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Kemik K, Ada E, Çavuşoğlu B, Aykaç C, Emek‐Savaş DD, Yener G. Functional magnetic resonance imaging study during resting state and visual oddball task in mild cognitive impairment. CNS Neurosci Ther 2024; 30:e14371. [PMID: 37475197 PMCID: PMC10848090 DOI: 10.1111/cns.14371] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Amnestic mild cognitive impairment (aMCI) is a transitional state between normal aging and dementia, and identifying early biomarkers is crucial for disease detection and intervention. Functional magnetic resonance imaging (fMRI) has the potential to identify changes in neural activity in MCI. METHODS We investigated neural activity changes in the visual network of the aMCI patients (n:20) and healthy persons (n:17) using resting-state fMRI and visual oddball task fMRI. We used independent component analysis to identify regions of interest and compared the activity between groups using a false discovery rate correction. RESULTS Resting-state fMRI revealed increased activity in the areas that have functional connectivity with the visual network, including the right superior and inferior lateral occipital cortex, the right angular gyrus and the temporo-occipital part of the right middle temporal gyrus (p-FDR = 0.008) and decreased activity in the bilateral thalamus and caudate nuclei, which are part of the frontoparietal network in the aMCI group (p-FDR = 0.002). In the visual oddball task fMRI, decreased activity was found in the right frontal pole, the right frontal orbital cortex, the left superior parietal lobule, the right postcentral gyrus, the right posterior part of the supramarginal gyrus, the right superior part of the lateral occipital cortex, and the right angular gyrus in the aMCI group. CONCLUSION Our results suggest the alterations in the visual network are present in aMCI patients, both during resting-state and task-based fMRI. These changes may represent early biomarkers of aMCI and highlight the importance of assessing visual processing in cognitive impairment. However, future studies with larger sample sizes and longitudinal designs are needed to confirm these findings.
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Affiliation(s)
- Kerem Kemik
- Department of NeuroscienceInstitute of Health Sciences, Dokuz Eylül UniversityIzmirTurkey
| | - Emel Ada
- Department of RadiologyDokuz Eylül University Medicine FacultyIzmirTurkey
| | - Berrin Çavuşoğlu
- Department of Medical PhysicsInstitute of Health Sciences, Dokuz Eylül UniversityIzmirTurkey
| | - Cansu Aykaç
- Department of NeuroscienceInstitute of Health Sciences, Dokuz Eylül UniversityIzmirTurkey
| | | | - Görsev Yener
- Department of Neurology, Faculty of MedicineIzmir Economy UniversityİzmirTurkey
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Brikou D, Charisis S, Drouka A, Christodoulakou SM, Ntanasi E, Mamalaki E, Constadinides VC, Scarmeas N, Yannakoulia M. Daily Energy Intake Distribution and Cognitive Performance in Non-Demented Individuals. Nutrients 2023; 15:nu15030673. [PMID: 36771379 PMCID: PMC9921864 DOI: 10.3390/nu15030673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/18/2023] [Accepted: 01/21/2023] [Indexed: 02/01/2023] Open
Abstract
Cognitive disorders have become important public health issues around the world. Studies evaluating the association between cognitive decline and food timing are lacking. The objective of this study was to examine the potential association between energy intake distribution during the day and cognitive performance in cognitively healthy and mildly cognitive impaired individuals. Data were derived from the ongoing Albion study which includes people aged 40 years or older who have a positive family history of cognitive disorder or concern about their cognitive status. A thorough dietary and cognitive assessment was performed. Participants consuming low energy intake at the beginning of the day or high energy at the end of the day had higher cognitive function compared to participants characterized by the opposite pattern. This trend remained statistically significant even after adjustment for potential confounders (p = 0.043). This study suggests that individuals with worse cognitive function may choose to eat earlier during the day, when cognitive performance is better, and it might be hypothesized that a meal pattern characterized by high energy consumption at the beginning of the day or low energy at the end of the day could be a marker of cognitive impairment.
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Affiliation(s)
- Dora Brikou
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece
| | - Sokratis Charisis
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Archontoula Drouka
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece
| | | | - Eva Ntanasi
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece
| | - Vasilios C. Constadinides
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
- The Gertrude H. Sergievsky Center, Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY 10032, USA
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece
- Correspondence:
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Li RX, Ma YH, Tan L, Yu JT. Prospective biomarkers of Alzheimer's disease: A systematic review and meta-analysis. Ageing Res Rev 2022; 81:101699. [PMID: 35905816 DOI: 10.1016/j.arr.2022.101699] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/17/2022] [Accepted: 07/24/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Alzheimer's disease (AD) involves a series of pathological changes and some biomarkers were reported to assist in monitoring and predicting disease progression before the emergence of clinical symptoms. We aimed to identify prospective biomarkers and quantify their effect on AD progression. METHODS PubMed, EMBASE and Web of Science databases were searched for prospective cohort studies published up to October 2021. Eligible studies were included, and the available data were extracted. Meta-analyses were conducted based on random-effect models. Relative risk (RR) with 95% confidence interval (CI) was adopted as the final effect size. RESULTS Totally 48,769 articles were identified, of which 84 studies with 20 prospective biomarkers were included in meta-analyses. In the present study, 15 biomarkers were associated with AD progression, comprising CSF Aβ42 (RR=2.49, 95%CI=1.68-3.69), t-tau (RR=1.88, 95%CI=1.49-2.37), p-tau (RR=1.74, 95%CI=1.37-2.21), tau/Aβ42 ratio (RR=5.11, 95%CI=2.01-13.00); peripheral blood Aβ42/Aβ40 (RR=1.26, 95%CI=1.05-1.51), t-tau (RR=1.33, 95%CI=1.08-1.64), NFL (RR=1.75, 95%CI=1.07-2.87); whole, left and right hippocampal volume (HV) (whole: RR=1.65, 95%CI=1.39-1.95; left: RR=2.60, 95%CI=1.02-6.64; right: RR=1.43, 95%CI=1.23-1.66), entorhinal cortex (EC) volume (RR=1.69, 95%CI=1.24-2.30), medial temporal lobe atrophy (MTA) (RR=1.52, 95%CI=1.33-1.74), 18 F-FDG PET (RR=2.24, 95%CI=1.29-3.89), 11 C-labeled Pittsburgh Compound B PET (11 C-PIB PET) (RR=3.91, 95%CI=1.06-14.41); APOE ε4 (RR=2.16, 1.83-2.55). A total of 70 articles were included in the qualitative review, in which 61 biomarkers were additionally associated with AD progression. CONCLUSION CSF Aβ42, t-tau, p-tau, tau/Aβ42; peripheral blood t-tau, Aβ42/Aβ40, NFL; whole, left and right HV, EC volume, MTA, 18 F-FDG PET, 11 C-PIB PET; APOE ε4 may be promising prospective biomarkers for AD progression.
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Affiliation(s)
- Rui-Xian Li
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
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Walsh CE, Yang YC, Oi K, Aiello A, Belsky D, Harris KM, Plassman BL. Age Profiles of Cognitive Decline and Dementia in Late Life in the Aging, Demographics, and Memory Study. J Gerontol B Psychol Sci Soc Sci 2022; 77:1880-1891. [PMID: 35171992 PMCID: PMC9535777 DOI: 10.1093/geronb/gbac038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To better understand the temporal dynamics of progression from cognitive decline to onset of dementia in the dementia-free older population in the United States. METHODS We used longitudinal data from a diverse national population-based sample of older adults (N = 531) in the Aging, Demographics, and Memory Study from the Health and Retirement Study with repeated measures of cognitive function and dementia diagnosis during 12 years of follow-up from 1996 to 2009. We employed joint latent class mixed models to estimate the association between cognitive change and competing risks of dementia and nondementia death and identify heterogeneity in the age profiles of such association adjusting for baseline characteristics. RESULTS Our analyses found 3 latent classes with distinct age profiles of cognitive decline and associated risk of dementia and mortality: "Rapid Cognitive Decline" (19.6%), "Moderate Progression" (44.6%), and "Optimal Cognitive Aging" (35.8%). When simultaneously accounting for cognitive trajectories and time-to-dementia/death, we also found associations of baseline covariates with slope of cognitive decline (e.g., steeper decline among non-Hispanic Blacks and more educated) and risk of dementia (e.g., greater risk for females and apolipoprotein E-4 carriers, but no difference by education level) that differ substantially from those in separate longitudinal mixed models or survival models. DISCUSSION The differential age patterns of cognitive decline predicting dementia incidences identified in this study suggest variation in the course of cognitive aging in older adults that may inform future etiological and intervention studies.
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Affiliation(s)
- Christine E Walsh
- Department of Health, Behavior, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yang C Yang
- Department of Sociology, Lineberger Cancer Center, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Katsuya Oi
- Department of Sociology, Northern Arizona University, Flagstaff, Arizona, USA
| | - Allison Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniel Belsky
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Kathleen Mullan Harris
- Department of Sociology, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brenda L Plassman
- Department of Psychiatry and Behavioral Science, Duke University, Durham, North Carolina, USA
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Lu Y, Liu C, Wells Y, Yu D. Challenges in detecting and managing mild cognitive impairment in primary care: a focus group study in Shanghai, China. BMJ Open 2022; 12:e062240. [PMID: 36127116 PMCID: PMC9490618 DOI: 10.1136/bmjopen-2022-062240] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Detection of mild cognitive impairment (MCI) is essential in slowing progression to dementia. Primary care plays a vital role in detecting and managing MCI. The chronic care model (CCM) provides effective methods to manage chronic diseases. OBJECTIVE This study aimed to explore how MCI services are delivered in primary care in China. METHODS Focus group interviews were conducted face to face among MCI stakeholders from six community health centres (CHCs) involved in the 'friendly community programme' in Shanghai, China. A total of 124 MCI stakeholders were interviewed, consisting of 6 groups (n=42) of general practitioners (GPs), 3 groups (n=18) of CHC managers, 4 groups (n=32) of people with MCI and 4 groups (n=32) of informal caregivers. Content and thematic analyses were performed using a combination of induction and deduction approaches. RESULTS Three major themes emerged from the data corresponding to the CCM framework: hesitant patients, unprepared providers and misaligned environments. While the public are hesitant to seek medical attention for MCI problems, due to misunderstanding, social stigma and a lack of perceived benefits, GPs and CHCs are not well prepared either, due to lack of knowledge and a shortage of GPs, and a lack of policy, funding and information support. None of these issues can be addressed separately without tackling the others. CONCLUSION This study combined the diverse perceptions of all the main stakeholders to detect and manage MCI in primary care settings in China. A vicious circle was found among the three interconnected CCM domains, creating a gridlock that should be addressed through a system's approach targeting all of the above-mentioned aspects.
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Affiliation(s)
- Yuan Lu
- Department of General Practice, Tongji University Affiliated Yangpu Hospital, Shanghai, China
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Yvonne Wells
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Dehua Yu
- Department of General Practice, Tongji University Affiliated Yangpu Hospital, Shanghai, China
- Shanghai General Practice and Community Health Development Research Center, Shanghai, China
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Comparing cardiovascular risk factors in older persons with mild cognitive impairment and lifetime history of major depressive disorder. Int Psychogeriatr 2022; 34:563-569. [PMID: 33775259 DOI: 10.1017/s1041610221000259] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To compare the prevalence of select cardiovascular risk factors (CVRFs) in patients with mild cognitive impairment (MCI) versus lifetime history of major depression disorder (MDD) and a normal comparison group using baseline data from the Prevention of Alzheimer's Dementia with Cognitive Remediation plus Transcranial Direct Current Stimulation (PACt-MD) study. DESIGN Baseline data from a multi-centered intervention study of older adults with MCI, history of MDD, or combined MCI and history of MDD (PACt-MD) were analyzed. SETTING Community-based multi-centered study based in Toronto across 5 academic sites. PARTICIPANTS Older adults with MCI, history of MDD, or combined MCI and history of MDD and healthy controls. MEASUREMENTS We examined the baseline distribution of smoking, hypertension and diabetes in three groups of participants aged 60+ years in the PACt-MD cohort study: MCI (n = 278), MDD (n = 95), and healthy older controls (n = 81). Generalized linear models were fitted to study the effect of CVRFs on MCI and MDD as well as neuropsychological composite scores. RESULTS A higher odds of hypertension among the MCI cohort compared to healthy controls (p < .05) was noted in unadjusted analysis. Statistical significance level was lost on adjusting for age, sex and education (p > .05). A history of hypertension was associated with lower performance in composite executive function (p < .05) and overall composite neuropsychological test score (p < .05) among a pooled cohort with MCI or MDD. CONCLUSIONS This study reinforces the importance of treating modifiable CVRFs, specifically hypertension, as a means of mitigating cognitive decline in patients with at-risk cognitive conditions.
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Ghafarimoghadam M, Mashayekh R, Gholami M, Fereydani P, Shelley-Tremblay J, Kandezi N, Sabouri E, Motaghinejad M. A review of behavioral methods for the evaluation of cognitive performance in animal models: Current techniques and links to human cognition. Physiol Behav 2022; 244:113652. [PMID: 34801559 DOI: 10.1016/j.physbeh.2021.113652] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 10/26/2021] [Accepted: 11/15/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Memory is defined as the ability to store, maintain and retrieve information. Learning is the acquisition of information that changes behavior and memory. Stress, dementia, head trauma, amnesia, Alzheimer's, Huntington, Parkinson's, Wernicke-Korsakoff syndrome (WKS) may be mentioned among the diseases in which memory and learning are affected. The task of understanding deficits in memory and learning in humans is daunting due to the complexity of neural and cognitive mechanisms in the nervous system. This job is made more difficult for clinicians and researchers by the fact that many techniques used to research memory are not ethically acceptable or technically feasible for use in humans. Thus, animal models have been necessary alternative for studying normal and disordered learning and memory. This review attempts to bridge these domains to allow biomedical researchers to have a firm grasp of "memory" and "learning" as constructs in humans whereby they may then select the proper animal cognitive test. RESULTS AND CONCLUSION Various tests (open field habituation test, Y-maze test, passive avoidance test, step-down inhibitory avoidance test, active avoidance test, 8-arms radial maze test, Morris water maze test, radial arm water maze, novel object recognition test and gait function test) have been designed to evaluate different kinds of memory. Each of these tests has their strengths and limits. Abnormal results obtained using these tasks in non-human animals indicate malfunctions in memory which may be due to several physiological and psychological diseases of nervous system. Further studies by using the discussed tests can be very beneficial for achieving a therapeutic answer to these diseases.
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Affiliation(s)
- Maryam Ghafarimoghadam
- Department of pharmaceutical chemistry, faculty of pharmaceutical chemistry, pharmaceutical sciences branch, Islamic Azad University (IUAPS), Tehran, Iran
| | - Roya Mashayekh
- Department of pharmaceutical chemistry, faculty of pharmaceutical chemistry, pharmaceutical sciences branch, Islamic Azad University (IUAPS), Tehran, Iran
| | - Mina Gholami
- School of medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pardis Fereydani
- Department of pharmaceutical chemistry, faculty of pharmaceutical chemistry, pharmaceutical sciences branch, Islamic Azad University (IUAPS), Tehran, Iran
| | | | - Niyoosha Kandezi
- Department of Psychology, University of South Alabama, Alabama, USA
| | - Erfan Sabouri
- Clinical Research Development Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Majid Motaghinejad
- Chronic Respiratory Disease Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Neuropsychiatric symptoms and mortality among patients with mild cognitive impairment and dementia due to Alzheimer's disease. J Formos Med Assoc 2021; 121:1705-1713. [PMID: 34933801 DOI: 10.1016/j.jfma.2021.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/28/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) could increase mortality risk in people with dementia due to Alzheimer's disease (AD). However, whether NPS affects mortality risk in people with mild cognitive impairment (MCI) and whether any specific syndrome of NPS influences this risk are still unclear. METHODS In total, 984 participants with dementia due to AD, 338 with MCI, and 365 controls were enrolled. Over a mean of 5-year follow-up, cause of death data were obtained from the Ministry of Health and Welfare in Taiwan. NPS were assessed using Neuropsychiatric Inventory Questionnaire (NPI-Q), and psychosis, mood, and frontal domain scores were determined. Survival analyses were conducted to determine the hazard ratio (HR) of death. RESULTS In controlled analyses, HR of death for AD was 2.19 (95% confidence interval [CI] = 1.29-3.71) compared with the control group, whereas no statistical significance was noted for the MCI group. A high NPI-Q score (above the median score) increased mortality risk for both the MCI and AD groups, with HRs of 2.32 (95% CI = 1.07-5.03) and 2.60 (95% CI = 1.51-4.47), respectively. Among NPI-Q domain scores, only high mood domain, but not psychosis or frontal domain, scores increased death risk for both the MCI (HR = 2.89, 95% CI = 1.00-8.51) and AD (HR = 2.59, 95% CI = 1.47-4.55) groups. CONCLUSION Mortality risk is high for patients with AD. Not only for AD, patients with MCI presenting with NPS, particularly mood symptoms, have high death risk.
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Tang Z, Chen X, Zhang W, Sun X, Hou Q, Li Y, Feng X, Chen Y, Lv J, Ji L, Ding G, Li D. Association Between Gamma-Glutamyl Transferase and Mild Cognitive Impairment in Chinese Women. Front Aging Neurosci 2021; 13:630409. [PMID: 33643024 PMCID: PMC7902766 DOI: 10.3389/fnagi.2021.630409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Dementia, as a global public health problem, is becoming increasingly serious. As a precursor of dementia, mild cognitive impairment (MCI) plays an important role in the diagnosis and prevention of dementia. Recent studies have found a correlation between gamma-glutamyl transferase (GGT) levels and cognitive function in men. The relationship between GGT levels and cognitive function in women remains unclear because GGT activity and expression differ between the sexes. Method: We recruited a total of 2,943 Chinese women from Jidong and Taian in 2019. We grouped the participants according to GGT levels, diagnosed MCI using the Montreal Cognitive Assessment (MOCA) scale, and modeled the study outcomes using logistic regression to explore the relationship between GGT level and MCI. We also analyzed the interaction of obesity, sleep duration, and hyperuricemia with GGT in the development of MCI. Results: The prevalence of MCI increased with increasing GGT level, from the lowest quartile to the highest quartile of GGT: 8.4% (66/786), 14.2% (119/840), 17.6% (108/613), and 21.4% (151/704), respectively. At the same time, as GGT levels increased, so did the risk of MCI. In the fully adjusted model, compared with those for participants in the lowest GGT quartiles, the odds ratios (ORs), and 95% confidence intervals (CIs) for MCI for participants in the second, third, and fourth GGT quartiles were 1.49 (1.04-2.12), 1.53(1.06-2.21), and 1.88 (1.33-2.65), respectively. The risk of developing MCI was further increased in people with high GGT levels who were obese (OR = 1.96, 95% CI: 1.39-2.76, P < 0.001), slept less (OR = 1.91, 95% CI: 1.35-2.71, P < 0.001), had high levels of uric acid (OR = 1.55, 95% CI: 1.03-2.32, P < 0.001), or after menopause (OR = 2.92, 95% CI: 2.07-4.12, P < 0.001). Conclusion: We found that MCI is more common in women with elevated GGT levels, so GGT could be a potential diagnostic marker for MCI. Meanwhile, our findings indicated that women with high GGT levels had an increased risk of MCI when they were obese, sleep deprived, had high serum uric acid (SUA) levels or underwent menopause.
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Affiliation(s)
- Zhaoyang Tang
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Xueyu Chen
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Wenran Zhang
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | | | - Qingzhi Hou
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Yuejin Li
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Xia Feng
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Yanru Chen
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Jian Lv
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Long Ji
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Guoyong Ding
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Dong Li
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China.,The Second Affiliated Hospital of Shandong First Medical University, Taian, China
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The Inflammasome Adaptor Protein ASC in Mild Cognitive Impairment and Alzheimer's Disease. Int J Mol Sci 2020; 21:ijms21134674. [PMID: 32630059 PMCID: PMC7370034 DOI: 10.3390/ijms21134674] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/23/2022] Open
Abstract
Mild cognitive impairment (MCI) is characterized by memory loss in the absence of dementia and is considered the translational stage between normal aging and early Alzheimer’s disease (AD). Patients with MCI have a greater risk of advancing to AD. Thus, identifying early markers of MCI has the potential to increase the therapeutic window to treat and manage the disease. Protein levels of the inflammasome signaling proteins apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) and interleukin (IL)-18 were analyzed in the serum of patients with MCI, AD and healthy age-matched donors as possible biomarkers, as well as levels of soluble amyloid precursor proteins α/β (sAPP α/β) and neurofilament light (NfL). Cut-off points and positive and negative predictive values, as well as receiver operator characteristic (ROC) curves, likelihood ratios and accuracy were determined for these proteins. Although the levels of ASC were higher in MCI and AD than in age-matched controls, protein levels of ASC were higher in MCI than in AD cases. For control vs. MCI, the area under the curve (AUC) for ASC was 0.974, with a cut-off point of 264.9 pg/mL. These data were comparable to the AUC for sAPP α and β of 0.9687 and 0.9068, respectively, as well as 0.7734 for NfL. Moreover, similar results were obtained for control vs. AD and MCI vs. AD. These results indicate that ASC is a promising biomarker of MCI and AD.
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Still CH, Pajewski NM, Chelune GJ, Rapp SR, Sink KM, Wadley VG, Williamson JD, Lerner AJ. The Association between the Montreal Cognitive Assessment and Functional Activity Questionnaire in the Systolic Blood Pressure Intervention Trial (SPRINT). Arch Clin Neuropsychol 2019; 34:814-824. [PMID: 30517599 PMCID: PMC6735721 DOI: 10.1093/arclin/acy094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 09/24/2018] [Accepted: 11/16/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine the association of global cognitive function assessed via the Montreal Cognitive Assessment (MoCA) and deficiencies in instrumental activities of daily living (IADL) on the Functional Activity Questionnaire (FAQ) in hypertensive older adults in the Systolic Blood Pressure Intervention Trial (SPRINT). METHODS In cross-sectional analysis, 9,296 SPRINT participants completed the MoCA at baseline. The FAQ was obtained from 2,705 informants for SPRINT participants scoring <21 or <22 on the MoCA, depending on education. FAQ severity ranged from no dysfunction (Score = 0) to moderate/severe dysfunction (Score = 5+). RESULTS Participants who triggered FAQ administration were older, less educated, and more likely to be Black or Hispanic (p < 0.001). Sixty-one percent (n = 1,661) of participants' informants reported no functional difficulties in IADLs. An informant report, however, of any difficulty on the FAQ was associated with lower MoCA scores after controlling for age, sex, race/ethnicity, and education (p < 0.05). Partial proportional odds regression indicates that participants scoring lower on the MoCA (in the 10th to <25th, fifth to <10th, and <fifth percentiles) had higher adjusted odds of their informant indicating dysfunction on the FAQ, relative to participants scoring at or above the 25th percentile on the MoCA (p < 0.001). CONCLUSIONS While lower global cognitive function was strongly associated with IADL deficits on FAQ, informants indicated no functional difficulties for the majority of SPRINT participants, despite low MoCA scores. These findings can help with designing future studies which aim to detect mild cognitive impairment and/or dementia in large, community-dwelling populations.
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Affiliation(s)
- Carolyn H Still
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Nicholas M Pajewski
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Gordon J Chelune
- Neurology Department, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Kaycee M Sink
- Section on Gerontology and Geriatric Medicine, Wake Forest Baptist Health, Department of Internal Medicine, Winston-Salem, NC, USA
| | | | - Jeff D Williamson
- Section on Gerontology and Geriatric Medicine, Wake Forest Baptist Health, Department of Internal Medicine, Winston-Salem, NC, USA
| | - Alan J Lerner
- University Hospitals Cleveland Medical Center, Department of Neurology, Cleveland, OH, USA
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Bachurin SO, Gavrilova SI, Samsonova A, Barreto GE, Aliev G. Mild cognitive impairment due to Alzheimer disease: Contemporary approaches to diagnostics and pharmacological intervention. Pharmacol Res 2018; 129:216-226. [DOI: 10.1016/j.phrs.2017.11.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/15/2017] [Accepted: 11/17/2017] [Indexed: 01/16/2023]
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Study of the Influence of Age in 18F-FDG PET Images Using a Data-Driven Approach and Its Evaluation in Alzheimer's Disease. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:3786083. [PMID: 29581708 PMCID: PMC5822896 DOI: 10.1155/2018/3786083] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/18/2017] [Accepted: 12/18/2017] [Indexed: 12/02/2022]
Abstract
Objectives 18F-FDG PET scan is one of the most frequently used neural imaging scans. However, the influence of age has proven to be the greatest interfering factor for many clinical dementia diagnoses when analyzing 18F-FDG PET images, since radiologists encounter difficulties when deciding whether the abnormalities in specific regions correlate with normal aging, disease, or both. In the present paper, the authors aimed to define specific brain regions and determine an age-correction mathematical model. Methods A data-driven approach was used based on 255 healthy subjects. Results The inferior frontal gyrus, the left medial part and the left medial orbital part of superior frontal gyrus, the right insula, the left anterior cingulate, the left median cingulate, and paracingulate gyri, and bilateral superior temporal gyri were found to have a strong negative correlation with age. For evaluation, an age-correction model was applied to 262 healthy subjects and 50 AD subjects selected from the ADNI database, and partial correlations between SUVR mean and three clinical results were carried out before and after age correction. Conclusion All correlation coefficients were significantly improved after the age correction. The proposed model was effective in the age correction of both healthy and AD subjects.
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14
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Fedin AI. The efficacy of cortexin and memantinol (memantine) in the treatment of cognitive impairment in patients with chronic cerebral ischemia. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:30-36. [DOI: 10.17116/jnevro20181181130-36] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Cuestionario de detección de deterioro cognitivo AD8-arg para su uso Atención Primaria de la salud en Argentina. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.neuarg.2016.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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16
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A correlativity study of plasma APL1β28 and clusterin levels with MMSE/MoCA/CASI in aMCI patients. Sci Rep 2015; 5:15546. [PMID: 26503441 PMCID: PMC4621490 DOI: 10.1038/srep15546] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/28/2015] [Indexed: 01/20/2023] Open
Abstract
Amnestic mild cognitive impairment (aMCI) is a sub-clinical condition characterized by memory deficits that are not severe enough to affect daily functioning. Here we investigated two potential biomarkers found in the cerebrospinal fluid of AD patients, APLP1-derived Aβ-like peptides 28 (APL1β28) and clusterin plasma levels, in terms of their relationship to cognitive function, as reflected in the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA) and the Cognitive Assessment Screening Instrument (CASI) in aMCI patients. Forty-seven aMCI patients and thirty-five age- and gender-matched healthy adult controls were recruited for this study. Using the ELISA method, we found that the mean concentrations of both APL1β28 and clusterin were not significantly different between the control and aMCI groups. The APL1β28 levels were positively correlated with clusterin and that both were negatively correlated with the MMSE scores of the aMCI patients. Clusterin levels were negatively correlated with the MoCA and CASI scores of the aMCI patients. Using multivariate analysis, the correlation between clusterin and MMSE/MoCA/CASI was independent of other AD risk factors including age, education, sex, body mass index and ApoE genotype. The data presented here demonstrate that plasma clusterin levels reflect cognitive function in aMCI patients.
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Abstract
Prevention in Alzheimer's disease and other dementias (AD/dementia) is defined on the basis of clinical states and their expressed symptoms. Primary prevention refers to delaying the development of the full-blown state of clinically expressed disease in normal individuals. Current primary prevention research is driven by evidence of AD/dementia protective factors that have emerged from epidemiological studies. The first randomized controlled trials (RCTs) of primary AD/dementia prevention have been designed to test the efficacy and safety of NSAIDs, hormonal therapy, antihypertensive drugs and antioxidants. The experience of these trials has indicated safety concerns as a key issue and highlighted significant design challenges in this type of research. These trials have required large sample sizes and unsustainable costs. There should be consideration given in future trials to enriching study samples with risk factors to increase progression rates to AD/dementia. Innovative strategies will also be needed to recruit and retain subjects given the long follow-up periods, modest perceived benefit and the potential for the risk-benefit ratio to change during the trial. It is foreseeable that regulatory authorities will be presented with primary prevention RCTs for approval and labelling, and that criteria to evaluate such evidence still need to be developed.
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Affiliation(s)
- Howard H Feldman
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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18
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Ye S, Jiang Y, Duan Y, Karim A, Fan D, Yang L, Zhao X, Yin J, Luo K. Constitutive expression of the poplar WRKY transcription factor PtoWRKY60 enhances resistance to Dothiorella gregaria Sacc. in transgenic plants. TREE PHYSIOLOGY 2014; 34:1118-29. [PMID: 25281841 DOI: 10.1093/treephys/tpu079] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
WRKY proteins are involved in various physiological processes in plants, especially in coping with diverse biotic and abiotic stresses. However, limited information is available on the roles of specific WRKY transcription factors in poplar defense. In this study, we reported the characterization of PtoWRKY60, a Group IIa WRKY member, from Populus tomentosa Carr. The gene expression profile of PtoWRKY60 in various tissues showed that it significantly accumulated in old leaves. Phylogenetic analyses revealed that PtoWRKY60 had a close relationship with AtWRKY18, AtWRKY40 and AtWRKY60. PtoWRKY60 was induced mainly by salicylic acid (SA) and slightly by Dothiorella gregaria Sacc., jasmonic acid, wounding treatment, low temperature and salinity stresses. Overexpression of PtoWRKY60 in poplar resulted in increased resistance to D. gregaria. The defense-associated genes, such as PR5.1, PR5.2, PR5.4, PR5.5 and CPR5, were markedly up-regulated in transgenic plants overexpressing PtoWRKY60. These results indicate that PtoWRKY60 might be partly involved in the signal transduction pathway initiated by SA in Populus.
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Affiliation(s)
- Shenglong Ye
- Key Laboratory of Eco-environments of Three Gorges Reservoir Region, Ministry of Education, Chongqing Key Laboratory of Transgenic Plant and Safety Control, Institute of Resources Botany, School of Life Sciences, Southwest University, No. 2, Tiansheng Road, Beibei, Chongqing 400715, China
| | - Yuanzhong Jiang
- Key Laboratory of Eco-environments of Three Gorges Reservoir Region, Ministry of Education, Chongqing Key Laboratory of Transgenic Plant and Safety Control, Institute of Resources Botany, School of Life Sciences, Southwest University, No. 2, Tiansheng Road, Beibei, Chongqing 400715, China
| | - Yanjiao Duan
- Key Laboratory of Eco-environments of Three Gorges Reservoir Region, Ministry of Education, Chongqing Key Laboratory of Transgenic Plant and Safety Control, Institute of Resources Botany, School of Life Sciences, Southwest University, No. 2, Tiansheng Road, Beibei, Chongqing 400715, China
| | - Abdul Karim
- Key Laboratory of Eco-environments of Three Gorges Reservoir Region, Ministry of Education, Chongqing Key Laboratory of Transgenic Plant and Safety Control, Institute of Resources Botany, School of Life Sciences, Southwest University, No. 2, Tiansheng Road, Beibei, Chongqing 400715, China
| | - Di Fan
- Key Laboratory of Eco-environments of Three Gorges Reservoir Region, Ministry of Education, Chongqing Key Laboratory of Transgenic Plant and Safety Control, Institute of Resources Botany, School of Life Sciences, Southwest University, No. 2, Tiansheng Road, Beibei, Chongqing 400715, China
| | - Li Yang
- Key Laboratory of Eco-environments of Three Gorges Reservoir Region, Ministry of Education, Chongqing Key Laboratory of Transgenic Plant and Safety Control, Institute of Resources Botany, School of Life Sciences, Southwest University, No. 2, Tiansheng Road, Beibei, Chongqing 400715, China
| | - Xin Zhao
- Key Laboratory of Eco-environments of Three Gorges Reservoir Region, Ministry of Education, Chongqing Key Laboratory of Transgenic Plant and Safety Control, Institute of Resources Botany, School of Life Sciences, Southwest University, No. 2, Tiansheng Road, Beibei, Chongqing 400715, China
| | - Jia Yin
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810008, China
| | - Keming Luo
- Key Laboratory of Eco-environments of Three Gorges Reservoir Region, Ministry of Education, Chongqing Key Laboratory of Transgenic Plant and Safety Control, Institute of Resources Botany, School of Life Sciences, Southwest University, No. 2, Tiansheng Road, Beibei, Chongqing 400715, China Key Laboratory of Adaptation and Evolution of Plateau Biota, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810008, China
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19
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Kaya Y, Aki OE, Can UA, Derle E, Kibaroğlu S, Barak A. Validation of Montreal Cognitive Assessment and Discriminant Power of Montreal Cognitive Assessment Subtests in Patients With Mild Cognitive Impairment and Alzheimer Dementia in Turkish Population. J Geriatr Psychiatry Neurol 2014; 27:103-9. [PMID: 24578463 DOI: 10.1177/0891988714522701] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 10/29/2013] [Indexed: 11/16/2022]
Abstract
Montreal Cognitive Assessment (MoCA) is a new cognitive tool developed for screening mild cognitive impairment (MCI). The authors examined validity of MoCA and discriminating power of subtests in a Turkish population comprising of 474 participants (246 healthy controls, 114 subjects with MCI and 114 subjects with dementia). The ANCOVAs showed that age and education had a main effect on MoCA scores. Cut scores were computed according to different education levels. The overall cut-off values for MCI and dementia were found to be lower compared to western studies. MoCA was found to have good internal consistency. The subtests most useful in discriminating MCI from healthy controls were recall, visuospatial and language, while in discriminating dementia from MCI were visuospatial, orientation and attention subtests. The results demonstrated that MoCA is a valid and reliable instrument in screening MCI, and compared with the MMSE, MoCA was proved to have superior sensitivity and specificity in detecting MCI.
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Affiliation(s)
- Yıldız Kaya
- Department of Neurology, School of Medicine, Baskent University, Ankara, Turkey
| | - Ozlem Erden Aki
- Department of Psychiatry, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Ufuk Anik Can
- Department of Neurology, School of Medicine, Baskent University, Ankara, Turkey
| | - Eda Derle
- Department of Neurology, School of Medicine, Baskent University, Ankara, Turkey
| | - Seda Kibaroğlu
- Department of Neurology, School of Medicine, Baskent University, Ankara, Turkey
| | - Anil Barak
- Department of Statistics, Hacettepe University, Ankara, Turkey
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20
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Zanto TP, Pa J, Gazzaley A. Reliability measures of functional magnetic resonance imaging in a longitudinal evaluation of mild cognitive impairment. Neuroimage 2014; 84:443-52. [PMID: 24018304 PMCID: PMC3855402 DOI: 10.1016/j.neuroimage.2013.08.063] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 08/24/2013] [Accepted: 08/29/2013] [Indexed: 11/23/2022] Open
Abstract
As the aging population grows, it has become increasingly important to carefully characterize amnestic mild cognitive impairment (aMCI), a preclinical stage of Alzheimer's disease (AD). Functional magnetic resonance imaging (fMRI) is a valuable tool for monitoring disease progression in selectively vulnerable brain regions associated with AD neuropathology. However, the reliability of fMRI data in longitudinal studies of older adults with aMCI is largely unexplored. To address this, aMCI participants completed two visual working tasks, a Delayed-Recognition task and a One-Back task, on three separate scanning sessions over a three-month period. Test-retest reliability of the fMRI blood oxygen level dependent (BOLD) activity was assessed using an intraclass correlation (ICC) analysis approach. Results indicated that brain regions engaged during the task displayed greater reliability across sessions compared to regions that were not utilized by the task. During task-engagement, differential reliability scores were observed across the brain such that the frontal lobe, medial temporal lobe, and subcortical structures exhibited fair to moderate reliability (ICC=0.3-0.6), while temporal, parietal, and occipital regions exhibited moderate to good reliability (ICC=0.4-0.7). Additionally, reliability across brain regions was more stable when three fMRI sessions were used in the ICC calculation relative to two fMRI sessions. In conclusion, the fMRI BOLD signal is reliable across scanning sessions in this population and thus a useful tool for tracking longitudinal change in observational and interventional studies in aMCI.
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Affiliation(s)
- Theodore P Zanto
- Department of Neurology, University of California San Francisco, San Francisco, CA 94158, USA.
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21
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Abstract
Angiotensin II represents a key molecule in hypertension and cerebrovascular pathology. By promoting inflammation and oxidative stress, enhanced Ang II levels accelerate the onset and progression of cell senescence. Sustained activation of RAS promotes end-stage organ injury associated with aging and results in cognitive impairment and dementia. The discovery of the angiotensin-converting enzyme ACE2-angiotensin (1–7)-Mas receptor axis that exerts vasodilator, antiproliferative, and antifibrotic actions opposed to those of the ACE-Ang II-AT1 receptor axis has led to the hypothesis that a decrease in the expression or activity of angiotensin (1–7) renders the systems more susceptible to the pathological actions of Ang II. Given the successful demonstration of beneficial effects of increased expression of ACE2/formation of Ang1–7/Mas receptor binding and modulation of Mas expression in animal models in containing cerebrovascular pathology in hypertensive conditions and aging, one could reasonably hope for analogous effects regarding the prevention of cognitive decline by protecting against hypertension and cerebral microvascular damage. Upregulation of ACE2 and increased balance of Ang 1–7/Ang II, along with positive modulation of Ang II signaling through AT2 receptors and Ang 1–7 signaling through Mas receptors, may be an appropriate strategy for improving cognitive function and treating dementia.
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22
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Nowrangi MA, Lyketsos CG, Leoutsakos JMS, Oishi K, Albert M, Mori S, Mielke MM. Longitudinal, region-specific course of diffusion tensor imaging measures in mild cognitive impairment and Alzheimer's disease. Alzheimers Dement 2013; 9:519-28. [PMID: 23245561 PMCID: PMC3639296 DOI: 10.1016/j.jalz.2012.05.2186] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 04/23/2012] [Accepted: 05/10/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) is a promising method for identifying significant cross-sectional differences of white-matter tracts in normal controls (NC) and those with mild cognitive impairment (MCI) or Alzheimer's disease (AD). There have not been many studies establishing its longitudinal utility. METHODS Seventy-five participants (25 NC, 25 amnestic MCI, and 25 AD) had 3-Tesla MRI scans and clinical evaluations at baseline and 3, 6, and 12 months. Fractional anisotropy (FA) and mean diffusivity (MD) were analyzed at each time-point and longitudinally in eight a priori-selected areas taken from four regions of interest (ROIs). RESULTS Cross-sectionally, MD values were higher, and FA values lower in the fornix and splenium of the AD group compared with either MCI or NC (P < .01). Within-group change was more evident in MD than in FA over 12 months: MD increased in the inferior, anterior cingulum, and fornix in both the MCI and AD groups (P < .01). CONCLUSIONS There were stable, cross-sectional, region-specific differences between the NC and AD groups in both FA and MD at each time-point over 12 months. Longitudinally, MD was a better indicator of change than FA. Significant increases of fornix MD in the MCI group suggest this is an early indicator of progression.
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Affiliation(s)
- Milap A Nowrangi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
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23
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Hibar DP, Stein JL, Ryles AB, Kohannim O, Jahanshad N, Medland SE, Hansell NK, McMahon KL, de Zubicaray GI, Montgomery GW, Martin NG, Wright MJ, Saykin AJ, Jack CR, Weiner MW, Toga AW, Thompson PM. Genome-wide association identifies genetic variants associated with lentiform nucleus volume in N = 1345 young and elderly subjects. Brain Imaging Behav 2013; 7:102-15. [PMID: 22903471 PMCID: PMC3779070 DOI: 10.1007/s11682-012-9199-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Deficits in lentiform nucleus volume and morphometry are implicated in a number of genetically influenced disorders, including Parkinson's disease, schizophrenia, and ADHD. Here we performed genome-wide searches to discover common genetic variants associated with differences in lentiform nucleus volume in human populations. We assessed structural MRI scans of the brain in two large genotyped samples: the Alzheimer's Disease Neuroimaging Initiative (ADNI; N = 706) and the Queensland Twin Imaging Study (QTIM; N = 639). Statistics of association from each cohort were combined meta-analytically using a fixed-effects model to boost power and to reduce the prevalence of false positive findings. We identified a number of associations in and around the flavin-containing monooxygenase (FMO) gene cluster. The most highly associated SNP, rs1795240, was located in the FMO3 gene; after meta-analysis, it showed genome-wide significant evidence of association with lentiform nucleus volume (P MA = 4.79 × 10(-8)). This commonly-carried genetic variant accounted for 2.68 % and 0.84 % of the trait variability in the ADNI and QTIM samples, respectively, even though the QTIM sample was on average 50 years younger. Pathway enrichment analysis revealed significant contributions of this gene to the cytochrome P450 pathway, which is involved in metabolizing numerous therapeutic drugs for pain, seizures, mania, depression, anxiety, and psychosis. The genetic variants we identified provide replicated, genome-wide significant evidence for the FMO gene cluster's involvement in lentiform nucleus volume differences in human populations.
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Affiliation(s)
- Derrek P. Hibar
- Imaging Genetics Center at the Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - Jason L. Stein
- Imaging Genetics Center at the Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - April B. Ryles
- Imaging Genetics Center at the Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - Omid Kohannim
- Imaging Genetics Center at the Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - Neda Jahanshad
- Imaging Genetics Center at the Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - Sarah E. Medland
- Genetic Epidemiology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia
- Neurogenetics Laboratory, Queensland Institute of Medical Research, Brisbane, Australia
- Broad Institute of Harvard and MIT, Boston, MA, USA
| | - Narelle K. Hansell
- Genetic Epidemiology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia
| | - Katie L. McMahon
- Centre for Advanced Imaging, University of Queensland, Brisbane, Queensland, Australia
| | - Greig I. de Zubicaray
- Functional Magnetic Resonance Imaging Laboratory, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Grant W. Montgomery
- Genetic Epidemiology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia
| | - Nicholas G. Martin
- Genetic Epidemiology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia
| | - Margaret J. Wright
- Genetic Epidemiology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia
| | - Andrew J. Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Michael W. Weiner
- Departments of Radiology, Medicine, Psychiatry, UC San Francisco, San Francisco, CA, USA
- Department of Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - Paul M. Thompson
- Imaging Genetics Center at the Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
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Hua X, Hibar DP, Ching CRK, Boyle CP, Rajagopalan P, Gutman BA, Leow AD, Toga AW, Jack CR, Harvey D, Weiner MW, Thompson PM. Unbiased tensor-based morphometry: improved robustness and sample size estimates for Alzheimer's disease clinical trials. Neuroimage 2012; 66:648-61. [PMID: 23153970 DOI: 10.1016/j.neuroimage.2012.10.086] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 10/29/2012] [Accepted: 10/30/2012] [Indexed: 01/11/2023] Open
Abstract
Various neuroimaging measures are being evaluated for tracking Alzheimer's disease (AD) progression in therapeutic trials, including measures of structural brain change based on repeated scanning of patients with magnetic resonance imaging (MRI). Methods to compute brain change must be robust to scan quality. Biases may arise if any scans are thrown out, as this can lead to the true changes being overestimated or underestimated. Here we analyzed the full MRI dataset from the first phase of Alzheimer's Disease Neuroimaging Initiative (ADNI-1) from the first phase of Alzheimer's Disease Neuroimaging Initiative (ADNI-1) and assessed several sources of bias that can arise when tracking brain changes with structural brain imaging methods, as part of a pipeline for tensor-based morphometry (TBM). In all healthy subjects who completed MRI scanning at screening, 6, 12, and 24months, brain atrophy was essentially linear with no detectable bias in longitudinal measures. In power analyses for clinical trials based on these change measures, only 39AD patients and 95 mild cognitive impairment (MCI) subjects were needed for a 24-month trial to detect a 25% reduction in the average rate of change using a two-sided test (α=0.05, power=80%). Further sample size reductions were achieved by stratifying the data into Apolipoprotein E (ApoE) ε4 carriers versus non-carriers. We show how selective data exclusion affects sample size estimates, motivating an objective comparison of different analysis techniques based on statistical power and robustness. TBM is an unbiased, robust, high-throughput imaging surrogate marker for large, multi-site neuroimaging studies and clinical trials of AD and MCI.
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Affiliation(s)
- Xue Hua
- Imaging Genetics Center, Laboratory of Neuro Imaging, Dept. of Neurology, UCLA School of Medicine, Los Angeles, CA 90095-1769, USA
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O'Hara R, Derouesné C, Fountoulakis KN, Yesavage JA. Therapeutic approaches to age-associated neurocognitive disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2012. [PMID: 22033831 PMCID: PMC3181653 DOI: 10.31887/dcns.2001.3.3/rohara] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The United Nations projects that the number of individuals with dementia in developed countries alone will be approximately 36,7 million by the year 2050. International recognition of the significant emotional and economic burden of Alzheimer's disease has been matched by a dramatic increase in the development of pharmacological and nonpharmacological approaches to this illness in the past decade. Changing demographics have underscored the necessity to develop similar approaches for the remediation of the cognitive impairment associated with more benign syndromes, such as mild cognitive impairment (MCI) and age-associated cognitive decline (AACD). The present article aims to provide an overview of the most current therapeutic approaches to age-associated neurocognitive disorders. Additionally, it discusses the conceptual and methodological issues that surround the design, implementation, and interpretation of such approaches.
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Affiliation(s)
- R O'Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, Calif, USA
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Giessing C, Thiel CM. Pro-cognitive drug effects modulate functional brain network organization. Front Behav Neurosci 2012; 6:53. [PMID: 22973209 PMCID: PMC3428580 DOI: 10.3389/fnbeh.2012.00053] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 07/25/2012] [Indexed: 12/14/2022] Open
Abstract
Previous studies document that cholinergic and noradrenergic drugs improve attention, memory and cognitive control in healthy subjects and patients with neuropsychiatric disorders. In humans neural mechanisms of cholinergic and noradrenergic modulation have mainly been analyzed by investigating drug-induced changes of task-related neural activity measured with functional magnetic resonance imaging (fMRI). Endogenous neural activity has often been neglected. Further, although drugs affect the coupling between neurons, only a few human studies have explicitly addressed how drugs modulate the functional connectome, i.e., the functional neural interactions within the brain. These studies have mainly focused on synchronization or correlation of brain activations. Recently, there are some drug studies using graph theory and other new mathematical approaches to model the brain as a complex network of interconnected processing nodes. Using such measures it is possible to detect not only focal, but also subtle, widely distributed drug effects on functional network topology. Most important, graph theoretical measures also quantify whether drug-induced changes in topology or network organization facilitate or hinder information processing. Several studies could show that functional brain integration is highly correlated with behavioral performance suggesting that cholinergic and noradrenergic drugs which improve measures of cognitive performance should increase functional network integration. The purpose of this paper is to show that graph theory provides a mathematical tool to develop theory-driven biomarkers of pro-cognitive drug effects, and also to discuss how these approaches can contribute to the understanding of the role of cholinergic and noradrenergic modulation in the human brain. Finally we discuss the "global workspace" theory as a theoretical framework of pro-cognitive drug effects and argue that pro-cognitive effects of cholinergic and noradrenergic drugs might be related to higher network integration.
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Affiliation(s)
- Carsten Giessing
- Biological Psychology Lab, Institute of Psychology, University of OldenburgOldenburg, Germany
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Mansbach WE, MacDougall EE, Rosenzweig AS. The Brief Cognitive Assessment Tool (BCAT): a new test emphasizing contextual memory, executive functions, attentional capacity, and the prediction of instrumental activities of daily living. J Clin Exp Neuropsychol 2011; 34:183-94. [PMID: 22149477 DOI: 10.1080/13803395.2011.630649] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The Brief Cognitive Assessment Tool (BCAT) is a new screening measure for cognitive dysfunction that emphasizes contextual memory and executive control functions. A total of 104 older adults referred for neuropsychological evaluation were recruited from assisted-living facilities. Psychometric analyses confirmed strong evidence for reliability, construct validity, and predictive validity. The BCAT's utility for identifying dementia versus mild cognitive impairment was excellent, with a sensitivity of .99, a specificity of .77, and an area under the receiver-operating characteristic (ROC) curve of .95. Executive control, contextual memory, and attentional capacity items were the best predictors of diagnostic category and of instrumental activities of daily living.
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Discovery and replication of dopamine-related gene effects on caudate volume in young and elderly populations (N=1198) using genome-wide search. Mol Psychiatry 2011; 16:927-37, 881. [PMID: 21502949 PMCID: PMC3140560 DOI: 10.1038/mp.2011.32] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The caudate is a subcortical brain structure implicated in many common neurological and psychiatric disorders. To identify specific genes associated with variations in caudate volume, structural magnetic resonance imaging and genome-wide genotypes were acquired from two large cohorts, the Alzheimer's Disease NeuroImaging Initiative (ADNI; N=734) and the Brisbane Adolescent/Young Adult Longitudinal Twin Study (BLTS; N=464). In a preliminary analysis of heritability, around 90% of the variation in caudate volume was due to genetic factors. We then conducted genome-wide association to find common variants that contribute to this relatively high heritability. Replicated genetic association was found for the right caudate volume at single-nucleotide polymorphism rs163030 in the ADNI discovery sample (P=2.36 × 10⁻⁶) and in the BLTS replication sample (P=0.012). This genetic variation accounted for 2.79 and 1.61% of the trait variance, respectively. The peak of association was found in and around two genes, WDR41 and PDE8B, involved in dopamine signaling and development. In addition, a previously identified mutation in PDE8B causes a rare autosomal-dominant type of striatal degeneration. Searching across both samples offers a rigorous way to screen for genes consistently influencing brain structure at different stages of life. Variants identified here may be relevant to common disorders affecting the caudate.
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Voxelwise gene-wide association study (vGeneWAS): multivariate gene-based association testing in 731 elderly subjects. Neuroimage 2011; 56:1875-91. [PMID: 21497199 DOI: 10.1016/j.neuroimage.2011.03.077] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 02/19/2011] [Accepted: 03/28/2011] [Indexed: 12/18/2022] Open
Abstract
Imaging traits provide a powerful and biologically relevant substrate to examine the influence of genetics on the brain. Interest in genome-wide, brain-wide search for influential genetic variants is growing, but has mainly focused on univariate, SNP-based association tests. Moving to gene-based multivariate statistics, we can test the combined effect of multiple genetic variants in a single test statistic. Multivariate models can reduce the number of statistical tests in gene-wide or genome-wide scans and may discover gene effects undetectable with SNP-based methods. Here we present a gene-based method for associating the joint effect of single nucleotide polymorphisms (SNPs) in 18,044 genes across 31,662 voxels of the whole brain in 731 elderly subjects (mean age: 75.56±6.82SD years; 430 males) from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Structural MRI scans were analyzed using tensor-based morphometry (TBM) to compute 3D maps of regional brain volume differences compared to an average template image based on healthy elderly subjects. Using the voxel-level volume difference values as the phenotype, we selected the most significantly associated gene (out of 18,044) at each voxel across the brain. No genes identified were significant after correction for multiple comparisons, but several known candidates were re-identified, as were other genes highly relevant to brain function. GAB2, which has been previously associated with late-onset AD, was identified as the top gene in this study, suggesting the validity of the approach. This multivariate, gene-based voxelwise association study offers a novel framework to detect genetic influences on the brain.
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Lake JI, Goldstein FC. An examination of an enhancing effect of music on attentional abilities in older persons with mild cognitive impairment. Percept Mot Skills 2011; 112:267-78. [PMID: 21466100 PMCID: PMC3307592 DOI: 10.2466/04.10.15.pms.112.1.267-278] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While the effect of listening to music on cognitive abilities is highly debated, studies reporting an enhancing effect of music in elderly populations appear to be more consistent. In this study, the effects of listening to music on attention in groups of cognitively normal older adults and those with mild cognitive impairment were considered. Participants were exposed to both a music and silence condition, and after each condition performed Digit Span and Coding tasks which require attention for maximal performance. The hypothesis that listening to music, compared to a silence condition, enhances performance was not supported for either group. Various explanations for these findings are considered.
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Affiliation(s)
- Jessica I Lake
- Department of Neuroscience and Behavioral Biology, Emory University, USA.
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Abstract
The progressive nature of neurodegeneration suggests an age-dependent process that ultimately leads to synaptic failure and neuronal damage in cortical areas of the brain critical for memory and higher mental functions. The increasing age of the population in developed countries suggests that, if unchecked, these disorders will become increasingly prevalent. In the absence of specific biologic markers, direct pathologic examination of brain tissue still is the only definitive method for establishing a diagnosis of Alzheimer disease (AD) and other types of dementia. Pathologic hallmarks of AD are intracellular neurofibrillary tangles (NFT) and extracellular amyloid plaques. NFT are intraneuronal bundles of paired helical filaments mainly composed of the aggregates of an abnormally phosphorylated form of tau protein; neuritic plaques consist of dense extracellular aggregates of β-amyloid (Aβ), surrounded by reactive gliosis and dystrophic neurites. To date, all available evidence strongly supports the notion that an imbalance between the production and removal of Aβ leading to its progressive accumulation is central to the pathogenesis of AD. A growing understanding of the molecular mechanisms of Aβ formation, degradation, and neurotoxicity is being translated into new therapeutic approaches. Whereas AD is the most common cause of dementia in the elderly, postmortem studies have found dementia with Lewy Bodies and frontotemporal lobe degeneration each to account for about 20% of cases. Molecular neuroimaging techniques such as PET have been used for the in vivo assessment of molecular processes at their sites of action, permitting detection of subtle pathophysiological changes in the brain at asymptomatic stages The development of molecular imaging methods for noninvasively assessing disease-specific traits such as Aβ burden in AD is allowing early diagnosis at presymptomatic stages, more accurate differential diagnosis and, when available, the evaluation and monitoring of disease-modifying therapy.
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Affiliation(s)
- Victor L Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084, Australia; The Mental Health Research Institute of Victoria, 135 Oak Street, Parkville, Victoria 3052, Australia; Department of Medicine, Austin Health, Victoria 3084, Australia.
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084, Australia; Department of Medicine, Austin Health, Victoria 3084, Australia
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Ho AJ, Hua X, Lee S, Leow AD, Yanovsky I, Gutman B, Dinov ID, Leporé N, Stein JL, Toga AW, Jack CR, Bernstein MA, Reiman EM, Harvey DJ, Kornak J, Schuff N, Alexander GE, Weiner MW, Thompson PM. Comparing 3 T and 1.5 T MRI for tracking Alzheimer's disease progression with tensor-based morphometry. Hum Brain Mapp 2010; 31:499-514. [PMID: 19780044 PMCID: PMC2875376 DOI: 10.1002/hbm.20882] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Revised: 07/15/2009] [Accepted: 07/20/2009] [Indexed: 11/07/2022] Open
Abstract
A key question in designing MRI-based clinical trials is how the main magnetic field strength of the scanner affects the power to detect disease effects. In 110 subjects scanned longitudinally at both 3.0 and 1.5 T, including 24 patients with Alzheimer's Disease (AD) [74.8 +/- 9.2 years, MMSE: 22.6 +/- 2.0 at baseline], 51 individuals with mild cognitive impairment (MCI) [74.1 +/- 8.0 years, MMSE: 26.6 +/- 2.0], and 35 controls [75.9 +/- 4.6 years, MMSE: 29.3 +/- 0.8], we assessed whether higher-field MR imaging offers higher or lower power to detect longitudinal changes in the brain, using tensor-based morphometry (TBM) to reveal the location of progressive atrophy. As expected, at both field strengths, progressive atrophy was widespread in AD and more spatially restricted in MCI. Power analysis revealed that, to detect a 25% slowing of atrophy (with 80% power), 37 AD and 108 MCI subjects would be needed at 1.5 T versus 49 AD and 166 MCI subjects at 3 T; however, the increased power at 1.5 T was not statistically significant (alpha = 0.05) either for TBM, or for SIENA, a related method for computing volume loss rates. Analysis of cumulative distribution functions and false discovery rates showed that, at both field strengths, temporal lobe atrophy rates were correlated with interval decline in Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), mini-mental status exam (MMSE), and Clinical Dementia Rating sum-of-boxes (CDR-SB) scores. Overall, 1.5 and 3 T scans did not significantly differ in their power to detect neurodegenerative changes over a year. Hum Brain Mapp, 2010. (c) 2009 Wiley-Liss, Inc.
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Affiliation(s)
- April J. Ho
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Xue Hua
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Suh Lee
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Alex D. Leow
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
- Resnick Neuropsychiatric Hospital at UCLA, Los Angeles, California
| | - Igor Yanovsky
- Department of Mathematics, University of California, Los Angeles, California
| | - Boris Gutman
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Ivo D. Dinov
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Natasha Leporé
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Jason L. Stein
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | | | | | - Eric M. Reiman
- Banner Alzheimer's Institute, Department of Psychiatry, University of Arizona, Phoenix, Arizona
| | - Danielle J. Harvey
- Department of Public Health Sciences, UC Davis School of Medicine, Davis, California
| | - John Kornak
- Department of Radiology and Biomedical Imaging and Department of Epidemiology and Biostatistics, UC San Francisco, San Francisco, California
| | - Norbert Schuff
- Veteran Affairs Medical Center and Department of Radiology and Biomedical Imaging, UC San Francisco, California
- Department of Radiology, UC San Francisco, California
| | - Gene E. Alexander
- Department Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona
| | - Michael W. Weiner
- Veteran Affairs Medical Center and Department of Radiology and Biomedical Imaging, UC San Francisco, California
- Department of Radiology, UC San Francisco, California
- Department of Medicine and Psychiatry, UC San Francisco, San Francisco, California
| | - Paul M. Thompson
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
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Stein JL, Hua X, Morra JH, Lee S, Hibar DP, Ho AJ, Leow AD, Toga AW, Sul JH, Kang HM, Eskin E, Saykin AJ, Shen L, Foroud T, Pankratz N, Huentelman MJ, Craig DW, Gerber JD, Allen AN, Corneveaux JJ, Stephan DA, Webster J, DeChairo BM, Potkin SG, Jack CR, Weiner MW, Thompson PM. Genome-wide analysis reveals novel genes influencing temporal lobe structure with relevance to neurodegeneration in Alzheimer's disease. Neuroimage 2010; 51:542-54. [PMID: 20197096 DOI: 10.1016/j.neuroimage.2010.02.068] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Revised: 01/15/2010] [Accepted: 02/22/2010] [Indexed: 12/16/2022] Open
Abstract
In a genome-wide association study of structural brain degeneration, we mapped the 3D profile of temporal lobe volume differences in 742 brain MRI scans of Alzheimer's disease patients, mildly impaired, and healthy elderly subjects. After searching 546,314 genomic markers, 2 single nucleotide polymorphisms (SNPs) were associated with bilateral temporal lobe volume (P<5 x 10(-7)). One SNP, rs10845840, is located in the GRIN2B gene which encodes the N-methyl-d-aspartate (NMDA) glutamate receptor NR2B subunit. This protein - involved in learning and memory, and excitotoxic cell death - has age-dependent prevalence in the synapse and is already a therapeutic target in Alzheimer's disease. Risk alleles for lower temporal lobe volume at this SNP were significantly over-represented in AD and MCI subjects vs. controls (odds ratio=1.273; P=0.039) and were associated with mini-mental state exam scores (MMSE; t=-2.114; P=0.035) demonstrating a negative effect on global cognitive function. Voxelwise maps of genetic association of this SNP with regional brain volumes, revealed intense temporal lobe effects (FDR correction at q=0.05; critical P=0.0257). This study uses large-scale brain mapping for gene discovery with implications for Alzheimer's disease.
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Affiliation(s)
- Jason L Stein
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
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Stein JL, Hua X, Lee S, Ho AJ, Leow AD, Toga AW, Saykin AJ, Shen L, Foroud T, Pankratz N, Huentelman MJ, Craig DW, Gerber JD, Allen AN, Corneveaux JJ, Dechairo BM, Potkin SG, Weiner MW, Thompson P. Voxelwise genome-wide association study (vGWAS). Neuroimage 2010; 53:1160-74. [PMID: 20171287 DOI: 10.1016/j.neuroimage.2010.02.032] [Citation(s) in RCA: 183] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 01/21/2010] [Accepted: 02/11/2010] [Indexed: 01/23/2023] Open
Abstract
The structure of the human brain is highly heritable, and is thought to be influenced by many common genetic variants, many of which are currently unknown. Recent advances in neuroimaging and genetics have allowed collection of both highly detailed structural brain scans and genome-wide genotype information. This wealth of information presents a new opportunity to find the genes influencing brain structure. Here we explore the relation between 448,293 single nucleotide polymorphisms in each of 31,622 voxels of the entire brain across 740 elderly subjects (mean age+/-s.d.: 75.52+/-6.82 years; 438 male) including subjects with Alzheimer's disease, Mild Cognitive Impairment, and healthy elderly controls from the Alzheimer's Disease Neuroimaging Initiative (ADNI). We used tensor-based morphometry to measure individual differences in brain structure at the voxel level relative to a study-specific template based on healthy elderly subjects. We then conducted a genome-wide association at each voxel to identify genetic variants of interest. By studying only the most associated variant at each voxel, we developed a novel method to address the multiple comparisons problem and computational burden associated with the unprecedented amount of data. No variant survived the strict significance criterion, but several genes worthy of further exploration were identified, including CSMD2 and CADPS2. These genes have high relevance to brain structure. This is the first voxelwise genome wide association study to our knowledge, and offers a novel method to discover genetic influences on brain structure.
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Affiliation(s)
- Jason L Stein
- Laboratory of Neuro Imaging, Department of Neurology, University of California, Los Angeles School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
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Hua X, Lee S, Yanovsky I, Leow AD, Chou YY, Ho AJ, Gutman B, Toga AW, Jack CR, Bernstein MA, Reiman EM, Harvey DJ, Kornak J, Schuff N, Alexander GE, Weiner MW, Thompson PM. Optimizing power to track brain degeneration in Alzheimer's disease and mild cognitive impairment with tensor-based morphometry: an ADNI study of 515 subjects. Neuroimage 2009; 48:668-81. [PMID: 19615450 PMCID: PMC2971697 DOI: 10.1016/j.neuroimage.2009.07.011] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Revised: 07/01/2009] [Accepted: 07/03/2009] [Indexed: 10/20/2022] Open
Abstract
Tensor-based morphometry (TBM) is a powerful method to map the 3D profile of brain degeneration in Alzheimer's disease (AD) and mild cognitive impairment (MCI). We optimized a TBM-based image analysis method to determine what methodological factors, and which image-derived measures, maximize statistical power to track brain change. 3D maps, tracking rates of structural atrophy over time, were created from 1030 longitudinal brain MRI scans (1-year follow-up) of 104 AD patients (age: 75.7+/-7.2 years; MMSE: 23.3+/-1.8, at baseline), 254 amnestic MCI subjects (75.0+/-7.2 years; 27.0+/-1.8), and 157 healthy elderly subjects (75.9+/-5.1 years; 29.1+/-1.0), as part of the Alzheimer's Disease Neuroimaging Initiative (ADNI). To determine which TBM designs gave greatest statistical power, we compared different linear and nonlinear registration parameters (including different regularization functions), and different numerical summary measures derived from the maps. Detection power was greatly enhanced by summarizing changes in a statistically-defined region-of-interest (ROI) derived from an independent training sample of 22 AD patients. Effect sizes were compared using cumulative distribution function (CDF) plots and false discovery rate methods. In power analyses, the best method required only 48 AD and 88 MCI subjects to give 80% power to detect a 25% reduction in the mean annual change using a two-sided test (at alpha=0.05). This is a drastic sample size reduction relative to using clinical scores as outcome measures (619 AD/6797 MCI for the ADAS-Cog, and 408 AD/796 MCI for the Clinical Dementia Rating sum-of-boxes scores). TBM offers high statistical power to track brain changes in large, multi-site neuroimaging studies and clinical trials of AD.
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Affiliation(s)
- Xue Hua
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - Suh Lee
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - Igor Yanovsky
- Department of Mathematics, UCLA, Los Angeles, CA, USA
| | - Alex D. Leow
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
- Resnick Neuropsychiatric Hospital at UCLA, Los Angeles, CA, USA
| | - Yi-Yu Chou
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - April J. Ho
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - Boris Gutman
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
| | | | | | - Eric M. Reiman
- Banner Alzheimer’s Institute, Department of Psychiatry, University of Arizona, Phoenix, AZ, USA
| | - Danielle J. Harvey
- Department of Public Health Sciences, UCD School of Medicine, Davis, CA, USA
| | - John Kornak
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA
| | - Norbert Schuff
- Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | | | - Michael W. Weiner
- Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
- Department of Medicine, UCSF, San Francisco, CA, USA
- Department of Psychiatry, UCSF, San Francisco, CA, USA
| | - Paul M. Thompson
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
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Iemolo F, Duro G, Rizzo C, Castiglia L, Hachinski V, Caruso C. Pathophysiology of vascular dementia. Immun Ageing 2009; 6:13. [PMID: 19895675 PMCID: PMC2784430 DOI: 10.1186/1742-4933-6-13] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Accepted: 11/06/2009] [Indexed: 02/05/2023]
Abstract
The concept of Vascular Dementia (VaD) has been recognized for over a century, but its definition and diagnostic criteria remain unclear. Conventional definitions identify the patients too late, miss subjects with cognitive impairment short of dementia, and emphasize consequences rather than causes, the true bases for treatment and prevention. We should throw out current diagnostic categories and describe cognitive impairment clinically and according to commonly agreed instruments that document the demographic data in a standardized manner and undertake a systematic effort to identify the underlying aetiology in each case. Increased effort should be targeted towards the concept of and criteria for Vascular Cognitive Impairment and Post-Stroke Dementia as well as for genetic factors involved, especially as these categories hold promise for early prevention and treatment.
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Affiliation(s)
- Francesco Iemolo
- Department of Clinical Neurological Sciences University of Western Ontario, Ontario, Canada.
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Morra JH, Tu Z, Apostolova LG, Green AE, Avedissian C, Madsen SK, Parikshak N, Hua X, Toga AW, Jack CR, Schuff N, Weiner MW, Thompson PM. Automated 3D mapping of hippocampal atrophy and its clinical correlates in 400 subjects with Alzheimer's disease, mild cognitive impairment, and elderly controls. Hum Brain Mapp 2009; 30:2766-88. [PMID: 19172649 PMCID: PMC2733926 DOI: 10.1002/hbm.20708] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 09/03/2008] [Accepted: 11/02/2008] [Indexed: 11/05/2022] Open
Abstract
We used a new method we developed for automated hippocampal segmentation, called the auto context model, to analyze brain MRI scans of 400 subjects from the Alzheimer's disease neuroimaging initiative. After training the classifier on 21 hand-labeled expert segmentations, we created binary maps of the hippocampus for three age- and sex-matched groups: 100 subjects with Alzheimer's disease (AD), 200 with mild cognitive impairment (MCI) and 100 elderly controls (mean age: 75.84; SD: 6.64). Hippocampal traces were converted to parametric surface meshes and a radial atrophy mapping technique was used to compute average surface models and local statistics of atrophy. Surface-based statistical maps visualized links between regional atrophy and diagnosis (MCI versus controls: P = 0.008; MCI versus AD: P = 0.001), mini-mental state exam (MMSE) scores, and global and sum-of-boxes clinical dementia rating scores (CDR; all P < 0.0001, corrected). Right but not left hippocampal atrophy was associated with geriatric depression scores (P = 0.004, corrected); hippocampal atrophy was not associated with subsequent decline in MMSE and CDR scores, educational level, ApoE genotype, systolic or diastolic blood pressure measures, or homocysteine. We gradually reduced sample sizes and used false discovery rate curves to examine the method's power to detect associations with diagnosis and cognition in smaller samples. Forty subjects were sufficient to discriminate AD from normal and correlate atrophy with CDR scores; 104, 200, and 304 subjects, respectively, were required to correlate MMSE with atrophy, to distinguish MCI from normal, and MCI from AD.
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Affiliation(s)
- Jonathan H. Morra
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Zhuowen Tu
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Liana G. Apostolova
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
- Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Amity E. Green
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
- Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Christina Avedissian
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Sarah K. Madsen
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Neelroop Parikshak
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Xue Hua
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
| | | | - Norbert Schuff
- Department of Veterans Affairs Medical Center, and Department of Radiology, UC San Francisco, San Francisco, California
| | - Michael W. Weiner
- Department of Veterans Affairs Medical Center, and Department of Radiology, UC San Francisco, San Francisco, California
- Department of Medicine and Psychiatry, UC San Francisco, San Francisco, California
| | - Paul M. Thompson
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California
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Cell Cycle Activation and CNS Injury. Neurotox Res 2009; 16:221-37. [PMID: 19526282 DOI: 10.1007/s12640-009-9050-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 03/26/2009] [Accepted: 03/26/2009] [Indexed: 12/28/2022]
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Leow AD, Yanovsky I, Parikshak N, Hua X, Lee S, Toga AW, Jack CR, Bernstein MA, Britson PJ, Gunter JL, Ward CP, Borowski B, Shaw LM, Trojanowski JQ, Fleisher AS, Harvey D, Kornak J, Schuff N, Alexander GE, Weiner MW, Thompson PM. Alzheimer's disease neuroimaging initiative: a one-year follow up study using tensor-based morphometry correlating degenerative rates, biomarkers and cognition. Neuroimage 2009; 45:645-55. [PMID: 19280686 PMCID: PMC2696624 DOI: 10.1016/j.neuroimage.2009.01.004] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Tensor-based morphometry can recover three-dimensional longitudinal brain changes over time by nonlinearly registering baseline to follow-up MRI scans of the same subject. Here, we compared the anatomical distribution of longitudinal brain structural changes, over 12 months, using a subset of the ADNI dataset consisting of 20 patients with Alzheimer's disease (AD), 40 healthy elderly controls, and 40 individuals with mild cognitive impairment (MCI). Each individual longitudinal change map (Jacobian map) was created using an unbiased registration technique, and spatially normalized to a geometrically-centered average image based on healthy controls. Voxelwise statistical analyses revealed regional differences in atrophy rates, and these differences were correlated with clinical measures and biomarkers. Consistent with prior studies, we detected widespread cerebral atrophy in AD, and a more restricted atrophic pattern in MCI. In MCI, temporal lobe atrophy rates were correlated with changes in mini-mental state exam (MMSE) scores, clinical dementia rating (CDR), and logical/verbal learning memory scores. In AD, temporal atrophy rates were correlated with several biomarker indices, including a higher CSF level of p-tau protein, and a greater CSF tau/beta amyloid 1-42 (ABeta42) ratio. Temporal lobe atrophy was significantly faster in MCI subjects who converted to AD than in non-converters. Serial MRI scans can therefore be analyzed with nonlinear image registration to relate ongoing neurodegeneration to a variety of pathological biomarkers, cognitive changes, and conversion from MCI to AD, tracking disease progression in 3-dimensional detail.
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Affiliation(s)
- Alex D Leow
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA 90095-1769, USA.
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40
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Fodero-Tavoletti MT, Cappai R, McLean CA, Pike KE, Adlard PA, Cowie T, Connor AR, Masters CL, Rowe CC, Villemagne VL. Amyloid imaging in Alzheimer's disease and other dementias. Brain Imaging Behav 2009; 3:246-61. [PMID: 22005989 DOI: 10.1007/s11682-009-9067-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Accepted: 03/18/2009] [Indexed: 02/06/2023]
Abstract
With the advent of new therapeutic strategies aimed at reducing β-amyloid (Aβ) burden in the brain to potentially prevent or delay functional and irreversible cognitive loss, there is increased interest in developing agents that allow assessment of Aβ burden in vivo. Molecular neuroimaging techniques such as positron emission tomography (PET), in conjunction with related biomarkers in plasma and cerebrospinal fluid, are proving valuable in the early and differential diagnosis of Alzheimer's disease (AD). (11)C-PiB PET has proven useful in the discrimination of dementias, showing significantly higher PiB retention in grey matter of AD patients when compared with healthy controls or patients with frontotemporal dementia. (11)C-PiB PET also appears to be more accurate than FDG for the diagnosis of AD. Despite apparently underestimating the Aβ burden in the brain, (11)C-PiB PET is an optimal method to differentiate healthy controls from AD, matching histopathological reports in aging and dementia and reflecting the true regional density of Aβ plaques in cortical areas. High striatal Aβ deposition seems to be typical for carriers of familial forms of AD, whilst ApoE ε4 carriers, independent of diagnosis or disease severity, present with higher Aβ burden than non- ε4 carriers. Characterization of the binding properties of PiB has shown that despite binding to other misfolded proteins in vitro, PiB is extremely selective for Aβ at the concentrations achieved during a PET scan. Aβ burden as assessed by PET does not correlate with measures of cognition or cognitive decline in AD. Approximately 30% of apparently healthy older people, and 50-60% of people with mild cognitive impairment, present with cortical (11)C-PiB retention. In these groups, Aβ burden does correlate with episodic memory and rate of memory decline. These observations suggest that Aβ deposition is not part of normal ageing, supporting the hypothesis that Αβ deposition occurs well before the onset of symptoms and is likely to represent preclinical AD. Further longitudinal observations, coupled with different disease-specific tracers and biomarkers are required not only to confirm this hypothesis, but also to better elucidate the role of Αβ deposition in the course of Alzheimer's disease.
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Morra JH, Tu Z, Apostolova LG, Green AE, Avedissian C, Madsen SK, Parikshak N, Toga AW, Jack CR, Schuff N, Weiner MW, Thompson PM. Automated mapping of hippocampal atrophy in 1-year repeat MRI data from 490 subjects with Alzheimer's disease, mild cognitive impairment, and elderly controls. Neuroimage 2008; 45:S3-15. [PMID: 19041724 DOI: 10.1016/j.neuroimage.2008.10.043] [Citation(s) in RCA: 179] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Accepted: 10/10/2008] [Indexed: 11/16/2022] Open
Abstract
As one of the earliest structures to degenerate in Alzheimer's disease (AD), the hippocampus is the target of many studies of factors that influence rates of brain degeneration in the elderly. In one of the largest brain mapping studies to date, we mapped the 3D profile of hippocampal degeneration over time in 490 subjects scanned twice with brain MRI over a 1-year interval (980 scans). We examined baseline and 1-year follow-up scans of 97 AD subjects (49 males/48 females), 148 healthy control subjects (75 males/73 females), and 245 subjects with mild cognitive impairment (MCI; 160 males/85 females). We used our previously validated automated segmentation method, based on AdaBoost, to create 3D hippocampal surface models in all 980 scans. Hippocampal volume loss rates increased with worsening diagnosis (normal=0.66%/year; MCI=3.12%/year; AD=5.59%/year), and correlated with both baseline and interval changes in Mini-Mental State Examination (MMSE) scores and global and sum-of-boxes Clinical Dementia Rating scale (CDR) scores. Surface-based statistical maps visualized a selective profile of ongoing atrophy in all three diagnostic groups. Healthy controls carrying the ApoE4 gene atrophied faster than non-carriers, while more educated controls atrophied more slowly; converters from MCI to AD showed faster atrophy than non-converters. Hippocampal loss rates can be rapidly mapped, and they track cognitive decline closely enough to be used as surrogate markers of Alzheimer's disease in drug trials. They also reveal genetically greater atrophy in cognitively intact subjects.
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Affiliation(s)
- Jonathan H Morra
- Laboratory of Neuro Imaging, Dept. of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
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42
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Morra JH, Tu Z, Apostolova LG, Green AE, Avedissian C, Madsen SK, Parikshak N, Hua X, Toga AW, Jack CR, Weiner MW, Thompson PM. Validation of a fully automated 3D hippocampal segmentation method using subjects with Alzheimer's disease mild cognitive impairment, and elderly controls. Neuroimage 2008; 43:59-68. [PMID: 18675918 PMCID: PMC2624575 DOI: 10.1016/j.neuroimage.2008.07.003] [Citation(s) in RCA: 161] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Revised: 05/27/2008] [Accepted: 07/02/2008] [Indexed: 11/30/2022] Open
Abstract
We introduce a new method for brain MRI segmentation, called the auto context model (ACM), to segment the hippocampus automatically in 3D T1-weighted structural brain MRI scans of subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI). In a training phase, our algorithm used 21 hand-labeled segmentations to learn a classification rule for hippocampal versus non-hippocampal regions using a modified AdaBoost method, based on approximately 18,000 features (image intensity, position, image curvatures, image gradients, tissue classification maps of gray/white matter and CSF, and mean, standard deviation, and Haar filters of size 1x1x1 to 7x7x7). We linearly registered all brains to a standard template to devise a basic shape prior to capture the global shape of the hippocampus, defined as the pointwise summation of all the training masks. We also included curvature, gradient, mean, standard deviation, and Haar filters of the shape prior and the tissue classified images as features. During each iteration of ACM - our extension of AdaBoost - the Bayesian posterior distribution of the labeling was fed back in as an input, along with its neighborhood features as new features for AdaBoost to use. In validation studies, we compared our results with hand-labeled segmentations by two experts. Using a leave-one-out approach and standard overlap and distance error metrics, our automated segmentations agreed well with human raters; any differences were comparable to differences between trained human raters. Our error metrics compare favorably with those previously reported for other automated hippocampal segmentations, suggesting the utility of the approach for large-scale studies.
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Affiliation(s)
- Jonathan H Morra
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA 90095-1769, USA
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Rate of entorhinal and hippocampal atrophy in incipient and mild AD: relation to memory function. Neurobiol Aging 2008; 31:1089-98. [PMID: 18809228 DOI: 10.1016/j.neurobiolaging.2008.08.003] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Revised: 07/30/2008] [Accepted: 08/04/2008] [Indexed: 11/24/2022]
Abstract
In the present study, as part of a more extensive longitudinal investigation of the in vivo anatomical markers of early and incipient AD in our laboratory, three groups of elderly participants were followed with yearly clinical evaluations and high resolution MRI scans over a 6-year period (baseline and 5 years of follow-up). At baseline, participants consisted of: (1) 35 old subjects with no cognitive impairment (controls); (2) 33 participants with amnestic mild cognitive impairment (MCI); and (3) 14 patients with very mild AD. 11 participants with amnestic MCI received a diagnosis of AD over the follow-up period and 9 controls declined in cognitive function. T1 weighted MRI scans were acquired using a 3D SPGR pulse sequence. At baseline, both the amnestic MCI and mild AD groups differed from the controls in hippocampal and entorhinal cortex volume, but not from each other. Longitudinal analyses showed that the rate of atrophy of the entorhinal cortex and hippocampus for the stable controls differed significantly from MCI participants who converted to AD and the AD groups. Furthermore, longitudinal decreases in hippocampal and entorhinal volume were related to longitudinal decline in declarative memory performance. These findings suggest that the rate of atrophy of mesial temporal lobe structures can differentiate healthy from pathological aging.
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Hua X, Leow AD, Parikshak N, Lee S, Chiang MC, Toga AW, Jack CR, Weiner MW, Thompson PM. Tensor-based morphometry as a neuroimaging biomarker for Alzheimer's disease: an MRI study of 676 AD, MCI, and normal subjects. Neuroimage 2008; 43:458-69. [PMID: 18691658 DOI: 10.1016/j.neuroimage.2008.07.013] [Citation(s) in RCA: 248] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Accepted: 07/11/2008] [Indexed: 10/21/2022] Open
Abstract
In one of the largest brain MRI studies to date, we used tensor-based morphometry (TBM) to create 3D maps of structural atrophy in 676 subjects with Alzheimer's disease (AD), mild cognitive impairment (MCI), and healthy elderly controls, scanned as part of the Alzheimer's Disease Neuroimaging Initiative (ADNI). Using inverse-consistent 3D non-linear elastic image registration, we warped 676 individual brain MRI volumes to a population mean geometric template. Jacobian determinant maps were created, revealing the 3D profile of local volumetric expansion and compression. We compared the anatomical distribution of atrophy in 165 AD patients (age: 75.6+/-7.6 years), 330 MCI subjects (74.8+/-7.5), and 181 controls (75.9+/-5.1). Brain atrophy in selected regions-of-interest was correlated with clinical measurements--the sum-of-boxes clinical dementia rating (CDR-SB), mini-mental state examination (MMSE), and the logical memory test scores - at voxel level followed by correction for multiple comparisons. Baseline temporal lobe atrophy correlated with current cognitive performance, future cognitive decline, and conversion from MCI to AD over the following year; it predicted future decline even in healthy subjects. Over half of the AD and MCI subjects carried the ApoE4 (apolipoprotein E4) gene, which increases risk for AD; they showed greater hippocampal and temporal lobe deficits than non-carriers. ApoE2 gene carriers--1/6 of the normal group--showed reduced ventricular expansion, suggesting a protective effect. As an automated image analysis technique, TBM reveals 3D correlations between neuroimaging markers, genes, and future clinical changes, and is highly efficient for large-scale MRI studies.
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Affiliation(s)
- Xue Hua
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, 635 Charles Young Drive, Los Angeles, CA 90095-1769, USA
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Chertkow H, Massoud F, Nasreddine Z, Belleville S, Joanette Y, Bocti C, Drolet V, Kirk J, Freedman M, Bergman H. Diagnosis and treatment of dementia: 3. Mild cognitive impairment and cognitive impairment without dementia. CMAJ 2008; 178:1273-85. [PMID: 18458258 DOI: 10.1503/cmaj.070797] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Mild cognitive impairment and cognitive impairment, no dementia, are emerging terms that encompass the clinical state between normal cognition and dementia in elderly people. Controversy surrounds their characterization, definition and application in clinical practice. In this article, we provide physicians with practical guidance on the definition, diagnosis and treatment of mild cognitive impairment and cognitive impairment, no dementia, based on recommendations from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia, held in March 2006. METHODS We developed evidence-based guidelines using systematic literature searches, with specific criteria for study selection and quality assessment, and a clear and transparent decision-making process. We selected studies published from January 1996 to December 2005 that had mild cognitive impairment or cognitive impairment, no dementia, as the outcome. Subsequent to the conference, we searched for additional articles published between January 2006 and January 2008. We graded the strength of evidence using the criteria of the Canadian Task Force on Preventive Health Care. RESULTS We identified 2483 articles, of which 314 were considered to be relevant and of good or fair quality. From a synthesis of the evidence in these studies, we made 16 recommendations. In brief, family physicians should be aware that most types of dementia are preceded by a recognizable phase of mild cognitive decline. They should be familiar with the concepts of mild cognitive impairment and of cognitive impairment, no dementia. Patients with these conditions should be closely monitored because of their increased risk for dementia. Leisure activities, cognitive stimulation and physical activity could be promoted as part of a healthy lifestyle in elderly people and those with mild cognitive impairment. Vascular risk factors should be treated optimally. No other specific therapies can yet be recommended. INTERPRETATION Physicians will increasingly see elderly patients with mild memory loss, and learning an approach to diagnosing states such as mild cognitive impairment is now warranted. Close monitoring for progression to dementia, promotion of a healthy lifestyle and treatment of vascular risk factors are recommended for the management of patients with mild cognitive impairment.
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Affiliation(s)
- Howard Chertkow
- Bloomfield Centre for Research in Aging, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montréal, Que.
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Gavrilova SI, Fedorova YB, Roshchina IF, Korovaitseva GI. Prognosis of mild cognitive impairment syndrome: data from a two-year clinical follow-up study. ACTA ACUST UNITED AC 2008; 38:129-34. [PMID: 18197377 DOI: 10.1007/s11055-008-0018-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The psychopathological structure and prognostic significance of mild cognitive impairment syndrome (MCI) were studied in a two-year prospective study of randomized cohorts of elderly subjects whose mental state corresponded to the criteria for MCI. A total of 40 patients aged from 50 to 80 years were studied. Patients underwent clinical history-taking, neuropsychological, psychometric, and genetic investigations (genotyping for ApoE), as well as brain imaging studies. The psychopathological structure and psychometric characteristics of MCI syndrome are presented. Clinical and genetic factors with prognostic significance are identified.
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Affiliation(s)
- S I Gavrilova
- Scientific Center for Mental Health, Russian Academy of Medical Sciences, Moscow
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Prince SE, Woo S, Doraiswamy PM, Petrella JR. Functional MRI in the early diagnosis of Alzheimer's disease: is it time to refocus? Expert Rev Neurother 2008; 8:169-75. [PMID: 18271703 DOI: 10.1586/14737175.8.2.169] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hua X, Leow AD, Lee S, Klunder AD, Toga AW, Lepore N, Chou YY, Brun C, Chiang MC, Barysheva M, Jack CR, Bernstein MA, Britson PJ, Ward CP, Whitwell JL, Borowski B, Fleisher AS, Fox NC, Boyes RG, Barnes J, Harvey D, Kornak J, Schuff N, Boreta L, Alexander GE, Weiner MW, Thompson PM. 3D characterization of brain atrophy in Alzheimer's disease and mild cognitive impairment using tensor-based morphometry. Neuroimage 2008; 41:19-34. [PMID: 18378167 DOI: 10.1016/j.neuroimage.2008.02.010] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 02/06/2008] [Accepted: 02/11/2008] [Indexed: 10/22/2022] Open
Abstract
Tensor-based morphometry (TBM) creates three-dimensional maps of disease-related differences in brain structure, based on nonlinearly registering brain MRI scans to a common image template. Using two different TBM designs (averaging individual differences versus aligning group average templates), we compared the anatomical distribution of brain atrophy in 40 patients with Alzheimer's disease (AD), 40 healthy elderly controls, and 40 individuals with amnestic mild cognitive impairment (aMCI), a condition conferring increased risk for AD. We created an unbiased geometrical average image template for each of the three groups, which were matched for sex and age (mean age: 76.1 years+/-7.7 SD). We warped each individual brain image (N=120) to the control group average template to create Jacobian maps, which show the local expansion or compression factor at each point in the image, reflecting individual volumetric differences. Statistical maps of group differences revealed widespread medial temporal and limbic atrophy in AD, with a lesser, more restricted distribution in MCI. Atrophy and CSF space expansion both correlated strongly with Mini-Mental State Exam (MMSE) scores and Clinical Dementia Rating (CDR). Using cumulative p-value plots, we investigated how detection sensitivity was influenced by the sample size, the choice of search region (whole brain, temporal lobe, hippocampus), the initial linear registration method (9- versus 12-parameter), and the type of TBM design. In the future, TBM may help to (1) identify factors that resist or accelerate the disease process, and (2) measure disease burden in treatment trials.
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Affiliation(s)
- Xue Hua
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Neuroscience Research Building 225E, Los Angeles, CA 90095-1769, USA
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Rasquin SMC, van Oostenbrugge RJ, Verhey FRJ, Lodder J. Vascular mild cognitive impairment is highly prevalent after lacunar stroke but does not increase over time: a 2-year follow-up study. Dement Geriatr Cogn Disord 2008; 24:396-401. [PMID: 17938568 DOI: 10.1159/000109747] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2007] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED Although ample research has been done into cognitive disorders occurring after stroke, relatively few data are available on the development and the course of vascularmild cognitive impairment (VMCI) after first-ever lacunar stroke. METHODS A cohort of 95 patients with a first-ever symptomaticlacunar infarct, older than 40 years, MMSE>or=15 and no other neurological or major psychiatric deficits were included. Patients were assessed (clinically and with a neuropsychological test battery) at 1 and 24 months after stroke, and CT was repeated. VMCI was diagnosed when patients had a deficit in at least one cognitive domain, in the absence of dementia. RESULTS Approximately 75% of the patients had VMCI at 1 month; this percentage was somewhat lower at 2 years. Only initial stroke severity was an independent predictor of VMCI after stroke. CONCLUSION VMCI is highly prevalent after lacunar stroke, but does not increase during the first 2 years thereafter.
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Affiliation(s)
- S M C Rasquin
- Institute for Rehabilitation Research, Hoensbroek, The Netherlands.
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50
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Abstract
As our society ages, age-related diseases assume increasing prominence as both personal and public health concerns. Disorders of cognition are particularly important in both regards, and Alzheimer's disease is by far the most common cause of dementia of aging. In 2000, the prevalence of Alzheimer's disease in the United States was estimated to be 4.5 million individuals, and this number has been projected to increase to 14 million by 2050. Although not an inevitable consequence of aging, these numbers speak to the dramatic scope of its impact. This article focuses on Alzheimer's disease and the milder degrees of cognitive impairment that may precede the clinical diagnosis of probable Alzheimer's disease, such as mild cognitive impairment.
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