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Liampas I, Dimitriou N, Siokas V, Messinis L, Nasios G, Dardiotis E. Cognitive trajectories preluding the onset of different dementia entities: a descriptive longitudinal study using the NACC database. Aging Clin Exp Res 2024; 36:119. [PMID: 38780681 PMCID: PMC11116253 DOI: 10.1007/s40520-024-02769-9] [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: 02/17/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To describe the 10-year preclinical cognitive trajectories of older, non-demented individuals towards the onset of the four most prevalent types of dementia, i.e., Alzheimer's disease(AD), Lewy body(LBD), vascular(VD) and frontotemporal dementia(FTD). METHODS Our analysis focused on data from older (≥ 60years) NACC (National Alzheimer's Coordinating Center) participants. Four distinct presymptomatic dementia groups (AD-LBD-VD-FTD) and a comparison group of cognitively unimpaired(CU) participants were formed. Comprehensive cognitive assessments involving verbal episodic memory, semantic verbal fluency, confrontation naming, mental processing speed - attention and executive function - cognitive flexibility were conducted at baseline and on an approximately yearly basis. Descriptive analyses (adjusted general linear models) were performed to determine and compare the yearly cognitive scores of each group throughout the follow-up. Exploratory analyses were conducted to estimate the rates of cognitive decline. RESULTS There were 3343 participants who developed AD, 247 LBD, 108 FTD, 155 VD and 3398 composed the CU group. Participants with AD performed worse on episodic memory than those with VD and LBD for about 3 to 4 years prior to dementia onset (the FTD group documented an intermediate course). Presymptomatic verbal fluency and confrontation naming trajectories differentiated quite well between the FTD group and the remaining dementia entities. Participants with incident LBD and VD performed worse than those with AD on executive functions and mental processing speed-attention since about 5 years prior to the onset of dementia, and worse than those with FTD more proximally to the diagnosis of the disorder. CONCLUSIONS Heterogeneous cognitive trajectories characterize the presymptomatic courses of the most prevalent dementia entities.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, Larissa, 41100, Greece.
| | - Nefeli Dimitriou
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, 45500, Greece
| | - Vasileios Siokas
- Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, Larissa, 41100, Greece
| | - Lambros Messinis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, 45500, Greece
| | - Efthimios Dardiotis
- Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, Larissa, 41100, Greece
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Possemis N, Verhey F, Prickaerts J, Blokland A, Ramakers I. A proof of concept phase II study with the PDE-4 inhibitor roflumilast in patients with mild cognitive impairment or mild Alzheimer's disease dementia (ROMEMA): study protocol of a double-blind, randomized, placebo-controlled, between-subjects trial. Trials 2024; 25:162. [PMID: 38438923 PMCID: PMC10910786 DOI: 10.1186/s13063-024-08001-3] [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: 12/27/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Research into the neurobiological underpinnings of learning and memory has demonstrated the cognitive-enhancing effects associated with diverse classes of phosphodiesterase (PDE) inhibitors. Specific PDE inhibitors have been identified to improve neuronal communication through selective inhibition of PDE activity. Roflumilast, a PDE4 inhibitor, has demonstrated efficacy in enhancing episodic memory in healthy adults and elderly participants with pronounced memory impairment, indicative of amnestic mild cognitive impairment (aMCI). In alignment with these findings, the present protocol aims to provide a proof of concept phase II of the potential of roflumilast to aid patients diagnosed with (a)MCI or mild Alzheimer's disease (AD) dementia. METHODS The study will be conducted according to a double-blind, randomized placebo-controlled, between-subjects design. Participants with (a)MCI and mild AD dementia will be recruited through the Memory Clinic at the Maastricht University Medical Centre + (MUMC +) in Maastricht, the Netherlands, alongside outreach through regional hospitals, and social media. The study will have three arms: placebo, 50 μg roflumilast, and 100 μg roflumilast, with a treatment duration of 24 weeks. The primary outcome measure will focus on the assessment of episodic memory, as evaluated through participants' performance on the 15-word Verbal Learning Task (VLT). Our secondary objectives are multifaceted, including an exploration of various cognitive domains. In addition, insights into the well-being and daily functioning of participants will be investigated through interviews with both the participants and their (informal) caregivers, we are interested in the well-being and daily functioning of the participants. DISCUSSION The outcomes of the present study aim to elucidate the significance of the PDE4 inhibition mechanism as a prospective therapeutic target for enhancing cognitive function in individuals with (a)MCI and mild AD dementia. Identifying positive effects within these patient cohorts could extend the relevance of this treatment to encompass a broader spectrum of neurological disorders. TRIAL REGISTRATION The Medical Ethics Committee of MUMC + granted ethics approval for the 4th version of the protocol on September 10th, 2020. The trial was registered at the European Drug Regulatory Affairs Clinical Trials (EudraCT) registered on the 19th of December 2019 ( https://www.clinicaltrialsregister.eu/ctr-search/trial/2019-004959-36/NL ) and ClinicalTrial.gov (NCT04658654, https://clinicaltrials.gov/study/NCT04658654?intr=roflumilast&cond=mci&rank=1 ) on the 8th of December 2020. The Central Committee on Research Involving Human Subjects (CCMO) granted approval on the 30th of September 2020.
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Affiliation(s)
- Nina Possemis
- Dept. of Psychiatry and Neuropsychology, School for Mental, Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre+ (MUMC+), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Jos Prickaerts
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Arjan Blokland
- Faculty of Psychology and Neuroscience, Department of Neuropsychology & Psychopharmacology, EURON, Maastricht University, Maastricht, the Netherlands
| | - Inez Ramakers
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre+ (MUMC+), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands.
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Possemis N, ter Huurne D, Banning L, Gruters A, Van Asbroeck S, König A, Linz N, Tröger J, Langel K, Blokland A, Prickaerts J, de Vugt M, Verhey F, Ramakers I. The Reliability and Clinical Validation of Automatically-Derived Verbal Memory Features of the Verbal Learning Test in Early Diagnostics of Cognitive Impairment. J Alzheimers Dis 2024; 97:179-191. [PMID: 38108348 PMCID: PMC10789344 DOI: 10.3233/jad-230608] [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] [Accepted: 10/10/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Previous research has shown that verbal memory accurately measures cognitive decline in the early phases of neurocognitive impairment. Automatic speech recognition from the verbal learning task (VLT) can potentially be used to differentiate between people with and without cognitive impairment. OBJECTIVE Investigate whether automatic speech recognition (ASR) of the VLT is reliable and able to differentiate between subjective cognitive decline (SCD) and mild cognitive impairment (MCI). METHODS The VLT was recorded and processed via a mobile application. Following, verbal memory features were automatically extracted. The diagnostic performance of the automatically derived features was investigated by training machine learning classifiers to distinguish between participants with SCD versus MCI/dementia. RESULTS The ICC for inter-rater reliability between the clinical and automatically derived features was 0.87 for the total immediate recall and 0.94 for the delayed recall. The full model including the total immediate recall, delayed recall, recognition count, and the novel verbal memory features had an AUC of 0.79 for distinguishing between participants with SCD versus MCI/dementia. The ten best differentiating VLT features correlated low to moderate with other cognitive tests such as logical memory tasks, semantic verbal fluency, and executive functioning. CONCLUSIONS The VLT with automatically derived verbal memory features showed in general high agreement with the clinical scoring and distinguished well between SCD and MCI/dementia participants. This might be of added value in screening for cognitive impairment.
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Affiliation(s)
- Nina Possemis
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Daphne ter Huurne
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Leonie Banning
- Maastricht University Medical Centre+ (MUMC+), Department of Psychiatry & Psychology, Maastricht, The Netherlands
| | | | - Stephanie Van Asbroeck
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Alexandra König
- National Institute for Research in Computer Science and Automation (INRIA), Valbonne, Sophia Antipolis, France
- ki:elements, Saarbrücken, Germany
| | | | | | - Kai Langel
- Janssen Clinical Innovation, Beerse, Belgium
| | - Arjan Blokland
- Faculty of Psychology and Neuroscience, Department of Neuropsychology & Psychopharmacology, EURON, Maastricht University, Maastricht, The Netherlands
| | - Jos Prickaerts
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Maastricht University Medical Centre+ (MUMC+), Department of Psychiatry & Psychology, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Maastricht University Medical Centre+ (MUMC+), Department of Psychiatry & Psychology, Maastricht, The Netherlands
| | - Inez Ramakers
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Maastricht University Medical Centre+ (MUMC+), Department of Psychiatry & Psychology, Maastricht, The Netherlands
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Wang J, Zhou Y, Zhang K, Ran W, Zhu X, Zhong W, Chen Y, Li J, Sun J, Lou M. Glymphatic function plays a protective role in ageing-related cognitive decline. Age Ageing 2023; 52:afad107. [PMID: 37392401 PMCID: PMC10314787 DOI: 10.1093/ageing/afad107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 01/24/2023] [Indexed: 07/03/2023] Open
Abstract
OBJECTIVE The glymphatic pathway, characterised as a cerebral drainage system, influences cognitive function in neurodegenerative diseases; however, evidence is limited in a normal ageing population. The aim of this study was to investigate the effect of glymphatic function on ageing-related cognitive decline. METHODS We retrospectively reviewed the Cognitive Impairment, Retinopathy, and Cerebrovascular Lesions in the Elderly (CIRCLE) study, and participants with multi-model magnetic resonance imaging (MRI) scans and Mini-Mental State Examinations (MMSE) were enrolled. Glymphatic function was evaluated via the diffusion tensor imaging along the perivascular space (DTI-ALPS) index. Regression models were used to estimate the impact of the DTI-ALPS index on cognitive decline cross-sectionally and longitudinally. We further analysed the mediation effect of the DTI-ALPS on age and cognitive function. RESULTS A total of 633 participants were included in this study (48.2% female; mean age, 62.8 ± 8.9 years). The DTI-ALPS index was positively associated with cognitive function cross-sectionally (β = 0.108, P = 0.003), and was an independent protective factor for cognitive decline longitudinally (odds ratio (OR) = 0.029, P = 0.007). The DTI-ALPS index declined progressively with ageing (r = -0.319, P <0.001), and the decrease was more pronounced after 65 years of age. Furthermore, the DTI-ALPS index mediated the relationship between age and MMSE score (β = -0.016, P <0.001). The mediation effect accounted for 21.3%, which was higher in subjects aged over 65 years (25.3%) compared with those aged under 65 years (5.3%). CONCLUSION Glymphatic function played a protective role in normal ageing-related cognitive decline, which may serve as a potential therapeutic target against cognitive decline in future.
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Affiliation(s)
- Junjun Wang
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China
- Department of Neurology, Zhejiang Hospital, Hangzhou 310012, China
| | - Ying Zhou
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Kemeng Zhang
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Wang Ran
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Xiao Zhu
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Wansi Zhong
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Yuping Chen
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Jiaping Li
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Jianzhong Sun
- Department of Radiology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Min Lou
- Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China
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McDonough IM, Cody SL, Harrell ER, Garrett SL, Popp TE. Cognitive differences across ethnoracial category, socioeconomic status across the Alzheimer's disease spectrum: Can an ability discrepancy score level the playing field? Mem Cognit 2023; 51:543-560. [PMID: 35338450 DOI: 10.3758/s13421-022-01304-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 12/29/2022]
Abstract
An ability discrepancy (crystallized minus fluid abilities) might be a personally relevant cognitive marker of risk for Alzheimer's disease (AD) and might help reduce measurement bias often present in traditional measures of cognition. In a large national sample of adults aged 60-104 years (N = 14,257), we investigated whether the intersectionality of group characteristics previously shown to pose a risk for AD including ethnoracial category, socioeconomic status, and sex (a) differed in ability discrepancy compared to traditional neuropsychological tests and (b) moderated the relationship between an ability discrepancy and AD symptom severity. In cognitively normal older adults, results indicated that across each decade, fluid and memory composite scores generally exhibited large group differences with sex, education, and ethnoracial category. In contrast, the ability discrepancy score showed much smaller group differences, thus removing much of the biases inherent in the tests. Women with higher education differed in discrepancy performance from other groups, suggesting a subgroup in which this score might reduce bias to a lesser extent. Importantly, a greater ability discrepancy was associated with greater AD symptom severity across the AD continuum. Subgroup analyses suggest that this relationship holds for all groups except for some subgroups of Hispanic Americans. These findings suggest that an ability discrepancy measure might be a better indicator of baseline cognition than traditional measures that show more egregious measurement bias across diverse groups of people.
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Affiliation(s)
- Ian M McDonough
- Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL, 35487, USA.
| | - Shameka L Cody
- College of Nursing, The University of Alabama, Tuscaloosa, AL, USA
| | - Erin R Harrell
- Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL, 35487, USA
| | | | - Taylor E Popp
- Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL, 35487, USA
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Nguyen HD, Clément M, Mansencal B, Coupé P. Towards better interpretable and generalizable AD detection using collective artificial intelligence. Comput Med Imaging Graph 2023; 104:102171. [PMID: 36640484 DOI: 10.1016/j.compmedimag.2022.102171] [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: 05/23/2022] [Revised: 12/24/2022] [Accepted: 12/24/2022] [Indexed: 01/03/2023]
Abstract
Alzheimer's Disease is the most common cause of dementia. Accurate diagnosis and prognosis of this disease are essential to design an appropriate treatment plan, increasing the life expectancy of the patient. Intense research has been conducted on the use of machine learning to identify Alzheimer's Disease from neuroimaging data, such as structural magnetic resonance imaging. In recent years, advances of deep learning in computer vision suggest a new research direction for this problem. Current deep learning-based approaches in this field, however, have a number of drawbacks, including the interpretability of model decisions, a lack of generalizability information and a lower performance compared to traditional machine learning techniques. In this paper, we design a two-stage framework to overcome these limitations. In the first stage, an ensemble of 125 U-Nets is used to grade the input image, producing a 3D map that reflects the disease severity at voxel-level. This map can help to localize abnormal brain areas caused by the disease. In the second stage, we model a graph per individual using the generated grading map and other information about the subject. We propose to use a graph convolutional neural network classifier for the final classification. As a result, our framework demonstrates comparative performance to the state-of-the-art methods in different datasets for both diagnosis and prognosis. We also demonstrate that the use of a large ensemble of U-Nets offers a better generalization capacity for our framework.
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Affiliation(s)
- Huy-Dung Nguyen
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, 33400 Talence, France.
| | - Michaël Clément
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, 33400 Talence, France
| | - Boris Mansencal
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, 33400 Talence, France
| | - Pierrick Coupé
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, 33400 Talence, France
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Cognitive trajectories preluding the imminent onset of Alzheimer's disease dementia in individuals with normal cognition: results from the HELIAD cohort. Aging Clin Exp Res 2023; 35:41-51. [PMID: 36322329 PMCID: PMC9816286 DOI: 10.1007/s40520-022-02265-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The cognitive trajectories of cognitively normal (CN) individuals rapidly progressing to Alzheimer's disease dementia (AD) have not been investigated. AIM To explore the preclinical pattern of cognitive performance heralding the rapid progression from normal cognition to AD. METHODS The HELIAD cohort underwent comprehensive neuropsychological assessments (memory, language, attention, executive and visuo-perceptual functions) at baseline and after approximately 3-year intervals. The cognitive trajectories of those with normal cognition at baseline were explored according to the follow-up diagnosis using adjusted generalised estimating equations analyses. RESULTS A total of 932 predominantly female (61%), older (72.9 ± 4.9), CN participants were followed for 3.09 (± 0.83) years. Among them, 761 individuals remained CN, 29 progressed to AD and 142 developed MCI (33 single-domain amnestic, 41 multidomain amnestic, 37 single-domain non-amnestic and 31 multidomain non-amnestic). Those progressing to AD were already performing worse than the healthy reference in every single cognitive domain at baseline. Cognitive deficits ranged between ~ 0.5SD (attention, executive function and language) and ~ 1.0SD (memory and visuo-perceptual skills). Throughout the 3-year follow-up, memory constantly exhibited the most prominent impairment compared to the remaining cognitive domains while executive function diminished in the most abrupt fashion (~ 0.19SD yearly) separating from the remaining three cognitive functions before the development of full-blown AD. Heterogeneous patterns of cognitive decline clearly differentiated those progressing to MCI from those rapidly converting to AD, as well. DISCUSSION Poor performance in every cognitive domain may characterise cognitively normal individuals at high risk of fast progression to AD. CONCLUSION Strict neuropsychological cut-offs fail to detect a considerable number of individuals at high risk of rapid progression to AD.
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Liampas I, Folia V, Zoupa E, Siokas V, Yannakoulia M, Sakka P, Hadjigeorgiou G, Scarmeas N, Dardiotis E, Kosmidis MH. Qualitative Verbal Fluency Components as Prognostic Factors for Developing Alzheimer's Dementia and Mild Cognitive Impairment: Results from the Population-Based HELIAD Cohort. Medicina (B Aires) 2022; 58:medicina58121814. [PMID: 36557016 PMCID: PMC9786933 DOI: 10.3390/medicina58121814] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Background and Objectives: The aim of the present study was to investigate the prognostic value of the qualitative components of verbal fluency (clustering, switching, intrusions, and perseverations) on the development of mild cognitive impairment (MCI) and dementia. Materials and Methods: Participants were drawn from the multidisciplinary, population-based, prospective HELIAD (Hellenic Longitudinal Investigation of Aging and Diet) cohort. Two participant sets were separately analysed: those with normal cognition and MCI at baseline. Verbal fluency was assessed via one category and one letter fluency task. Separate Cox proportional hazards regressions adjusted for important sociodemographic parameters were performed for each qualitative semantic and phonemic verbal fluency component. Results: There were 955 cognitively normal (CN), older (72.9 years ±4.9), predominantly female (~60%) individuals with available follow-up assessments after a mean of 3.09 years (±0.83). Among them, 34 developed dementia at follow-up (29 of whom progressed to Alzheimer's dementia (AD)), 160 developed MCI, and 761 remained CN. Each additional perseveration on the semantic condition increased the risk of developing all-cause dementia and AD by 52% and 55%, respectively. Of note, participants with two or more perseverations on the semantic task presented a much more prominent risk for incident dementia compared to those with one or no perseverations. Among the remaining qualitative indices, none were associated with the hazard of developing all-cause dementia, AD, and MCI at follow-up. Conclusions: Perseverations on the semantic fluency condition were related to an increased risk of incident all-cause dementia or AD in older, CN individuals.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Vasiliki Folia
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
- Correspondence:
| | - Elli Zoupa
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou, 17671 Athens, Greece
| | - Paraskevi Sakka
- Athens Alzheimer’s Association, 89 M. Mousourou & 33 Stilponos St, 11636 Athens, Greece
| | - Georgios Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
- School of Medicine, University of Cyprus, 93 Agiou Nikolaou St, Engomi, Nicosia 2408, Cyprus
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, 72-74 Vassilissis Sofias Ave, 11528 Athens, Greece
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, 710 West 168th St, New York, NY 10032, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Mary H. Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
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Fu M, Wang H, Bai Q, Du J, Niu Q, Nie J. Urinary polycyclic aromatic hydrocarbon metabolites, plasma p-tau231 and mild cognitive impairment in coke oven workers. CHEMOSPHERE 2022; 307:135911. [PMID: 35961449 DOI: 10.1016/j.chemosphere.2022.135911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 07/21/2022] [Accepted: 07/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND As a group of environmental pollutants, polycyclic aromatic hydrocarbons (PAHs) may be neurotoxic,especially in high-exposure occupational populations. However, the effect of PAHs on mild cognitive impairment (MCI) is still unclear. OBJECTIVE We aimed to investigate the relationship between PAH metabolites and MCI and to explore whether plasma p-tau231 can be used as a potential biomarker to reflect MCI in coke oven workers. METHOD A total of 330 workers were recruited from a coke oven plant as the exposure group, and 234 workers were recruited from a water treatment plant as the control group. The concentrations of eleven PAH metabolites and plasma p-tau231 were determined by high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS) and ELISA. Cognitive function was measured by the Montreal Cognitive Assessment (MoCA) questionnaire. A multivariate logistic regression model and multiple linear regression model were used to analyze the associations of urinary PAH metabolites with the detection rate of MCI, MoCA scores and plasma p-tau231. The dose-response relationships were evaluated using restricted cubic spline models. RESULTS We found 146 MCI-positive workers in coke oven plant (44.24%), and 69 MCI-positive workers in water treatment plant (29.49%). In addition, the urinary sum of PAH metabolites (Ʃ-OH PAHs) was significantly associated with MCI (OR, 1.371; 95% CI:1.102-1.705). Each one-unit increase in ln-transformed Ʃ-OH PAHs was associated with a 0.429 decrease in the sum of MoCA, a 0.281 reduction in the visuospatial/executive function and a 9.416 increase in the level of plasma P-Tau231. We found a negative association between plasma P-Tau231 and visuospatial/executive function (β = -0.007, 95% CI: -0.011, -0.003). CONCLUSION Our data indicated that urinary Ʃ-OH PAHs levels of workers were positively associated with MCI and the level of plasma P-Tau231.
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Affiliation(s)
- Mengmeng Fu
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China.
| | - Huimin Wang
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China.
| | - QianXiang Bai
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China.
| | - Juanjuan Du
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China.
| | - Qiao Niu
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China.
| | - Jisheng Nie
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China.
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Payton NM, Marseglia A, Grande G, Fratiglioni L, Kivipelto M, Bäckman L, Laukka EJ. Trajectories of cognitive decline and dementia development: A 12-year longitudinal study. Alzheimers Dement 2022; 19:857-867. [PMID: 35715929 DOI: 10.1002/alz.12704] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/09/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Mapping the preclinical dementia phase is important for early detection and evaluation of interventions. We assessed the trajectories of cognitive decline in preclinical dementia over 12 years and investigated whether being a fast decliner across 6 years is associated with increased risk of dementia the following 6 years. METHODS Rates of cognitive decline were determined using mixed-effects models for 1646 participants from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) cohort. Cox regression was used to assess the future likelihood of dementia for fast decliners (declining ≥1.5 standard deviations [SDs] faster than the age-specific rates). RESULTS Participants in a preclinical phase of dementia showed increased rates of decline in all cognitive tests compared to the no-dementia group, particularly closer (0-6 years) to diagnosis. Participants declining fast in three or more cognitive tests 12-6 years before diagnosis demonstrated a high risk of dementia 6 years later (hazard ratio [HR] 3.90, 95% confidence interval [CI] 2.28-6.69). DISCUSSION Being a fast decliner is linked to increased risk of future dementia.
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Affiliation(s)
- Nicola M Payton
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anna Marseglia
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholms Sjukhem, Research & Development Unit, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Lars Bäckman
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
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11
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Frausto DM, Forsyth CB, Keshavarzian A, Voigt RM. Dietary Regulation of Gut-Brain Axis in Alzheimer's Disease: Importance of Microbiota Metabolites. Front Neurosci 2021; 15:736814. [PMID: 34867153 PMCID: PMC8639879 DOI: 10.3389/fnins.2021.736814] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/18/2021] [Indexed: 12/12/2022] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease that impacts 45 million people worldwide and is ranked as the 6th top cause of death among all adults by the Centers for Disease Control and Prevention. While genetics is an important risk factor for the development of AD, environment and lifestyle are also contributing risk factors. One such environmental factor is diet, which has emerged as a key influencer of AD development/progression as well as cognition. Diets containing large quantities of saturated/trans-fats, refined carbohydrates, limited intake of fiber, and alcohol are associated with cognitive dysfunction while conversely diets low in saturated/trans-fats (i.e., bad fats), high mono/polyunsaturated fats (i.e., good fats), high in fiber and polyphenols are associated with better cognitive function and memory in both humans and animal models. Mechanistically, this could be the direct consequence of dietary components (lipids, vitamins, polyphenols) on the brain, but other mechanisms are also likely to be important. Diet is considered to be the single greatest factor influencing the intestinal microbiome. Diet robustly influences the types and function of micro-organisms (called microbiota) that reside in the gastrointestinal tract. Availability of different types of nutrients (from the diet) will favor or disfavor the abundance and function of certain groups of microbiota. Microbiota are highly metabolically active and produce many metabolites and other factors that can affect the brain including cognition and the development and clinical progression of AD. This review summarizes data to support a model in which microbiota metabolites influence brain function and AD.
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Affiliation(s)
- Dulce M. Frausto
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
| | - Christopher B. Forsyth
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
- Department of Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Ali Keshavarzian
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
- Department of Medicine, Rush University Medical Center, Chicago, IL, United States
- Department of Physiology, Rush University Medical Center, Chicago, IL, United States
| | - Robin M. Voigt
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
- Department of Medicine, Rush University Medical Center, Chicago, IL, United States
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12
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Moorman SM, Greenfield EA, Carr K. Using Mixture Modeling to Construct Subgroups of Cognitive Aging in the Wisconsin Longitudinal Study. J Gerontol B Psychol Sci Soc Sci 2021; 76:1512-1522. [PMID: 33152080 DOI: 10.1093/geronb/gbaa191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Longitudinal surveys of older adults increasingly incorporate assessments of cognitive performance. However, very few studies have used mixture modeling techniques to describe cognitive aging, identifying subgroups of people who display similar patterns of performance across discrete cognitive functions. We employ this approach to advance empirical evidence concerning interindividual variability and intraindividual change in patterns of cognitive aging. METHOD We drew upon data from 3,713 participants in the Wisconsin Longitudinal Study (WLS). We used latent class analysis to generate subgroups of cognitive aging based on assessments of verbal fluency and episodic memory at ages 65 and 72. We also employed latent transition analysis to identify how individual participants moved between subgroups over the 7-year period. RESULTS There were 4 subgroups at each point in time. Approximately 3 quarters of the sample demonstrated continuity in the qualitative type of profile between ages 65 and 72, with 17.9% of the sample in a profile with sustained overall low performance at both ages 65 and 72. An additional 18.7% of participants made subgroup transitions indicating marked decline in episodic memory. DISCUSSION Results demonstrate the utility of using mixture modeling to identify qualitatively and quantitatively distinct subgroups of cognitive aging among older adults. We discuss the implications of these results for the continued use of population health data to advance research on cognitive aging.
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Affiliation(s)
| | | | - Kyle Carr
- Boston College, Chestnut Hill, Massachusetts
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13
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Dietary and supplemental long-chain omega-3 fatty acids as moderators of cognitive impairment and Alzheimer's disease. Eur J Nutr 2021; 61:589-604. [PMID: 34392394 PMCID: PMC8854294 DOI: 10.1007/s00394-021-02655-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/04/2021] [Indexed: 12/06/2022]
Abstract
Purpose There is an ever-growing body of literature examining the relationship between dietary omega-3 polyunsaturated fatty acids (ω3 PUFAs) and cerebral structure and function throughout life. In light of this, the use of ω3 PUFAs, namely, long-chain (LC) ω3 PUFAs (i.e., eicosapentaenoic acid and docosahexaenoic acid), as a therapeutic strategy to mitigate cognitive impairment, and progression to Alzheimer’s disease is an attractive prospect. This review aims to summarise evidence reported by observational studies and clinical trials that investigated the role of LC ω3 PUFAs against cognition impairment and future risk of Alzheimer’s disease. Methods Studies were identified in PubMed and Scopus using the search terms “omega-3 fatty acids”, “Alzheimer’s disease” and “cognition”, along with common variants. Inclusion criteria included observational or randomised controlled trials (RCTs) with all participants aged ≥ 50 years that reported on the association between LC ω3 PUFAs and cognitive function or biological markers indicative of cognitive function linked to Alzheimer’s disease. Results Evidence from 33 studies suggests that dietary and supplemental LC ω3 PUFAs have a protective effect against cognitive impairment. Synaptic plasticity, neuronal membrane fluidity, neuroinflammation, and changes in expression of genes linked to cognitive decline have been identified as potential targets of LC ω3 PUFAs. The protective effects LC ω3 PUFAs on cognitive function and reduced risk of Alzheimer’s disease were supported by both observational studies and RCTs, with RCTs suggesting a more pronounced effect in individuals with early and mild cognitive impairment. Conclusion The findings of this review suggest that individuals consuming higher amounts of LC ω3 PUFAs are less likely to develop cognitive impairment and that, as a preventative strategy against Alzheimer’s disease, it is most effective when dietary LC ω3 PUFAs are consumed prior to or in the early stages of cognitive decline. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02655-4.
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14
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van Oudenhoven FM, Swinkels SHN, Soininen H, Kivipelto M, Hartmann T, Rizopoulos D. A competing risk joint model for dealing with different types of missing data in an intervention trial in prodromal Alzheimer's disease. Alzheimers Res Ther 2021; 13:63. [PMID: 33752738 PMCID: PMC7983401 DOI: 10.1186/s13195-021-00801-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/04/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Missing data can complicate the interpretability of a clinical trial, especially if the proportion is substantial and if there are different, potentially outcome-dependent causes. METHODS We aimed to obtain unbiased estimates, in the presence of a high level of missing data, for the intervention effects in a prodromal Alzheimer's disease trial: the LipiDiDiet study. We used a competing risk joint model that can simultaneously model each patient's longitudinal outcome trajectory in combination with the timing and type of missingness. RESULTS Using the competing risk joint model, we were able to provide unbiased estimates of the intervention effects in the presence of the different types of missingness. For the LipiDiDiet study, the intervention effects remained statistically significant after this correction for the timing and type of missingness. CONCLUSION Missing data is a common problem in (Alzheimer) clinical trials. It is important to realize that statistical techniques make specific assumptions about the missing data mechanisms. When there are different missing data sources, a competing risk joint model is a powerful method because it can explicitly model the association between the longitudinal data and each type of missingness. TRIAL REGISTRATION Dutch Trial Register, NTR1705 . Registered on 9 March 2009.
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Affiliation(s)
- Floor M van Oudenhoven
- Department of Biostatistics, Erasmus Medical Center, PO Box 2040, 3000, Rotterdam, CA, the Netherlands.
- Danone Nutricia Research, Uppsalalaan 12, 3584 CT, Utrecht, The Netherlands.
| | | | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, PO Box 1627, 70211, Kuopio, Finland
- Neurocenter, Department of Neurology, Kuopio University Hospital, PO Box 100, 70029, Kuopio, Finland
| | - Miia Kivipelto
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, PO Box 1627, 70211, Kuopio, Finland
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, 14157, Huddinge, Sweden
- Clinical Trials Unit, Theme Aging, Karolinska University Hospital, 14152, Huddinge, Sweden
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, St Dunstan's Road, London, UK
| | - Tobias Hartmann
- Deutsches Institut für Demenz Prävention (DIDP), Medical Faculty, Saarland University, Kirrbergerstraße, 66421, Homburg, Germany
- Department of Experimental Neurology, Saarland University, Kirrbergerstraße, 66421, Homburg, Germany
| | - Dimitris Rizopoulos
- Department of Biostatistics, Erasmus Medical Center, PO Box 2040, 3000, Rotterdam, CA, the Netherlands
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15
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Gruters AAA, Ramakers IHGB, Verhey FRJ, Köhler S, Kessels RPC, de Vugt ME. Association Between Proxy- or Self-Reported Cognitive Decline and Cognitive Performance in Memory Clinic Visitors. J Alzheimers Dis 2020; 70:1225-1239. [PMID: 31322557 DOI: 10.3233/jad-180857] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND It is uncertain whether self- and proxy-reported cognitive decline in older adults reflect an actual objective cognitive dysfunction in the clinical sense, and if these are predictive for developing dementia. OBJECTIVE The aim of the present study is to investigate the cross-sectional and longitudinal relation between subjective cognitive decline and objective cognitive performance, depressive symptoms, and to determine the predictive value for development of dementia. METHODS We included 405 patients without dementia at first visit from the Maastricht memory clinic participating in a longitudinal cohort study. Subjective cognitive decline was measured using a self- and proxy-report questionnaire. All patients underwent a standardized neuropsychological assessment. Follow-up assessments were performed yearly for three consecutive years, and once after five years. RESULTS Subjective cognitive decline was associated with lower cognitive performance and more depressive symptoms. When comparing self- (n = 342, 84%) and proxy-reported decline (n = 110, 27%), it was shown that proxy reports were associated with a more widespread pattern of lower cognitive performance. In participants without cognitive impairment proxy-reported decline was not associated with depressive symptoms. In contrast, self-reported decline was associated with a stable course of depressive symptoms at follow-up. Proxy-reported cognitive decline (HR = 1.76, 95% CI = 1.12- 2.78), and mutual complaints (HR = 1.73, CI:1.09- 2.76) predicted incident dementia while self-reported decline did not reach statistical significance (HR = 1.26, 95% CI = 0.65- 2.43). CONCLUSION Proxy-reported cognitive decline was consistently associated with lower cognitive performance and conversion to dementia over 5 years. Self-reported cognitive decline in patients without cognitive impairment might indicate underlying depressive symptoms and thus deserve clinical attention as well.
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Affiliation(s)
- Angélique A A Gruters
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Inez H G B Ramakers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Department of Medical Psychology & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
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16
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Long-term cognitive impairment after ICU treatment: a prospective longitudinal cohort study (Cog-I-CU). Sci Rep 2020; 10:15518. [PMID: 32968099 PMCID: PMC7511316 DOI: 10.1038/s41598-020-72109-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/21/2020] [Indexed: 01/16/2023] Open
Abstract
In this prospective cohort study we aimed to investigate the trajectory of the cognitive performance of patients after discharge from an intensive care unit (ICU). Special consideration was given to patients with suspected premorbid cognitive impairment who might be at risk for the development of dementia. Clinical characteristics were collected until discharge. The premorbid cognitive state was estimated by a structured interview with a close relative. Cognitive outcome was assessed using the Consortium to Establish a Registry of Alzheimer’s Disease (CERAD) Plus battery and the Stroop Color and Word Test at the time of discharge from ICU and 9 months later. The results of the study group were compared to an established healthy control group and to normative data. A total number of 108 patients were finally included. At the time of discharge, patients underperformed the healthy control group. In linear regression models, delirium during the ICU stay and the factor premorbid cognitive impairment were associated with poorer cognitive outcome (p = 0.047 and p = 0.001). After 9 months, in 6% of patients without evidence of premorbid cognitive impairment long-lasting deficits were found. In patients with suspected premorbid cognitive impairment, performance in tests of executive function failed to improve.
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17
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Vonk JMJ, Bouteloup V, Mangin J, Dubois B, Blanc F, Gabelle A, Ceccaldi M, Annweiler C, Krolak‐Salmon P, Belin C, Rivasseau‐Jonveaux T, Julian A, Sellal F, Magnin E, Chupin M, Habert M, Chêne G, Dufouil C. Semantic loss marks early Alzheimer's disease-related neurodegeneration in older adults without dementia. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12066. [PMID: 32775598 PMCID: PMC7403823 DOI: 10.1002/dad2.12066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To assess progression of semantic loss in early stages of cognitive decline using semantic and letter fluency performance, and its relation with Alzheimer's disease (AD)-specific neurodegeneration using longitudinal multimodal neuroimaging measures. METHODS Change in verbal fluency was analyzed among 2261 non-demented individuals with a follow-up diagnosis of no mild cognitive impairment (MCI), amnestic MCI (aMCI), non-amnestic MCI (naMCI), or incident dementia, using linear mixed models across 4 years of follow-up, and relations with magnetic resonance imaging (MRI; n = 1536) and 18F-fluorodeoxyglucose brain positron emission tomography (18F-FDG-PET) imaging (n = 756) using linear regression models across 2 years of follow-up. RESULTS Semantic fluency declined-fastest in those at higher risk for AD (apolipoprotein E [APOE] e4 carriers, Clinical Dementia Rating score of .5, aMCI, or incident dementia)-while letter fluency did not except for those with incident dementia. Lower baseline semantic fluency was associated with an increase in white matter hyperintensities and total mean cortical thinning over time, and regionally with less hippocampal volume as well as more cortical thinning and reduced 18F-FDG-PET uptake in the inferior parietal lobule, entorhinal cortex, isthmus cingulate, and precuneus-posterior cingulate area. In contrast, baseline letter fluency was not associated with change in total nor regional neurodegeneration. Whole-brain neurodegeneration over time was associated with faster decline in both fluencies, while AD-specific regions were associated with a faster rate of decline in semantic but not letter fluency. INTERPRETATION This study provides strong evidence of distinctive degeneration of semantic abilities early on in relation to both cognitive decline and AD-specific neurodegeneration.
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Affiliation(s)
- Jet M. J. Vonk
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainDepartment of NeurologyCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
- Julius Center for Health Sciences and Primary Care, Department of EpidemiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Vincent Bouteloup
- Centre Inserm U1219d'Epidémiologie et de Développement (ISPED)Bordeaux School of Public HealthInstitut de Santé PubliqueUniversité de BordeauxBordeauxFrance
- Pole de sante publiqueCentre Hospitalier Universitaire (CHU) de BordeauxBordeauxFrance
| | - Jean‐François Mangin
- CATI Multicenter Neuroimaging PlatformParisFrance
- NeurospinCEAParis Saclay UniversityGif‐sur‐YvetteFrance
| | - Bruno Dubois
- IM2AAP‐HPINSERMUMR‐S975Groupe Hospitalier Pitié‐SalpêtrièreInstitut de la Mémoire et de la Maladie d'AlzheimerInstitut du Cerveau et de la Moelle épinièreSorbonne UniversitéParisFrance
| | - Frédéric Blanc
- Hôpitaux Universitaire de StrasbourgCM2R (Centre Mémoire de Ressource et de Recherche)Hôpital de jourpôle de Gériatrieet CNRSlaboratoire ICube UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMISStrasbourgFrance
| | - Audrey Gabelle
- Centre Mémoire Ressources RechercheDépartement de NeurologieCHU Gui de ChauliacMontpellierFrance
- Inserm U1061La ColombièreUniversité de MontpellierMontpellierFrance
| | - Mathieu Ceccaldi
- CMMR PACA OuestCHU TimoneAPHM & Aix Marseille UnivINSERMINSInst Neurosci SystMarseilleFrance
| | - Cédric Annweiler
- Department of Geriatric MedicineAngers University HospitalAngersFrance
- Angers University Memory ClinicAngersFrance
- Research Center on Autonomy and LongevityAngersFrance
- UPRES EA 4638University of AngersAngersFrance
- Robarts Research InstituteDepartment of Medical BiophysicsSchulich School of Medicine and Dentistrythe University of Western Ontario, OntarioLondonCanada
| | - Pierre Krolak‐Salmon
- Institut du VieillissementCentre Mémoire Ressources Recherche de LyonHospices civils de LyonUniversité Lyon 1, Inserm U1048LyonFrance
| | | | - Thérèse Rivasseau‐Jonveaux
- Centre Mémoire de Ressources et de Recherche de Lorraine Unité Cognitivo Comportementale CHRU NancyLaboratoire Lorrain de Psychologie et de Neurosciences de la dynamique des comportements 2LPN EA 7489 Université de LorraineNancyFrance
| | - Adrien Julian
- Service de NeurologieCHU La MilétrieCentre Mémoire de Ressources et de RecherchePoitiersFrance
| | - François Sellal
- CMRR Département de NeurologieHôpitaux CivilsColmarFrance
- INSERM U‐1118Université de Strasbourg. Faculté de MédecineStrasbourgFrance
| | - Eloi Magnin
- Centre Mémoire Ressources et Recherche (CMRR)service de NeurologieCHRU BesançonBesançonFrance
- Neurosciences intégratives et cliniques EA481Univ. Bourgogne Franche‐ComtéBesançonFrance
| | - Marie Chupin
- CATI Multicenter Neuroimaging PlatformParisFrance
| | - Marie‐Odile Habert
- CATI Multicenter Neuroimaging PlatformParisFrance
- CNRSINSERMLaboratoire d'Imagerie BiomédicaleLIBSorbonne UniversitéParisFrance
- AP‐HPHôpital Pitié‐SalpêtrièreMédecine NucléaireParisFrance
| | - Geneviève Chêne
- Centre Inserm U1219d'Epidémiologie et de Développement (ISPED)Bordeaux School of Public HealthInstitut de Santé PubliqueUniversité de BordeauxBordeauxFrance
- Pole de sante publiqueCentre Hospitalier Universitaire (CHU) de BordeauxBordeauxFrance
| | - Carole Dufouil
- Centre Inserm U1219d'Epidémiologie et de Développement (ISPED)Bordeaux School of Public HealthInstitut de Santé PubliqueUniversité de BordeauxBordeauxFrance
- Pole de sante publiqueCentre Hospitalier Universitaire (CHU) de BordeauxBordeauxFrance
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Biperiden Selectively Impairs Verbal Episodic Memory in a Dose- and Time-Dependent Manner in Healthy Subjects. J Clin Psychopharmacol 2020; 40:30-37. [PMID: 31834098 DOI: 10.1097/jcp.0000000000001157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE/BACKGROUND Biperiden is a muscarinic antagonist that produces memory impairments without impairing attention or motor functions in healthy subjects. It has been suggested that a biperiden-induced memory deficit could model age- and dementia-related memory impairments. The goal of the current study was to determine the dose- and time-dependent effects of biperiden on cognition in healthy volunteers. METHODS/PROCEDURES Twenty-one healthy volunteers participated in a placebo-controlled, 3-way, crossover study. After a baseline test, cognitive performance was tested at 3 time points after a single dose of biperiden 2 or 4 mg, or placebo. Episodic memory was measured using a 15-word verbal learning task (VLT). Furthermore, n-back tasks, a sustained attention to response task and a reaction time task were used, as well as subjective alertness and a side effects questionnaire. In addition, blood serum values and physiological measures were taken. FINDINGS/RESULTS Biperiden decreased the number of words recalled in immediate and delayed recall of the VLT 90 minutes after drug intake. A dose-dependent impairment was found for the delayed recall, whereas the immediate recall was equally impaired by the 2 doses. Biperiden did not affect the performance on the VLT 4 hours after administration. Performance in the n-back task and the sustained attention to response task were not affected by biperiden at any time point. Both doses were well tolerated as reported side effects were mild at Tmax and were minimal at the other time points. IMPLICATIONS/CONCLUSIONS Biperiden exerts effects on episodic memory without negatively affecting other cognitive performance and behavioral measures that were assessed in this study. The data provide further evidence that biperiden has selective effects on cognition, even after a high dose.
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Lin W, Gao Q, Yuan J, Chen Z, Feng C, Chen W, Du M, Tong T. Predicting Alzheimer's Disease Conversion From Mild Cognitive Impairment Using an Extreme Learning Machine-Based Grading Method With Multimodal Data. Front Aging Neurosci 2020; 12:77. [PMID: 32296326 PMCID: PMC7140986 DOI: 10.3389/fnagi.2020.00077] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/02/2020] [Indexed: 12/12/2022] Open
Abstract
Identifying patients with mild cognitive impairment (MCI) who are at high risk of progressing to Alzheimer's disease (AD) is crucial for early treatment of AD. However, it is difficult to predict the cognitive states of patients. This study developed an extreme learning machine (ELM)-based grading method to efficiently fuse multimodal data and predict MCI-to-AD conversion. First, features were extracted from magnetic resonance (MR) images, and useful features were selected using a feature selection method. Second, multiple modalities of MCI subjects, including MRI, positron emission tomography, cerebrospinal fluid biomarkers, and gene data, were individually graded using the ELM method. Finally, these grading scores calculated from different modalities were fed into a classifier to discriminate subjects with progressive MCI from those with stable MCI. The proposed approach has been validated on the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort, and an accuracy of 84.7% was achieved for an AD prediction within 3 years. Experiments on predicting AD conversion from MCI within different periods showed similar results with the 3-year prediction. The experimental results demonstrate that the proposed approach benefits from the efficient fusion of four modalities, resulting in an accurate prediction of MCI-to-AD conversion.
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Affiliation(s)
- Weiming Lin
- School of Opto-Electronic and Communication Engineering, Xiamen University of Technology, Xiamen, China
- College of Physics and Information Engineering, Fuzhou University, Fuzhou, China
| | - Qinquan Gao
- College of Physics and Information Engineering, Fuzhou University, Fuzhou, China
- Imperial Vision Technology, Fuzhou, China
| | - Jiangnan Yuan
- School of Opto-Electronic and Communication Engineering, Xiamen University of Technology, Xiamen, China
- Fujian Key Laboratory of Communication Network and Information Processing, Xiamen University of Technology, Xiamen, China
| | - Zhiying Chen
- School of Electrical Engineering & Automation, Xiamen University of Technology, Xiamen, China
| | - Chenwei Feng
- School of Opto-Electronic and Communication Engineering, Xiamen University of Technology, Xiamen, China
- Fujian Key Laboratory of Communication Network and Information Processing, Xiamen University of Technology, Xiamen, China
| | - Weisheng Chen
- Department of Thoracic Surgery, Fujian Cancer Hospital, Fuzhou, China
| | - Min Du
- College of Physics and Information Engineering, Fuzhou University, Fuzhou, China
- Fujian Provincial Key Laboratory of Eco-Industrial Green Technology, Wuyi University, Wuyishan, China
| | - Tong Tong
- College of Physics and Information Engineering, Fuzhou University, Fuzhou, China
- Fujian Key Lab of Medical Instrumentation and Pharmaceutical Technology, Fuzhou University, Fuzhou, China
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20
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Yoon HJ, Kim SG, Kim SH, Choo ILH, Park SH, Seo EH. Distinct Neural Correlates of Executive Function by Amyloid Positivity and Associations with Clinical Progression in Mild Cognitive Impairment. Yonsei Med J 2019; 60:935-943. [PMID: 31538428 PMCID: PMC6753349 DOI: 10.3349/ymj.2019.60.10.935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/05/2019] [Accepted: 08/08/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to identify the neural basis of executive function (EF) in amnestic mild cognitive impairment (aMCI) according to beta-amyloid (Aβ) positivity. Furthermore, we explored if the identified brain areas could serve as predictors for clinical progression. MATERIALS AND METHODS We included individuals with aMCI using data from [18F]-florbetapir-positron emission tomography (PET), fluorodeoxyglucose-PET, and EF scores, as well as follow-up clinical severity scores at 1 and 5 years from baseline from the Alzheimer's Disease Neuroimaging Initiative database. The correlations between EF score and regional cerebral glucose metabolism (rCMglc) were analyzed separately for aMCI with low Aβ burden (aMCI Aβ-, n=230) and aMCI with high Aβ burden (aMCI Aβ+, n=268). Multiple linear regression analysis was conducted to investigate the associations between rCMglc and clinical progression. RESULTS Longitudinal courses differed between aMCI Aβ- and aMCI Aβ+ groups. On average, aMCI Aβ- subjects maintained their level of clinical severity, whereas aMCI Aβ+ subjects showed progression. EF impairment in aMCI Aβ- was related to the anterior cingulate cortex (ACC), whereas that in aMCI Aβ+ was related to Alzheimer's Disease-vulnerable brain regions. ACC and the posterior cingulate cortex were associated with clinical progression in aMCI Aβ- and aMCI Aβ+, respectively. CONCLUSION Our findings suggest that although MCI subjects showed similar behavioral phenotypes at the time of diagnosis, EF and further progression were associated with different brain regions according to Aβ burden. Clarification of the etiologies and nature of EF impairment in aMCI are critical for disease prognosis and management.
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Affiliation(s)
- Hyung Jun Yoon
- Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Korea
| | - Seung Gon Kim
- Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Korea
| | - Sang Hoon Kim
- Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Korea
| | - I L Han Choo
- Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Korea
| | - Sang Hag Park
- Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Korea
| | - Eun Hyun Seo
- Premedical Science, College of Medicine, Chosun University, Gwangju, Korea.
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21
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Blokland A, Van Duinen MA, Sambeth A, Heckman PRA, Tsai M, Lahu G, Uz T, Prickaerts J. Acute treatment with the PDE4 inhibitor roflumilast improves verbal word memory in healthy old individuals: a double-blind placebo-controlled study. Neurobiol Aging 2019; 77:37-43. [PMID: 30776650 DOI: 10.1016/j.neurobiolaging.2019.01.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 01/17/2019] [Accepted: 01/17/2019] [Indexed: 11/30/2022]
Abstract
There is ample evidence that phosphodiesterase 4 (PDE4) inhibition can improve memory performance in animal studies. In the present study, we examined the acute effects of the PDE4 inhibitor roflumilast on memory performance in healthy individuals (60-80 years of age). We tested the effects of acute roflumilast administration (100, 250, 1000 μg) in a double-blind, placebo-controlled, 4-way crossover design. Participants were first screened for their verbal word memory performance to ensure normal memory performance (within 0.5 standard deviation from norm score; n = 20) Drug effects on memory performance were tested in a verbal memory test and a spatial memory test. Reported side effects of drug treatment were registered. Roflumilast (100 μg) improved the delayed recall performance of the participants (Cohen's d, 0.69). No effects were observed in the spatial memory task. Roflumilast was well tolerated at this low dose. Although no clear adverse side effects were reported at the low dose, mild adverse events (including headache, dizziness, insomnia, and diarrhea) were reported after the 1000 μg dose. The present study provides first evidence that the PDE4 inhibitor roflumilast improves verbal memory performance in old participants. The current data encourage further development of PDE4 inhibitors for improving memory.
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Affiliation(s)
- Arjan Blokland
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
| | - Marlies A Van Duinen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Anke Sambeth
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
| | - Pim R A Heckman
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Max Tsai
- Department of Clinical Development, Takeda Development Center Americas, Deerfield, IL, USA
| | - Gezim Lahu
- Department of Clinical Development, Takeda Development Center Americas, Deerfield, IL, USA
| | - Tolga Uz
- Department of Clinical Development, Takeda Development Center Americas, Deerfield, IL, USA
| | - Jos Prickaerts
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
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22
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Noll KR, Bradshaw ME, Weinberg JS, Wefel JS. Neurocognitive functioning is associated with functional independence in newly diagnosed patients with temporal lobe glioma. Neurooncol Pract 2018; 5:184-193. [PMID: 30094046 PMCID: PMC6075221 DOI: 10.1093/nop/npx028] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cancer and treatment-related neurocognitive dysfunction has the potential to significantly disrupt the lives of survivors. While neurocognitive functioning is known to predict aspects of patient-reported quality of life in individuals with glioma, little is known regarding the association between neurocognitive functioning and clinician-rated functional independence. METHODS Newly diagnosed patients with glioma in the left (n = 73; 49% glioblastoma) or right (n = 30; 57% glioblastoma) temporal lobe completed comprehensive neuropsychological testing. Clinicians rated patient functional independence using the Functional Independence Measure (FIM) and Karnofsky Performance Status (KPS) scale. Correlational and regression analyses were conducted to determine relationships between neurocognitive functioning and functional independence. RESULTS Tests of verbal learning, executive function, and language comprehension were moderately to strongly associated with clinician-rated functional independence, particularly for items pertaining to need for assistance with memory, problem-solving, and language functions. Stepwise linear regression showed that tests of verbal learning, executive functioning, and language comprehension predicted FIM ratings, together accounting for 40% of variance (P < .001). A test of executive functioning also predicted KPS scores and accounted for 19% of variance (P < .001). CONCLUSIONS In patients with newly diagnosed temporal lobe glioma, neurocognitive functioning is associated with functional independence. Verbal learning, executive functioning, and language comprehension demonstrated the strongest associations across both measures of functional independence. These findings provide support for the ecological validity of neuropsychological assessment by demonstrating the real-world clinical significance of objectively assessed neurocognitive functioning in glioma patients.
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Affiliation(s)
- Kyle R Noll
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mariana E Bradshaw
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey S Weinberg
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey S Wefel
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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23
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Evans TE, Adams HHH, Licher S, Wolters FJ, van der Lugt A, Ikram MK, O'Sullivan MJ, Vernooij MW, Ikram MA. Subregional volumes of the hippocampus in relation to cognitive function and risk of dementia. Neuroimage 2018; 178:129-135. [PMID: 29778641 DOI: 10.1016/j.neuroimage.2018.05.041] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Total hippocampal volume has been consistently linked to cognitive function and dementia. Yet, given its complex and parcellated internal structure, the role of subregions of the hippocampus in cognition and risk of dementia remains relatively underexplored. We studied subregions of the hippocampus in a large population-based cohort to further understand their role in cognitive impairment and dementia risk. METHODS We studied 5035 dementia- and stroke-free persons from the Rotterdam Study, aged over 45 years. All participants underwent magnetic resonance imaging (1.5 T) between 2005 and 2015. Automatic segmentation of the hippocampus and 12 of its subregions was performed using the FreeSurfer software (version 6.0). A cognitive test battery was performed, and participants were followed up for the development of dementia until 2015. Associations of hippocampal subregion volumes with cognition and incident dementia were examined using linear and Cox regression models, respectively. All analyses were adjusted for age, sex, education, and total hippocampal volume. RESULTS Mean age was 64.3 years (SD 10.6) with 56% women. Smaller volumes of the hippocampal fimbria, presubiculum and subiculum showed the strongest associations with poor performance on several cognitive domains, including executive function but not memory. During a mean follow-up of 5.5 years, 76 persons developed dementia. Smaller subiculum volume was associated with risk of dementia adjusted for total volume (hazard ratio per SD decrease in volume: 1.75, 95% confidence interval 1.35; 2.26). CONCLUSIONS In a community-dwelling non-demented population, we describe patterns of association between hippocampal subregions with cognition and risk of dementia. Specifically, the subiculum was associated with both poorer cognition and higher risk of dementia.
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Affiliation(s)
- Tavia E Evans
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands; Division of Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, Maurice Wohl Clinical Neuroscience Institute, 5 Cutcombe Road, London, SE5 9RX, UK.
| | - Hieab H H Adams
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - Silvan Licher
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - Frank J Wolters
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - Michael J O'Sullivan
- Division of Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, Maurice Wohl Clinical Neuroscience Institute, 5 Cutcombe Road, London, SE5 9RX, UK; Mater Centre for Neuroscience and Queensland Brain Institute, 79, University of Queensland, St Lucia, QLD, 4072, Australia.
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Wytemaweg 90, 3015 CN, Rotterdam, The Netherlands.
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24
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Katzorke A, Zeller JBM, Müller LD, Lauer M, Polak T, Deckert J, Herrmann MJ. Decreased hemodynamic response in inferior frontotemporal regions in elderly with mild cognitive impairment. Psychiatry Res Neuroimaging 2018; 274:11-18. [PMID: 29472145 DOI: 10.1016/j.pscychresns.2018.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 01/15/2018] [Accepted: 02/09/2018] [Indexed: 02/01/2023]
Abstract
The verbal fluency task (VFT) is a well-established cognitive marker for mild cognitive impairment (MCI) in the prodromal stage of Alzheimer´s dementia (AD). The behavioral VFT performance of patients allows the prediction of dementia two years later. But effective compensatory mechanism might cover or reduce the predictive value of the VFT. Therefore the aim of this study is to measure the hemodynamic response during VFT in patients with mild cognitive impairment (MCI) to establish the hemodynamic response during the VFT as a screening instrument for the prediction of dementia. One method which allows measuring the hemodynamic response during speech production without severe problems with moving artifacts like in functional magnetic resonance imaging (fMRI) is the functional near-infrared spectroscopy (fNIRS). It is optimal as a screening instrument, as it is easy to apply and without any contraindications. In this study we assessed the hemodynamic response in prefrontal and temporal regions in patients with MCI as well as matched healthy controls with fNIRS. We found a decreased hemodynamic response in the inferior frontotemporal cortex for the MCI group. Our results indicate that a frontotemporal decreased hemodynamic response could serve as a diagnostic biomarker for dementia.
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Affiliation(s)
- Andrea Katzorke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D - 97080 Würzburg, Germany.
| | - Julia B M Zeller
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D - 97080 Würzburg, Germany
| | - Laura D Müller
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D - 97080 Würzburg, Germany
| | - Martin Lauer
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D - 97080 Würzburg, Germany
| | - Thomas Polak
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D - 97080 Würzburg, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D - 97080 Würzburg, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D - 97080 Würzburg, Germany
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25
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Lin FV, Wang X, Wu R, Rebok GW, Chapman BP. Identification of Successful Cognitive Aging in the Alzheimer's Disease Neuroimaging Initiative Study. J Alzheimers Dis 2018; 59:101-111. [PMID: 28582857 DOI: 10.3233/jad-161278] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present prospective observational study aimed to identify the existence of successful cognitive agers among a group of well-defined cognitively healthy older adults (n = 354, mean age = 75 years), and to examine baseline individual-level predictors and associated health outcomes over time. Episodic memory (EM) and executive function (EF) composite scores and multiple health outcomes were obtained annually over 5 years. Potential individual-level predictors that were related to Alzheimer's disease pathology or genetic risk, neurodegeneration, and vascular risks were collected at baseline. Three latent classes with matched age and education were identified using growth mixture modeling: a group of participants who exhibited high, stable EM and EF (40.7% of the sample, "successful agers"); a group who had initial high cognitive performance that declined over time (21.2%, "declining agers"); and a group who had normal (EM) or poor (EF) but stable cognitive performance over time (38.1%, "low stable agers"). The group classification predicted significant differences in the incidence of global cognitive impairment, the development of at least one depressive symptom, and everyday functional impairment. Sex, apolipoprotein E allele 4, amyloid-β1-42, and t-tau significantly contributed to the difference in cognitive trajectories between the successful agers and the other two groups. Characterizing successful cognitive agers who are relatively resistant to both tau and amyloid pathology provides potential pathways for promoting successful cognitive aging and preventing cognitive decline.
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Affiliation(s)
- Feng V Lin
- School of Nursing, University of Rochester Medical Center, Rochester, NY, USA.,Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.,Department of Brain and Cognitive Science, University of Rochester, Rochester, NY, USA.,Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
| | - Xixi Wang
- Department of Brain and Cognitive Science, University of Rochester, Rochester, NY, USA.,Department of Biomedical Engineering, University of Rochester, Rochester, NY, USA
| | - Rachel Wu
- Department of Psychology, University of California, Riverside, Riverside, CA, USA
| | - George W Rebok
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Benjamin P Chapman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.,Department of Public Health Science, University of Rochester Medical Center, Rochester, NY, USA
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26
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Seo EH, Kim H, Lee KH, Choo IH. Altered Executive Function in Pre-Mild Cognitive Impairment. J Alzheimers Dis 2018; 54:933-940. [PMID: 27567814 DOI: 10.3233/jad-160052] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND For the early detection of Alzheimer's disease (AD), there is increasing interest in pre-mild cognitive impairment (pre-MCI). OBJECTIVE We explored the neuropsychological characteristics in a group of pre-MCI and cognitively normal (CN) elderly individuals, with the aim of providing measures sensitive to cognitive change in pre-MCI. METHODS We included 188 CN elderly and 77 individuals with pre-MCI. All participants underwent comprehensive clinical and neuropsychological assessment. We compared 17 cognitive tests between the CN and pre-MCI groups by using one-way ANOVAs with false discovery rate correction for multiple comparisons. Pearson's correlations were also obtained between episodic memory and executive function tests in the pre-MCI group. RESULTS The pre-MCI group showed significantly lower scores for visual immediate recall, fluency tests, and Stroop color naming in the color-word incongruent condition than the CN group (p < 0.05). Most of these executive function measures were significantly correlated with episodic memory (p < 0.05). There were no significant group-differences in other tests assessing attention, verbal memory, visuospatial ability, and language. CONCLUSION Our findings indicate that poor executive function especially demanding inhibition and goal-directed behaviors within time limit could be the characteristics of the very early cognitive sign in the course of AD.
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Affiliation(s)
- Eun Hyun Seo
- National Research Center for Dementia, Gwangju, Korea.,Premedical Science, College of Medicine, Chosun University, Gwangju, Korea
| | - Hoowon Kim
- National Research Center for Dementia, Gwangju, Korea.,Department of Neurology, School of Medicine, Chosun University/Chosun University Hospital, Gwangju, Korea
| | - Kun Ho Lee
- National Research Center for Dementia, Gwangju, Korea.,College of Natural Sciences, Chosun University, Gwangju, South Korea
| | - Il Han Choo
- National Research Center for Dementia, Gwangju, Korea.,Department of Neuropsychiatry, School of Medicine, Chosun University/Chosun University Hospital, Gwangju, Korea
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27
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Soininen H, Solomon A, Visser PJ, Hendrix SB, Blennow K, Kivipelto M, Hartmann T. 24-month intervention with a specific multinutrient in people with prodromal Alzheimer's disease (LipiDiDiet): a randomised, double-blind, controlled trial. Lancet Neurol 2017; 16:965-975. [PMID: 29097166 PMCID: PMC5697936 DOI: 10.1016/s1474-4422(17)30332-0] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 09/06/2017] [Accepted: 09/12/2017] [Indexed: 01/31/2023]
Abstract
Background Nutrition is an important modifiable risk factor in Alzheimer's disease. Previous trials of the multinutrient Fortasyn Connect showed benefits in mild Alzheimer's disease dementia. LipiDiDiet investigated the effects of Fortasyn Connect on cognition and related measures in prodromal Alzheimer's disease. Here, we report the 24-month results of the trial. Methods LipiDiDiet was a 24-month randomised, controlled, double-blind, parallel-group, multicentre trial (11 sites in Finland, Germany, the Netherlands, and Sweden), with optional 12-month double-blind extensions. The trial enrolled individuals with prodromal Alzheimer's disease, defined according to the International Working Group (IWG)-1 criteria. Participants were randomly assigned (1:1) to active product (125 mL once-a-day drink containing Fortasyn Connect) or control product. Randomisation was computer-generated centrally in blocks of four, stratified by site. All study personnel and participants were masked to treatment assignment. The primary endpoint was change in a neuropsychological test battery (NTB) score. Analysis was by modified intention to treat. Safety analyses included all participants who consumed at least one study product dose. This trial is registered with the Dutch Trial Register, number NTR1705. Findings Between April 20, 2009, and July 3, 2013, 311 of 382 participants screened were randomly assigned to the active group (n=153) or control group (n=158). Mean change in NTB primary endpoint was −0·028 (SD 0·453) in the active group and −0·108 (0·528) in the control group; estimated mean treatment difference was 0·098 (95% CI −0·041 to 0·237; p=0·166). The decline in the control group was less than the prestudy estimate of −0·4 during 24 months. 66 (21%) participants dropped out of the study. Serious adverse events occurred in 34 (22%) participants in the active group and 30 (19%) in control group (p=0·487), none of which were regarded as related to the study intervention. Interpretation The intervention had no significant effect on the NTB primary endpoint over 2 years in prodromal Alzheimer's disease. However, cognitive decline in this population was much lower than expected, rendering the primary endpoint inadequately powered. Group differences on secondary endpoints of disease progression measuring cognition and function and hippocampal atrophy were observed. Further study of nutritional approaches with larger sample sizes, longer duration, or a primary endpoint more sensitive in this pre-dementia population, is needed. Funding European Commission 7th Framework Programme.
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Affiliation(s)
- Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland.
| | - Alina Solomon
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Department of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden; Clinical Trials Unit, Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, University of Maastricht, Maastricht, Netherlands; Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, Netherlands
| | | | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Miia Kivipelto
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Department of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden; Clinical Trials Unit, Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Tobias Hartmann
- German Institute for Dementia Prevention (DIDP), Medical Faculty, and Department of Experimental Neurology, Saarland University, Homburg, Germany
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28
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McDonough IM. Beta-amyloid and Cortical Thickness Reveal Racial Disparities in Preclinical Alzheimer's Disease. Neuroimage Clin 2017; 16:659-667. [PMID: 29868439 PMCID: PMC5984571 DOI: 10.1016/j.nicl.2017.09.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/13/2017] [Accepted: 09/20/2017] [Indexed: 01/06/2023]
Abstract
African Americans are two to four times more likely to develop dementia as Non-Hispanic Whites. This increased risk among African Americans represents a critical health disparity that affects nearly 43 million Americans. The present study tested the hypothesis that older African Americans with elevated beta-amyloid would show greater neurodegeneration (smaller hippocampal volumes and decreased cortical thickness) than older Non-Hispanic Whites with elevated beta-amyloid. Data from the Harvard Aging Brain Study (HABS) were used to form a group of older African Americans and two matched groups of Non-Hispanic White adults. Amyloid-positive African Americans had decreased cortical thickness in most of the Alzheimer's disease (AD) signature regions compared with amyloid-positive Non-Hispanic Whites. This factor was negatively correlated with age and white matter hypointensities. Using support vector regression, we also found some evidence that African Americans have an older "brain age" than Non-Hispanic Whites. These findings suggest that African Americans might be more susceptible to factors causing neurodegeneration, which then might accelerate the rate of a diagnosis of AD.
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Affiliation(s)
- Ian M. McDonough
- Department of Psychology, The University of Alabama, Tuscaloosa, AL 35487, USA
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29
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Aisen PS, Cummings J, Jack CR, Morris JC, Sperling R, Frölich L, Jones RW, Dowsett SA, Matthews BR, Raskin J, Scheltens P, Dubois B. On the path to 2025: understanding the Alzheimer's disease continuum. Alzheimers Res Ther 2017; 9:60. [PMID: 28793924 PMCID: PMC5549378 DOI: 10.1186/s13195-017-0283-5] [Citation(s) in RCA: 267] [Impact Index Per Article: 38.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/04/2017] [Indexed: 12/02/2022]
Abstract
Basic research advances in recent years have furthered our understanding of the natural history of Alzheimer's disease (AD). It is now recognized that pathophysiological changes begin many years prior to clinical manifestations of disease and the spectrum of AD spans from clinically asymptomatic to severely impaired. Defining AD purely by its clinical presentation is thus artificial and efforts have been made to recognize the disease based on both clinical and biomarker findings. Advances with biomarkers have also prompted a shift in how the disease is considered as a clinico-pathophysiological entity, with an increasing appreciation that AD should not only be viewed with discrete and defined clinical stages, but as a multifaceted process moving along a seamless continuum. Acknowledging this concept is critical to understanding the development process for disease-modifying therapies, and for initiating effective diagnostic and disease management options. In this article, we discuss the concept of a disease continuum from pathophysiological, biomarker, and clinical perspectives, and highlight the importance of considering AD as a continuum rather than discrete stages. While the pathophysiology of AD has still not been elucidated completely, there is ample evidence to support researchers and clinicians embracing the view of a disease continuum in their study, diagnosis, and management of the disease.
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Affiliation(s)
- Paul S. Aisen
- University of Southern California, San Diego, CA USA
| | - Jeffrey Cummings
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV USA
| | | | - John C. Morris
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO USA
| | - Reisa Sperling
- Center for Alzheimer’s Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Roy W. Jones
- The Research Institute for the Care of Older People (RICE), Royal United Hospital, Bath, UK
| | | | | | | | - Philip Scheltens
- Department of Neurology & Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Bruno Dubois
- Institute for Memory and Alzheimer’s Disease (IM2A) and ICM, Salpêtrière University Hospital, Paris University (UPMC), Paris, France
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Pagani M, Nobili F, Morbelli S, Arnaldi D, Giuliani A, Öberg J, Girtler N, Brugnolo A, Picco A, Bauckneht M, Piva R, Chincarini A, Sambuceti G, Jonsson C, De Carli F. Early identification of MCI converting to AD: a FDG PET study. Eur J Nucl Med Mol Imaging 2017; 44:2042-2052. [PMID: 28664464 DOI: 10.1007/s00259-017-3761-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/13/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer's disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not. METHODS FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy. RESULTS The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89% (AUC 0.91), correctly detecting 93% of the nc-MCI patients. CONCLUSION In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89%. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD.
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Affiliation(s)
- Marco Pagani
- Institute of Cognitive Sciences and Technologies, CNR, Via Palestro 32, 00185, Rome, Italy. .,Department of Nuclear Medicine, Karolinska Hospital Stockholm, Stockholm, Sweden.
| | - Flavio Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Silvia Morbelli
- Department of Nuclear Medicine, Department of Health Science (DISSAL), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Dario Arnaldi
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Alessandro Giuliani
- Environment and Health Department, Istituto Superiore di Sanità, Rome, Italy
| | - Johanna Öberg
- Department of Hospital Physics, Karolinska Hospital, Stockholm, Sweden
| | - Nicola Girtler
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy.,Clinical Psychology, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Andrea Brugnolo
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Agnese Picco
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Matteo Bauckneht
- Department of Nuclear Medicine, Department of Health Science (DISSAL), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Roberta Piva
- Department of Nuclear Medicine, Department of Health Science (DISSAL), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Andrea Chincarini
- National Institute of Nuclear Physics (INFN), Genoa section, Genoa, Italy
| | - Gianmario Sambuceti
- Department of Nuclear Medicine, Department of Health Science (DISSAL), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Cathrine Jonsson
- Medical Radiation Physics and Nuclear Medicine, Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Fabrizio De Carli
- Institute of Molecular Bioimaging and Physiology, CNR - Genoa Unit, AOU San Martino-IST, Genoa, Italy
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31
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Validation of Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL), a Performance- Based Measurement of Instrumental Activities of Daily Living for Patients with Vascular Cognitive Impairment. PLoS One 2016; 11:e0166546. [PMID: 27851810 PMCID: PMC5113008 DOI: 10.1371/journal.pone.0166546] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 10/31/2016] [Indexed: 11/19/2022] Open
Abstract
Objective Patients with cerebrovascular diseases often presented both cognitive and physical impairment. Disability in everyday functioning involving cognitive impairment among patients may be hard to completely rely on informants’ reports, as their reports may be confounded with physical impairment. The aim of this study was to validate a performance-based measure of functional assessment, the Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL), for vascular cognitive impairment (VCI) by examining its psychometric properties and diagnostic accuracy. Methods Ninety-seven patients with cerebrovascular diseases, including 30 with vascular dementia (VaD), 28 with mild cognitive impairment and 39 with no cognitive impairment, and 49 healthy control adults were recruited during study period. The TPIADL, as well as the Mini Mental State Examination (MMSE), Lawton-IADL and Barthel Index (BI), were performed. The internal consistency, convergent and criteria validity of the TPIADL were examined. Results Cronbach’s alpha of the TPIADL test was 0.84. The TPIADL scores were significantly correlated with the Lawton IADL (r = –0.587, p <0.01). Notably, the TPIADL had a higher correlation coefficient with the cognitive domain of Lawton IADL (r = –0.663) than with physical domain of Lawton IADL (r = –0.541). The area under the relative operating characteristic curve was 0.888 (95% CI = 0.812–0.965) to differentiate VaD from other groups. The optimal cut-off point of the TPIADL for detecting VaD was 6/7, which gives a sensitivity of 73.3% and a specificity of 84.5%. Conclusion The TPIADL is a brief and sensitive tool for the detection of IADL impairment in patients with VaD.
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Lancaster MA, Seidenberg M, Smith JC, Nielson KA, Woodard JL, Durgerian S, Rao SM. Diffusion Tensor Imaging Predictors of Episodic Memory Decline in Healthy Elders at Genetic Risk for Alzheimer's Disease. J Int Neuropsychol Soc 2016; 22:1005-1015. [PMID: 27903333 PMCID: PMC5916766 DOI: 10.1017/s1355617716000904] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES White matter (WM) integrity within the mesial temporal lobe (MTL) is important for episodic memory (EM) functioning. The current study investigated the ability of diffusion tensor imaging (DTI) in MTL WM tracts to predict 3-year changes in EM performance in healthy elders at disproportionately higher genetic risk for Alzheimer's disease (AD). METHODS Fifty-one cognitively intact elders (52% with family history (FH) of dementia and 33% possessing an Apolipoprotein E ε4 allelle) were administered the Rey Auditory Verbal Learning Test (RAVLT) at study entry and at 3-year follow-up. DTI scanning, conducted at study entry, examined fractional anisotropy and mean, radial and axial diffusion within three MTL WM tracts: uncinate fasciculus (UNC), cingulate-hippocampal (CHG), and fornix-stria terminalis (FxS). Correlations were performed between residualized change scores computed from RAVLT trials 1-5, immediate recall, and delayed recall scores and baseline DTI measures; MTL gray matter (GM) and WM volumes; demographics; and AD genetic and metabolic risk factors. RESULTS Higher MTL mean and axial diffusivity at baseline significantly predicted 3-year changes in EM, whereas baseline MTL GM and WM volumes, FH, and metabolic risk factors did not. Both ε4 status and DTI correlated with change in immediate recall. CONCLUSIONS Longitudinal EM changes in cognitively intact, healthy elders can be predicted by disruption of the MTL WM microstructure. These results are derived from a sample with a disproportionately higher genetic risk for AD, suggesting that the observed WM disruption in MTL pathways may be related to early neuropathological changes associated with the preclinical stage of AD. (JINS, 2016, 22, 1005-1015).
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Affiliation(s)
- Melissa A. Lancaster
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Michael Seidenberg
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - J. Carson Smith
- Department of Kinesiology, University of Maryland, College Park, MD, USA
| | - Kristy A. Nielson
- Department of Psychology, Marquette University, Milwaukee, WI, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - John L. Woodard
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Sally Durgerian
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Stephen M. Rao
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
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The Effect of Task-Irrelevant Fearful-Face Distractor on Working Memory Processing in Mild Cognitive Impairment versus Healthy Controls: An Exploratory fMRI Study in Female Participants. Behav Neurol 2016; 2016:1637392. [PMID: 26949290 PMCID: PMC4753321 DOI: 10.1155/2016/1637392] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 12/31/2015] [Accepted: 01/05/2016] [Indexed: 11/25/2022] Open
Abstract
In mild cognitive impairment (MCI), a risk state for Alzheimer's disease, patients have objective cognitive deficits with relatively preserved functioning. fMRI studies have identified anomalies during working memory (WM) processing in individuals with MCI. The effect of task-irrelevant emotional face distractor on WM processing in MCI remains unclear. We aim to explore the impact of fearful-face task-irrelevant distractor on WM processing in MCI using fMRI. Hypothesis. Compared to healthy controls (HC), MCI patients will show significantly higher BOLD signal in a priori identified regions of interest (ROIs) during a WM task with a task-irrelevant emotional face distractor. Methods. 9 right-handed female participants with MCI and 12 matched HC performed a WM task with standardized task-irrelevant fearful versus neutral face distractors randomized and counterbalanced across WM trials. MRI images were acquired during the WM task and BOLD signal was analyzed using statistical parametric mapping (SPM) to identify signal patterns during the task response phase. Results. Task-irrelevant fearful-face distractor resulted in higher activation in the amygdala, anterior cingulate, and frontal areas, in MCI participants compared to HC. Conclusions. This exploratory study suggests altered WM processing as a result of fearful-face distractor in MCI.
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Verlinden VJ, van der Geest JN, de Bruijn RF, Hofman A, Koudstaal PJ, Ikram MA. Trajectories of decline in cognition and daily functioning in preclinical dementia. Alzheimers Dement 2015; 12:144-153. [DOI: 10.1016/j.jalz.2015.08.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/23/2015] [Accepted: 08/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Vincentius J.A. Verlinden
- Department of Epidemiology; Erasmus MC University Medical Centre Rotterdam; Rotterdam The Netherlands
- Department of Radiology; Erasmus MC University Medical Centre Rotterdam; Rotterdam The Netherlands
| | - Jos N. van der Geest
- Department of Neuroscience; Erasmus MC University Medical Centre Rotterdam; Rotterdam The Netherlands
| | - Renée F.A.G. de Bruijn
- Department of Epidemiology; Erasmus MC University Medical Centre Rotterdam; Rotterdam The Netherlands
- Department of Neurology; Erasmus MC University Medical Centre Rotterdam; Rotterdam The Netherlands
| | - Albert Hofman
- Department of Epidemiology; Erasmus MC University Medical Centre Rotterdam; Rotterdam The Netherlands
| | - Peter J. Koudstaal
- Department of Neurology; Erasmus MC University Medical Centre Rotterdam; Rotterdam The Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology; Erasmus MC University Medical Centre Rotterdam; Rotterdam The Netherlands
- Department of Radiology; Erasmus MC University Medical Centre Rotterdam; Rotterdam The Netherlands
- Department of Neurology; Erasmus MC University Medical Centre Rotterdam; Rotterdam The Netherlands
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