AD) in patients and animal models. However, it is unclear whether the retinal abnormities appear in the mouse model of sporadic Alzheimer's disease (sAD) induced by acrolein. We investigated the alterations of retinal function and structure, the levels of β-amyloid (Aβ) and phosphorylated Tau (p-Tau) in the retina, and the changes in the retinal vascular system in this mouse model. We demonstrated that the levels of Aβ and p-Tau were increased in the retinas of mice from the acrolein groups. Subsequently, a decreased amplitudes of b-waves in the scotopic and photopic electroretinogram (ERG), decreased thicknesses of the retinal nerve fiber layer (RNFL) in the retina, and slight retinal venous beading were found in the mice induced by acrolein. We propose that sAD mice induced by acrolein showed abnormalities in the retina, which may provide a valuable reference for the study of the retina in sAD.
Collapse
Affiliation(s)
- Shuyi Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Xiuying Jiang
- Department of Ophthalmology, Affiliated Foshan Hospital, Southern Medical University, Foshan 528000, China
| | - Weijia Peng
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Shuangjian Yang
- Guangdong Provincial Institute for Vision and Eye Research, Guangzhou 510060, China
| | - Rongbiao Pi
- School of Medicine, Sun Yat-sen University, Shenzhen 528406, China
| | - Shiyou Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| |
Collapse
|
6
|
The Relationship between Visual-Evoked Potential and Optic Coherence Tomography and Clinical Findings in Parkinson Patients. PARKINSON'S DISEASE 2023; 2023:7739944. [PMID: 36873294 PMCID: PMC9981293 DOI: 10.1155/2023/7739944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 12/14/2022] [Accepted: 01/18/2023] [Indexed: 02/25/2023]
Abstract
Background In Parkinson's disease (PD), dopamine deficiency is present not only in the nigrostriatal pathway but also in the retinal and visual pathways. Optic coherence tomography (OCT) can be used as morphological evidence of visual influence from early nonmotor symptoms. The aim of this study was to investigate the relationship of OCT and visual evoked potentials (VEPs) of eyes with the severity of clinical findings and ocular findings in PD. Methods A group of 42 patients diagnosed with idiopathic PD and a control group of 29 people between the ages of 45-85 were included in our study. VEP was recorded in the patient and control groups. OCT measurement was made with the Optovue spectral-domain device. Foveal thickness and macular volume were measured in the foveal region and in the parafoveal and perifoveal regions in the temporal, superior, nasal, and inferior quadrants. RNFL (retinal nerve fiber layer) was measured in temporal, superior, nasal, and inferior quadrants. Ganglion cell complex (GCC) was evaluated in the superior and inferior quadrants. Using the UPDRS clinical scale, the relationship between measurements and the differences between the control group and the patient group were evaluated. Results Among the OCT values in our study, foveal, parafoveal, perifoveal thickness, macular volume, RNFL, and GCC measurements were performed for the right and left eyes, and no difference was found between the patient group and the control group. There was no difference in VEP amplitude and latency values between the patient and control groups. The relationships between UPDRS and modified Hoehn Yahr staging and OCT and VEP measurements in the patient revealed no correlation. Conclusions Studies on whether OCT measurements can functionally be a marker or which segments are more valuable for disease progression in patients with PD are needed. Visual dysfunction in PD cannot be attributed only to retinal pathology; however, the retina may provide monitoring of the status of dopaminergic neurodegeneration and axonal loss in PD.
Collapse
|
7
|
Jung Y, Kim K, Choi ST, Kang JM, Cho NR, Ko DS, Kim YH. Association between surgeon age and postoperative complications/mortality: a systematic review and meta-analysis of cohort studies. Sci Rep 2022; 12:11251. [PMID: 35788658 PMCID: PMC9252995 DOI: 10.1038/s41598-022-15275-7] [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: 01/02/2022] [Accepted: 06/21/2022] [Indexed: 11/09/2022] Open
Abstract
The surgical workforce, like the rest of the population, is ageing. This has raised concerns about the association between the age of the surgeon and their surgical outcomes. We performed a systematic review and meta-analysis of cohort studies on postoperative mortality and major morbidity according to the surgeons' age. The search was performed on February 2021 using the Embase, Medline and CENTRAL databases. Postoperative mortality and major morbidity were evaluated as clinical outcomes. We categorized the surgeons' age into young-, middle-, and old-aged surgeons. We compared the differences in clinical outcomes for younger and older surgeons compared to middle-aged surgeons. Subgroup analyses were performed for major and minor surgery. Ten retrospective cohort studies on 29 various surgeries with 1,666,108 patients were considered. The mortality in patients undergoing surgery by old-aged surgeons was 1.14 (1.02-1.28, p = 0.02) (I2 = 80%) compared to those by middle-aged surgeon. No significant differences were observed according to the surgeon's age in the major morbidity and subgroup analyses. This meta-analysis indicated that surgeries performed by old-aged surgeons had a higher risk of postoperative mortality than those by middle-aged surgeons. Thus, it necessitates the introduction of a multidisciplinary approach to evaluate the performance of senior surgeons.
Collapse
Affiliation(s)
- Yeongin Jung
- Department of Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Kihun Kim
- Department of Occupational and Environmental Medicine, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Sang Tae Choi
- Division of Vascular Surgery, Department of Surgery, Gachon University Gil Medical Center, Incheon, 21565, Republic of Korea
| | - Jin Mo Kang
- Division of Vascular Surgery, Department of Surgery, Gachon University Gil Medical Center, Incheon, 21565, Republic of Korea
| | - Noo Ree Cho
- Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Incheon, 21565, Republic of Korea.
| | - Dai Sik Ko
- Division of Vascular Surgery, Department of Surgery, Gachon University Gil Medical Center, Incheon, 21565, Republic of Korea.
| | - Yun Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea. .,Department of Anatomy, School of Medicine, Pusan National University, Busan, Republic of Korea.
| |
Collapse
|
8
|
Frame G, Schuller A, Smith MA, Crish SD, Dengler-Crish CM. Alterations in Retinal Signaling Across Age and Sex in 3xTg Alzheimer’s Disease Mice. J Alzheimers Dis 2022; 88:471-492. [PMID: 35599482 PMCID: PMC9398084 DOI: 10.3233/jad-220016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background: Visual disturbances often precede cognitive dysfunction in patients with Alzheimer’s disease (AD) and may coincide with early accumulation of amyloid-β (Aβ) protein in the retina. These findings have inspired critical research on in vivo ophthalmic Aβ imaging for disease biomarker detection but have not fully answered mechanistic questions on how retinal pathology affects visual signaling between the eye and brain. Objective: The goal of this study was to provide a functional and structural assessment of eye-brain communication between retinal ganglion cells (RGCs) and their primary projection target, the superior colliculus, in female and male 3xTg-AD mice across disease stages. Methods: Retinal electrophysiology, axonal transport, and immunofluorescence were used to determine RGC projection integrity, and retinal and collicular Aβ levels were assessed with advanced protein quantitation techniques. Results: 3xTg mice exhibited nuanced deficits in RGC electrical signaling, axonal transport, and synaptic integrity that exceeded normal age-related decrements in RGC function in age- and sex-matched healthy control mice. These deficits presented in sex-specific patterns among 3xTg mice, differing in the timing and severity of changes. Conclusion: These data support the premise that retinal Aβ is not just a benign biomarker in the eye, but may contribute to subtle, nuanced visual processing deficits. Such disruptions might enhance the biomarker potential of ocular amyloid and differentiate patients with incipient AD from patients experiencing normal age-related decrements in visual function.
Collapse
Affiliation(s)
- Gabrielle Frame
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
- Biomedical Sciences Graduate Program, Kent State University, Kent, OH, USA
| | - Adam Schuller
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Matthew A. Smith
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
- Rebecca D. Considine Research Institute, Akron Children’s Hospital, Akron, OH, USA
| | - Samuel D. Crish
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, OH, USA
| | | |
Collapse
|
9
|
Yan Z, Liao H, Deng C, Zhong Y, Mayeesa TZ, Zhuo Y. DNA damage and repair in the visual center in the rhesus monkey model of glaucoma. Exp Eye Res 2022; 219:109031. [DOI: 10.1016/j.exer.2022.109031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/27/2022] [Accepted: 03/06/2022] [Indexed: 11/04/2022]
|
10
|
Karimi H, Marefat H, Khanbagi M, Kalafatis C, Modarres MH, Vahabi Z, Khaligh-Razavi SM. Temporal dynamics of animacy categorization in the brain of patients with mild cognitive impairment. PLoS One 2022; 17:e0264058. [PMID: 35196356 PMCID: PMC8865635 DOI: 10.1371/journal.pone.0264058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/02/2022] [Indexed: 11/18/2022] Open
Abstract
Electroencephalography (EEG) has been commonly used to measure brain alterations in Alzheimer’s Disease (AD). However, reported changes are limited to those obtained from using univariate measures, including activation level and frequency bands. To look beyond the activation level, we used multivariate pattern analysis (MVPA) to extract patterns of information from EEG responses to images in an animacy categorization task. Comparing healthy controls (HC) with patients with mild cognitive impairment (MCI), we found that the neural speed of animacy information processing is decreased in MCI patients. Moreover, we found critical time-points during which the representational pattern of animacy for MCI patients was significantly discriminable from that of HC, while the activation level remained unchanged. Together, these results suggest that the speed and pattern of animacy information processing provide clinically useful information as a potential biomarker for detecting early changes in MCI and AD patients.
Collapse
Affiliation(s)
- Hamed Karimi
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
- Department of Mathematics and Computer Science, Amirkabir University of Technology, Tehran, Iran
- * E-mail: (HK); (SMKR)
| | - Haniyeh Marefat
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Mahdiyeh Khanbagi
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Chris Kalafatis
- South London & Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Old Age Psychiatry, King’s College London, London, United Kingdom
- Cognetivity Ltd, London, United Kingdom
| | | | - Zahra Vahabi
- Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Memory and Behavioral Neurology Division, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Mahdi Khaligh-Razavi
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
- Cognetivity Ltd, London, United Kingdom
- * E-mail: (HK); (SMKR)
| |
Collapse
|
11
|
Chang Z, Xie F, Li H, Yuan F, Zeng L, Shi L, Zhu S, Lu X, Wei X, Wang Q. Retinal Nerve Fiber Layer Thickness and Associations With Cognitive Impairment in Parkinson’s Disease. Front Aging Neurosci 2022; 14:832768. [PMID: 35222000 PMCID: PMC8867012 DOI: 10.3389/fnagi.2022.832768] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/20/2022] [Indexed: 01/18/2023] Open
Abstract
ObjectiveThis study intended to investigate whether retinal nerve fiber layer (RNFL) thickness could become a potential marker in patients with Parkinson’s disease with cognitive impairment (PD-CI).MethodsFifty-seven PD patients and 45 age-matched healthy controls (HCs) were recruited in our cross-sectional study and completed optical coherence tomography (OCT) evaluations. PD with normal cognition (PD-NC) and cognitive impairment (PD-CI) patients were divided following the 2015 Movement Disorder Society criteria. RNFL thickness was quantified in subfields of the 3.0-mm circle surrounding the optic disk; while a battery of neuropsychiatric assessments was conducted to estimate the Parkinsonism severity. General linear models and one-way ANOVA were adopted to assess RNFL thickness between subgroups with different cognitive statuses; logistic regression analyses were applied to determine the relation between RNFL and PD-CI cases.ResultsCompared with HCs, more thinning of the RNFL was observed in the inferior and temporal sectors in PD patients, especially in the PD-CI group. Inferior RNFL thickness was reduced in PD-CI compared with PD-NC patients. Logistic regression analysis found that inferior RNFL thickness was independently associated with PD-CI cases (odds ratio = 0.923, p = 0.014). Receiver operating characteristic analysis showed that the RNFL-involved combined model provided a high accuracy in screening cognitive deficiency in PD cases (area under the curve = 0.85, p < 0.001).ConclusionReduced RNFL thickness especially in the inferior sector is independently associated with PD-CI patients. Our study present new perspectives into verifying possible indicators for neuropathological processes or disease severity in Parkinsonians with cognitive dysfunction.
Collapse
Affiliation(s)
- Zihan Chang
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Fen Xie
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hualing Li
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Feilan Yuan
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Lina Zeng
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shuzhen Zhu
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaohe Lu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Xiaohe Lu,
| | - Xiaobo Wei
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Xiaobo Wei,
| | - Qing Wang
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Qing Wang, ;
| |
Collapse
|
12
|
Abstract
BACKGROUND With doctors in short supply and a strong demand for surgeon services in all areas of the United States, urban and rural, there are pressures to remain in active practice for longer. Even with an older workforce, there are currently no requirements for when a surgeon must retire in the United States. OBJECTIVES The aim of this article was to highlight the importance of the aging surgeon to the medical community and to provide an evidence-based overview of age-related cognitive and physical issues that develop during the later stages of a surgeon's career. METHODS A search of the PubMed/MEDLINE database was performed for the phrase "aging surgeon." Inclusion criteria were applied to include only those articles related to surgeon age or retirement. Additional reports were handpicked from citations to substantiate claims with statistical evidence. RESULTS The aging surgeon contributes extensive experience to patient care, but is also prone to age-related changes in cognition, vision, movement, and stress as it relates to new techniques, surgical performance, and safety measures. Studies show that although surgeons are capable of operating well into their senior years, there is the potential of decline. Nevertheless, there are proven recommendations on how to prepare an older surgeon for retirement. CONCLUSIONS Age-related trends in cognitive and physical decline must be counterbalanced with wisdom gained through decades of surgical experience.
Collapse
Affiliation(s)
| | - Jeffrey E Janis
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| |
Collapse
|
13
|
Abstract
PURPOSE OF REVIEW This review addresses the importance of some of the human factors for intraoperative patient safety with particular focus on the active failures. These are the mishaps or sentinel events related to decisons taken and actions performed by the individual at the delivery end of a system. Such sentinel events may greatly affect intraoperative patient safety. RECENT FINDINGS Intimidating, aggressive and disruptive communication is a cause of adverse staff interaction, which may then represent an important patient safety threat. Also, anaesthesiologist's physical and mental state and limitations may interfere with patient safety. SUMMARY The concept of physician well being is multidimensional and includes factors related to each physician as an individual as well as to the working environment. Creating optimal safe conditions for patients, therefore, requires actions at both the personal level and the working conditions. Also, initiatives to ban rude and dismissive communication should be implemented in order to further improve intraoperative patient safety.
Collapse
Affiliation(s)
- Stefan De Hert
- Department of Anesthesiology and Perioperative Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium
| |
Collapse
|
14
|
Abstract
Clinical neuropsychology lacks tests of basic visuoperceptual and spatial skills that have well-controlled administration and sophisticated measurement methods. Items from the Visual Assessment Battery (VAB), a simultaneous match-to-sample task, assessed visual discrimination in 40 healthy adults aged 51-91 during fMRI. The tasks were designed to isolate discrimination of either location, shape, or velocity, and they each had three levels of difficulty. The Location task uniquely activated the dorsal visual processing stream, the Shape task the ventral stream, and the Velocity task an area encompassing V5. Greater age was associated with greater neural recruitment, particularly in frontal areas. Behaviorally, greater age was associated with prolonged response times, but not reduced accuracy. Increased difficulty was associated with slower responses and reduced accuracy, regardless of age. Results validated the specialization of brain regions for spatial, perceptual, and movement discriminations and the use of the VAB to assess functioning localized to these regions. Visual discrimination ability does not change dramatically with age, but like many cognitive processes, performance slows. Anterior neural recruitment during visual discrimination increases with age.
Collapse
|
15
|
Latina V, Giacovazzo G, Cordella F, Balzamino BO, Micera A, Varano M, Marchetti C, Malerba F, Florio R, Ercole BB, La Regina F, Atlante A, Coccurello R, Di Angelantonio S, Calissano P, Amadoro G. Systemic delivery of a specific antibody targeting the pathological N-terminal truncated tau peptide reduces retinal degeneration in a mouse model of Alzheimer's Disease. Acta Neuropathol Commun 2021; 9:38. [PMID: 33750467 PMCID: PMC7942014 DOI: 10.1186/s40478-021-01138-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/26/2021] [Indexed: 12/28/2022] Open
Abstract
Retina and optic nerve are sites of extra-cerebral manifestations of Alzheimer's Disease (AD). Amyloid-β (Aβ) plaques and neurofibrillary tangles of hyperphosphorylated tau protein are detected in eyes from AD patients and transgenic animals in correlation with inflammation, reduction of synapses, visual deficits, loss of retinal cells and nerve fiber. However, neither the pathological relevance of other post-translational tau modifications-such as truncation with generation of toxic fragments-nor the potential neuroprotective action induced by their in vivo clearance have been investigated in the context of AD retinal degeneration. We have recently developed a monoclonal tau antibody (12A12mAb) which selectively targets the neurotoxic 20-22 kDa NH2-derived peptide generated from pathological truncation at the N-terminal domain of tau without cross-reacting with its full-length normal protein. Previous studies have shown that 12A12mAb, when intravenously (i.v.)-injected into 6-month-old Tg2576 animals, markedly improves their AD-like, behavioural and neuropathological syndrome. By taking advantage of this well-established tau-directed immunization regimen, we found that 12A12mAb administration also exerts a beneficial action on biochemical, morphological and metabolic parameters (i.e. APP/Aβ processing, tau hyperphosphorylation, neuroinflammation, synaptic proteins, microtubule stability, mitochondria-based energy production, neuronal death) associated with ocular injury in the AD phenotype. These findings prospect translational implications in the AD field by: (1) showing for the first time that cleavage of tau takes part in several pathological changes occurring in vivo in affected retinas and vitreous bodies and that its deleterious effects are successfully antagonized by administration of the specific 12A12mAb; (2) shedding further insights on the tight connections between neurosensory retina and brain, in particular following tau-based immunotherapy. In our view, the parallel response we detected in this preclinical animal model, both in the eye and in the hippocampus, following i.v. 12A12mAb injection opens novel diagnostic and therapeutic avenues for the clinical management of cerebral and extracerebral AD signs in human beings.
Collapse
Affiliation(s)
- Valentina Latina
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Giacomo Giacovazzo
- IRCSS Santa Lucia Foundation, Via Fosso del Fiorano 64-65, 00143 Rome, Italy
| | - Federica Cordella
- Department of Physiology and Pharmacology, University of Rome La Sapienza, Piazzale Aldo Moro 5, 00185 Rome, Italy
- Center for Life Nanoscience, Istituto Italiano Di Tecnologia, Viale Regina Elena 291, 00161 Rome, Italy
| | - Bijorn Omar Balzamino
- Research Laboratories in Ophthalmology, IRCCS - Fondazione Bietti, Via Santo Stefano Rotondo, 6, 00184 Rome, Italy
| | - Alessandra Micera
- Research Laboratories in Ophthalmology, IRCCS - Fondazione Bietti, Via Santo Stefano Rotondo, 6, 00184 Rome, Italy
| | - Monica Varano
- Research Laboratories in Ophthalmology, IRCCS - Fondazione Bietti, Via Santo Stefano Rotondo, 6, 00184 Rome, Italy
| | - Cristina Marchetti
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Francesca Malerba
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Rita Florio
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Bruno Bruni Ercole
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Federico La Regina
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Anna Atlante
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies (IBIOM)-CNR, Via Amendola 122/O, 70126 Bari, Italy
| | - Roberto Coccurello
- IRCSS Santa Lucia Foundation, Via Fosso del Fiorano 64-65, 00143 Rome, Italy
- Institute for Complex System (ISC)-CNR, Via dei Taurini 19, 00185 Rome, Italy
| | - Silvia Di Angelantonio
- Department of Physiology and Pharmacology, University of Rome La Sapienza, Piazzale Aldo Moro 5, 00185 Rome, Italy
- Center for Life Nanoscience, Istituto Italiano Di Tecnologia, Viale Regina Elena 291, 00161 Rome, Italy
| | - Pietro Calissano
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Giuseppina Amadoro
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
- Institute of Translational Pharmacology (IFT), National Research Council (CNR), Via Fosso del Cavaliere 100, 00133 Rome, Italy
| |
Collapse
|
16
|
Retinal layers in prolactinoma patients: a spectral-domain optical coherence tomography study. Int Ophthalmol 2021; 41:1373-1379. [PMID: 33481152 DOI: 10.1007/s10792-021-01701-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Prolactinoma is a type of pituitary tumour that produces an excessive amount of the hormone prolactin. It is the most common type of hormonally-active pituitary tumour. These tumours can cause ocular complications such as vision loss and visual fields (VF) defect. In this study, we aimed to evaluate the thickness of chorioretinal layers in patients with prolactinoma. METHODS We enrolled 63 eyes of 32 prolactinoma patients and 36 eyes of 18 age and gender-matched healthy controls. All participants underwent complete hormonal and ophthalmological examination, including spectral-domain optical coherence tomography (SD-OCT) and VF test.The complete biochemical response was defined as serum PRL concentration ≤ 20 ng/mL at the time of evaluation.The seven layers were retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), and retinal pigment epithelium (RPE). The results of prolactinoma patients were compared with the control group. RESULTS The mean RNFL, GCL, IPL, INL, ONL, and RPE were thinner in prolactinoma patients than the control group (p < 0.05) while OPL was similar between groups (p > 0.05).None of the patients had VF defect.The thickness of retinal layers was similar in patients with and without complete biochemical response (p > 0.05). CONCLUSION To our knowledge, this is the first study that evaluates the thickness of chorioretinal layers in patients with prolactinoma.Most of the layers were thinner than the control group.Therefore, detailed eye assessment should be a routine component of the follow-up visits of prolactinoma patients and further studies related to this condition are required.
Collapse
|
17
|
Billig AR, Feng NC, Behforuzi H, McFeeley BM, Nicastri CM, Daffner KR. Capacity-limited resources are used for managing sensory degradation and cognitive demands: Implications for age-related cognitive decline and dementia. Cortex 2020; 133:277-294. [PMID: 33157347 DOI: 10.1016/j.cortex.2020.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/27/2020] [Accepted: 09/07/2020] [Indexed: 01/11/2023]
Abstract
Older adults with sensory deficits are at higher risk for developing cognitive impairment and dementia. It remains uncertain if the link between sensory and cognitive functioning reflects a common underlying factor or whether sensory deficits directly undermine cognitive processing. This issue was addressed by comparing behavioral and event-related potential responses of 16 older and 16 young adults during a working memory paradigm that parametrically varied visual contrast level (100%, 69%, 22%) and cognitive task load (1-4 face pairs to remember). The groups were well-matched on demographic and neuropsychological variables; however, older adults had worse corrected visual acuity and contrast sensitivity. The study's major finding was an interaction between visual contrast level and task load on performance accuracy (percent of correct responses) and the allocation of resources for decision making/updating (as indexed by the P3b amplitude). The negative impact of degraded visual processing was greater at higher levels of task demand. This result suggests that a shared pool of processing resources is used to mediate cognitive operations and manage the processing of degraded images. The study also demonstrated that older adults reach the limits of their processing capacity at lower levels of task load. The interaction between visual degradation and task demand, accompanied by the age-related reduction in available processing resources highlight the increased vulnerability of older adults. Specifically, an age-associated decline in visual acuity and contrast sensitivity puts older adults at risk for depleting their limited resources in the service of processing degraded visual images. The results of this study underscore the potential importance of optimizing vision in older adults to help mitigate age-associated cognitive decline.
Collapse
Affiliation(s)
- Adam R Billig
- Laboratory of Healthy Cognitive Aging, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
| | - Nicole C Feng
- Laboratory of Healthy Cognitive Aging, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
| | - Hura Behforuzi
- Laboratory of Healthy Cognitive Aging, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
| | - Brittany M McFeeley
- Laboratory of Healthy Cognitive Aging, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
| | - Casey M Nicastri
- Laboratory of Healthy Cognitive Aging, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
| | - Kirk R Daffner
- Laboratory of Healthy Cognitive Aging, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
| |
Collapse
|
18
|
The Retinal Inner Plexiform Synaptic Layer Mirrors Grey Matter Thickness of Primary Visual Cortex with Increased Amyloid β Load in Early Alzheimer's Disease. Neural Plast 2020; 2020:8826087. [PMID: 33014034 PMCID: PMC7525303 DOI: 10.1155/2020/8826087] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 11/17/2022] Open
Abstract
The retina may serve as putative window into neuropathology of synaptic loss in Alzheimer's disease (AD). Here, we investigated synapse-rich layers versus layers composed by nuclei/cell bodies in an early stage of AD. In addition, we examined the associations between retinal changes and molecular and structural markers of cortical damage. We recruited 20 AD patients and 17 healthy controls (HC). Combining optical coherence tomography (OCT), magnetic resonance (MR), and positron emission tomography (PET) imaging, we measured retinal and primary visual cortex (V1) thicknesses, along with V1 amyloid β (Aβ) retention ([11C]-PiB PET tracer) and neuroinflammation ([11C]-PK11195 PET tracer). We found that V1 showed increased amyloid-binding potential, in the absence of neuroinflammation. Although thickness changes were still absent, we identified a positive association between the synapse-rich inner plexiform layer (IPL) and V1 in AD. This retinocortical interplay might reflect changes in synaptic function resulting from Aβ deposition, contributing to early visual loss.
Collapse
|
19
|
Campos JL, Höbler F, Bitton E, Labreche T, McGilton KS, Wittich W. Screening for Vision Impairments in Individuals with Dementia Living in Long-Term Care: A Scoping Review. J Alzheimers Dis 2020; 68:1039-1049. [PMID: 30909236 PMCID: PMC6484267 DOI: 10.3233/jad-181129] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Vision impairments are prevalent, but underdiagnosed in individuals with dementia living in long-term care (LTC). Effective screening tools could identify remediable vision problems. This scoping review was conducted to identify vision screening tests used with individuals with dementia and assesses their suitability for administration by nurses in LTC. A literature search using the Arksey and O’Malley (2005) method included research articles, conference proceedings, and dissertations. Data were included from participants over 65 years of age with a diagnosis of probable dementia. A panel of vision experts evaluated the suitability of the candidate vision tests. The search yielded 179 publications that met the inclusion criteria. Of 134 vision tests that were identified, 19 were deemed suitable for screening by nurses in LTC. Tests screened for acuity (12), visual field (1), anatomy (2), color vision (2), and general visual abilities (2). Tests were excluded because of complexity of interpretation (90), need for specialized training (83), use in research only (57), need for specialized equipment (54), not assessing visual function (44), long test duration (21), uncommonness (13), and needing an act reserved for specialists (7). Psychometric properties were not often reported for tests. Few of the tests identified had been validated for use with individuals with dementia. Based on our review, few tests were deemed suitable for use by nurses to assess this population in LTC. Identifying appropriate tools to screen vision in individuals with dementia is a necessary first step to interventions that could potentially improve functioning and quality of life.
Collapse
Affiliation(s)
- Jennifer L Campos
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Fiona Höbler
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Etty Bitton
- École d'optométrie, Université de Montréal, Montréal, Québec, Canada
| | - Tammy Labreche
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Katherine S McGilton
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Walter Wittich
- École d'optométrie, Université de Montréal, Montréal, Québec, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montréal, Québec, Canada
| |
Collapse
|
20
|
Designing ICTs for Users with Mild Cognitive Impairment: A Usability Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145153. [PMID: 32708861 PMCID: PMC7399939 DOI: 10.3390/ijerph17145153] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 01/08/2023]
Abstract
Background: Research has supported the cost-effectiveness of cognitive training tools enhanced by information and communication technologies (ICT) in several populations, including individuals with mild cognitive impairment (MCI) and age-related cognitive decline. The implementation of ICTs in this population, however, is sometimes challenging to their cognitive and age characteristics. Ultimately, this might compromise the effectiveness of ICT-enhanced therapies in this population. The aim of this study is to test the usability and acceptability of a European project prototype for elderly care, in an attempt to explore the ICT design needs of users with MCI. Methods: Participants were 28 individuals aged 58–95 years and with a diagnosis of MCI. Results: The results showed a low perception of peripheral elements and the need to place main interaction elements in the centre of the screen. The correlation between the general level of autonomy (daily life activities) and the ICT autonomy level was significant and positive. The speed of audio help had a significant impact on performance. Conclusion: The present work contributes to the literature on ICT usability needs of users with MCI. Some usability recommendations for designing interfaces for this type of user are provided in the text.
Collapse
|
21
|
Guo J, Xu C, Ni S, Zhang S, Li Q, Zeng P, Pi G, Liu E, Sun DS, Liu Y, Wang Z, Chen H, Yang Y, Wang JZ. Elevation of pS262-Tau and Demethylated PP2A in Retina Occurs Earlier than in Hippocampus During Hyperhomocysteinemia. J Alzheimers Dis 2020; 68:367-381. [PMID: 30775994 DOI: 10.3233/jad-180978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Hyperhomocysteinemia is an independent risk factor of Alzheimer's disease (AD), which is not diagnosed for many years before onset due to lack of peripherally detectable early biomarkers. Visual dysfunction is prevalent in AD patients and correlates with the severity of cognitive defects. Importantly, alterations in eyes can be non-invasively detected. To search for early biomarkers in eyes from high risk factors of AD, we injected homocysteine (Hcy) into the rats via vena caudalis for 3, 7, and 14 days, respectively, and characterized the chronological order of the AD-like pathologies appearing in retina and the hippocampus during the progression of hyperhomocysteinemia, and their correlations with cognitive impairment. We found that administration of Hcy for 14 days, but not 3 or 7 days, induced hyperhomocysteinemia, although a gradually increased blood Hcy level was detected. In retina and/or the hippocampus, significant loss of retinal ganglion cells and stenosis of retinal arteries with the AD-like tau and amyloid-β (Aβ) pathologies and memory deficit were shown only in the 14-day Hcy group. Interestingly, accumulation of Ser262 hyperphosphorylated tau (pS262-tau) but not Aβ with decreased methylation of protein phosphatase-2A catalytic subunit (M-PP2Ac) and increased de-methylated PP2Ac (DM-PP2Ac) was detected in retina of the 3-day Hcy group, in which the retinal pathologies were preceded by those of the hippocampus. These findings suggest that elevated pS262-tau and DM-PP2Ac and reduced M-PP2Ac in retina may serve as surveillance biomarkers for diagnosis of the hyperhomocysteinemia-induced AD in the early stage.
Collapse
Affiliation(s)
- Jing Guo
- Department of Pathophysiology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Key Laboratory of Ministry of Education of China for Neurological Disorders, Hubei Provincial Key Laboratory of Neurological Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Cheng Xu
- Department of Pathophysiology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Key Laboratory of Ministry of Education of China for Neurological Disorders, Hubei Provincial Key Laboratory of Neurological Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Shaozhou Ni
- Department of Emergency, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shujuan Zhang
- Department of Pathophysiology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Key Laboratory of Ministry of Education of China for Neurological Disorders, Hubei Provincial Key Laboratory of Neurological Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Qihang Li
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical College, Zhejiang, China
| | - Peng Zeng
- Department of Pathophysiology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Key Laboratory of Ministry of Education of China for Neurological Disorders, Hubei Provincial Key Laboratory of Neurological Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Guilin Pi
- Department of Pathophysiology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Key Laboratory of Ministry of Education of China for Neurological Disorders, Hubei Provincial Key Laboratory of Neurological Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Enjie Liu
- Department of Pathophysiology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Key Laboratory of Ministry of Education of China for Neurological Disorders, Hubei Provincial Key Laboratory of Neurological Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Dong-Sheng Sun
- Department of Pathophysiology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Key Laboratory of Ministry of Education of China for Neurological Disorders, Hubei Provincial Key Laboratory of Neurological Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Yanchao Liu
- Department of Pathophysiology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Key Laboratory of Ministry of Education of China for Neurological Disorders, Hubei Provincial Key Laboratory of Neurological Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Zhouyi Wang
- Department of Neurology, Center Hospital of Huang Gang City, Hubei Province, PR China
| | - Haote Chen
- Department of Neurology, Center Hospital of Huang Gang City, Hubei Province, PR China
| | - Ying Yang
- Department of Pathophysiology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Key Laboratory of Ministry of Education of China for Neurological Disorders, Hubei Provincial Key Laboratory of Neurological Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Jian-Zhi Wang
- Department of Pathophysiology, School of Basic Medicine and the Collaborative Innovation Center for Brain Science, Key Laboratory of Ministry of Education of China for Neurological Disorders, Hubei Provincial Key Laboratory of Neurological Diseases, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.,Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China
| |
Collapse
|
22
|
Higgen FL, Heine C, Krawinkel L, Göschl F, Engel AK, Hummel FC, Xue G, Gerloff C. Crossmodal Congruency Enhances Performance of Healthy Older Adults in Visual-Tactile Pattern Matching. Front Aging Neurosci 2020; 12:74. [PMID: 32256341 PMCID: PMC7090137 DOI: 10.3389/fnagi.2020.00074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 03/02/2020] [Indexed: 11/23/2022] Open
Abstract
One of the pivotal challenges of aging is to maintain independence in the activities of daily life. In order to adapt to changes in the environment, it is crucial to continuously process and accurately combine simultaneous input from different sensory systems, i.e., crossmodal or multisensory integration. With aging, performance decreases in multiple domains, affecting bottom-up sensory processing as well as top-down control. However, whether this decline leads to impairments in crossmodal interactions remains an unresolved question. While some researchers propose that crossmodal interactions degrade with age, others suggest that they are conserved or even gain compensatory importance. To address this question, we compared the behavioral performance of older and young participants in a well-established crossmodal matching task, requiring the evaluation of congruency in simultaneously presented visual and tactile patterns. Older participants performed significantly worse than young controls in the crossmodal task when being stimulated at their individual unimodal visual and tactile perception thresholds. Performance increased with adjustment of stimulus intensities. This improvement was driven by better detection of congruent stimulus pairs, while the detection of incongruent pairs was not significantly enhanced. These results indicate that age-related impairments lead to poor performance in complex crossmodal scenarios and demanding cognitive tasks. Crossmodal congruency effects attenuate the difficulties of older adults in visuotactile pattern matching and might be an important factor to drive the benefits of older adults demonstrated in various crossmodal integration scenarios. Congruency effects might, therefore, be used to develop strategies for cognitive training and neurological rehabilitation.
Collapse
Affiliation(s)
- Focko L Higgen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Charlotte Heine
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lutz Krawinkel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Göschl
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas K Engel
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Friedhelm C Hummel
- Defitech Chair of Clinical Neuroengineering, Brain Mind Institute and Center for Neuroprosthetics, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland.,Defitech Chair of Clinical Neuroengineering, Brain Mind Institute and Center for Neuroprosthetics, Swiss Federal Institute of Technology Valais (EPFL Valais), Clinique Romande de Réadaptation, Sion, Switzerland.,Clinical Neuroscience, Medical School University of Geneva, Geneva, Switzerland
| | - Gui Xue
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
23
|
Prokopiou E, Kolovos P, Georgiou C, Kalogerou M, Potamiti L, Sokratous K, Kyriacou K, Georgiou T. Omega-3 fatty acids supplementation protects the retina from age-associated degeneration in aged C57BL/6J mice. BMJ Open Ophthalmol 2019; 4:e000326. [PMID: 31799410 PMCID: PMC6861077 DOI: 10.1136/bmjophth-2019-000326] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/28/2019] [Accepted: 09/22/2019] [Indexed: 11/03/2022] Open
Abstract
Objective To evaluate the therapeutic effects of omega-3 (ω3) fatty acids in the retina of aged mice when the blood arachidonic acid (AA)/eicosapentaenoic acid (EPA) ratio is maintained between 1.0 and 1.5. Methods and analysis Aged (24-month-old) wild-type C57BL/6J mice were allocated to two groups: ω3 treated and untreated. Treatment with ω3 was by daily gavage administration of EPA and docosahexaenoic acid for 60 days. Gas chromatography was used to identify and quantify fatty acids in the blood and retina. To count lipofuscin granules and measure the photoreceptor layer, eyecups were examined histologically using transmission electron microscopy and light microscopy. We also analysed eyecups using mass spectrometry-based proteomics. Results AA levels were lower, and EPA levels were higher, in the blood and retinas of the ω3-treated group than in the untreated group, resulting in a lower AA/EPA ratio. The ω3-treated group also showed significantly fewer lipofuscin granules and a thicker outer nuclear layer than the untreated group. Proteomic analysis revealed significantly greater expression of myelin basic protein, myelin regulatory factor-like protein, myelin proteolipid protein and glial fibrillar acidic protein in the ω3-treated group than in the untreated group. Three different pathways were significantly affected by ω3 treatment: fatty acid elongation, biosynthesis of unsaturated fatty acids and metabolic pathways. Conclusion Two months of ω3 supplementation (when the blood AA/EPA~1.0-1.5) in aged mice reduced lipofuscin granule formation in the retina and protected the photoreceptor layer, suggesting that ω3 supplementation slows normal age-related retinal degeneration.
Collapse
Affiliation(s)
- Ekatherine Prokopiou
- Ophthalmos Research and Educational Institute, Nicosia, Cyprus.,University of Nicosia Medical School, Nicosia, Cyprus
| | | | | | - Maria Kalogerou
- Ophthalmos Research and Educational Institute, Nicosia, Cyprus
| | - Louiza Potamiti
- Department of Electron Microscopy/Molecular Pathology, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Kleitos Sokratous
- Department of Electron Microscopy/Molecular Pathology, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,Bioinformatics Group, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Kyriacos Kyriacou
- Department of Electron Microscopy/Molecular Pathology, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus.,The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Tassos Georgiou
- Ophthalmos Research and Educational Institute, Nicosia, Cyprus
| |
Collapse
|
24
|
Omari A, Niziol LM, Gardner TW. Reading deficits in diabetic patients treated with panretinal photocoagulation and good visual acuity. Acta Ophthalmol 2019; 97:e1013-e1018. [PMID: 30968579 DOI: 10.1111/aos.14097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/04/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Patients with proliferative diabetic retinopathy (PDR) treated with panretinal photocoagulation (PRP) can have abnormal visual functioning that may be missed by Snellen visual acuity alone. We investigated reading deficits in patients treated with PRP for PDR using the Minnesota reading (MNREAD) test. METHODS Thirty patients treated with PRP and 15 controls underwent best-corrected visual acuity (BCVA), the MNREAD, frequency doubling perimetry (FDP), and fundus photography. Panretinal photocoagulation (PRP)-treated subjects were compared to controls on MNREAD results by two-sample t-tests and Wilcoxon tests and Pearson correlations were used to assess the association between performance on MNREAD and other central visual function tests within PRP subjects. RESULTS Panretinal photocoagulation (PRP)-treated patients had reduced MNREAD acuity (p < 0.0001) and increased critical print size (p = 0.01) compared to controls but not a significantly reduced maximum reading speed (p = 0.06). Logmar MNREAD acuity was strongly positive correlated with logMAR BCVA (r = 0.58, p = 0.0098) and strongly negatively correlated with FDP foveal threshold (r = -0.63, p = 0.0030). Maximum reading speed was positively correlated with FDP foveal threshold (r = 0.57, p = 0.0143) and FDP mean deviation (r = 0.51, p = 0.0432). Visual acuity did not correlate with the sensitivities on the FDP. CONCLUSION The MNREAD test reveals that PRP reduces reading ability and other aspects of macular function, and thus provides new understanding of how vision-related quality of life is impaired. These findings may lead to improved means to evaluate and enhance vision following treatment for PDR.
Collapse
Affiliation(s)
- Amro Omari
- Department of Ophthalmology and Visual Sciences W. K. Kellogg Eye Center University of Michigan Ann Arbor Michigan USA
| | - Leslie M Niziol
- Department of Ophthalmology and Visual Sciences W. K. Kellogg Eye Center University of Michigan Ann Arbor Michigan USA
| | - Thomas W Gardner
- Department of Ophthalmology and Visual Sciences W. K. Kellogg Eye Center University of Michigan Ann Arbor Michigan USA
| |
Collapse
|
25
|
Xiang M, Mo L, Zhan Y, Wen H, Zhou H, Miao W. P38-Mediated Cellular Senescence in Conjunctivochalasis Fibroblasts. Invest Ophthalmol Vis Sci 2019; 60:4643-4651. [PMID: 31682715 DOI: 10.1167/iovs.19-27617] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Conjunctivochalasis (CCH) is a common ocular disease and has received extensive attention recently. However, its exact pathogenesis remains largely unknown. Owing to the high morbidity of CCH in older people, this study aimed to investigate whether cellular senescence contributes to CCH progression and the underlying mechanism. Methods Loose conjunctival tissues from CCH patients (n = 13) and normal conjunctival tissues from age-matched persons (n = 12) were obtained and the fibroblasts were separately induced and obtained. Cellular senescence, and the expression of senescence-associated genes (p53 and p21) and p38 in CCH conjunctival tissues and normal controls, were determined by senescence-associated β-galactosidase (SA-β-Gal) staining and quantitative (q)RT-PCR, respectively. To explore the effects of p38 on cellular senescence in CCH fibroblasts, small interfering RNA (siRNA) targeting p38 (siP38) and p38-specific inhibitor SB203580 was performed in CCH fibroblasts. Then, cellular senescence, cell viability, reactive oxygen species (ROS) production, and gene expression were detected according to the corresponding methods. Results CCH conjunctival tissues had significantly more senescent cells, evidenced by more SA-β-Gal-positive cells, and higher expression of senescence-associated genes (p53 and p21) and p38. CCH fibroblasts transfected with siP38 or treated with SB203580 had obviously reduced numbers of senescent cells, decreased ROS production, and increased cell viability, as well as reduced expression of senescence-associated genes. Meanwhile, blocking p38 signaling decreased the expression of p53 and p21. Conclusions Therefore, these findings indicate that cellular senescence might be a causative factor for CCH. P38 signaling might play an important role in the progress of cellular senescence in CCH fibroblasts via manipulation of p53/p21 signaling.
Collapse
Affiliation(s)
- Minhong Xiang
- Department of Ophthalmology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lijuan Mo
- Department of Ophthalmology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yueping Zhan
- Department of Ophthalmology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hang Wen
- Department of Ophthalmology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huanming Zhou
- Department of Ophthalmology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wanhong Miao
- Department of Ophthalmology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Department of Ophthalmology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
26
|
Ma LJ, Xu LL, Mao CJ, Fu YT, Ji XY, Shen Y, Chen J, Yang YP, Liu CF. Progressive Changes in the Retinal Structure of Patients with Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2019; 8:85-92. [PMID: 29480221 DOI: 10.3233/jpd-171184] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many optical coherence tomography (OCT) studies have reported alterations in the retinal nerve fiber layer (RNFL) in Parkinson's disease (PD) and other neurodegenerative diseases. However, whether retinal alterations are a biomarker for PD is still controversial. OBJECTIVE To investigate potential correlations between PD and morphological changes in retina using OCT and to determine its usefulness as a biomarker of disease progression in PD. METHODS We performed a cross-sectional study on patients with PD (N = 37) and age-matched controls (N = 42), followed by a longitudinal study of the PD patients (N = 22) over approximately 2.5 years. RESULTS The average retinal nerve fiber layer (RNFL) thickness (p < 0.001), total macular thickness (p = 0.001), and macular volume (p = 0.001) were decreased in PD patients compared to controls and had further decreased at the follow-up visit (p < 0.05 for all). The average RNFL thickness and the total thickness of macular were negatively correlated with age in PD patients at baseline. Linear regression analysis revealed that age (p = 0.002, p = 0.003, respectively) and LEDD (p = 0.011, p = 0.013, respectively) were correlated to total thickness and volume of macular in 22 PD patients in the follow-up study. However, no correlation was found between RNFL and other parameters. CONCLUSIONS PD progression is associated with pronounced retinal structure changes, which can be quantified by OCT. Patterns of RNFL and macular damage detected by the noninvasive technology of OCT can be a useful biomarker for evaluating the progression of PD.
Collapse
Affiliation(s)
- Li-Jing Ma
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Ling-Li Xu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Cheng-Jie Mao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yun-Ting Fu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiao-Yan Ji
- Department of Ophthalmology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yun Shen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jing Chen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Ya-Ping Yang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China.,Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| |
Collapse
|
27
|
Abstract
SIGNIFICANCE In the field of visual rehabilitation of patients with central visual field loss (CFL), knowledge on how peripheral visual function can be improved is essential. This study presents measurements of peripheral dynamic contrast sensitivity (with optical correction) for off-axis viewing angles in subjects with CFL. PURPOSE Subjects with CFL rely on a peripheral preferred retinal locus (PRL) for many visual tasks. It is therefore important to ascertain that contrast sensitivity (CS) is maximized in the PRL. This study evaluates the effect of stimulus motion, in combination with optical correction, on CS in subjects with CFL. METHODS The off-axis refractive errors in the PRL of five young CFL subjects were measured with a COAS open-view Hartmann-Shack aberrometer. Low-contrast (25% and 10%) and high-contrast resolution acuity for stationary gratings was assessed with and without optical correction. High-contrast resolution was also measured for gratings drifting at 7.5 Hz (within a fixed Gaussian window). Furthermore, resolution CS was evaluated for both stationary and moving gratings with optical correction for a total of two to three spatial frequencies per subject. RESULTS High-contrast resolution acuity was relatively insensitive to stimulus drift motion of 7.5 Hz, whereas CS for gratings of 0.5 cycles per degree improved with drift for all subjects. Furthermore, both high- and low-contrast static resolution improved with optical correction. CONCLUSIONS Just as for healthy eyes, stimulus motion of 7.5 Hz enhances CS for gratings of low spatial frequency also in the PRL of eyes with CFL. Concurrently, high-contrast resolution is unaffected by the 7.5-Hz drift but improves with off-axis optical correction. This highlights the importance of providing optimal refractive correction for subjects with CFL and that stimulus motion can be used to further enhance CS at low spatial frequencies.
Collapse
|
28
|
Zhang X, Zhu J, Chen X, Jie-Qiong Z, Li X, Luo L, Huang H, Liu W, Zhou X, Yan J, Lin S, Ye J. Interferon Regulatory Factor 3 Deficiency Induces Age-Related Alterations of the Retina in Young and Old Mice. Front Cell Neurosci 2019; 13:272. [PMID: 31281243 PMCID: PMC6596281 DOI: 10.3389/fncel.2019.00272] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 06/05/2019] [Indexed: 12/20/2022] Open
Abstract
Age-related changes in visual function and retina structure are very common in aged animals, but the underlying mechanisms of these changes remain unclear. Here we report that the expression of interferon regulatory factor 3 (IRF3), a critical immune regulatory factor, is dramatically down-regulated in mouse retinas during aging. To address the role of IRF3 in the retina, we examined the structure and function of retinas in young (3–4 months) and old (22–24 months) Irf3-/- mice in comparison to age-matched wildtype (WT) mice. We found that IRF3 deletion resulted in impaired electroretinogram (ERG) responses and decreased retinal thickness in both young and old mice. In addition, numerous synapses of the outer plexiform layer (OPL) were found obviously extending into outer nuclear layer (ONL) in Irf3-/- mice, along with a reduction of the average synapse density in the OPL. These changes suggest that IRF3 deletion may accelerate retinal senescence. In support of this hypothesis, a number of classic senescence-associated markers were found in remarkably elevated level in Irf3-/- retina, including p53, p16INK4a, inositol-requiring enzyme 1α (IREα), p-H2A.X and promyelocytic leukemia protein (PML). Overall, our results indicate that maintenance normal IRF3 levels is necessary for retinal structure and function and suggest that IRF3 is an important regulator of retinal senescence.
Collapse
Affiliation(s)
- Xi Zhang
- Department of Ophthalmology, Institute of Surgery Research, Army Medical Center of PLA (Daping Hospital), Army Medical University, Chongqing, China
| | - Jingyi Zhu
- Department of Ophthalmology, Institute of Surgery Research, Army Medical Center of PLA (Daping Hospital), Army Medical University, Chongqing, China
| | - Xianjun Chen
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing, China
| | - Zhang Jie-Qiong
- Department of Ophthalmology, Institute of Surgery Research, Army Medical Center of PLA (Daping Hospital), Army Medical University, Chongqing, China
| | - Xue Li
- Department of Ophthalmology, Institute of Surgery Research, Army Medical Center of PLA (Daping Hospital), Army Medical University, Chongqing, China
| | - Linlin Luo
- Department of Ophthalmology, Institute of Surgery Research, Army Medical Center of PLA (Daping Hospital), Army Medical University, Chongqing, China
| | - Huang Huang
- Institute of Immunology, Army Medical University, Chongqing, China
| | - Wenyi Liu
- Department of Ophthalmology, Institute of Surgery Research, Army Medical Center of PLA (Daping Hospital), Army Medical University, Chongqing, China
| | - Xinyuan Zhou
- Institute of Immunology, Army Medical University, Chongqing, China
| | - Jun Yan
- Department of Ophthalmology, Institute of Surgery Research, Army Medical Center of PLA (Daping Hospital), Army Medical University, Chongqing, China
| | - Sen Lin
- Department of Ophthalmology, Institute of Surgery Research, Army Medical Center of PLA (Daping Hospital), Army Medical University, Chongqing, China
| | - Jian Ye
- Department of Ophthalmology, Institute of Surgery Research, Army Medical Center of PLA (Daping Hospital), Army Medical University, Chongqing, China
| |
Collapse
|
29
|
Impact of Surgeon’s Experience on Surgical Outcomes in Colorectal Surgery. Indian J Surg 2019. [DOI: 10.1007/s12262-018-1784-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
30
|
Pergher V, Tournoy J, Schoenmakers B, Van Hulle MM. P300, Gray Matter Volume and Individual Characteristics Correlates in Healthy Elderly. Front Aging Neurosci 2019; 11:104. [PMID: 31130855 PMCID: PMC6510164 DOI: 10.3389/fnagi.2019.00104] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/17/2019] [Indexed: 12/16/2022] Open
Abstract
We investigated whether P300-ERP and cognitive test performance differ for age, sex, and education in two groups of healthy elderly, and verified whether any correlations exist between P300 amplitude and latency and gray matter volume using whole brain voxel-by-voxel-based mapping, controlling for age, education, sex and Total Intracranial Volume (TIV). We used 32 channel electroencephalograms (EEG) to record the P300 responses and 3T Magnetic Resonance Imaging (MRI) to determine gray matter volume. We recruited 36 native-Dutch speaking healthy older subjects, equally divided in two sub-groups of 52-64 and 65-76 years old, administered a battery of cognitive tests and recorded their demographics, EEGs and task performance; additionally, 16 adults from the second sub-group underwent an MRI scan. We found significant differences between age groups in their cognitive tests performance, P300 amplitudes for the frontal and parietal electrodes for the most difficult task, and P300 latencies for frontal, central and parietal electrodes for all three tasks difficulty levels. Interesting, sex and education affected cognitive and P300 results. Higher education was related to higher accuracy, and P300 amplitudes and shorter latencies. Moreover, females exhibited higher P300 amplitudes and shorter latencies, and better cognitive tasks performance compared to males. Additionally, for the 16 adults underwent to MRI scan, we found positive correlations between P300 characteristics in frontal, central and parietal areas and gray matter volume, controlling for demographic variables and TIV, but also showing that age, sex, and education correlate with gray matter volume. These findings provide support that age, sex, and education affect an individual's cognitive, neurophysiological and structural characteristics, and therefore motivate the need to further investigate these in relation to P300 responses and gray matter volume in healthy elderly.
Collapse
Affiliation(s)
- Valentina Pergher
- Laboratory for Neuro- and Psychophysiology, Department of Neurosciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Jos Tournoy
- Department of Chronic Disease, Metabolism and Ageing, KU Leuven - University of Leuven, Leuven, Belgium
| | - Birgitte Schoenmakers
- Academic Centre of General Practice, KU Leuven - University of Leuven, Leuven, Belgium
| | - Marc M Van Hulle
- Laboratory for Neuro- and Psychophysiology, Department of Neurosciences, KU Leuven - University of Leuven, Leuven, Belgium
| |
Collapse
|
31
|
Khaligh-Razavi SM, Habibi S, Sadeghi M, Marefat H, Khanbagi M, Nabavi SM, Sadeghi E, Kalafatis C. Integrated Cognitive Assessment: Speed and Accuracy of Visual Processing as a Reliable Proxy to Cognitive Performance. Sci Rep 2019; 9:1102. [PMID: 30705371 PMCID: PMC6355897 DOI: 10.1038/s41598-018-37709-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 12/11/2018] [Indexed: 12/18/2022] Open
Abstract
Various mental disorders are accompanied by some degree of cognitive impairment. Particularly in neurodegenerative disorders, cognitive impairment is the phenotypical hallmark of the disease. Effective, accurate and timely cognitive assessment is key to early diagnosis of this family of mental disorders. Current standard-of-care techniques for cognitive assessment are primarily paper-based, and need to be administered by a healthcare professional; they are additionally language and education-dependent and typically suffer from a learning bias. These tests are thus not ideal for large-scale pro-active cognitive screening and disease progression monitoring. We developed the Integrated Cognitive Assessment (referred to as CGN_ICA), a 5-minute computerized cognitive assessment tool based on a rapid visual categorization task, in which a series of carefully selected natural images of varied difficulty are presented to participants. Overall 448 participants, across a wide age-range with different levels of education took the CGN_ICA test. We compared participants' CGN_ICA test results with a variety of standard pen-and-paper tests, such as Symbol Digit Modalities Test (SDMT) and Montreal Cognitive Assessment (MoCA), that are routinely used to assess cognitive performance. CGN_ICA had excellent test-retest reliability, showed convergent validity with the standard-of-care cognitive tests used here, and demonstrated to be suitable for micro-monitoring of cognitive performance.
Collapse
Affiliation(s)
- Seyed-Mahdi Khaligh-Razavi
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.
- Department of Brain and Cognitive Sciences, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
- Cognetivity ltd, London, UK.
| | | | | | - Haniye Marefat
- School of Cognitive Sciences (SCS), Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Mahdiyeh Khanbagi
- Department of Brain and Cognitive Sciences, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Seyed Massood Nabavi
- Department of Brain and Cognitive Sciences, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | | | - Chris Kalafatis
- Cognetivity ltd, London, UK
- South London & Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
32
|
Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy. J Ophthalmol 2019; 2018:8479850. [PMID: 30647965 PMCID: PMC6311844 DOI: 10.1155/2018/8479850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/08/2018] [Accepted: 09/23/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose Diabetic retinal neuropathy refers to retinal neural tissue damage occurring before the structural retinal changes of diabetic retinopathy and fulfils many of the criteria for causality for the subsequent vasculopathy. Developing reliable means of measuring neuronal damage in diabetes may be important in efforts to prevent retinopathy of a clinically significant and irreversible stage. This study aimed at systematically assessing current clinical measurements of diabetic retinal neuropathy so that future studies may utilise a consensual battery of tests in studying this poorly understood disease state between a healthy retina and one that is retinopathic. Methods A systematic search of the medical literature since 1984 was performed on PUBMED and EMBASE, and the evidence supporting each identified method as an indicator for clinically important diabetic retinal neuropathy was graded relatively as compelling, medium, or weak according to criteria assessing its relationship to subsequent diabetic retinopathy, quality of supporting studies, and published reproducibility. Results The systematic search yielded 6432 results. Subsequent assessment by two independent investigators identified 601 multiple subject studies in humans assessing clinical aspects of the retinal structure, function, or psychophysics in the prediabetic retina. The 933 separate instances of clinical methods assessed as being supported by relatively “compelling” evidence included colour vision changes, flash ERG b-wave latency, flash multifocal b-wave latency, scotopic b-wave and oscillatory potentials in ERG, and contrast sensitivity. Conclusion The results showed moderately poor quality of extant evidence and indicate the best clinical methods for assessing diabetic retinal neuropathy that remain to be confirmed. This is the first systematic assessment of the medical literature aiming at assessing the breadth and validity of these methods and represents an early step in identifying and developing clinical endpoints for use in trials designed to identify at-risk patients or prevent diabetic retinopathy.
Collapse
|
33
|
Harrison IF, Whitaker R, Bertelli PM, O’Callaghan JM, Csincsik L, Bocchetta M, Ma D, Fisher A, Ahmed Z, Murray TK, O’Neill MJ, Rohrer JD, Lythgoe MF, Lengyel I. Optic nerve thinning and neurosensory retinal degeneration in the rTg4510 mouse model of frontotemporal dementia. Acta Neuropathol Commun 2019; 7:4. [PMID: 30616676 PMCID: PMC6322294 DOI: 10.1186/s40478-018-0654-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 12/20/2018] [Indexed: 01/09/2023] Open
Abstract
Visual impairments, such as difficulties in reading and finding objects, perceiving depth and structure from motion, and impaired stereopsis, have been reported in tauopathy disorders, such as frontotemporal dementia (FTD). These impairments however have been previously attributed to cortical pathologies rather than changes in the neurosensory retina or the optic nerve. Here, we examined tau pathology in the neurosensory retina of the rTg(tauP301L)4510 mouse model of FTD. Optic nerve pathology in mice was also assessed using MRI, and corresponding measurements taken in a cohort of five FTD sufferers and five healthy controls. rTg(tauP301L)4510 mice were imaged (T2-weighted MRI) prior to being terminally anesthetized and eyes and brains removed for immunohistochemical and histological analysis. Central and peripheral retinal labelling of tau and phosphorylated tau (pTau) was quantified and retinal layer thicknesses and cell numbers assessed. MR volumetric changes of specific brain regions and the optic nerve were compared to tau accumulation and cell loss in the visual pathway. In addition, the optic nerves of a cohort of healthy controls and behavioural variant FTD patients, were segmented from T1- and T2-weighted images for volumetric study. Accumulation of tau and pTau were observed in both the central and peripheral retinal ganglion cell (RGC), inner plexiform and inner nuclear layers of the neurosensory retina of rTg(tauP301L)4510 mice. This pathology was associated with reduced nuclear density (− 24.9 ± 3.4%) of the central RGC layer, and a reduced volume (− 19.3 ± 4.6%) and elevated T2 signal (+ 27.1 ± 1.8%) in the optic nerve of the transgenic mice. Significant atrophy of the cortex (containing the visual cortex) was observed but not in other area associated with visual processing, e.g. the lateral geniculate nucleus or superior colliculus. Atrophic changes in optic nerve volume were similarly observed in FTD patients (− 36.6 ± 2.6%). The association between tau-induced changes in the neurosensory retina and reduced optic nerve volume in mice, combined with the observation of optic nerve atrophy in clinical FTD suggests that ophthalmic tau pathology may also exist in the eyes of FTD patients. If tau pathology and neurodegeneration in the retina were to reflect the degree of cortical tau burden, then cost-effective and non-invasive imaging of the neurosensory retina could provide valuable biomarkers in tauopathy. Further work should aim to validate whether these observations are fully translatable to a clinical scenario, which would recommend follow-up retinal and optic nerve examination in FTD.
Collapse
|
34
|
White AA, Sage WM, Osinska PH, Salgaonkar MJ, Gallagher TH. Patient safety and the ageing physician: a qualitative study of key stakeholder attitudes and experiences. BMJ Qual Saf 2018; 28:468-475. [PMID: 30237318 DOI: 10.1136/bmjqs-2018-008276] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/20/2018] [Accepted: 08/12/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Unprecedented numbers of physicians are practicing past age 65. Unlike other safety-conscious industries, such as aviation, medicine lacks robust systems to ensure late-career physician (LCP) competence while promoting career longevity. OBJECTIVE To describe the attitudes of key stakeholders about the oversight of LCPs and principles that might shape policy development. DESIGN Thematic content analysis of interviews and focus groups. PARTICIPANTS 40 representatives of stakeholder groups including state medical board leaders, institutional chief medical officers, senior physicians (>65 years old), patient advocates (patients or family members in advocacy roles), nurses and junior physicians. Participants represented a balanced sample from all US regions, surgical and non-surgical specialties, and both academic and non-academic institutions. RESULTS Stakeholders describe lax professional self-regulation of LCPs and believe this represents an important unsolved challenge. Patient safety and attention to physician well-being emerged as key organising principles for policy development. Stakeholders believe that healthcare institutions rather than state or certifying boards should lead implementation of policies related to LCPs, yet expressed concerns about resistance by physicians and the ability of institutions to address politically complex medical staff challenges. Respondents recommended a coaching and professional development framework, with environmental changes, to maximise safety and career longevity of physicians as they age. CONCLUSIONS Key stakeholders express a desire for wider adoption of LCP standards, but foresee significant culture change and practical challenges ahead. Participants recommended that institutions lead this work, with support from regulatory stakeholders that endorse standards and create frameworks for policy adoption.
Collapse
Affiliation(s)
- Andrew A White
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - William M Sage
- Surgery and Perioperative Care, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.,School of Law at the University of Texas at Austin, Austin, Texas, USA
| | - Paulina H Osinska
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Monica J Salgaonkar
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Thomas H Gallagher
- Departments of Medicine and Bioethics, University of Washington School of Medicine, Seattle, Washington, USA
| |
Collapse
|
35
|
Lee SE, Han K, Baek JY, Ko KS, Lee KU, Koh EH. Association Between Diabetic Retinopathy and Parkinson Disease: The Korean National Health Insurance Service Database. J Clin Endocrinol Metab 2018; 103:3231-3238. [PMID: 29982669 DOI: 10.1210/jc.2017-02774] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 06/27/2018] [Indexed: 12/13/2022]
Abstract
CONTEXT Studies have shown an association between diabetes and Parkinson disease (PD). The retina is a part of the central nervous system; it was proposed that diabetic retinopathy (DR) and PD share common pathophysiology of dopamine deficiency. However, no epidemiologic studies have investigated the relationship between these two diseases. OBJECTIVE We assessed the association between DR and incident PD using a population-based database. DESIGN/SETTING/PARTICIPANTS Using the Korean National Health Insurance Service database, 14,912,368 participants who underwent regular health checkup from 2005 to 2008 were included. Subjects were classified into non-diabetes, diabetes without DR, and diabetes with DR groups at baseline and followed up until the date of PD incidence, death, or 31 December 2013. Cox proportional hazards regression analysis was used to evaluate the association between DR and incident PD. RESULTS During the period, 34,834 subjects were newly diagnosed with PD. The incidence of PD was 2.74, 8.39, and 15.51 per 10,000 person-years for the non-diabetes, diabetes without DR, and diabetes with DR groups, respectively. In multivariate Cox proportional hazard models, DR groups were associated with significantly higher risk of PD than non-diabetes or diabetes without DR groups even after adjusting for age, sex, fasting plasma glucose level, insulin usage, and other possible risk factors. CONCLUSION Concurrent DR was associated with an increased risk of incident PD. Future studies are necessary to investigate the mechanism of increased risk of PD in DR including dopamine deficiency in the central nervous system and long-lasting poor glycemic control.
Collapse
Affiliation(s)
- Seung Eun Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, The Catholic University of Korea, Seoul, Korea
| | - Ji Yeon Baek
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Soo Ko
- Department of Internal Medicine, Cardiovascular and Metabolic Disease Center, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Ki-Up Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Hee Koh
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | | |
Collapse
|
36
|
Ehlman MC, Nimkar S, Nolan BAD, Thomas P, Caballero CE, Snow T. Health Workers' Knowledge and Perceptions on Dementia in Skilled Nursing Homes: A Pilot Implementation of Teepa Snow's Positive Approach to Care Certification Course. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2018; 38:190-197. [PMID: 30157153 DOI: 10.1097/ceh.0000000000000216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION A knowledge gap on caring for people with dementia exists among health workers employed in skilled nursing facilities. This article reports on knowledge gained and perceptions changed among 24 skilled nursing facility health workers who completed Teepa Snow's innovative Positive Approach to Care Certification course as a regional initiative. METHODS This pilot study used a quasi-experiment with a one-group pretest-posttest design to assess the dementia knowledge and perceptions of health workers who participated in the course. Paired responses (n = 22) for the 54-item dementia knowledge and training/coaching perceptions survey were compared using the McNemar test, Paired t test, and Wilcoxon signed-rank test to analyze the improvement in knowledge and perceptions of dementia. RESULTS Significant knowledge gain was found among health workers after completing the program (t(21) = -7.46, P < .001). Statistical differences (P < .05) were present in eight knowledge items (ie, working memory, mental health, temporal lobe, "sapphire", "space and awareness", personal space, binocular vision, and hippocampus) and four perception areas (ie, approaching, understanding, calming, and instructing) about dementia. Significant changes were also found in four areas of health workers' perceptions about dementia (P < .05). DISCUSSION The certification course can improve knowledge and facilitate perceptual change on dementia. Implementing this program as a novel regional initiative has robust potential in ensuring continuing workforce development in health care settings challenged with ever-changing people living with dementia needs and high staff turnover.
Collapse
Affiliation(s)
- Mary C Ehlman
- Dr. Ehlman: Associate Professor, Health Services, University of Southern Indiana, College of Nursing and Health Professions, Evansville, IN. Dr. Nimkar: Assistant Professor, Health Services, University of Southern Indiana, Evansville, IN. Dr. Nolan: Director of Research and Policy, Positive Approach, LLC, Efland, NC. Dr. Thomas: Instructor, Nursing, University of Southern Indiana, Evansville, IN. Mr. Caballero: Graduate Assistant, University of Southern Indiana, Evansville, IN. Ms. Snow: Dementia Care & Training Specialist, Owner, Positive Approach, LLC, Efland, NC
| | | | | | | | | | | |
Collapse
|
37
|
Bucolo C, Platania CBM, Drago F, Bonfiglio V, Reibaldi M, Avitabile T, Uva M. Novel Therapeutics in Glaucoma Management. Curr Neuropharmacol 2018; 16:978-992. [PMID: 28925883 PMCID: PMC6120119 DOI: 10.2174/1570159x15666170915142727] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 06/26/2017] [Accepted: 09/03/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Glaucoma is a progressive optic neuropathy characterized by retinal ganglion cell death and alterations of visual field. Elevated intraocular pressure (IOP) is considered the main risk factor of glaucoma, even though other factors cannot be ruled out, such as epigenetic mechanisms. OBJECTIVE An overview of the ultimate promising experimental drugs to manage glaucoma has been provided. RESULTS In particular, we have focused on purinergic ligands, KATP channel activators, gases (nitric oxide, carbon monoxide and hydrogen sulfide), non-glucocorticoid steroidal compounds, neurotrophic factors, PI3K/Akt activators, citicoline, histone deacetylase inhibitors, cannabinoids, dopamine and serotonin receptors ligands, small interference RNA, and Rho kinase inhibitors. CONCLUSIONS The review has been also endowed of a brief chapter on last reports about potential neuroprotective benefits of anti-glaucoma drugs already present in the market.
Collapse
Affiliation(s)
- Claudio Bucolo
- Address correspondence to this author at the Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Via S. Sofia 97, 95123 Catania, Italy; Tel: +39 095 4781196;
| | | | | | | | | | | | | |
Collapse
|
38
|
Bastos AM, Rodrigues AR, Côrtes MIT, Lacerda EMDCB, Lima MG, Teixeira CEC, Silveira LCDL. Evidence of Asymptomatic Visual Losses after Surgical Repair of Cerebral Aneurysm. Front Neurol 2017; 8:487. [PMID: 28983277 PMCID: PMC5613110 DOI: 10.3389/fneur.2017.00487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 08/31/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Albedy Moreira Bastos
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | | | | | | | - Mônica Gomes Lima
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Cláudio Eduardo Corrêa Teixeira
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
- Centro de Ciências Biológicas e da Saúde, Universidade da Amazônia, Belém, Brazil
- Centro Universitário do Estado do Pará, Belém, Brazil
- *Correspondence: Cláudio Eduardo Corrêa Teixeira,
| | - Luiz Carlos de Lima Silveira
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| |
Collapse
|
39
|
Chiasseu M, Alarcon-Martinez L, Belforte N, Quintero H, Dotigny F, Destroismaisons L, Vande Velde C, Panayi F, Louis C, Di Polo A. Tau accumulation in the retina promotes early neuronal dysfunction and precedes brain pathology in a mouse model of Alzheimer's disease. Mol Neurodegener 2017; 12:58. [PMID: 28774322 PMCID: PMC5543446 DOI: 10.1186/s13024-017-0199-3] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/31/2017] [Indexed: 12/14/2022] Open
Abstract
Background Tau is an axon-enriched protein that binds to and stabilizes microtubules, and hence plays a crucial role in neuronal function. In Alzheimer’s disease (AD), pathological tau accumulation correlates with cognitive decline. Substantial visual deficits are found in individuals affected by AD including a preferential loss of retinal ganglion cells (RGCs), the neurons that convey visual information from the retina to the brain. At present, however, the mechanisms that underlie vision changes in these patients are poorly understood. Here, we asked whether tau plays a role in early retinal pathology and neuronal dysfunction in AD. Methods Alterations in tau protein and gene expression, phosphorylation, and localization were investigated by western blots, qPCR, and immunohistochemistry in the retina and visual pathways of triple transgenic mice (3xTg) harboring mutations in the genes encoding presenilin 1 (PS1M146 V), amyloid precursor protein (APPSwe), and tau (MAPTP301L). Anterograde axonal transport was assessed by intraocular injection of the cholera toxin beta subunit followed by quantification of tracer accumulation in the contralateral superior colliculus. RGC survival was analyzed on whole-mounted retinas using cell-specific markers. Reduction of tau expression was achieved following intravitreal injection of targeted siRNA. Results Our data demonstrate an age-related increase in endogenous retinal tau characterized by epitope-specific hypo- and hyper-phosphorylation in 3xTg mice. Retinal tau accumulation was observed as early as three months of age, prior to the reported onset of behavioral deficits, and preceded tau aggregation in the brain. Intriguingly, tau build up occurred in RGC soma and dendrites, while tau in RGC axons in the optic nerve was depleted. Tau phosphorylation changes and missorting correlated with substantial defects in anterograde axonal transport that preceded RGC death. Importantly, targeted siRNA-mediated knockdown of endogenous tau improved anterograde transport along RGC axons. Conclusions Our study reveals profound tau pathology in the visual system leading to early retinal neuron damage in a mouse model of AD. Importantly, we show that tau accumulation promotes anterograde axonal transport impairment in vivo, and identify this response as an early feature of neuronal dysfunction that precedes cell death in the AD retina. These findings provide the first proof-of-concept that a global strategy to reduce tau accumulation is beneficial to improve axonal transport and mitigate functional deficits in AD and tauopathies.
Collapse
Affiliation(s)
- Marius Chiasseu
- Department of Neuroscience and Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, 900 Rue Saint-Denis, Tour Viger, Room R09.720, Montréal, QC, H2X 0A9, Canada
| | - Luis Alarcon-Martinez
- Department of Neuroscience and Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, 900 Rue Saint-Denis, Tour Viger, Room R09.720, Montréal, QC, H2X 0A9, Canada
| | - Nicolas Belforte
- Department of Neuroscience and Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, 900 Rue Saint-Denis, Tour Viger, Room R09.720, Montréal, QC, H2X 0A9, Canada
| | - Heberto Quintero
- Department of Neuroscience and Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, 900 Rue Saint-Denis, Tour Viger, Room R09.720, Montréal, QC, H2X 0A9, Canada
| | - Florence Dotigny
- Department of Neuroscience and Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, 900 Rue Saint-Denis, Tour Viger, Room R09.720, Montréal, QC, H2X 0A9, Canada
| | - Laurie Destroismaisons
- Department of Neuroscience and Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, 900 Rue Saint-Denis, Tour Viger, Room R09.720, Montréal, QC, H2X 0A9, Canada
| | - Christine Vande Velde
- Department of Neuroscience and Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, 900 Rue Saint-Denis, Tour Viger, Room R09.720, Montréal, QC, H2X 0A9, Canada
| | - Fany Panayi
- Institut de Recherches Servier, 78290, Croissy-sur-Seine, France
| | - Caroline Louis
- Institut de Recherches Servier, 78290, Croissy-sur-Seine, France
| | - Adriana Di Polo
- Department of Neuroscience and Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, 900 Rue Saint-Denis, Tour Viger, Room R09.720, Montréal, QC, H2X 0A9, Canada.
| |
Collapse
|
40
|
Jongkees BJ, Steenbergen L, Colzato LS. Color vision predicts processing modes of goal activation during action cascading. Cortex 2017; 94:123-130. [PMID: 28759802 DOI: 10.1016/j.cortex.2017.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/03/2017] [Accepted: 07/03/2017] [Indexed: 11/19/2022]
Abstract
One of the most important functions of cognitive control is action cascading: the ability to cope with multiple response options when confronted with various task goals. A recent study implicates a key role for dopamine (DA) in this process, suggesting higher D1 efficiency shifts the action cascading strategy toward a more serial processing mode, whereas higher D2 efficiency promotes a shift in the opposite direction by inducing a more parallel processing mode (Stock, Arning, Epplen, & Beste, 2014). Given that DA is found in high concentration in the retina and modulation of retinal DA release displays characteristics of D2-receptors (Peters, Schweibold, Przuntek, & Müller, 2000), color vision discrimination might serve as an index of D2 efficiency. We used color discrimination, assessed with the Lanthony Desaturated Panel D-15 test, to predict individual differences (N = 85) in a stop-change paradigm that provides a well-established measure of action cascading. In this task it is possible to calculate an individual slope value for each participant that estimates the degree of overlap in task goal activation. When the stopping process of a previous task goal has not finished at the time the change process toward a new task goal is initiated (parallel processing), the slope value becomes steeper. In case of less overlap (more serial processing), the slope value becomes flatter. As expected, participants showing better color vision were more prone to activate goals in a parallel manner as indicated by a steeper slope. Our findings suggest that color vision might represent a predictor of D2 efficiency and the predisposed processing mode of goal activation during action cascading.
Collapse
Affiliation(s)
- Bryant J Jongkees
- Institute of Psychological Research and Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
| | - Laura Steenbergen
- Institute of Psychological Research and Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands; Amsterdam Brain & Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Lorenza S Colzato
- Institute of Psychological Research and Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands; Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany; Institute for Sports and Sport Science, University of Kassel, Kassel, Germany
| |
Collapse
|
41
|
Tau Accumulation, Altered Phosphorylation, and Missorting Promote Neurodegeneration in Glaucoma. J Neurosci 2017; 36:5785-98. [PMID: 27225768 DOI: 10.1523/jneurosci.3986-15.2016] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 04/13/2016] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED Glaucoma, the leading cause of irreversible blindness worldwide, is characterized by the selective death of retinal ganglion cells (RGCs). Ocular hypertension is the most significant known risk factor for developing the disease, but the mechanism by which elevated pressure damages RGCs is currently unknown. The axonal-enriched microtubule-associated protein tau is a key mediator of neurotoxicity in Alzheimer's disease and other tauopathies. Using a well characterized in vivo rat glaucoma model, we show an age-related increase in endogenous retinal tau that was markedly exacerbated by ocular hypertension. Early alterations in tau phosphorylation, characterized by epitope-dependent hyperphosphorylation and hypophosphorylation, correlated with the appearance of tau oligomers in glaucomatous retinas. Our data demonstrate the mislocalization of tau in the somatodendritic compartment of RGCs subjected to high intraocular pressure. In contrast, tau was depleted from RGC axons in the optic nerve of glaucomatous eyes. Importantly, intraocular administration of short interfering RNA against tau effectively reduced retinal tau accumulation and promoted robust survival of RGC somas and axons, supporting a critical role for tau alterations in ocular hypertension-induced neuronal damage. Our study reveals that glaucoma displays signature pathological features of tauopathies, including tau accumulation, altered phosphorylation, and missorting; and identifies tau as a novel target to counter RGC neurodegeneration in glaucoma and prevalent optic neuropathies. SIGNIFICANCE STATEMENT In this study, we investigated the role of tau in retinal ganglion cell (RGC) damage in glaucoma. We demonstrate that high intraocular pressure leads to a rapid increase in endogenous retinal tau with altered phosphorylation profile and the formation of tau oligomers. Tau accumulation was primarily observed in RGC dendrites, while tau in RGC axons within the optic nerve was depleted. Attenuation of endogenous retinal tau using a targeted siRNA led to striking protection of RGC somas and axons from hypertension-induced damage. Our study identifies novel and substantial alterations of endogenous tau protein in glaucoma, including abnormal subcellular distribution, an altered phosphorylation profile, and neurotoxicity.
Collapse
|
42
|
Anderson BR, Wallace AS, Hill KD, Gulack BC, Matsouaka R, Jacobs JP, Bacha EA, Glied SA, Jacobs ML. Association of Surgeon Age and Experience With Congenital Heart Surgery Outcomes. Circ Cardiovasc Qual Outcomes 2017; 10:e003533. [PMID: 28710297 PMCID: PMC5656266 DOI: 10.1161/circoutcomes.117.003533] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 06/09/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Surgeon experience concerns both families of children with congenital heart disease and medical providers. Relationships between surgeon seniority and patient outcomes are often assumed, yet there are little data. METHODS AND RESULTS This national study used linked data from the American Medical Association Physician Masterfile and the Society of Thoracic Surgeons-Congenital Heart Surgery Database to examine associations between surgeon years since medical school and major morbidity/mortality for children undergoing cardiac surgery. Sensitivity analyses explored the effects of patient characteristics, institutional/surgeon volumes, and various measures of institutional surgeon team experience. In secondary analyses, major morbidity and mortality were examined as separate end points. We identified 206 congenital heart surgeons from 91 centers performing 62 851 index operations (2010-2014). Median time from school was 25 years (range 9-55 years). A major morbidity/mortality occurred in 11.5% of cases. In multivariable analyses, the odds of major morbidity/mortality were similar for early-career (<15 years from medical school, ≈<40 years old), midcareer (15-24 years, ≈40-50 years old), and senior surgeons (25-35 years, ≈50-60 years old). The odds of major morbidity/mortality were ≈25% higher for operations performed by very senior surgeons (35-55 years from school, ≈60-80 years old; n=9044 cases). Results were driven by differences in morbidity. In extensive sensitivity analyses, these effects remained constant. CONCLUSIONS In this study of >200 congenital heart surgeons, we found patient outcomes for surgeons with the fewest years of experience to be comparable to those of their midcareer and senior colleagues, within the context of existing referral and support practices. Very senior surgeons had higher risk-adjusted odds of major morbidity/mortality. Contemporary approaches to training, referral, mentoring, surgical planning, and other support practices might contribute to the observed outcomes of junior congenital heart surgeons being comparable to those of more experienced colleagues. Understanding and disseminating these practices might benefit the medical community at large.
Collapse
Affiliation(s)
- Brett R Anderson
- From the Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Medical Center (B.R.A.); Duke Clinical Research Institute, Durham, NC (A.S.W.); Department of Pediatrics, Duke Clinical Research Institute (K.D.H.) and Department of Surgery (B.C.G.), Duke University Medical Center, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (R.M.); Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, St. Petersburg, FL (J.P.J., M.L.J.); Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD (J.P.J., M.L.J.); Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, NY (E.A.B.); and The Robert F. Wagner Graduate School of Public Service, New York University (S.A.G.).
| | - Amelia S Wallace
- From the Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Medical Center (B.R.A.); Duke Clinical Research Institute, Durham, NC (A.S.W.); Department of Pediatrics, Duke Clinical Research Institute (K.D.H.) and Department of Surgery (B.C.G.), Duke University Medical Center, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (R.M.); Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, St. Petersburg, FL (J.P.J., M.L.J.); Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD (J.P.J., M.L.J.); Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, NY (E.A.B.); and The Robert F. Wagner Graduate School of Public Service, New York University (S.A.G.)
| | - Kevin D Hill
- From the Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Medical Center (B.R.A.); Duke Clinical Research Institute, Durham, NC (A.S.W.); Department of Pediatrics, Duke Clinical Research Institute (K.D.H.) and Department of Surgery (B.C.G.), Duke University Medical Center, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (R.M.); Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, St. Petersburg, FL (J.P.J., M.L.J.); Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD (J.P.J., M.L.J.); Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, NY (E.A.B.); and The Robert F. Wagner Graduate School of Public Service, New York University (S.A.G.)
| | - Brian C Gulack
- From the Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Medical Center (B.R.A.); Duke Clinical Research Institute, Durham, NC (A.S.W.); Department of Pediatrics, Duke Clinical Research Institute (K.D.H.) and Department of Surgery (B.C.G.), Duke University Medical Center, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (R.M.); Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, St. Petersburg, FL (J.P.J., M.L.J.); Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD (J.P.J., M.L.J.); Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, NY (E.A.B.); and The Robert F. Wagner Graduate School of Public Service, New York University (S.A.G.)
| | - Roland Matsouaka
- From the Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Medical Center (B.R.A.); Duke Clinical Research Institute, Durham, NC (A.S.W.); Department of Pediatrics, Duke Clinical Research Institute (K.D.H.) and Department of Surgery (B.C.G.), Duke University Medical Center, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (R.M.); Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, St. Petersburg, FL (J.P.J., M.L.J.); Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD (J.P.J., M.L.J.); Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, NY (E.A.B.); and The Robert F. Wagner Graduate School of Public Service, New York University (S.A.G.)
| | - Jeffrey P Jacobs
- From the Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Medical Center (B.R.A.); Duke Clinical Research Institute, Durham, NC (A.S.W.); Department of Pediatrics, Duke Clinical Research Institute (K.D.H.) and Department of Surgery (B.C.G.), Duke University Medical Center, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (R.M.); Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, St. Petersburg, FL (J.P.J., M.L.J.); Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD (J.P.J., M.L.J.); Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, NY (E.A.B.); and The Robert F. Wagner Graduate School of Public Service, New York University (S.A.G.)
| | - Emile A Bacha
- From the Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Medical Center (B.R.A.); Duke Clinical Research Institute, Durham, NC (A.S.W.); Department of Pediatrics, Duke Clinical Research Institute (K.D.H.) and Department of Surgery (B.C.G.), Duke University Medical Center, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (R.M.); Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, St. Petersburg, FL (J.P.J., M.L.J.); Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD (J.P.J., M.L.J.); Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, NY (E.A.B.); and The Robert F. Wagner Graduate School of Public Service, New York University (S.A.G.)
| | - Sherry A Glied
- From the Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Medical Center (B.R.A.); Duke Clinical Research Institute, Durham, NC (A.S.W.); Department of Pediatrics, Duke Clinical Research Institute (K.D.H.) and Department of Surgery (B.C.G.), Duke University Medical Center, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (R.M.); Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, St. Petersburg, FL (J.P.J., M.L.J.); Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD (J.P.J., M.L.J.); Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, NY (E.A.B.); and The Robert F. Wagner Graduate School of Public Service, New York University (S.A.G.)
| | - Marshall L Jacobs
- From the Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Medical Center (B.R.A.); Duke Clinical Research Institute, Durham, NC (A.S.W.); Department of Pediatrics, Duke Clinical Research Institute (K.D.H.) and Department of Surgery (B.C.G.), Duke University Medical Center, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (R.M.); Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, St. Petersburg, FL (J.P.J., M.L.J.); Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD (J.P.J., M.L.J.); Division of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, New York, NY (E.A.B.); and The Robert F. Wagner Graduate School of Public Service, New York University (S.A.G.)
| |
Collapse
|
43
|
Beta-amyloid sequelae in the eye: a critical review on its diagnostic significance and clinical relevance in Alzheimer's disease. Mol Psychiatry 2017; 22:353-363. [PMID: 28093567 DOI: 10.1038/mp.2016.251] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/31/2016] [Accepted: 11/22/2016] [Indexed: 01/14/2023]
Abstract
Alzheimer's disease (AD) is a progressive and fatal neurodegenerative disorder. There is no test for its definitive diagnosis in routine clinical practice. Although phase III clinical trials have failed, only symptomatic treatment is currently available; a possible reason for these failed trials is that intervention commenced at an advanced stage of the disease. The hallmarks of an AD brain include plaques comprising of extracellular beta-amyloid (Aβ) protein aggregates and intracellular hyperphosphorylated neurofibrillary tangles of tau. Research into the preclinical diagnosis of AD has provided considerable evidence regarding early neuropathological changes using brain Aβ imaging and the cerebrospinal fluid biomarkers, Aβ and tau. Both these approaches have limitations that are expensive, invasive or time consuming and thus preclude them from screening at-risk population. Recent studies have demonstrated the presence of Aβ plaques in the eyes of AD subjects, which is positively associated with their brain Aβ burden. Thus ocular biomarkers point to a potential avenue for an earlier, relatively low-cost diagnosis in order for therapeutic interventions to be effective. Here we review the literature that spans the investigation for the presence of Aβ in aging eyes and the significance of its deposition in relation to AD pathology. We discuss clinical studies investigating in vivo imaging of Aβ in the eye and its association with brain Aβ burden and therapies that target ocular Aβ. Finally, we focus on the need to characterize AD-specific retinal Aβ to differentiate Aβ found in some eye diseases. Based on the current evidence, we conclude that integration of ocular biomarkers that can correctly predict brain Aβ burden would have an important role as a non-invasive, yet economical surrogate marker in the diagnostic process of AD.
Collapse
|
44
|
Gupta V, Gupta VB, Chitranshi N, Gangoda S, Vander Wall R, Abbasi M, Golzan M, Dheer Y, Shah T, Avolio A, Chung R, Martins R, Graham S. One protein, multiple pathologies: multifaceted involvement of amyloid β in neurodegenerative disorders of the brain and retina. Cell Mol Life Sci 2016; 73:4279-4297. [PMID: 27333888 PMCID: PMC11108534 DOI: 10.1007/s00018-016-2295-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 01/18/2023]
Abstract
Accumulation of amyloid β (Aβ) and its aggregates in the ageing central nervous system is regarded synonymous to Alzheimer's disease (AD) pathology. Despite unquestionable advances in mechanistic and diagnostic aspects of the disease understanding, the primary cause of Aβ accumulation as well as its in vivo roles remains elusive; nonetheless, the majority of the efforts to address pathological mechanisms for therapeutic development are focused towards moderating Aβ accumulation in the brain. More recently, Aβ deposition has been identified in the eye and is linked with distinct age-related diseases including age-related macular degeneration, glaucoma as well as AD. Awareness of the Aβ accumulation in these markedly different degenerative disorders has led to an increasing body of work exploring overlapping mechanisms, a prospective biomarker role for Aβ and the potential to use retina as a model for brain related neurodegenerative disorders. Here, we present an integrated view of current understanding of the retinal Aβ deposition discussing the accumulation mechanisms, anticipated impacts and outlining ameliorative approaches that can be extrapolated to the retina for potential therapeutic benefits. Further longitudinal investigations in humans and animal models will determine retinal Aβ association as a potential pathognomonic, diagnostic or prognostic biomarker.
Collapse
Affiliation(s)
- Vivek Gupta
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Veer B Gupta
- School of Medical Sciences, Edith Cowan University, Perth, Australia.
| | - Nitin Chitranshi
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Sumudu Gangoda
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Roshana Vander Wall
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Mojdeh Abbasi
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Mojtaba Golzan
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Yogita Dheer
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Tejal Shah
- School of Medical Sciences, Edith Cowan University, Perth, Australia
| | - Alberto Avolio
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Roger Chung
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Ralph Martins
- School of Medical Sciences, Edith Cowan University, Perth, Australia
| | - Stuart Graham
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
- Save Sight Institute, Sydney University, Sydney, Australia
| |
Collapse
|
45
|
Affiliation(s)
- Cynthia Owsley
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Alabama 35294;
| |
Collapse
|
46
|
Sanfilippo C, Malaguarnera L, Di Rosa M. Chitinase expression in Alzheimer's disease and non-demented brains regions. J Neurol Sci 2016; 369:242-249. [DOI: 10.1016/j.jns.2016.08.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/03/2016] [Accepted: 08/12/2016] [Indexed: 12/20/2022]
|
47
|
Affiliation(s)
- Mark R Katlic
- Department of Surgery, Sinai Center for Geriatric Surgery, Sinai Hospital, Northwest Hospital, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA.
| | - JoAnn Coleman
- Department of Surgery, Sinai Center for Geriatric Surgery, Sinai Hospital, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA
| |
Collapse
|
48
|
Linking cognitive and visual perceptual decline in healthy aging: The information degradation hypothesis. Neurosci Biobehav Rev 2016; 69:166-73. [PMID: 27484869 DOI: 10.1016/j.neubiorev.2016.07.031] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/25/2016] [Accepted: 07/26/2016] [Indexed: 11/22/2022]
Abstract
Several hypotheses attempt to explain the relation between cognitive and perceptual decline in aging (e.g., common-cause, sensory deprivation, cognitive load on perception, information degradation). Unfortunately, the majority of past studies examining this association have used correlational analyses, not allowing for these hypotheses to be tested sufficiently. This correlational issue is especially relevant for the information degradation hypothesis, which states that degraded perceptual signal inputs, resulting from either age-related neurobiological processes (e.g., retinal degeneration) or experimental manipulations (e.g., reduced visual contrast), lead to errors in perceptual processing, which in turn may affect non-perceptual, higher-order cognitive processes. Even though the majority of studies examining the relation between age-related cognitive and perceptual decline have been correlational, we reviewed several studies demonstrating that visual manipulations affect both younger and older adults' cognitive performance, supporting the information degradation hypothesis and contradicting implications of other hypotheses (e.g., common-cause, sensory deprivation, cognitive load on perception). The reviewed evidence indicates the necessity to further examine the information degradation hypothesis in order to identify mechanisms underlying age-related cognitive decline.
Collapse
|
49
|
Chintalapudi SR, Djenderedjian L, Stiemke AB, Steinle JJ, Jablonski MM, Morales-Tirado VM. Isolation and Molecular Profiling of Primary Mouse Retinal Ganglion Cells: Comparison of Phenotypes from Healthy and Glaucomatous Retinas. Front Aging Neurosci 2016; 8:93. [PMID: 27242509 PMCID: PMC4870266 DOI: 10.3389/fnagi.2016.00093] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 04/12/2016] [Indexed: 12/11/2022] Open
Abstract
Loss of functional retinal ganglion cells (RGC) is an element of retinal degeneration that is poorly understood. This is in part due to the lack of a reliable and validated protocol for the isolation of primary RGCs. Here we optimize a feasible, reproducible, standardized flow cytometry-based protocol for the isolation and enrichment of homogeneous RGC with the Thy1.2(hi)CD48(neg)CD15(neg)CD57(neg) surface phenotype. A three-step validation process was performed by: (1) genomic profiling of 25-genes associated with retinal cells; (2) intracellular labeling of homogeneous sorted cells for the intracellular RGC-markers SNCG, brain-specific homeobox/POU domain protein 3A (BRN3A), TUJ1, and RNA-binding protein with multiple splicing (RBPMS); and (3) by applying the methodology on RGC from a mouse model with elevated intraocular pressure (IOP) and optic nerve damage. Use of primary RGC cultures will allow for future careful assessment of important cell specific pathways in RGC to provide mechanistic insights into the declining of visual acuity in aged populations and those suffering from retinal neurodegenerative diseases.
Collapse
Affiliation(s)
- Sumana R. Chintalapudi
- Department of Ophthalmology, The University of Tennessee Health Science CenterMemphis, TN, USA
| | - Levon Djenderedjian
- Department of Ophthalmology, The University of Tennessee Health Science CenterMemphis, TN, USA
| | - Andrew B. Stiemke
- Department of Ophthalmology, The University of Tennessee Health Science CenterMemphis, TN, USA
| | - Jena J. Steinle
- Department of Anatomy and Cell Biology, Wayne State UniversityDetroit, MI, USA
- Department of Ophthalmology, Wayne State UniversityDetroit, MI, USA
| | - Monica M. Jablonski
- Department of Ophthalmology, The University of Tennessee Health Science CenterMemphis, TN, USA
- Department of Anatomy and Neurobiology, The University of Tennessee Health Science CenterMemphis, TN, USA
- Department of Pharmaceutical Sciences, The University of Tennessee Health Science CenterMemphis, TN, USA
| | - Vanessa M. Morales-Tirado
- Department of Ophthalmology, The University of Tennessee Health Science CenterMemphis, TN, USA
- Department of Microbiology, Immunology and Biochemistry, The University of Tennessee Health Science CenterMemphis, TN, USA
| |
Collapse
|
50
|
Gramlich OW, Teister J, Neumann M, Tao X, Beck S, von Pein HD, Pfeiffer N, Grus FH. Immune response after intermittent minimally invasive intraocular pressure elevations in an experimental animal model of glaucoma. J Neuroinflammation 2016; 13:82. [PMID: 27090083 PMCID: PMC4836145 DOI: 10.1186/s12974-016-0542-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 04/07/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Elevated intraocular pressure (IOP), as well as fluctuations in IOP, is a main risk factor for glaucoma, but its pathogenic effect has not yet been clarified. Beyond the multifactorial pathology of the disease, autoimmune mechanisms seem to be linked to retinal ganglion cell (RGC) death. This study aimed to identify if intermittent IOP elevations in vivo (i) elicit neurodegeneration, (ii) provokes an immune response and (iii) whether progression of RGC loss can be attenuated by the B lymphocyte inhibitor Belimumab. METHODS Using an intermittent ocular hypertension model (iOHT), Long Evans rats (n = 21) underwent 27 unilateral simulations of a fluctuating pressure profile. Nine of these animals received Belimumab, and additional seven rats served as normotensive controls. Axonal density was analyzed in PPD-stained optic nerve cross-sections. Retinal cross-sections were immunostained against Brn3a, Iba1, and IgG autoantibody depositions. Serum IgG concentration and IgG reactivities were determined using ELISA and protein microarrays. Data was analyzed using ANOVA and Tukey HSD test (unequal N) or student's independent t test by groups. RESULTS A wavelike IOP profile led to a significant neurodegeneration of optic nerve axons (-10.6 %, p < 0.001) and RGC (-19.5 %, p = 0.02) in iOHT eyes compared with fellow eyes. Belimumab-treated animals only showed slightly higher axonal survival and reduced serum IgG concentration (-29 %) after iOHT. Neuroinflammatory events, indicated by significantly upregulated microglia activation and IgG autoantibody depositions, were shown in all injured retinas. Significantly elevated serum autoantibody immunoreactivities against glutathione-S-transferase, spectrin, and transferrin were observed after iOHT and were negatively correlated to the axon density. CONCLUSIONS Intermittent IOP elevations are sufficient to provoke neurodegeneration in the optic nerve and the retina and elicit changes of IgG autoantibody reactivities. Although the inhibition of B lymphocyte activation failed to ameliorate axonal survival, the correlation between damage and changes in the autoantibody reactivity suggests that autoantibody profiling could be useful as a biomarker for glaucoma.
Collapse
Affiliation(s)
- Oliver W Gramlich
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.,Glaucoma Cell Biology Laboratory, Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA, 62242, USA
| | - Julia Teister
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Mareike Neumann
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Xue Tao
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Sabine Beck
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Harald D von Pein
- Department of Neuropathology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - Norbert Pfeiffer
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Franz H Grus
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
| |
Collapse
|