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Lam AKF, Carrick J, Kao CH, Phillips CL, Zheng YZ, Yee BJ, Kim JW, Grunstein RR, Naismith SL, D’Rozario AL. Electroencephalographic slowing during REM sleep in older adults with subjective cognitive impairment and mild cognitive impairment. Sleep 2024; 47:zsae051. [PMID: 38394454 PMCID: PMC11168761 DOI: 10.1093/sleep/zsae051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/27/2023] [Indexed: 02/25/2024] Open
Abstract
STUDY OBJECTIVES In older adults with Alzheimer's disease, slowing of electroencephalographic (EEG) activity during REM sleep has been observed. Few studies have examined EEG slowing during REM in those with mild cognitive impairment (MCI) and none have examined its relationship with cognition in this at-risk population. METHODS Two hundred and ten older adults (mean age = 67.0, SD = 8.2 years) underwent comprehensive neuropsychological, medical, and psychiatric assessment and overnight polysomnography. Participants were classified as subjective cognitive impairment (SCI; n = 75), non-amnestic MCI (naMCI, n = 85), and amnestic MCI (aMCI, n = 50). REM EEG slowing was defined as (δ + θ)/(α + σ + β) power and calculated for frontal, central, parietal, and occipital regions. Analysis of variance compared REM EEG slowing between groups. Correlations between REM EEG slowing and cognition, including learning and memory, visuospatial and executive functions, were examined within each subgroup. RESULTS The aMCI group had significantly greater REM EEG slowing in the parietal and occipital regions compared to the naMCI and SCI groups (partial η2 = 0.06, p < 0.05 and 0.06, p < 0.05, respectively), and greater EEG slowing in the central region compared to SCI group (partial η2 = 0.03, p < 0.05). Greater REM EEG slowing in parietal (r = -0.49) and occipital regions (r = -0.38 [O1/M2] and -0.33 [O2/M1]) were associated with poorer visuospatial performance in naMCI. CONCLUSIONS REM EEG slowing may differentiate older adults with memory impairment from those without. Longitudinal studies are now warranted to examine the prognostic utility of REM EEG slowing for cognitive and dementia trajectories.
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Affiliation(s)
- Aaron Kin Fu Lam
- School of Psychology, University of Sydney, Camperdown, NSW, Australia
- Woolcock Institute of Medical Research, Centre for Sleep and Chronobiology, Glebe, NSW, Australia
- School of Psychological Sciences, Faculty of Medicine, Macquarie University, Sydney, NSW, Australia
| | - James Carrick
- School of Psychology, University of Sydney, Camperdown, NSW, Australia
| | - Chien-Hui Kao
- Woolcock Institute of Medical Research, Centre for Sleep and Chronobiology, Glebe, NSW, Australia
- School of Psychological Sciences, Faculty of Medicine, Macquarie University, Sydney, NSW, Australia
| | - Craig L Phillips
- Woolcock Institute of Medical Research, Centre for Sleep and Chronobiology, Glebe, NSW, Australia
- School of Psychological Sciences, Faculty of Medicine, Macquarie University, Sydney, NSW, Australia
| | - Yi Zhong Zheng
- Woolcock Institute of Medical Research, Centre for Sleep and Chronobiology, Glebe, NSW, Australia
| | - Brendon J Yee
- Woolcock Institute of Medical Research, Centre for Sleep and Chronobiology, Glebe, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Central Clinical School, University of Sydney, Camperdown, NSW, Australia
| | - Jong Won Kim
- Department of Healthcare IT, Inje University, Gimhae, Gyeongsangnam-do, South Korea
| | - Ronald R Grunstein
- Woolcock Institute of Medical Research, Centre for Sleep and Chronobiology, Glebe, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Sharon L Naismith
- School of Psychology, University of Sydney, Camperdown, NSW, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Angela L D’Rozario
- Woolcock Institute of Medical Research, Centre for Sleep and Chronobiology, Glebe, NSW, Australia
- School of Psychological Sciences, Faculty of Medicine, Macquarie University, Sydney, NSW, Australia
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Yuan M, Long X, Zhang Z, Rong M, Lian S, Peng Y, Fang Y. Longitudinal trajectory effects of different MCI subtypes on general cognitive and daily functions in a population-based cohort of older adults. J Psychiatr Res 2024; 171:296-305. [PMID: 38335640 DOI: 10.1016/j.jpsychires.2024.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 01/04/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To identify different mild cognitive impairment (MCI) phenotypes based on substantial relative impairment in specific cognitive domains and then characterize the complex process of general cognitive and daily functions over time in older adults with these MCI subtypes. METHODS A total of 1020 participants with MCI at baseline from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were recruited. MCI subtypes were obtained based on neuropsychological tests in five cognitive domains: memory (M), visuospatial function (V), language (L), processing speed (P), and executive function (E). General cognitive function and daily function were measured by the Mini-Mental State Examination (MMSE) and the Functional Assessment Questionnaire (FAQ), respectively. Linear mixed models were fitted to curve their trajectories across different MCI subtypes. RESULTS Considering visuospatial function, subtypes were MO (memory impaired only), M&V (memory and visuospatial function impaired) and M&nV (memory impaired and visuospatial function non-impaired). Similar subtypes and naming rules were obtained based on language, executive function, and processing speed. Further, depending on the number of relative impaired cognitive domains M&S and M&M were obtained. Participants with MO had the highest prevalence in the sample (53.4 %), followed by M&nV (31.1 %). Participants with M&V had the highest mean age (74.69 years) at baseline and the greatest dementia conversion rate (53.2 %). The MMSE and FAQ score trajectories changed most slowly in participants with MO while fastest in those with M&V. Obvious different trajectories of both MMSE and FAQ scores were observed across different subtypes based on visuospatial function and executive function. CONCLUSION Compared to MO, individuals with multi-dimensional cognitive impairment have worse general cognitive and daily functions, especially for those with M&V.
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Affiliation(s)
- Manqiong Yuan
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China; Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China
| | - Xianxian Long
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China; Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China
| | - Zeyun Zhang
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China; Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China
| | - Meng Rong
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China; Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China
| | - Shuli Lian
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China; Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China
| | - Yingxue Peng
- School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China; Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China.
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Lane HY, Wang SH, Lin CH. Adjunctive transcranial direct current stimulation (tDCS) plus sodium benzoate for the treatment of early-phase Alzheimer's disease: A randomized, double-blind, placebo-controlled trial. Psychiatry Res 2023; 328:115461. [PMID: 37729717 DOI: 10.1016/j.psychres.2023.115461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 09/01/2023] [Accepted: 09/03/2023] [Indexed: 09/22/2023]
Abstract
Previous studies found that an NMDA receptor (NMDAR) enhancer, sodium benzoate, improved cognitive function of patients with early-phase Alzheimer's disease (AD). Transcranial direct current stimulation (tDCS) induces NMDAR-dependent synaptic plasticity and strengthens cognitive function of AD patients. This study aimed to evaluate efficacy and safety of tDCS plus benzoate in early-phase dementia. In this 24-week randomized, double-blind, placebo-controlled trial, 97 patients with early-phase AD received 10-session tDCS during the first 2 weeks. They then took benzoate or placebo for 24 weeks. We assessed the patients using Alzheimer's disease assessment scale - cognitive subscale (ADAS-cog), Clinician's Interview-Based Impression of Change plus Caregiver Input, Mini Mental Status Examination, Alzheimer's disease Cooperative Study scale for ADL in MCI, and a battery of additional cognitive tests. Forty-seven patients received sodium benzoate, and the other 50 placebo. The two treatment groups didn't differ significantly in ADAS-cog or other measures. Addition of benzoate to tDCS didn't get extra benefit or side effect in this study. For more thoroughly studying the potential of combining tDCS with benzoate in the AD treatment, future research should use other study designs, such as longer-term benzoate treatment, adding benzoate in the middle of tDCS trial sessions, or administering benzoate then tDCS.
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Affiliation(s)
- Hsien-Yuan Lane
- Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Shi-Heng Wang
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
| | - Chieh-Hsin Lin
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Fiamingo G, Capittini C, De Silvestri A, Rebuffi C, Cerami C, Arnaldi D, Terzaghi M. Neuropsychological evaluation of phenoconversion risk in REM sleep behaviour disorder: A scoping review. J Sleep Res 2023; 32:e13873. [PMID: 36958793 DOI: 10.1111/jsr.13873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/25/2023]
Abstract
The objective of this study was to assess the role of cognitive evaluation in the prediction of phenoconversion in polysomnography-confirmed idiopathic or isolated rapid eye movement sleep behaviour disorder, through a scoping review focussing on a longitudinal comprehensive neuropsychological assessment of patients with idiopathic REM sleep behaviour disorder. A literature search (2006-2022) yielded 1034 records, and 20 were selected for analysis. The sample included 899 patients from eight different cohorts and five countries. We extracted data on clinical evolution, mild cognitive impairment diagnosis, neuropsychological tests used, and classification of cognitive domains. Tests, cognitive domains, and mild cognitive impairment definitions were heterogeneous across the studies, precluding a meta-analysis. Ten studies (50%) evaluated the presence of mild cognitive impairment; 14 studies (70%) grouped neuropsychological tests into between three (6 studies, 21.4%) and seven (1 study, 7.1%) cognitive domains. The most frequently used tests were semantic fluency, Stroop colour word test, trail making test A and B, digit span, Rey auditory verbal learning test, and Rey-Osterrieth figure. All except digit span showed a role in predicting phenoconversion. The authors did not consistently assign tests to specific cognitive domains. In conclusion, we discuss methodological differences between the studies and highlight the need for a standardised framework for neuropsychological data acquisition and presentation, based on a multilevel approach covering test selection, domain assignment, and mild cognitive impairment diagnostic criteria.
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Affiliation(s)
- Giuseppe Fiamingo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Capittini
- Clinical Epidemiology and Biometric Unit, Scientific Direction, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometric Unit, Scientific Direction, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | | | - Chiara Cerami
- Scuola Universitaria di Studi Superiori IUSS, Pavia, Italy
- Cognitive Computational Neuroscience Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Dario Arnaldi
- Clinical Neurology, DINOGMI, University of Genoa, Genoa, Italy
- IRCSS Ospedale Policlinico San Martino, Genoa, Italy
| | - Michele Terzaghi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Unit of Sleep Medicine and Epilepsy, IRCSS Mondino Foundation, Pavia, Italy
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Chiara C, Gilda C, Daniela M, Antonio C, Miriana M, Marcello M, Elena S, Roberta L, Ciro C, Vincenzo BM. A two-year longitudinal study of retinal vascular impairment in patients with amnestic mild cognitive impairment. Front Aging Neurosci 2022; 14:993621. [PMID: 36420311 PMCID: PMC9678013 DOI: 10.3389/fnagi.2022.993621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
ObjectiveTo evaluate the relation between retinal vascular impairment and cognitive decline in patients with amnestic mild cognitive impairment (aMCI) over time.MethodsSpectral domain-optical coherence tomography (SD-OCT) and OCT angiography study was performed in aMCI patients over 2 years follow-up and compared to baseline.ResultsThirty-eight eyes from 19 aMCI patients were evaluated. Structural and vascular OCT measures were reduced at follow-up except for vessel density (VD) of the choriocapillaris, unchanged, and foveal avascular zone, which was increased; no changes in any parameter were found in 18 age-matched healthy controls. Overall, these findings were confirmed when patients were evaluated separately according to progression to dementia. Only non-converters to dementia showed significant VD reduction in the deep capillary plexuses (coeff. β = −4.20; p < 0.001), may be for an initial massive VD depletion becoming less evident with progression of the disease. MMSE reduction was associated with a higher ganglion cell complex reduction (coeff. β = 0.10; p = 0.04) and a higher VD reduction in the radial peripapillary capillary (RPC) plexus (coeff. β = 0.14; p = 0.02) in the whole patient group, while it was associated with a higher VD reduction only in RPC plexus in converters (coeff. β = 0.21; p < 0.001).ConclusionOur data shows vascular impairment progression in the inner retina of aMCI patients and support the hypothesis that vascular changes may contribute to the onset and progression of Alzheimer’s disease. Other follow-up studies, with a larger number of patients, are needed to better define VD as a potential biomarker.
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Lin CH, Lane HY. Blood D-Amino Acid Oxidase Levels Increased With Cognitive Decline Among People With Mild Cognitive Impairment: A Two-Year Prospective Study. Int J Neuropsychopharmacol 2022; 25:660-665. [PMID: 35430632 PMCID: PMC9380713 DOI: 10.1093/ijnp/pyac027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/04/2022] [Accepted: 04/14/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Dysregulation of N-methyl-D-aspartate receptor (NMDAR) neurotransmission has been reported to be implicated in the pathogenesis of Alzheimer's disease (AD). D-amino acid oxidase (DAO), responsible for degradation of NMDAR-related D-amino acids such as D-serine, regulates NMDAR function. A cross-section study found that serum DAO levels were positively related with the severity of cognitive aging among elderly individuals. This 2-year prospective study aimed to explore the role of DAO levels in predicting the outcome of patients with very early-phase AD, such as mild cognitive impairment (MCI). METHODS Fifty-one patients with MCI and 21 healthy individuals were recruited. Serum DAO levels and cognitive function, measured by the AD assessment scale-cognitive subscale and the Mini-Mental Status Examination, were monitored every 6 months. We employed multiple regressions to examine the role of DAO concentration in cognitive decline in the 2-year period. RESULTS From baseline to endpoint (24 months), serum DAO levels increased significantly, and cognitive ability declined according to both cognitive tests in the MCI patients. Among the healthy individuals, DAO concentrations also increased and Mini-Mental Status Examination scores declined; however, AD assessment scale-cognitive subscale scores did not significantly change. Further, DAO levels at both months 12 and 18 were predictive of cognitive impairment at month 24 among the MCI patients. CONCLUSIONS To our knowledge, this is the first study to demonstrate that blood DAO levels increased with cognitive deterioration among the MCI patients in a prospective manner. If replicated by future studies, blood DAO concentration may be regarded as a biomarker for monitoring cognitive change in the patients with MCI.
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Affiliation(s)
- Chieh-Hsin Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan,School of Medicine, Chang Gung University, Taoyuan, Taiwan,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Hsien-Yuan Lane
- Correspondence: Hsien-Yuan Lane, MD, PhD, Department of Psychiatry, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan ()
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Hugon J, Msika EF, Queneau M, Farid K, Paquet C. Long COVID: cognitive complaints (brain fog) and dysfunction of the cingulate cortex. J Neurol 2022; 269:44-46. [PMID: 34143277 PMCID: PMC8211714 DOI: 10.1007/s00415-021-10655-x] [Citation(s) in RCA: 97] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/03/2021] [Accepted: 06/09/2021] [Indexed: 12/26/2022]
Abstract
Many patients who have suffered from acute COVID infections have long-lasting symptoms affecting several organs including the brain. This long COVID status can include "brain fog" and cognitive deficits that can disturb activities of daily living and can delay complete recovery. Here, we report two cases of neurological long COVID with abnormal FDG PET findings marked by hypometabolic regions of the cingulate cortex.
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Affiliation(s)
- Jacques Hugon
- Center of Cognitive Neurology, APHP, Inserm 1144, University of Paris Lariboisiere Hospital, Paris, France. .,Memory Clinic, 16 rue de Téhéran, 75008, Paris, France.
| | | | - Mathieu Queneau
- Department of Molecular Imaging, North Cardiologic Center, Saint-Denis, France
| | - Karim Farid
- grid.412874.cDepartment of Molecular Medicine, CHU Fort de France, Martinique, France
| | - Claire Paquet
- grid.508487.60000 0004 7885 7602Center of Cognitive Neurology, APHP, Inserm 1144, University of Paris Lariboisiere Hospital, Paris, France
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Plasma Glutathione Levels Decreased with Cognitive Decline among People with Mild Cognitive Impairment (MCI): A Two-Year Prospective Study. Antioxidants (Basel) 2021; 10:antiox10111839. [PMID: 34829710 PMCID: PMC8615204 DOI: 10.3390/antiox10111839] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 01/31/2023] Open
Abstract
Glutathione (GSH) is a major endogenous antioxidant. Several studies have shown GSH redox imbalance and altered GSH levels in Alzheimer’s disease (AD) patients. Early detection is crucial for the outcome of AD. However, whether GSH can serve as a biomarker during the very early-phase of AD, such as mild cognitive impairment (MCI), remains unknown. The current prospective study aimed to examine the longitudinal change in plasma GSH concentration and its influence on cognitive decline in MCI. Overall, 49 patients with MCI and 16 healthy individuals were recruited. Plasma GSH levels and cognitive function, measured by the Mini-Mental Status Examination (MMSE) and Alzheimer’s disease assessment scale-cognitive subscale (ADAS-cog), were monitored every 6 months. We employed multiple regressions to examine the role of GSH level in cognitive decline in the 2 years period. The MCI patients showed significant decline in plasma GSH levels and cognitive function from baseline to endpoint (month 24). In comparison, the healthy individuals’ GSH concentration and cognitive function did not change significantly. Further, both GSH level at baseline and GSH level change from baseline to endpoint significantly influenced cognitive decline among the MCI patients. To our knowledge, this is the first study to demonstrate that both plasma GSH levels and cognitive function declined 2 years later among the MCI patients in a prospective manner. If replicated by future studies, blood GSH concentration may be regarded as a biomarker for monitoring cognitive change in MCI.
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Kantarci K, Boeve BF, Przybelski SA, Lesnick TG, Chen Q, Fields J, Schwarz CG, Senjem ML, Gunte JL, Jack CR, Min P, Jain M, Miyagawa T, Savica R, Graff-Radford J, Botha H, Jones DT, Knopman DS, Graff-Radford N, Ferman TJ, Petersen RC, Lowe VJ. FDG PET metabolic signatures distinguishing prodromal DLB and prodromal AD. Neuroimage Clin 2021; 31:102754. [PMID: 34252877 PMCID: PMC8278422 DOI: 10.1016/j.nicl.2021.102754] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Patients with dementia with Lewy bodies (DLB) are characterized by hypometabolism in the parieto-occipital cortex and the cingulate island sign (CIS) on 18F-fluorodeoxyglucose (FDG) PET. Whether this pattern of hypometabolism is present as early as the prodromal stage of DLB is unknown. We investigated the pattern of hypometabolism in patients with mild cognitive impairment (MCI) who progressed to probable DLB compared to MCI patients who progressed to Alzheimer's disease (AD) dementia and clinically unimpaired (CU) controls. METHODS Patients with MCI from the Mayo Clinic Alzheimer's Disease Research Center who underwent FDG PET at baseline and progressed to either probable DLB (MCI-DLB; n = 17) or AD dementia (MCI-AD; n = 41) during follow-up, and a comparison cohort of CU controls (n = 100) were included. RESULTS Patients with MCI-DLB had hypometabolism in the parieto-occipital cortex extending into temporal lobes, substantia nigra and thalamus. When compared to MCI-AD, medial temporal and posterior cingulate metabolism were preserved in patients with MCI-DLB, accompanied by greater hypometabolism in the substantia nigra in MCI-DLB compared to MCI-AD. In distinguishing MCI-DLB from MCI-AD at the maximum value of Youden's index, CIS ratio was highly specific (90%) but not sensitive (59%), but a higher medial temporal to substantia nigra ratio was both sensitive (94%) and specific (83%). CONCLUSION FDG PET is a potential biomarker for the prodromal stage of DLB. A higher medial temporal metabolism and CIS ratio, and lower substantia nigra metabolism have additive value in distinguishing prodromal DLB and AD.
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Affiliation(s)
- Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
| | | | | | - Timothy G Lesnick
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Qin Chen
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Julie Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew L Senjem
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Jeffrey L Gunte
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | | | - Paul Min
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Manoj Jain
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Tanis J Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Hoffmann J, Busse S, von Hoff F, Borucki K, Frodl T, Busse M. Association Between Homocysteine and Vitamin Levels in Demented Patients. J Alzheimers Dis 2021; 81:1781-1792. [PMID: 33998538 DOI: 10.3233/jad-201481] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Although it is known that the nutritional status among elderly persons and, in particular, patients with dementia, is compromised, malnutrition that results in insufficient uptake of several vitamins is often not diagnosed. OBJECTIVE An elevated homocysteine level is a known strong risk factor for vascular dementia (VaD) and Alzheimer's disease (AD). Several B vitamins are involved in the metabolism of homocysteine. Therefore, we investigated the serum levels of vitamin B1, vitamin B6, folate, and vitamin B12 in 97 patients with mild cognitive impairment (MCI) or different forms of dementia and 54 elderly control persons without dementia. RESULTS Compared to aged non-demented people, vitamins B1, B6, B12, and folate were decreased in serum of patients with AD, and patients with Lewy body dementia had reduced vitamin B12 level. Vitamin B6 was diminished in VaD. Patients with frontotemporal dementia showed no alterations in vitamin levels. Age was identified as an important factor contributing to the concentrations of vitamin B1 and B6 in serum, but not vitamin B12 and folate. Increased levels of total homocysteine were detected especially in MCI and AD. Homocysteine correlated negatively with levels of vitamins B6, B12, and folate and positively with Q Albumin. CONCLUSION Our data suggest that despite increased homocysteine already present in MCI, vitamin levels are decreased only in dementia. We propose to determine the vitamin levels in patients with cognitive decline, but also elderly people in general, and recommend supplementing these nutrients if needed.
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Affiliation(s)
- Jessica Hoffmann
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany
| | - Stefan Busse
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany
| | - Franz von Hoff
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany
| | - Katrin Borucki
- Institute for Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany
| | - Mandy Busse
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany.,Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
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11
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Chen Q, Lowe VJ, Boeve BF, Przybelski SA, Miyagawa T, Senjem ML, Jack CR, Lesnick TG, Kremers WK, Fields JA, Min HK, Schwarz CG, Gunter JL, Graff-Radford J, Savica R, Knopman DS, Jones D, Ferman TJ, Graff-Radford NR, Petersen RC, Kantarci K. β-Amyloid PET and 123I-FP-CIT SPECT in Mild Cognitive Impairment at Risk for Lewy Body Dementia. Neurology 2021; 96:e1180-e1189. [PMID: 33408148 PMCID: PMC8055344 DOI: 10.1212/wnl.0000000000011454] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/26/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To determine the clinical phenotypes associated with the β-amyloid PET and dopamine transporter imaging (123I-FP-CIT SPECT) findings in mild cognitive impairment (MCI) with the core clinical features of dementia with Lewy bodies (DLB; MCI-LB). METHODS Patients with MCI who had at least 1 core clinical feature of DLB (n = 34) were grouped into β-amyloid A+ or A- and 123I-FP-CIT SPECT D+ or D- groups based on previously established abnormality cut points for A+ with Pittsburgh compound B PET standardized uptake value ratio (PiB SUVR) ≥1.48 and D+ with putamen z score with DaTQUANT <-0.82 on 123I-FP-CIT SPECT. Individual patients with MCI-LB fell into 1 of 4 groups: A+D+, A+D-, A-D+, or A-D-. Log-transformed PiB SUVR and putamen z score were tested for associations with patient characteristics. RESULTS The A-D+ biomarker profile was most common (38.2%), followed by A+D+ (26.5%) and A-D- (26.5%). The least common was the A+D- biomarker profile (8.8%). The A+ group was older, had a higher frequency of APOE ε4 carriers, and had a lower Mini-Mental State Examination score than the A- group. The D+ group was more likely to have probable REM sleep behavior disorder. Lower putamen DaTQUANT z scores and lower PiB SUVRs were independently associated with higher Unified Parkinson's Disease Rating Scale-III scores. CONCLUSIONS A majority of patients with MCI-LB are characterized by low β-amyloid deposition and reduced dopaminergic activity. β-Amyloid PET and 123I-FP-CIT SPECT are complementary in characterizing clinical phenotypes of patients with MCI-LB.
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Affiliation(s)
- Qin Chen
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Val J Lowe
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Bradley F Boeve
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Scott A Przybelski
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Toji Miyagawa
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Matthew L Senjem
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Clifford R Jack
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Timothy G Lesnick
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Walter K Kremers
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Julie A Fields
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Hoon-Ki Min
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Christopher G Schwarz
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Jeffrey L Gunter
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Jonathan Graff-Radford
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Rodolfo Savica
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - David S Knopman
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - David Jones
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Tanis J Ferman
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Neill R Graff-Radford
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Ronald C Petersen
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Kejal Kantarci
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL.
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Lane HY, Tu CH, Lin WC, Lin CH. Brain Activity of Benzoate, a D-Amino Acid Oxidase Inhibitor, in Patients With Mild Cognitive Impairment in a Randomized, Double-Blind, Placebo Controlled Clinical Trial. Int J Neuropsychopharmacol 2021; 24:392-399. [PMID: 33406269 PMCID: PMC8130199 DOI: 10.1093/ijnp/pyab001] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/05/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Current anti-dementia drugs cannot benefit mild cognitive impairment (MCI). Sodium benzoate (a D-amino acid oxidase [DAO] inhibitor) has been found to improve the cognitive function of patients with early-phase Alzheimer's disease (mild Alzheimer's disease or MCI). However, its effect on brain function remains unknown. This study aimed to evaluate the influence of benzoate on functional magnetic resonance imaging in patients with amnestic MCI. METHODS This was a 24-week, randomized, double-blind, placebo-controlled trial that enrolled 21 patients with amnestic MCI and allocated them randomly to either of 2 treatment groups: (1) benzoate group (250-1500 mg/d), or (2) placebo group. We assessed the patients' working memory, verbal learning and memory, and resting-state functional magnetic resonance imaging and regional homogeneity (ReHo) maps at baseline and endpoint. RESULTS Resting-state ReHo decreased in right orbitofrontal cortex after benzoate treatment but did not change after placebo. Moreover, after benzoate treatment, the change in working memory was positively correlated with the change in ReHo in right precentral gyrus and right middle occipital gyrus; and the change in verbal learning and memory was positively correlated with the change in ReHo in left precuneus. In contrast, after placebo treatment, the change in working memory or in verbal learning and memory was not correlated with the change in ReHo in any brain region. CONCLUSION The current study is the first to our knowledge to demonstrate that a DAO inhibitor, sodium benzoate herein, can alter brain activity as well as cognitive functions in individuals with MCI. The preliminary finding lends supports for DAO inhibition as a novel approach for early dementing processes.
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Affiliation(s)
- Hsien-Yuan Lane
- Department of Psychiatry and Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan ,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan ,Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Cheng-Hao Tu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
| | - Wei-Che Lin
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Chieh-Hsin Lin
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan,Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan,School of Medicine, Chang Gung University, Taoyuan, Taiwan ,Correspondence: Chieh-Hsin Lin, MD, PhD, Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong District, Kaohsiung City, 833, Taiwan ()
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Berberine ameliorates rats model of combined Alzheimer's disease and type 2 diabetes mellitus via the suppression of endoplasmic reticulum stress. 3 Biotech 2020; 10:359. [PMID: 32832321 DOI: 10.1007/s13205-020-02354-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 07/22/2020] [Indexed: 12/30/2022] Open
Abstract
This study is aimed to investigate the protective effect against type 2 diabetes mellitus (T2DM) and Alzheimer's disease (AD) of Berberine (BBR), and the underlying mechanism of action is explored. We established a rat model of combined AD and T2DM and used it to investigate the effect of BBR (150 mg/kg) on the course of these pathologies. The Morris water maze, biochemical analysis, hematoxylin-eosin staining, immunohistochemical study, immunofluorescent staining, TUNEL assay, RT-qPCR and western blot were used to reveal the effect of BBR on blood glucose, lipid changes, hippocampal injuries and cognitive impairment. The results showed that BBR could alleviate memory deficits, restore the disordered arrangement of nerve cells, the damage of neurons, improve TUNEL-positive cells and decrease the elevated levels of fasting blood glucose, triglyceride, total cholesterol and glycosylated serum protein levels in Alzheimer diabetic rats. Moreover, BBR treatment reduces the transcription of mRNAs and expression of proteins related to endoplasmic reticulum (ER) stress. These findings conclude that BBR can protect neurons by inhibiting the pathway of ER stress and thereby play an essential role in the preventive and therapeutic of AD and T2DM.
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Abstract
OBJECTIVES Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) have substantial clinical and biological overlap, with cognitive deficits typically observed in the executive and visuospatial domains. However, the neuropsychological profiles of mild cognitive impairment (MCI) associated with these disorders are not well understood. METHODS This systematic review examined existing literature on cognition in MCI due to LB disease (MCI-LB) and PD (PD-MCI) using an electronic search of seven databases (Medline, Embase, Psychinfo, PubMed, ProQuest, Scopus, and ScienceDirect). MCI-LB results were reviewed narratively given the small number of resulting papers (n = 7). Outcome variables from PD-MCI studies (n = 13) were extracted for meta-analysis of standardised mean differences (SMD). RESULTS In MCI-LB, executive dysfunction and slowed processing speed were the most prominent impairments, while visuospatial and working memory (WM) functions were also poor. MCI-LB scored significantly lower on verbal memory tests relative to controls, but significantly higher than patients with MCI due to Alzheimer's disease. Quantitative analysis of studies in PD-MCI showed a similar profile of impairment, with the largest deficits in visuospatial function (Benton Judgement of Line Orientation, SMD g = -2.09), executive function (Trail Making Test B, SMD g = -1.65), verbal ability (Naming Tests, SMD g = -0.140), and WM (Trail Making Test A, SMD g = -1.20). In both MCI-LB and PD-MCI, verbal and visuospatial memory retrieval was impaired, while encoding and storage appeared relatively intact. CONCLUSIONS The findings of this systematic review indicate similar neuropsychological profiles in the MCI stages of DLB and PDD. Executive impairment may at least partially explain poor performance in other domains.
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Galbiati A, Carli G, Hensley M, Ferini-Strambi L. REM Sleep Behavior Disorder and Alzheimer's Disease: Definitely No Relationship? J Alzheimers Dis 2019; 63:1-11. [PMID: 29578489 DOI: 10.3233/jad-171164] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Rapid eye movement (REM) sleep behavior disorder (RBD) is a REM sleep parasomnia characterized by the loss of the typical muscular atonia present during healthy REM sleep. RBD can occur in the absence of other neurological conditions or in association with a neurodegenerative disorder. It is now well established that RBD is a strong predictor of neurodegeneration, in particular synucleinopathies, such as Parkinson's disease, Lewy body dementia (LBD), or multiple system atrophy. However, some longitudinal studies report that a minority of patients develop either overlapping form of dementia or Alzheimer disease's (AD). Although AD is reported as a possible development in patients with RBD, it is in a limited number of cases and there are concerns about the accuracy of the diagnostic criteria. Neuropsychological impairments identified in cross-sectional studies of RBD patients describe a profile similar to that observed in dementia related to synucleinopathies. However, only deficits in executive function predict the development of neurodegeneration. Longitudinal studies reported the development of AD in RBD patients in about 7% of cases with variability ranging from 3% and 11%. Since the majority of longitudinal investigations do not report AD as a possible development for RBD patients the proportion may be overestimated. The study of the relationship between RBD and AD may be confounded by two factors that lead to misdiagnosis: the use of clinical criteria alone and the overlap between the clinical features and neuropathology of AD and LBD. Future studies to investigate this association must use updated diagnostic criteria incorporating ancillary investigations.
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Affiliation(s)
- Andrea Galbiati
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Neurology - Sleep Disorders Center, Milan, Italy.,"Vita-Salute" San Raffaele University, Faculty of Psychology, Milan, Italy
| | - Giulia Carli
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Neurology - Sleep Disorders Center, Milan, Italy
| | - Michael Hensley
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, NSW, Australia
| | - Luigi Ferini-Strambi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Neurology - Sleep Disorders Center, Milan, Italy.,"Vita-Salute" San Raffaele University, Faculty of Psychology, Milan, Italy
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Ahmad MH, Fatima M, Mondal AC. Role of Hypothalamic-Pituitary-Adrenal Axis, Hypothalamic-Pituitary-Gonadal Axis and Insulin Signaling in the Pathophysiology of Alzheimer's Disease. Neuropsychobiology 2019; 77:197-205. [PMID: 30605907 DOI: 10.1159/000495521] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/13/2018] [Indexed: 11/19/2022]
Abstract
Alzheimer's disease (AD), the commonest progressive neurodegenerative disorder of the brain, is clinically characterized by the formation of extracellular amyloid plaques and intracellular neurofibrillary tangles. Recent studies suggest a relationship between the endocrinal dysregulation and the neuronal loss during the AD pathology. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and hypothalamic-pituitary-gonadal (HPG) axis regulating circulating levels of glucocorticoid hormones has been implicated in the pathophysiology of AD. Likewise, dysregulated insulin signaling, impaired glucose uptake and insulin resistance are some of the prime factors in the onset/progression of AD. In this review, we have discussed the changes in HPA and HPG axes, implicated insulin resistance/signaling and glucose regulation during the onset/progression of AD. Therefore, simultaneous detection of these endocrinal markers in the early or presymptomatic stages may help in the early diagnosis of AD. This evidence for implicated endocrinal functions supports the fact that modulation of endocrinal pathways can be used as therapeutic targets for AD. Future studies need to determine how the induction or inhibition of endocrinal targets could be used for predictable neuroprotection in AD therapies.
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Affiliation(s)
- Mir Hilal Ahmad
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Mahino Fatima
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Amal Chandra Mondal
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India,
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Bousiges O, Blanc F. Diagnostic value of cerebro-spinal fluid biomarkers in dementia with lewy bodies. Clin Chim Acta 2019; 490:222-228. [DOI: 10.1016/j.cca.2018.11.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/20/2018] [Accepted: 11/20/2018] [Indexed: 12/17/2022]
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Zheng H, Niu S, Zhao H, Li S, Jiao J. Donepezil improves the cognitive impairment in a tree shrew model of Alzheimer's disease induced by amyloid-β 1-40 via activating the BDNF/TrkB signal pathway. Metab Brain Dis 2018; 33:1961-1974. [PMID: 30105614 DOI: 10.1007/s11011-018-0303-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 08/03/2018] [Indexed: 12/22/2022]
Abstract
Alzheimer's disease (AD) is a chronic neurodegenerative disorder which can contribute to memory loss and cognitive damage in the elderly; moreover, evidence from clinical and animal studies demonstrated that AD always exhibit severe cognitive deficits. However, the effects of donepezil medications on cognition are controversial. Additionally, it is unclear whether donepezil can protect neurons to improve cognitive function through the brain-derived neurotropic factor (BDNF)/tyrosine receptor kinase B (TrkB) signalling pathway in the tree shrew (TS), which has a closer evolutionary relationship to primates than rodents. Here, we designed a study on an amyloid-β1-40 (Aβ1-40)-induced TS model of AD and investigated the molecular mechanism by which donepezil protects neurons and improves cognitive function through activating the BDNF/TrkB signalling pathway. The results showed that donepezil could rescue Aβ1-40-induced spatial cognition deficits, and reverse Aβ1-40-induced temporal horn along with ADC enlargement in the TS brain. Meanwhile, it suppressed Aβ1-40-induced neuronal damage and loss of body weight. Intriguingly, donepezil could increase the choline acetyl transferase (ChAT) expression level and reduce the fibrillary acid protein (GFAP) expression level in the hippocampus and cortex of TS. Additionally, donepezil significantly upregulated the expression level of BDNF, as well as the phosphorylated level of TrkB. These results suggested that donepezil could protect neurocytes from senility and ameliorate learning and memory impairment in the TS model of AD, which appeared to be through regulating the cholinergic system and inhibiting the BDNF/TrkB-dependent signalling pathway. Moreover, the study underlines the potency of TS to be a novel animal model for research on AD, and it deserves intensive attention.
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Affiliation(s)
- Hong Zheng
- Department of Laboratory Animal Science, Kunming Medical University, Kunming, 650500, China
| | - Shiwei Niu
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Kunming Medical University, Kunming, 650500, China
| | - Hongbin Zhao
- Department of Emergency Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Shude Li
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Kunming Medical University, Kunming, 650500, China.
| | - Jianlin Jiao
- Technology Transfer Center, Kunming Medical University, Kunming, 650031, China.
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19
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Tang M, Pi J, Long Y, Huang N, Cheng Y, Zheng H. Quantum dots-based sandwich immunoassay for sensitive detection of Alzheimer's disease-related Aβ 1-42. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2018; 201:82-87. [PMID: 29734108 DOI: 10.1016/j.saa.2018.04.060] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 04/12/2018] [Accepted: 04/29/2018] [Indexed: 05/24/2023]
Abstract
Amyloid-beta peptide 1-42 (Aβ1-42) is known as a component of amyloid plaques in association with Alzheimer's disease. Herein, we developed a reliable and remarkably sensitive sandwich immunoassay to detect the Aβ1-42 using quantum dots (QDs) as fluorescent label. In the presence of Aβ1-42, the biotinylated Anti-beta Amyloid 1-16 (N-Ab) recognized the target and formed C-Ab-Aβ1-42-N-Ab sandwich immunocomplexes. Then Streptavidin-QDs conjugated to biotinylated N-Ab and the concentration of Aβ1-42 was determined by detecting the fluorescence intensity in the supernatant. This method is faster and more efficient than the previous approach we reported. It also has reasonable sensitivity and selectivity. Under the optimized conditions, the linear range is 5.0 to 100 pM (0.023-0.45 ng/mL) and the detection limit is 1.7 pM (7.6 pg/ mL). In addition, this method has been successfully applied to detect the Aβ1-42 in human cerebrospinal fluid sample.
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Affiliation(s)
- Menghuan Tang
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing 400715, PR China
| | - Jiangli Pi
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing 400715, PR China
| | - Yijuan Long
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing 400715, PR China
| | - Ning Huang
- Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, PR China
| | - Yuan Cheng
- Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, PR China
| | - Huzhi Zheng
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing 400715, PR China.
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20
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Lee JH, Jahrling JB, Denner L, Dineley KT. Targeting Insulin for Alzheimer’s Disease: Mechanisms, Status and Potential Directions. J Alzheimers Dis 2018; 64:S427-S453. [DOI: 10.3233/jad-179923] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Jung Hyun Lee
- Department of Neurology, University of Texas Medical Branch, Galveston, TX, USA
| | - Jordan B. Jahrling
- Department of Neurology, University of Texas Medical Branch, Galveston, TX, USA
| | - Larry Denner
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Kelly T. Dineley
- Department of Neurology, University of Texas Medical Branch, Galveston, TX, USA
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21
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Kim MS, Yoon JH, Hong JM. Early differentiation of dementia with Lewy bodies and Alzheimer's disease: Heart rate variability at mild cognitive impairment stage. Clin Neurophysiol 2018; 129:1570-1578. [PMID: 29883835 DOI: 10.1016/j.clinph.2018.05.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 04/16/2018] [Accepted: 05/19/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Our study aimed to investigate whether heart rate variability (HRV) could be a useful diagnostic screening tool at MCI (mild cognitive impairment) stage of Dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). METHODS This retrospective study used a selected sample from Ajou neurological registry. We identified MCI patients who underwent HRV testing at baseline, and who developed probable DLB (MCI-DLB: n = 23) or AD (MCI-AD: n = 32). RESULTS The MCI-DLB group exhibited significantly lower levels of almost all HRV parameters compared with the MCI-AD group. Fronto-executive function and visuospatial abilities were poorer in the MCI-DLB group, whereas the extent of verbal memory impairment was greater in the MCI-AD. Verbal memory score was negatively correlated with overall HRV parameters, and visuospatial function was positively correlated with the frequency domain of HRV. Receiver operating curve area under the curve (AUC) analysis revealed that the low frequency component was the best potential diagnostic marker (AUC = 0.88). CONCLUSION MCI-DLB patients exhibited greater cardiac autonomic dysfunction (as measured by HRV) and greater fronto-executive and visuospatial deficit compared with MCI-AD patients. SIGNIFICANCE HRV may be useful method to differentiate DLB from AD in patients with MCI; this would facilitate early disease-specific intervention.
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Affiliation(s)
- Min Seung Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Jung Han Yoon
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea.
| | - Ji Man Hong
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
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22
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Bousiges O, Bombois S, Schraen S, Wallon D, Quillard MM, Gabelle A, Lehmann S, Paquet C, Amar-Bouaziz E, Magnin E, Miguet-Alfonsi C, Delbeuck X, Lavaux T, Anthony P, Philippi N, Blanc F. Cerebrospinal fluid Alzheimer biomarkers can be useful for discriminating dementia with Lewy bodies from Alzheimer's disease at the prodromal stage. J Neurol Neurosurg Psychiatry 2018; 89:467-475. [PMID: 29321140 DOI: 10.1136/jnnp-2017-316385] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 10/24/2017] [Accepted: 11/08/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Differential diagnosis between dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) is not straightforward, especially in the early stages of disease. We compared AD biomarkers (phospho-Tau181, total-Tau, Aβ42 and Aβ40) in cerebrospinal fluid (CSF) of patients with DLB and AD, focusing especially on the prodromal stage. METHODS A total of 1221 CSF were collected in different memory centres (ePLM network) in France and analysed retrospectively. Samples were obtained from patients with prodromal DLB (pro-DLB; n=57), DLB dementia (DLB-d; n=154), prodromal AD (pro-AD; n=132) and AD dementia (n=783), and control subjects (CS; n=95). These centres use the same diagnostic procedure and criteria to evaluate the patients. RESULTS In patients with pro-DLB, CSF Aβ42 levels appeared much less disrupted than in patients at the demented stage (DLB-d) (P<0.05 CS>pro-DLB; P<0.001 CS>DLB-d). On average, Aβ40 levels in patients with DLB (pro-DLB and DLB-d) were much below those in patients with pro-AD (P<0.001 DLB groups<pro-AD). The Aβ42/Aβ40 ratio in patients with pro-DLB remained close to that of CS. t-Tau and phospho-Tau181 levels were unaltered in patients with DLB (pro-DLB and DLB-d). CONCLUSIONS Reduced levels of CSF Aβ42 were found in patients with DLB but rather at a later stage, reaching those of patients with AD, in whom Aβ42 levels were decreased even at the prodromal stage. At the prodromal stage of DLB, the majority of patients presented a normal CSF profile. CSF t-Tau and phospho-Tau181 were the best biomarkers to discriminate between AD and DLB, whatever the stage of disease.
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Affiliation(s)
- Olivier Bousiges
- Laboratory of Biochemistry and Molecular Biology, and CNRS, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), University Hospital of Strasbourg, Strasbourg, Alsace, France
| | - Stephanie Bombois
- Université Lille Nord de France, DISTALZ, Memory Center, Lille, France
| | - Susanna Schraen
- UMR-S 1172 - JPArc-Centre de recherches Jean-Pierre Aubert Neurosciences et Cancer and CHU Lille, UF Neurobiologie, Université Lille, Lille, France
| | - David Wallon
- Department of Neurology, Rouen University Hospital, Rouen, France
| | | | - Audrey Gabelle
- CMRR (Memory Resources and Research Centre), Department of Neurology, CHU de Montpellier, Hôpital, Gui de Chauliac, Montpellier, France
| | - Sylvain Lehmann
- Laboratoire de Biochimie et Protéomique Clinique, CHU de Montpellier and Université de Montpellier, IRMB, CRB, Montpellier, France
| | - Claire Paquet
- CMRR (Memory Resources and Research Centre) Paris Nord Ile de France and Histologie et Biologie du Vieillissement, Groupe Hospitalier Saint-Louis Lariboisière Fernand-Widal APHP, INSERM U942, Université Paris Diderot, Paris, France
| | - Elodie Amar-Bouaziz
- Service de Biochimie et Biologie moléculaire, GH Saint-Louis-Lariboisière-Fernand Widal, APHP, Paris, France
| | - Eloi Magnin
- Department of Neurology, Centre Mémoire Ressources Recherche Besançon Franche-Comté, CHU de Besançon, Besançon, France
| | | | - Xavier Delbeuck
- Université Lille Nord de France, DISTALZ, Memory Center, Lille, France
| | - Thomas Lavaux
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Strasbourg, Strasbourg, France
| | - Pierre Anthony
- Neuropsychology Unit, Neurology Service, and CNRS, ICube Laboratory UMR 7357 and FMTS, Team IMIS/Neurocrypto, University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
| | - Nathalie Philippi
- Neuropsychology Unit, Neurology Service, and CNRS, ICube Laboratory UMR 7357 and FMTS, Team IMIS/Neurocrypto, University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
| | - Frederic Blanc
- Neuropsychology Unit, Neurology Service, and CNRS, ICube Laboratory UMR 7357 and FMTS, Team IMIS/Neurocrypto, University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
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23
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Tomadesso C, de La Sayette V, de Flores R, Bourgeat P, Villemagne VL, Egret S, Eustache F, Chételat G. Neuropsychology and neuroimaging profiles of amyloid-positive versus amyloid-negative amnestic mild cognitive impairment patients. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:269-277. [PMID: 29780872 PMCID: PMC5956939 DOI: 10.1016/j.dadm.2018.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction Patients with amnestic mild cognitive impairment (aMCI) are heterogeneous as regard to their amyloid status. The present study aimed at highlighting the neuropsychological, brain atrophy, and hypometabolism profiles of amyloid-positive (Aβpos) versus amyloid-negative (Aβneg) aMCI patients. Methods Forty-four aMCI patients and 24 Aβneg healthy controls underwent neuropsychological, structural magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography scans. Data were compared between groups in specific regions of interest and voxelwise with statistical parametric mapping. Results When directly comparing Aβpos to Aβneg aMCI, the former had lower performances in episodic memory tests (P = .02 to P < .001) while the latter had worse scores in working memory (P = .01) and language (P < .005). Compared to Aβneg healthy controls, both aMCI subgroups showed similar profiles of atrophy and hypometabolism, with no difference between both aMCI subgroups. Conclusion In a sample of aMCI patients recruited and scanned in the same center, the main difference at baseline between Aβpos and Aβneg aMCI concerned the neuropsychological profile, but not the structural magnetic resonance imaging or 18F-fluorodeoxyglucose positron emission tomography profiles of brain alterations. Amyloid-positive (Aβpos) amnestic mild cognitive impairment (aMCI) had lower performances than amyloid-negative (Aβneg) aMCI in episodic memory. Aβneg aMCI had lower performances than Aβpos aMCI in working memory and language. Aβneg and Aβpos aMCI did not differ in terms of brain atrophy or metabolism. Cognition is more efficient than neuroimaging to discriminate Aβneg from Aβpos aMCI.
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Affiliation(s)
- Clémence Tomadesso
- Inserm, Inserm U1077, Université de Caen Normandie, Ecole Pratique des Hautes Etudes, Caen, France.,Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Boulevard H. Becquerel, Caen, France
| | - Vincent de La Sayette
- Inserm, Inserm U1077, Université de Caen Normandie, Ecole Pratique des Hautes Etudes, Caen, France.,CHU de Caen, Service de Neurologie, Caen, France
| | - Robin de Flores
- Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Boulevard H. Becquerel, Caen, France
| | - Pierrick Bourgeat
- CSIRO Digital Productivity Flagship, The Australian e-Health Research Centre-BioMedIA, Herston, Queensland, Australia
| | - Victor L Villemagne
- Department of Molecular Imaging and Therapy, Centre for PET, Austin Health, Heidelberg, Victoria, Australia.,The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia
| | - Stéphanie Egret
- Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Boulevard H. Becquerel, Caen, France
| | - Francis Eustache
- Inserm, Inserm U1077, Université de Caen Normandie, Ecole Pratique des Hautes Etudes, Caen, France
| | - Gaël Chételat
- Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Boulevard H. Becquerel, Caen, France
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24
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Insular atrophy at the prodromal stage of dementia with Lewy bodies: a VBM DARTEL study. Sci Rep 2017; 7:9437. [PMID: 28842567 PMCID: PMC5573371 DOI: 10.1038/s41598-017-08667-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 07/12/2017] [Indexed: 11/25/2022] Open
Abstract
Diffuse atrophy including the insula was previously demonstrated in dementia with Lewy bodies (DLB) patients but little is known about the prodromal stage of DLB (pro-DLB). In this prospective study, we used SPM8-DARTEL to measure gray matter (GM) and white matter (WM) atrophy in pro-DLB patients (n = 54), prodromal Alzheimer’s disease (pro-AD) patients (n = 16), DLB patients at the stage of dementia (mild-DLB) (n = 15), and Alzheimer’s disease patients at the stage of dementia (mild-AD) (n = 28), and compared them with healthy elderly controls (HC, n = 22). Diminished GM volumes were found in bilateral insula in pro-DLB patients, a trend to significance in right hippocampus and parahippocampal gyrus in pro-AD patients, in left insula in mild-DLB patients, and in medial temporal lobes and insula in mild-AD patients. The comparison between prodromal groups did not showed any differences. The comparison between groups with dementia revealed atrophy around the left middle temporal gyrus in mild-AD patients. Reduced WM volume was observed in mild-DLB in the pons. The insula seems to be a key region in DLB as early as the prodromal stage. MRI studies looking at perfusion, and functional and anatomical connectivity are now needed to better understand the role of this region in DLB.
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25
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Malek N, Baker MR, Mann C, Greene J. Electroencephalographic markers in dementia. Acta Neurol Scand 2017; 135:388-393. [PMID: 27430350 DOI: 10.1111/ane.12638] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2016] [Indexed: 11/28/2022]
Abstract
Dementia is a global health problem with a huge impact on the lives of those afflicted. There are several distinct diseases that are classified under the umbrella term "dementia" ranging from neurodegenerative disorders such as Alzheimer's disease to chronic infections of the central nervous system such as subacute sclerosing panencephalitis (SSPE), a rare complication of measles virus infection in childhood. Clinical features, neuropsychological profiles and imaging characteristics of the various dementia syndromes can be sufficiently distinct to distinguish them from one another. However, in some cases, the cognitive, psychiatric and behavioural features can sufficiently overlap such that neurophysiologic testing may be of help. While it is recognized the electroencephalogram (EEG) may have a special role to play in the diagnosis of certain dementing illnesses such as SSPE and Creutzfeldt-Jakob disease (CJD) that have characteristic EEG changes, current research focusses on the potential utility of quantitative EEG as one more tool in the armamentarium of clinicians dealing with patients who suffer from a dementing illness. We searched PubMed and the Cochrane Database from 1 January 1946 up to 1 January 2016, combining the search terms "EEG," "electroencephalography," "dementia" and "status epilepticus"; identified papers from these searches were then read in detail and summarized. Here, we discuss both the qualitative and quantitative EEG findings in the various types of dementia.
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Affiliation(s)
- N. Malek
- Department of Neurology; Institute of Neurological Sciences; Queen Elizabeth University Hospital; Glasgow UK
| | - M. R. Baker
- Department of Neurology; Royal Victoria Infirmary; Newcastle -upon-Tyne UK
- Department of Clinical Neurophysiology; Royal Victoria Infirmary; Newcastle -upon-Tyne UK
- Institute of Neuroscience; Newcastle University; Newcastle -upon-Tyne UK
| | - C. Mann
- Department of Neurophysiology; Institute of Neurological Sciences; Queen Elizabeth University Hospital; Glasgow UK
| | - J. Greene
- Department of Neurology; Institute of Neurological Sciences; Queen Elizabeth University Hospital; Glasgow UK
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26
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Kemp J, Philippi N, Phillipps C, Demuynck C, Albasser T, Martin-Hunyadi C, Schmidt-Mutter C, Cretin B, Blanc F. Cognitive profile in prodromal dementia with Lewy bodies. ALZHEIMERS RESEARCH & THERAPY 2017; 9:19. [PMID: 28302161 PMCID: PMC5356316 DOI: 10.1186/s13195-017-0242-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 02/06/2017] [Indexed: 01/18/2023]
Abstract
Background Cortical and subcortical cognitive impairments have been found in dementia with Lewy bodies (DLB). Roughly, they comprise visuoconstructive and executive dysfunction, whereas memory would remain relatively spared. However, the cognitive profile of patients with prodromal DLB remains poorly illustrated to date. Methods We included 37 patients with prodromal DLB (age 67.2 ± 8.6 years, 18 men, Mini Mental State Examination [MMSE] score 27.4 ± 2) and 29 healthy control subjects (HCs; age 68.8 ± 7.9 years, 15 men, MMSE score 29.0 ± 0.9). They were presented with an extensive neuropsychological test battery to assess memory; speed of processing; executive function; visuoperceptual, visuospatial and visuoconstructive abilities; language; and social cognition. Results Compared with HCs, patients had lower scores on a visual recognition memory test (Delayed Matching to Sample-48 items; p ≤ 0.021) and lower free recall (all p ≤ 0.035), but not total recall, performance on a verbal episodic memory test (Free and Cued Selective Reminding Test). Short-term memory (p = 0.042) and working memory (p = 0.002) scores were also lower in patients. Assessment of executive function showed no slowing but overall lower performance in patients than in HCs (all p ≤ 0.049), whereas assessment of instrumental function yielded mixed results. Indeed, patients had lower scores on language tests (p ≤ 0.022), apraxia for pantomime of tool use (p = 0.002) and imitation of meaningless gesture (p = 0.005), as well as weakened visuospatial abilities (p = 0.047). Visuoconstruction was also impaired in patients. However, visuoperceptual abilities did not differ between groups. Finally, theory of mind abilities were lower in patients than in HCs (p < 0.05), but their emotion recognition abilities were similar. Conclusions This study presents the cognitive profile in patients with prodromal DLB. In line with the literature on DLB with dementia, our results show lower performance on tests of executive function and visuoconstruction. However, we found, from a prodromal stage of DLB, memory (free recall and visual recognition) and social cognition deficits, as well as weakened visuospatial and praxic abilities.
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Affiliation(s)
- Jennifer Kemp
- Neuropsychology Unit, Neurology Department, University Hospitals of Strasbourg, Strasbourg, France. .,Geriatrics Department, University Hospitals of Strasbourg, Geriatric Day Hospital, Strasbourg, France. .,CMRR (Memory Resources and Research Center), University Hospitals of Strasbourg, Strasbourg, France. .,Team IMIS/Neurocrypto, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), University Hospitals of Strasbourg and CNRS, Strasbourg, France.
| | - Nathalie Philippi
- Neuropsychology Unit, Neurology Department, University Hospitals of Strasbourg, Strasbourg, France.,Geriatrics Department, University Hospitals of Strasbourg, Geriatric Day Hospital, Strasbourg, France.,CMRR (Memory Resources and Research Center), University Hospitals of Strasbourg, Strasbourg, France.,Team IMIS/Neurocrypto, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), University Hospitals of Strasbourg and CNRS, Strasbourg, France
| | - Clélie Phillipps
- Neuropsychology Unit, Neurology Department, University Hospitals of Strasbourg, Strasbourg, France.,Geriatrics Department, University Hospitals of Strasbourg, Geriatric Day Hospital, Strasbourg, France.,CMRR (Memory Resources and Research Center), University Hospitals of Strasbourg, Strasbourg, France
| | - Catherine Demuynck
- Neuropsychology Unit, Neurology Department, University Hospitals of Strasbourg, Strasbourg, France.,Geriatrics Department, University Hospitals of Strasbourg, Geriatric Day Hospital, Strasbourg, France.,CMRR (Memory Resources and Research Center), University Hospitals of Strasbourg, Strasbourg, France
| | - Timothée Albasser
- Neuropsychology Unit, Neurology Department, University Hospitals of Strasbourg, Strasbourg, France.,Geriatrics Department, University Hospitals of Strasbourg, Geriatric Day Hospital, Strasbourg, France.,CMRR (Memory Resources and Research Center), University Hospitals of Strasbourg, Strasbourg, France
| | - Catherine Martin-Hunyadi
- Neuropsychology Unit, Neurology Department, University Hospitals of Strasbourg, Strasbourg, France.,Geriatrics Department, University Hospitals of Strasbourg, Geriatric Day Hospital, Strasbourg, France.,CMRR (Memory Resources and Research Center), University Hospitals of Strasbourg, Strasbourg, France
| | - Catherine Schmidt-Mutter
- INSERM Centre d'Investigation Clinique-1434, University Hospitals of Strasbourg, Strasbourg, France
| | - Benjamin Cretin
- Neuropsychology Unit, Neurology Department, University Hospitals of Strasbourg, Strasbourg, France.,Geriatrics Department, University Hospitals of Strasbourg, Geriatric Day Hospital, Strasbourg, France.,CMRR (Memory Resources and Research Center), University Hospitals of Strasbourg, Strasbourg, France.,Team IMIS/Neurocrypto, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), University Hospitals of Strasbourg and CNRS, Strasbourg, France
| | - Frédéric Blanc
- Neuropsychology Unit, Neurology Department, University Hospitals of Strasbourg, Strasbourg, France.,Geriatrics Department, University Hospitals of Strasbourg, Geriatric Day Hospital, Strasbourg, France.,CMRR (Memory Resources and Research Center), University Hospitals of Strasbourg, Strasbourg, France.,Team IMIS/Neurocrypto, ICube Laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), University Hospitals of Strasbourg and CNRS, Strasbourg, France.,INSERM Centre d'Investigation Clinique-1434, University Hospitals of Strasbourg, Strasbourg, France
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27
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Roalf DR, Moberg MJ, Turetsky BI, Brennan L, Kabadi S, Wolk DA, Moberg PJ. A quantitative meta-analysis of olfactory dysfunction in mild cognitive impairment. J Neurol Neurosurg Psychiatry 2017; 88:226-232. [PMID: 28039318 PMCID: PMC5350628 DOI: 10.1136/jnnp-2016-314638] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/08/2016] [Accepted: 12/05/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND The connection between Alzheimer's disease (AD) and olfactory deficits is well documented and further, alterations in olfactory functioning may signal declines in functions associated with dementia. The aim of the present comprehensive meta-analysis was to investigate the nature of olfactory deficits in mild cognitive impairment (MCI). METHODS Articles were identified through computerised literature search from inception to 30 June 2016 using PubMed, MEDLINE and PsychInfo databases. In order to control for differences in sample size during effect size computation, studies were weighted according to their inverse variance estimates. RESULTS 31 articles (62 effects) were identified, which included 1993 MCI patients and 2861 healthy older adults (HOA). Included studies contrasted odour identification, discrimination, detection threshold and/or memory between cases and controls. Moderate to large and heterogeneous effects were seen for olfactory deficits in MCI relative to HOA (d=-0.76, 95% CI -0.87<δ<-0.64). Moderator analysis revealed that tests of odour identification yielded larger effect sizes than those of odour detection threshold or memory. In addition, a potential interaction between age and sex was observed, with male patients carrying a larger burden of olfactory deficit and older female patients performing better on olfactory tests. CONCLUSIONS AND RELEVANCE Olfactory deficits are present and robust in MCI. Odour identification is most impaired in MCI, which parallels the most prominent sensory deficit seen in AD. As such, a simple-to-administer test of odour identification warrants inclusion in the screening of individuals at risk for developing AD.
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Affiliation(s)
- David R Roalf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Madelyn J Moberg
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Bruce I Turetsky
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Laura Brennan
- Department of Neurology, Drexel University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Sushila Kabadi
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David A Wolk
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Paul J Moberg
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.,Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Blanc F, Colloby SJ, Cretin B, de Sousa PL, Demuynck C, O’Brien JT, Martin-Hunyadi C, McKeith I, Philippi N, Taylor JP. Grey matter atrophy in prodromal stage of dementia with Lewy bodies and Alzheimer's disease. Alzheimers Res Ther 2016; 8:31. [PMID: 27484179 PMCID: PMC4970221 DOI: 10.1186/s13195-016-0198-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 06/29/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Little is known about the patterns of brain atrophy in prodromal dementia with Lewy bodies (pro-DLB). METHODS In this study, we used SPM8 with diffeomorphic anatomical registration through exponentiated lie algebra to measure grey matter (GM) volume and investigate patterns of GM atrophy in pro-DLB (n = 28) and prodromal Alzheimer's disease (pro-AD) (n = 27) and compared and contrasted them with those in elderly control subjects (n = 33) (P ≤ 0.05 corrected for family-wise error). RESULTS Patients with pro-DLB showed diminished GM volumes of bilateral insulae and right anterior cingulate cortex compared with control subjects. Comparison of GM volume between patients with pro-AD and control subjects showed a more extensive pattern, with volume reductions in temporal (hippocampi and superior and middle gyri), parietal and frontal structures in the former. Direct comparison of prodromal groups suggested that more atrophy was evident in the parietal lobes of patients with pro-AD than patients with pro-DLB. In patients with pro-DLB, we found that visual hallucinations were associated with relative atrophy of the left cuneus. CONCLUSIONS Atrophy in pro-DLB involves the insulae and anterior cingulate cortex, regions rich in von Economo neurons, which we speculate may contribute to the early clinical phenotype of pro-DLB.
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Affiliation(s)
- Frederic Blanc
- Geriatrics day hospital and neuropsychology unit. Geriatrics department and Neurology service, Memory Resources and Research Centre (CMRR), University Hospital of Strasbourg, Strasbourg, France
- Team IMIS/Neurocrypto, French National Center for Scientific Research (CNRS), ICube Laboratory and Fédération de Médecine Translationnelle de Strasbourg (FMTS), University of Strasbourg, Strasbourg, France
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Sean J. Colloby
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Benjamin Cretin
- Geriatrics day hospital and neuropsychology unit. Geriatrics department and Neurology service, Memory Resources and Research Centre (CMRR), University Hospital of Strasbourg, Strasbourg, France
- Team IMIS/Neurocrypto, French National Center for Scientific Research (CNRS), ICube Laboratory and Fédération de Médecine Translationnelle de Strasbourg (FMTS), University of Strasbourg, Strasbourg, France
| | - Paulo Loureiro de Sousa
- Team IMIS/Neurocrypto, French National Center for Scientific Research (CNRS), ICube Laboratory and Fédération de Médecine Translationnelle de Strasbourg (FMTS), University of Strasbourg, Strasbourg, France
| | - Catherine Demuynck
- Geriatrics day hospital and neuropsychology unit. Geriatrics department and Neurology service, Memory Resources and Research Centre (CMRR), University Hospital of Strasbourg, Strasbourg, France
| | - John T. O’Brien
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Catherine Martin-Hunyadi
- Geriatrics day hospital and neuropsychology unit. Geriatrics department and Neurology service, Memory Resources and Research Centre (CMRR), University Hospital of Strasbourg, Strasbourg, France
| | - Ian McKeith
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Nathalie Philippi
- Geriatrics day hospital and neuropsychology unit. Geriatrics department and Neurology service, Memory Resources and Research Centre (CMRR), University Hospital of Strasbourg, Strasbourg, France
- Team IMIS/Neurocrypto, French National Center for Scientific Research (CNRS), ICube Laboratory and Fédération de Médecine Translationnelle de Strasbourg (FMTS), University of Strasbourg, Strasbourg, France
| | - John-Paul Taylor
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, UK
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Rapid eye movement sleep disruption and sleep fragmentation are associated with increased orexin-A cerebrospinal-fluid levels in mild cognitive impairment due to Alzheimer's disease. Neurobiol Aging 2016; 40:120-126. [DOI: 10.1016/j.neurobiolaging.2016.01.007] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 01/11/2016] [Accepted: 01/13/2016] [Indexed: 01/30/2023]
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Blanc F, Colloby SJ, Philippi N, de Pétigny X, Jung B, Demuynck C, Phillipps C, Anthony P, Thomas A, Bing F, Lamy J, Martin-Hunyadi C, O'Brien JT, Cretin B, McKeith I, Armspach JP, Taylor JP. Cortical Thickness in Dementia with Lewy Bodies and Alzheimer's Disease: A Comparison of Prodromal and Dementia Stages. PLoS One 2015; 10:e0127396. [PMID: 26061655 PMCID: PMC4489516 DOI: 10.1371/journal.pone.0127396] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/15/2015] [Indexed: 11/18/2022] Open
Abstract
Objectives To assess and compare cortical thickness (CTh) of patients with prodromal Dementia with Lewy bodies (pro-DLB), prodromal Alzheimer's disease (pro-AD), DLB dementia (DLB-d), AD dementia (AD-d) and normal ageing. Methods Study participants(28 pro-DLB, 27 pro-AD, 31 DLB-d, 54 AD-d and 33 elderly controls) underwent 3Tesla T1 3D MRI and detailed clinical and cognitive assessments. We used FreeSurfer analysis package to measure CTh and investigate patterns of cortical thinning across groups. Results Comparison of CTh between pro-DLB and pro-AD (p<0.05, FDR corrected) showed more right anterior insula thinning in pro-DLB, and more bilateral parietal lobe and left parahippocampal gyri thinning in pro-AD. Comparison of prodromal patients to healthy elderly controls showed the involvement of the same regions. In DLB-d (p<0.05, FDR corrected) cortical thinning was found predominantly in the right temporo-parietal junction, and insula, cingulate, orbitofrontal and lateral occipital cortices. In AD-d(p<0.05, FDR corrected),the most significant areas affected included the entorhinal cortices, parahippocampal gyri and parietal lobes. The comparison of AD-d and DLB-d demonstrated more CTh in AD-d in the left entorhinal cortex (p<0.05, FDR corrected). Conclusion Cortical thickness is a sensitive measure for characterising patterns of grey matter atrophy in early stages of DLB distinct from AD. Right anterior insula involvement may be a key region at the prodromal stage of DLB and needs further investigation.
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Affiliation(s)
- Frederic Blanc
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
- * E-mail:
| | - Sean J. Colloby
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Nathalie Philippi
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Xavier de Pétigny
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Barbara Jung
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Catherine Demuynck
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Clélie Phillipps
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Pierre Anthony
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Alan Thomas
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fabrice Bing
- University Hospital of Strasbourg, Neuroradiology Service, Strasbourg, France
| | - Julien Lamy
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
| | - Catherine Martin-Hunyadi
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - John T. O'Brien
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Benjamin Cretin
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Ian McKeith
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jean-Paul Armspach
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
| | - John-Paul Taylor
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
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Yoon JH, Kim M, Moon SY, Yong SW, Hong JM. Olfactory function and neuropsychological profile to differentiate dementia with Lewy bodies from Alzheimer's disease in patients with mild cognitive impairment: A 5-year follow-up study. J Neurol Sci 2015; 355:174-9. [PMID: 26076880 DOI: 10.1016/j.jns.2015.06.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 06/05/2015] [Accepted: 06/08/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a well-known precursor of Alzheimer's disease (AD) but often also precedes dementia with Lewy bodies (DLB). The early differentiation of DLB from AD is important to delay disease progression. Olfactory dysfunction is a well-known early sign of both AD and Lewy body disorders, including Parkinson's disease (PD) and DLB. Thus, the aim of the present study was to determine whether olfactory and neuropsychological tests can aid in the differentiation of DLB from AD at the MCI stage. METHODS The present study included 122 MCI patients who were monitored until they developed dementia or until their condition stabilized; the follow-up period averaged 4.9 years (range: 3.9-6.2 years). Baseline olfactory function as measured with the Cross-Cultural Smell Identification (CCSI) test and neuropsychological data were compared. RESULTS During the follow-up period, 32 subjects developed probable AD (MCI-AD), 18 had probable DLB (MCI-DLB), 45 did not convert to dementia (MCI-stable), and eight developed a non-AD/DLB dementia. The mean CCSI score (95% confidence interval [CI]) in patients with MCI-DLB (4.6; 95% CI: 4.0-5.3) was significantly lower than that of MCI-AD patients (6.4; 95% CI: 6.0-6.7, p<0.001) and MCI-stable patients (7.3; 95% CI: 6.9-7.8, p<0.001). The area under the curve of the receiver operating characteristic to discriminate MCI-DLB from MCI-AD using CCSI scores was (0.84; 95% CI: 0.72-0.97). Frontal-executive function and visuospatial ability was worse in patients with MCI-DLB, while verbal recognition memory impairment was greater in those with MCI-AD. CONCLUSION Olfactory and neuropsychological tests can help predict conversion to DLB or AD in patients with MCI.
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Affiliation(s)
- Jung Han Yoon
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea.
| | - Min Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Seok Woo Yong
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Ji Man Hong
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
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Chung EJ, Kim SJ. (123)I-Metaiodobenzylguanidine Myocardial Scintigraphy in Lewy Body-Related Disorders: A Literature Review. J Mov Disord 2015; 8:55-66. [PMID: 26090077 PMCID: PMC4460541 DOI: 10.14802/jmd.15015] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/28/2015] [Accepted: 05/04/2015] [Indexed: 01/18/2023] Open
Abstract
Lewy body-related disorders are characterized by the presence of Lewy bodies and Lewy neurites, which have abnormal aggregations of α-synuclein in the nigral and extranigral areas, including in the heart. 123I-metaiodobenzylguanidine (MIBG) scintigraphy is a well-known tool to evaluate cardiac sympathetic denervation in the Lewy body-related disorders. MIBG scintigraphy showed low uptake of MIBG in the Lewy body-related disorders, including Parkinson’s disease, dementia with Lewy bodies, pure autonomic failure and rapid eye movement sleep behavior disorder. This review summarizes previous results on the diagnostic applications of MIBG scintigraphy in Lewy body-related disorders.
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Affiliation(s)
- Eun Joo Chung
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang Jin Kim
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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Fujishiro H, Nakamura S, Sato K, Iseki E. Prodromal dementia with Lewy bodies. Geriatr Gerontol Int 2015; 15:817-26. [PMID: 25690399 DOI: 10.1111/ggi.12466] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2014] [Indexed: 11/26/2022]
Abstract
Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementing disorder after Alzheimer's disease (AD), but there is limited information regarding the prodromal DLB state compared with that of AD. Parkinson's disease (PD) and DLB share common prodromal symptoms with Lewy body disease (LBD), allowing us to use a common strategy for identifying the individuals with an underlying pathophysiology of LBD. Dysautonomia, olfactory dysfunction, rapid eye movement sleep behavior disorder (RBD) and psychiatric symptoms antedate the onset of dementia by years or even decades in patients with DLB. Although RBD is the most potentially accurate prodromal predictor of DLB, disease progression before the onset of dementia could differ between the prodromal DLB state with and without RBD. Experts who specialize in idiopathic RBD and DLB might need communication in order to clarify the clinical relevance of RBD with the disease progression of DLB. The presence of prodromal LBD symptoms or findings of occipital hypoperfusion/hypometabolism helps us to predict the possible pathophysiological process of LBD in non-demented patients. This approach might provide the opportunity for additional neuroimaging, including cardiac (123) I-metaiodobenzylguanidine scintigraphy and dopamine transporter imaging. Although limited radiological findings in patients with prodromal DLB states have been reported, there is now a need for larger clinical multisite studies with pathological verification. The long prodromal phase of DLB provides a critical opportunity for potential intervention with disease-modifying therapy, but only if we are able to clearly identify the diversity in the clinical courses of DLB. In the present article, we reviewed the limited literature regarding the clinical profiles of prodromal DLB.
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Affiliation(s)
- Hiroshige Fujishiro
- Department of Sleep Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Kiyoshi Sato
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Koto, Japan
| | - Eizo Iseki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Koto, Japan
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Cagnin A, Bussè C, Jelcic N, Gnoato F, Mitolo M, Caffarra P. High specificity of MMSE pentagon scoring for diagnosis of prodromal dementia with Lewy bodies. Parkinsonism Relat Disord 2014; 21:303-5. [PMID: 25547859 DOI: 10.1016/j.parkreldis.2014.12.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/20/2014] [Accepted: 12/06/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patients with dementia with Lewy bodies (DLB) may display a different cognitive pattern from Alzheimer's disease (AD) with more severe impairment performing visuospatial/visuoconstructive tasks. The aim of this study was to investigate whether the analysis of the MMSE pentagon copy could be a useful diagnostic screening tool in prodromal DLB. METHODS Fifty-three patients with Mild Cognitive Impairment (MCI) were followed over 3-years until a diagnosis of DLB (MCI-DLB: n = 30) and AD (MCI-AD: n = 23) were made according to standard criteria. At the first assessment patients underwent a thorough cognitive assessment including the Qualitative Scoring MMSE Pentagon Test (QSPT), the NPI, the UPDRS as well as questionnaires to determine fluctuations and sleep disorders. RESULTS The percentage of subjects who were unable to determine the correct number of angles in the pentagon copy test was 45.1% of MCI-DLB and 8.3% of MCI-AD patients (sensitivity 41.1%; specificity 91%). Attentive/executive functions and visual-spatial abilities were worse in the MCI-DLB group, while episodic memory impairment was greater in MCI-AD. Subtle extrapyramidal signs (63%) and RBD symptoms (56%) were the most frequent clinical features supporting the diagnosis of MCI-DLB. CONCLUSIONS We suggest that a poor performance in determining the number of angles when performing the pentagon copying test, together with the presence of subtle extrapyramidal signs and symptoms of RBD may serve as a predictive tool for early DLB.
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Affiliation(s)
- Annachiara Cagnin
- Department of Neurosciences, SNPSRR, University of Padova, Padova, Italy; IRCCS San Camillo Research Hospital, Venice, Italy.
| | - Cinzia Bussè
- Department of Neurosciences, SNPSRR, University of Padova, Padova, Italy
| | - Nela Jelcic
- IRCCS San Camillo Research Hospital, Venice, Italy
| | - Francesca Gnoato
- Department of Neurosciences, SNPSRR, University of Padova, Padova, Italy
| | - Micaela Mitolo
- Department of Psychology, University of Padova, Padova, Italy
| | - Paolo Caffarra
- Department of Neuroscience, University of Parma and Center for Cognitive Disorders, AUSL of Parma, Parma, Italy
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Insulin resistance in Alzheimer's disease. Neurobiol Dis 2014; 72 Pt A:92-103. [PMID: 25237037 DOI: 10.1016/j.nbd.2014.09.001] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 09/02/2014] [Accepted: 09/05/2014] [Indexed: 12/16/2022] Open
Abstract
Insulin is a key hormone regulating metabolism. Insulin binding to cell surface insulin receptors engages many signaling intermediates operating in parallel and in series to control glucose, energy, and lipids while also regulating mitogenesis and development. Perturbations in the function of any of these intermediates, which occur in a variety of diseases, cause reduced sensitivity to insulin and insulin resistance with consequent metabolic dysfunction. Chronic inflammation ensues which exacerbates compromised metabolic homeostasis. Since insulin has a key role in learning and memory as well as directly regulating ERK, a kinase required for the type of learning and memory compromised in early Alzheimer's disease (AD), insulin resistance has been identified as a major risk factor for the onset of AD. Animal models of AD or insulin resistance or both demonstrate that AD pathology and impaired insulin signaling form a reciprocal relationship. Of note are human and animal model studies geared toward improving insulin resistance that have led to the identification of the nuclear receptor and transcription factor, peroxisome proliferator-activated receptor gamma (PPARγ) as an intervention tool for early AD. Strategic targeting of alternate nodes within the insulin signaling network has revealed disease-stage therapeutic windows in animal models that coalesce with previous and ongoing clinical trial approaches. Thus, exploiting the connection between insulin resistance and AD provides powerful opportunities to delineate therapeutic interventions that slow or block the pathogenesis of AD.
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Zhang B, Ferman TJ, Boeve BF, Smith GE, Maroney-Smith M, Spychalla AJ, Knopman DS, Jack CR, Petersen RC, Kantarci K. MRS in mild cognitive impairment: early differentiation of dementia with Lewy bodies and Alzheimer's disease. J Neuroimaging 2014; 25:269-274. [PMID: 25039916 DOI: 10.1111/jon.12138] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 03/09/2014] [Accepted: 03/31/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND PURPOSE Mild cognitive impairment (MCI) precedes both Alzheimer's disease (AD) dementia and with Lewy bodies (DLB). We investigated proton magnetic resonance spectroscopy (MRS) characteristics of MCI patients who progressed to DLB compared to those who progressed to AD dementia or remained stable. METHODS Consecutive MCI patients who underwent single voxel MRS at baseline and progressed to DLB (n = 10) were identified during a median follow-up period of 18 months. From the same cohort, we identified age- and sex-matched MCI patients who progressed to AD dementia (n = 27) or remained stable (n = 20) during a similar follow-up period. This study was approved by the Institutional Review Board and informed consent was from every subject. RESULTS MCI patients who progressed to AD dementia were characterized by lower N-acetylaspartate (NAA)/Cr ratio in the posterior cingulate voxel compared to those who progressed to DLB (P = .001). Decreased NAA/Cr in the posterior cingulate voxel differentiated MCI patients who progressed to DLB from those who progressed to AD with an area under the receiver operating characteristic curve of .85 (P < .001) on logistic regression analysis. CONCLUSIONS MRS may be useful in differentiating MCI patients with prodromal AD dementia from those with prodromal DLB for early disease-specific interventions.
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Affiliation(s)
- Bing Zhang
- Department of Radiology, Mayo Clinic, Rochester, MN.,Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Tanis J Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL
| | | | - Glenn E Smith
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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Bonanni L, Perfetti B, Bifolchetti S, Taylor JP, Franciotti R, Parnetti L, Thomas A, Onofrj M. Quantitative electroencephalogram utility in predicting conversion of mild cognitive impairment to dementia with Lewy bodies. Neurobiol Aging 2014; 36:434-45. [PMID: 25129239 PMCID: PMC4270449 DOI: 10.1016/j.neurobiolaging.2014.07.009] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 06/19/2014] [Accepted: 07/08/2014] [Indexed: 11/25/2022]
Abstract
Mild cognitive impairment (MCI) as a precursor of dementia with Lewy bodies (DLB) is the focus of recent research, trying to explore the early mechanisms and possible biomarkers of DLB. Quantitative electroencephalogram (QEEG) methods are able to differentiate early DLB from Alzheimer's disease (AD). The aim of the present study was to assess whether QEEG abnormalities, characterized by dominant frequency <8 Hz and dominant frequency variability >1.5 Hz, typical of early DLB, are already present at the stage of MCI and to evaluate whether EEG abnormalities can predict the development of DLB. Forty-seven MCI subjects were followed for 3 years. EEG recordings were obtained at admission and at the end of the study. At the end of follow-up, 20 subjects had developed probable DLB (MCI-DLB), 14 had probable AD (MCI-AD), 8 did not convert to dementia, 5 developed a non-AD/DLB dementia. One hundred percent of MCI-DLB showed EEG abnormalities at admission. Ninety three percent of MCI-AD maintained a normal EEG throughout the study. QEEG may represent a powerful tool to predict the progression from MCI to DLB with a sensitivity and specificity close to 100%. We studied in mild cognitive impairment (MCI) subjects the predictive value of electroencephalogram (EEG) alterations for the development of dementia with Lewy bodies (DLB). One hundred percent of MCI subjects converted to DLB already had EEG alterations typical of DLB (dominant frequency <8 Hz and dominant frequency variability ≥1.5 Hz) at admission to the study. Quantitative EEG may represent a powerful tool to predict the progression from MCI to DLB.
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Affiliation(s)
- Laura Bonanni
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Aging Research Centre, Ce.S.I., G. d'Annunzio University Foundation, Chieti, Italy.
| | - Bernardo Perfetti
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Aging Research Centre, Ce.S.I., G. d'Annunzio University Foundation, Chieti, Italy
| | - Stefania Bifolchetti
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Aging Research Centre, Ce.S.I., G. d'Annunzio University Foundation, Chieti, Italy
| | - John-Paul Taylor
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Raffaella Franciotti
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Institute for Advanced Biomedical Technologies (ITAB), G. d'Annunzio University Foundation, Chieti, Italy
| | - Lucilla Parnetti
- Center for Memory Disturbances and Alzheimer's Center, Section of Neurology, University of Perugia, Perugia, Italy
| | - Astrid Thomas
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Aging Research Centre, Ce.S.I., G. d'Annunzio University Foundation, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy; Aging Research Centre, Ce.S.I., G. d'Annunzio University Foundation, Chieti, Italy
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Busse S, Brix B, Kunschmann R, Bogerts B, Stoecker W, Busse M. N-methyl-d-aspartate glutamate receptor (NMDA-R) antibodies in mild cognitive impairment and dementias. Neurosci Res 2014; 85:58-64. [PMID: 24973618 DOI: 10.1016/j.neures.2014.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/06/2014] [Accepted: 06/12/2014] [Indexed: 01/07/2023]
Abstract
The N-methyl-d-aspartate glutamate receptor (NMDA-R) plays a central role in learning and memory and has therefore a potential role in the pathophysiology of neuropsychiatric disorders. Recently, we detected NMDA-R autoantibodies in aged healthy volunteers without neuropsychiatric disorders. Since studies showing the involvement of NMDA-R antibodies in mild cognitive impairment and different forms of dementia are rare, we examined NMDA-R antibodies (Abs) in serum of 46 patients with Alzheimer's disease (AD), 26 patients with subcortical ischemic vascular dementia (SIVD), 18 patients with frontotemporal dementia (FTD), 11 patients with Lewy body disease (LBD) and 33 patients with mild cognitive impairment (MCI) and in 21 healthy aged, gender-matched volunteers. While IgM and/or IgA NMDA-R Abs were present in all groups, IgG was only detected in one AD sample. Seropositivity could be correlated with the presence of co-symptoms: MCI and AD patients suffering from depression and AD and SIVD patients with a psychosis were almost all NMDA-R Ab positive. We conclude that the presence of NMDA-R Abs in dementia could influence the incidence of comorbid depressive and/or psychotic states.
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Affiliation(s)
- Stefan Busse
- Department of Psychiatry, University of Magdeburg, Magdeburg, Germany.
| | - Britta Brix
- Institute for Experimental Immunology, Affiliated to Euroimmun, Lübeck, Lübeck, Germany
| | - Ralf Kunschmann
- Department of Psychiatry, University of Magdeburg, Magdeburg, Germany
| | - Bernhard Bogerts
- Department of Psychiatry, University of Magdeburg, Magdeburg, Germany; Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Winfried Stoecker
- Institute for Experimental Immunology, Affiliated to Euroimmun, Lübeck, Lübeck, Germany
| | - Mandy Busse
- Department of Pediatric Pulmonology & Allergology, Medical University of Hannover, Hannover, Germany
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Preclinical polymodal hallucinations for 13 years before dementia with Lewy bodies. Behav Neurol 2014; 2014:694296. [PMID: 24868122 PMCID: PMC4020531 DOI: 10.1155/2014/694296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 11/29/2013] [Indexed: 01/08/2023] Open
Abstract
Objective. We describe a case of dementia with Lewy bodies (DLB) that presented long-lasting preclinical complex polymodal hallucinations. Background. Few studies have deeply investigated the characteristics of hallucinations in DLB, especially in the preclinical phase. Moreover, the clinical phenotype of mild cognitive impairment-(MCI-) DLB is poorly understood. Methods. The patient was followed for 4 years and a selective phenomenological and cognitive study was performed at the predementia stage. Results. The phenomenological study showed the presence of hypnagogic and hypnopompic hallucinations that allowed us to make a differential diagnosis between DLB and Charles Bonnet syndrome (CBS). The neuropsychological evaluation showed a multiple domain without amnesia MCI subtype with prefrontal dysexecutive, visuoperceptual, and visuospatial impairments and simultanagnosia, which has not previously been reported in MCI-DLB. Conclusions. This study extends the prognostic value of hallucinations for DLB to the preclinical phases. It supports and refines the MCI-DLB concept and identifies simultanagnosia as a possible early cognitive marker. Finally, it confirms an association between hallucinations and visuoperceptual impairments at an intermediate stage of the disease course and strongly supports the hypothesis that hallucinations in the earliest stages of DLB may reflect a narcolepsy-like REM-sleep disorder.
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Gilbert BJ. Republished: The role of amyloid β in the pathogenesis of Alzheimer's disease. Postgrad Med J 2014; 90:113-7. [DOI: 10.1136/postgradmedj-2013-201515rep] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Rolma G, Jelcic N, Gnoato F, Cecchin D, Cagnin A. Combined duloxetine and benzodiazepine-induced visual hallucinations in prodromal dementia with Lewy bodies. Gen Hosp Psychiatry 2013; 35:678.e7-9. [PMID: 23523020 DOI: 10.1016/j.genhosppsych.2013.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 02/12/2013] [Accepted: 02/12/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We describe a patient with prodromal dementia with Lewy bodies (DLB) presenting with drug-induced visual hallucinations (VHs). CASE REPORT A 78-year-old woman complained of daytime recurrent VHs characterized by seeing her face and arms covered in fur and viewing moustaches on her daughter's face. VHs started a few days after the beginning of a combination therapy with duloxetine and lorazepam and ceased within 24 h after their discontinuation. Nonamnestic mild cognitive impairment with profound visual perception deficits and very mild extrapyramidal signs, with abnormal brain DaTscan single photon emission tomography, were present. Three years later, cognitive and neurological follow-up assessments supported the diagnosis of DLB. CONCLUSION Perturbation of cerebral serotonergic tone induced by duloxetine, associated with reduced attentional control due to benzodiazepine use, may be the physiopathological substrate of transient VHs in prodromal DLB.
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Affiliation(s)
- Giacomo Rolma
- Department of Neurosciences: Sciences NPSRR, University of Padova, Padova, Italy
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Schenck CH, Montplaisir JY, Frauscher B, Hogl B, Gagnon JF, Postuma R, Sonka K, Jennum P, Partinen M, Arnulf I, Cochen de Cock V, Dauvilliers Y, Luppi PH, Heidbreder A, Mayer G, Sixel-Döring F, Trenkwalder C, Unger M, Young P, Wing YK, Ferini-Strambi L, Ferri R, Plazzi G, Zucconi M, Inoue Y, Iranzo A, Santamaria J, Bassetti C, Möller JC, Boeve BF, Lai YY, Pavlova M, Saper C, Schmidt P, Siegel JM, Singer C, St Louis E, Videnovic A, Oertel W. Rapid eye movement sleep behavior disorder: devising controlled active treatment studies for symptomatic and neuroprotective therapy--a consensus statement from the International Rapid Eye Movement Sleep Behavior Disorder Study Group. Sleep Med 2013; 14:795-806. [PMID: 23886593 DOI: 10.1016/j.sleep.2013.02.016] [Citation(s) in RCA: 164] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 01/25/2013] [Accepted: 02/22/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES We aimed to provide a consensus statement by the International Rapid Eye Movement Sleep Behavior Disorder Study Group (IRBD-SG) on devising controlled active treatment studies in rapid eye movement sleep behavior disorder (RBD) and devising studies of neuroprotection against Parkinson disease (PD) and related neurodegeneration in RBD. METHODS The consensus statement was generated during the fourth IRBD-SG symposium in Marburg, Germany in 2011. The IRBD-SG identified essential methodologic components for a randomized trial in RBD, including potential screening and diagnostic criteria, inclusion and exclusion criteria, primary and secondary outcomes for symptomatic therapy trials (particularly for melatonin and clonazepam), and potential primary and secondary outcomes for eventual trials with disease-modifying and neuroprotective agents. The latter trials are considered urgent, given the high conversion rate from idiopathic RBD (iRBD) to Parkinsonian disorders (i.e., PD, dementia with Lewy bodies [DLB], multiple system atrophy [MSA]). RESULTS Six inclusion criteria were identified for symptomatic therapy and neuroprotective trials: (1) diagnosis of RBD needs to satisfy the International Classification of Sleep Disorders, second edition, (ICSD-2) criteria; (2) minimum frequency of RBD episodes should preferably be ⩾2 times weekly to allow for assessment of change; (3) if the PD-RBD target population is included, it should be in the early stages of PD defined as Hoehn and Yahr stages 1-3 in Off (untreated); (4) iRBD patients with soft neurologic dysfunction and with operational criteria established by the consensus of study investigators; (5) patients with mild cognitive impairment (MCI); and (6) optimally treated comorbid OSA. Twenty-four exclusion criteria were identified. The primary outcome measure for RBD treatment trials was determined to be the Clinical Global Impression (CGI) efficacy index, consisting of a four-point scale with a four-point side-effect scale. Assessment of video-polysomnographic (vPSG) changes holds promise but is costly and needs further elaboration. Secondary outcome measures include sleep diaries; sleepiness scales; PD sleep scale 2 (PDSS-2); serial motor examinations; cognitive indices; mood and anxiety indices; assessment of frequency of falls, gait impairment, and apathy; fatigue severity scale; and actigraphy and customized bed alarm systems. Consensus also was established for evaluating the clinical and vPSG aspects of RBD. End points for neuroprotective trials in RBD, taking lessons from research in PD, should be focused on the ultimate goal of determining the performance of disease-modifying agents. To date no compound with convincing evidence of disease-modifying or neuroprotective efficacy has been identified in PD. Nevertheless, iRBD patients are considered ideal candidates for neuroprotective studies. CONCLUSIONS The IRBD-SG provides an important platform for developing multinational collaborative studies on RBD such as on environmental risk factors for iRBD, as recently reported in a peer-reviewed journal article, and on controlled active treatment studies for symptomatic and neuroprotective therapy that emerged during the 2011 consensus conference in Marburg, Germany, as described in our report.
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Affiliation(s)
- C H Schenck
- Minnesota Regional Sleep Disorders Center, Department of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, MN, USA.
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Abstract
FDG-PET is a valuable tool that will continue to aid in identifying AD in its prodromal and early dementia stages, distinguishing it from other causes of dementia, and tracking progression of the disease. As brain FDG-PET scans and well-trained readers of these scans are becoming more widely available to clinicians who are becoming more informed about the role FDG-PET can play in early AD diagnosis, its use is expected to increase.
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Affiliation(s)
- Jessica Chew
- Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at University of California, Los Angeles, CA 90095-7370, USA
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Abstract
The amyloid-β peptide (Aβ) is widely considered to be the major toxic agent in the pathogenesis of Alzheimer's disease, a condition which afflicts approximately 36 million people worldwide. Despite a plethora of studies stretching back over two decades, identifying the toxic Aβ species has proved difficult. Debate has centred on the Aβ fibril and oligomer. Despite support from numerous experimental models, important questions linger regarding the role of the Aβ oligomer in particular. It is likely a huge array of oligomers, rather than a single species, which cause toxicity. Reappraisal of the role of the Aβ fibril points towards a dynamic relationship with the Aβ oligomer within an integrated system, as supported by evidence from microglia. However, some continue to doubt the pathological role of amyloid β, instead proposing a protective role. If the field is to progress, all Aβ oligomers should be characterised, the nomenclature revised and a consistent experimental protocol defined. For this to occur, collaboration will be required between major research groups and innovative analytical tools developed. Such action must surely be taken if amyloid-based therapeutic endeavour is to progress.
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Affiliation(s)
- Barnabas James Gilbert
- Medical Sciences Division, University of Oxford, Green Templeton College, 43 Woodstock Road, Summertown, Oxford OX2 6HG, UK.
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