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Dang C, Wang Y, Li Q, Lu Y. Neuroimaging modalities in the detection of Alzheimer's disease-associated biomarkers. PSYCHORADIOLOGY 2023; 3:kkad009. [PMID: 38666112 PMCID: PMC11003434 DOI: 10.1093/psyrad/kkad009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/04/2023] [Accepted: 06/20/2023] [Indexed: 04/28/2024]
Abstract
Alzheimer's disease (AD) is the most common cause of dementia. Neuropathological changes in AD patients occur up to 10-20 years before the emergence of clinical symptoms. Specific diagnosis and appropriate intervention strategies are crucial during the phase of mild cognitive impairment (MCI) and AD. The detection of biomarkers has emerged as a promising tool for tracking the efficacy of potential therapies, making an early disease diagnosis, and prejudging treatment prognosis. Specifically, multiple neuroimaging modalities, including magnetic resonance imaging (MRI), positron emission tomography, optical imaging, and single photon emission-computed tomography, have provided a few potential biomarkers for clinical application. The MRI modalities described in this review include structural MRI, functional MRI, diffusion tensor imaging, magnetic resonance spectroscopy, and arterial spin labelling. These techniques allow the detection of presymptomatic diagnostic biomarkers in the brains of cognitively normal elderly people and might also be used to monitor AD disease progression after the onset of clinical symptoms. This review highlights potential biomarkers, merits, and demerits of different neuroimaging modalities and their clinical value in MCI and AD patients. Further studies are necessary to explore more biomarkers and overcome the limitations of multiple neuroimaging modalities for inclusion in diagnostic criteria for AD.
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Affiliation(s)
- Chun Dang
- Department of Periodical Press, West China Hospital, Sichuan University, Chengdu 610000, China
| | - Yanchao Wang
- Department of Neurology, Chifeng University of Affiliated Hospital, Chifeng 024000, China
| | - Qian Li
- Department of Neurology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Yaoheng Lu
- Department of General Surgery, Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital, Chengdu 610000, China
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2
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Mirkin S, Albensi BC. Should artificial intelligence be used in conjunction with Neuroimaging in the diagnosis of Alzheimer's disease? Front Aging Neurosci 2023; 15:1094233. [PMID: 37187577 PMCID: PMC10177660 DOI: 10.3389/fnagi.2023.1094233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
Alzheimer's disease (AD) is a progressive, neurodegenerative disorder that affects memory, thinking, behavior, and other cognitive functions. Although there is no cure, detecting AD early is important for the development of a therapeutic plan and a care plan that may preserve cognitive function and prevent irreversible damage. Neuroimaging, such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET), has served as a critical tool in establishing diagnostic indicators of AD during the preclinical stage. However, as neuroimaging technology quickly advances, there is a challenge in analyzing and interpreting vast amounts of brain imaging data. Given these limitations, there is great interest in using artificial Intelligence (AI) to assist in this process. AI introduces limitless possibilities in the future diagnosis of AD, yet there is still resistance from the healthcare community to incorporate AI in the clinical setting. The goal of this review is to answer the question of whether AI should be used in conjunction with neuroimaging in the diagnosis of AD. To answer the question, the possible benefits and disadvantages of AI are discussed. The main advantages of AI are its potential to improve diagnostic accuracy, improve the efficiency in analyzing radiographic data, reduce physician burnout, and advance precision medicine. The disadvantages include generalization and data shortage, lack of in vivo gold standard, skepticism in the medical community, potential for physician bias, and concerns over patient information, privacy, and safety. Although the challenges present fundamental concerns and must be addressed when the time comes, it would be unethical not to use AI if it can improve patient health and outcome.
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Affiliation(s)
- Sophia Mirkin
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Benedict C. Albensi
- Barry and Judy Silverman College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL, United States
- St. Boniface Hospital Research, Winnipeg, MB, Canada
- University of Manitoba, Winnipeg, MB, Canada
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3
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Zhang W, Zheng X, Li R, Liu M, Xiao W, Huang L, Xu F, Dong N, Li Y. Research on nonstroke dementia screening and cognitive function prediction model for older people based on brain atrophy characteristics. Brain Behav 2022; 12:e2726. [PMID: 36278400 PMCID: PMC9660432 DOI: 10.1002/brb3.2726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/12/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Brain atrophy is an important feature in dementia and is meaningful to explore a brain atrophy model to predict dementia. Using machine learning algorithm to establish a dementia model and cognitive function model based on brain atrophy characteristics is unstoppable. METHOD We acquired 157 dementia and 156 normal old people.s clinical information and MRI data, which contains 44 brain atrophy features, including visual scale assessment of brain atrophy and multiple linear measurement indexes and brain atrophy index. Five machine learning models were used to establish prediction models for dementia, general cognition, and subcognitive domains. RESULTS The extreme Gradient Boosting (XGBoost) model had the best effect in predicting dementia, with a sensitivity of 0.645, a specificity of 0.839, and the area under curve (AUC) of 0.784. In this model, the important brain atrophy features for predicting dementia were temporal horn ratio, cella media index, suprasellar cistern ratio, and the thickness of the corpus callosum genu. CONCLUSION For nonstroke elderly people, the machine learning model based on clinical head MRI brain atrophy features had good predictive value for dementia, general cognitive impairment, immediate memory impairment, word fluency disorder, executive dysfunction, and visualspatial disorder.
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Affiliation(s)
- Wei Zhang
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoran Zheng
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Renren Li
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Meng Liu
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weixin Xiao
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lihe Huang
- Research Center for Ageing, Language and Care at Tongji University, Shanghai, China
| | - Feiyang Xu
- iFlytek Research, iFlytek Co. Ltd, Hefei, China
| | - Ningxin Dong
- Department of Radiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yunxia Li
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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4
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Chen R, Cai G, Xu S, Sun Q, Luo J, Wang Y, Li M, Lin H, Liu J. Body mass index related to executive function and hippocampal subregion volume in subjective cognitive decline. Front Aging Neurosci 2022; 14:905035. [PMID: 36062154 PMCID: PMC9428252 DOI: 10.3389/fnagi.2022.905035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
Abstract
Objective This study aims to explore whether body mass index (BMI) level affects the executive function and hippocampal subregion volume of subjective cognitive decline (SCD). Materials and methods A total of 111 participants were included in the analysis, including SCD (38 of normal BMI, 27 of overweight and obesity) and normal cognitive control (NC) (29 of normal BMI, 17 of overweight and obesity). All subjects underwent the Chinese version of the Stroop Color-Word Test (SCWT) to measure the executive function and a high-resolution 3D T1 structural image acquisition. Two-way ANOVA was used to examine the differences in executive function and gray matter volume in hippocampal subregions under different BMI levels between the SCD and NC. Result The subdimensions of executive function in which different BMI levels interact with SCD and NC include inhibition control function [SCWT C-B reaction time(s): F (1,104) = 5.732, p = 0.018], and the hippocampal subregion volume of CA1 [F (1,99) = 8.607, p = 0.004], hippocampal tail [F (1,99) = 4.077, p = 0.046], and molecular layer [F (1,99) = 6.309, p = 0.014]. After correction by Bonferroni method, the population × BMI interaction only had a significant effect on the CA1 (p = 0.004). Further analysis found that the SCWT C-B reaction time of SCD was significantly longer than NC no matter whether it is at the normal BMI level [F (1,104) = 4.325, p = 0.040] or the high BMI level [F (1,104) = 21.530, p < 0.001], and the inhibitory control function of SCD was worse than that of NC. In the normal BMI group, gray matter volume in the hippocampal subregion (CA1) of SCD was significantly smaller than that of NC [F (1,99) = 4.938, p = 0.029]. For patients with SCD, the high BMI group had worse inhibitory control function [F (1,104) = 13.499, p < 0.001] and greater CA1 volume compared with the normal BMI group [F (1,99) = 7.619, p = 0.007]. Conclusion The BMI level is related to the inhibition control function and the gray matter volume of CA1 subregion in SCD. Overweight seems to increase the gray matter volume of CA1 in the elderly with SCD, but it is not enough to compensate for the damage to executive function caused by the disease. These data provide new insights into the relationship between BMI level and executive function of SCD from the perspective of imaging.
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Affiliation(s)
- Ruilin Chen
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Guiyan Cai
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shurui Xu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Qianqian Sun
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jia Luo
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yajun Wang
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ming Li
- Affiliated Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hui Lin
- Department of Physical Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiao Liu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, China
- Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation, Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Daigle KM, Pietrzykowski MO, Waters AB, Swenson LP, Gansler DA. Central Executive Network and Executive Function in Patients With Alzheimer's Disease and Healthy Individuals: Meta-Analysis of Structural and Functional MRI. J Neuropsychiatry Clin Neurosci 2022; 34:204-213. [PMID: 35272491 DOI: 10.1176/appi.neuropsych.20110279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The neural architecture of executive function is of interest given its utility as a transdiagnostic predictor of adaptive functioning. However, a gap exists in the meta-analytic literature assessing this relationship in neuropsychiatric populations, concordance between structural and functional architecture, and the relationship with neuropsychological assessment of executive function. Given the importance of the central executive network (CEN) in Alzheimer's disease, this population may be useful in understanding this relationship in Alzheimer's disease pathology. METHODS A meta-analysis of studies (k=21) was conducted to elucidate the relationship between executive function and CEN for structural architecture (k=10; N=1,027) among patients with Alzheimer's disease (k=6; N=250) and healthy control subjects (HCs) (k=4; N=777) and for functional architecture (k=11; N=522) among patients with Alzheimer's disease (k=6; N=306) and HCs (k=5; N=216). Random-effects modeling was used to increase accuracy of conclusions about population means. RESULTS Analyses revealed a positive brain-behavior relationship (pr=0.032, 95% CI=0.07, 0.54), although there was a lack of statistically significant heterogeneity between functional and structural neuroimaging (Q=9.89, p=0.971, I2=0.00%) and between the Alzheimer's and HC groups in functional (Q=8.18, p=0.612, I2=0.00%) and structural (Q=1.60, p=0.996, I2=0.00%) neuroimaging. Similarly, a lack of statistically significant heterogeneity was revealed between functional and structural neuroimaging among patients with Alzheimer's disease (Q=3.59, p=0.980, I2=0.00%) and HCs (Q=3.67, p=0.885, I2=0.00%). CONCLUSIONS Structural and functional imaging in the CEN are predictive of executive function performance among patients with Alzheimer's disease and HCs. Regardless of how the CEN is affected, behavior is correlated to the degree to which the CEN is affected. Findings are significant in the context of methodological decisions in multimodal neuroimaging research.
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Affiliation(s)
- Katrina M Daigle
- Clinical Neuroscience of Cognitive Control Laboratory, Department of Psychology, Suffolk University, Boston (Daigle, Pietrzykowski, Waters, Gansler); and Department of Psychology, Suffolk University, Boston (Swenson)
| | - Malvina O Pietrzykowski
- Clinical Neuroscience of Cognitive Control Laboratory, Department of Psychology, Suffolk University, Boston (Daigle, Pietrzykowski, Waters, Gansler); and Department of Psychology, Suffolk University, Boston (Swenson)
| | - Abigail B Waters
- Clinical Neuroscience of Cognitive Control Laboratory, Department of Psychology, Suffolk University, Boston (Daigle, Pietrzykowski, Waters, Gansler); and Department of Psychology, Suffolk University, Boston (Swenson)
| | - Lance P Swenson
- Clinical Neuroscience of Cognitive Control Laboratory, Department of Psychology, Suffolk University, Boston (Daigle, Pietrzykowski, Waters, Gansler); and Department of Psychology, Suffolk University, Boston (Swenson)
| | - David A Gansler
- Clinical Neuroscience of Cognitive Control Laboratory, Department of Psychology, Suffolk University, Boston (Daigle, Pietrzykowski, Waters, Gansler); and Department of Psychology, Suffolk University, Boston (Swenson)
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Association between Self-Reported Pain, Cognition, and Neuropathology in Older Adults Admitted to an Outpatient Memory Clinic-A Cross-Sectional Study. Brain Sci 2021; 11:brainsci11091156. [PMID: 34573177 PMCID: PMC8465123 DOI: 10.3390/brainsci11091156] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/19/2021] [Accepted: 08/27/2021] [Indexed: 12/14/2022] Open
Abstract
Cognitive impairment has been linked to reduced self-reporting of pain. However, it is unclear whether the various cognitive functions are similarly and/or independently associated with such pain report measures. In the present study, we explored how executive functioning (EF), memory, and global cognition relate to self-reported pain and investigated whether underlying neuropathology partially accounts for these results. We used Lasso categorical regression to analyze data from 179 individuals visiting a memory clinic. The data included the self-reported pain occurrence, intensity, severity and frequency, clinical diagnoses, neuropsychological scores, white matter hyperintensities, medial temporal lobe atrophy, depressive symptoms, and demographics. Our results showed that worse memory and EF performance predicted a lower pain occurrence. In those individuals who did report pain, worse memory predicted lower pain intensity, severity, and frequency levels, but for EF reversed effects were found, with worse EF predicting higher pain scores. These relationships were only partially explained by reductions in white matter and medial temporal lobe integrity. Similar effects were found for depressive symptoms. Our findings highlight the distinct associations of EF and memory with self-reported pain. A similar pattern of relationships found for both self-reported pain and depressive symptoms may reflect shared latent affective components.
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Ter Telgte A, van Leijsen EMC, Wiegertjes K, Klijn CJM, Tuladhar AM, de Leeuw FE. Cerebral small vessel disease: from a focal to a global perspective. Nat Rev Neurol 2019; 14:387-398. [PMID: 29802354 DOI: 10.1038/s41582-018-0014-y] [Citation(s) in RCA: 299] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Cerebral small vessel disease (SVD) is commonly observed on neuroimaging among elderly individuals and is recognized as a major vascular contributor to dementia, cognitive decline, gait impairment, mood disturbance and stroke. However, clinical symptoms are often highly inconsistent in nature and severity among patients with similar degrees of SVD on brain imaging. Here, we provide a new framework based on new advances in structural and functional neuroimaging that aims to explain the remarkable clinical variation in SVD. First, we discuss the heterogeneous pathology present in SVD lesions despite an identical appearance on imaging and the perilesional and remote effects of these lesions. We review effects of SVD on structural and functional connectivity in the brain, and we discuss how network disruption by SVD can lead to clinical deficits. We address reserve and compensatory mechanisms in SVD and discuss the part played by other age-related pathologies. Finally, we conclude that SVD should be considered a global rather than a focal disease, as the classically recognized focal lesions affect remote brain structures and structural and functional network connections. The large variability in clinical symptoms among patients with SVD can probably be understood by taking into account the heterogeneity of SVD lesions, the effects of SVD beyond the focal lesions, the contribution of neurodegenerative pathologies other than SVD, and the interaction with reserve mechanisms and compensatory mechanisms.
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Affiliation(s)
- Annemieke Ter Telgte
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Esther M C van Leijsen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Kim Wiegertjes
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Catharina J M Klijn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Anil M Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.
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8
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van den Berg E, Geerlings MI, Biessels GJ, Nederkoorn PJ, Kloppenborg RP. White Matter Hyperintensities and Cognition in Mild Cognitive Impairment and Alzheimer's Disease: A Domain-Specific Meta-Analysis. J Alzheimers Dis 2019; 63:515-527. [PMID: 29630548 DOI: 10.3233/jad-170573] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND White matter hyperintensities (WMHs) are related to cognitive dysfunction in the general population. The clinical relevance of WMHs in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) is, however, unclear. OBJECTIVE This meta-analysis aimed to quantify the association of WMHs and specific cognitive domains in patients with MCI or AD. METHODS PubMed (January 1990-January 2017) was searched for studies that used MRI to quantify WMHs, and measured cognitive functioning (≥1 predefined cognitive domain with ≥1 test) in a well-defined population of persons diagnosed with MCI or AD. Fischer's Z was used as the common metric for effect size. Modifying effects of demographics, MMSE, and WMH location were examined. RESULTS Twelve cross-sectional studies on AD (total n = 1,370, median age 75 years) and 10 studies on MCI (9 cross-sectional, 1 longitudinal; total n = 2,286, median age 73 years) were included. The association between WMHs and overall cognition was significantly stronger for MCI (-0.25, -0.36 to -0.14) than for AD (-0.11, -0.14 to -0.08; QM = 10.7, p < 0.05). For both groups, largest effect sizes were found in attention and executive functions (-0.26, -0.36 to -0.15) and processing speed (-0.21, -0.35 to -0.12). No significant modifying effects of age and gender were found. CONCLUSION WMHs have a medium-sized association with different cognitive functions in patients with MCI and a small, but statistically significant, association with cognition in AD. These result underscore the role of co-occurring vascular brain damage in MCI and AD.
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Affiliation(s)
- Esther van den Berg
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul J Nederkoorn
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
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van Leijsen EMC, Tay J, van Uden IWM, Kooijmans ECM, Bergkamp MI, van der Holst HM, Ghafoorian M, Platel B, Norris DG, Kessels RPC, Markus HS, Tuladhar AM, de Leeuw FE. Memory decline in elderly with cerebral small vessel disease explained by temporal interactions between white matter hyperintensities and hippocampal atrophy. Hippocampus 2018; 29:500-510. [PMID: 30307080 DOI: 10.1002/hipo.23039] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/07/2018] [Accepted: 09/29/2018] [Indexed: 11/11/2022]
Abstract
White matter hyperintensities (WMH) constitute the visible spectrum of cerebral small vessel disease (SVD) markers and are associated with cognitive decline, although they do not fully account for memory decline observed in individuals with SVD. We hypothesize that WMH might exert their effect on memory decline indirectly by affecting remote brain structures such as the hippocampus. We investigated the temporal interactions between WMH, hippocampal atrophy and memory decline in older adults with SVD. Five hundred and three participants of the RUNDMC study underwent neuroimaging and cognitive assessments up to 3 times over 8.7 years. We assessed WMH volumes semi-automatically and calculated hippocampal volumes (HV) using FreeSurfer. We used linear mixed effects models and causal mediation analyses to assess both interaction and mediation effects of hippocampal atrophy in the associations between WMH and memory decline, separately for working memory (WM) and episodic memory (EM). Linear mixed effect models revealed that the interaction between WMH and hippocampal volumes explained memory decline (WM: β = .067; 95%CI[.024-0.111]; p < .01; EM: β = .061; 95%CI[.025-.098]; p < .01), with better model fit when the WMH*HV interaction term was added to the model, for both WM (likelihood ratio test, χ2 [1] = 9.3, p < .01) and for EM (likelihood ratio test, χ2 [1] = 10.7, p < .01). Mediation models showed that both baseline WMH volume (β = -.170; p = .001) and hippocampal atrophy (β = 0.126; p = .009) were independently related to EM decline, but the effect of baseline WMH on EM decline was not mediated by hippocampal atrophy (p value indirect effect: 0.572). Memory decline in elderly with SVD was best explained by the interaction of WMH and hippocampal volumes. The relationship between WMH and memory was not causally mediated by hippocampal atrophy, suggesting that memory decline during aging is a heterogeneous condition in which different pathologies contribute to the memory decline observed in elderly with SVD.
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Affiliation(s)
- Esther M C van Leijsen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jonathan Tay
- Department of Clinical Neurosciences, Neurology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Ingeborg W M van Uden
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Eline C M Kooijmans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Mayra I Bergkamp
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Mohsen Ghafoorian
- Radboud University Medical Centre, Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands.,Radboud University, Institute for Computing and Information Sciences, Nijmegen, The Netherlands
| | - Bram Platel
- Radboud University Medical Centre, Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands
| | - David G Norris
- Radboud University, Donders Institute for Brain Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands.,Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany
| | - Roy P C Kessels
- Department of Medical Psychology, Radboud University Medical Centre, Radboud Alzheimer Centre, Nijmegen, The Netherlands.,Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Nijmegen, The Netherlands
| | - Hugh S Markus
- Department of Clinical Neurosciences, Neurology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Anil M Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Center for Medical Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
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10
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Magnetic resonance imaging in Alzheimer's disease and mild cognitive impairment. J Neurol 2018; 266:1293-1302. [PMID: 30120563 PMCID: PMC6517561 DOI: 10.1007/s00415-018-9016-3] [Citation(s) in RCA: 170] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/07/2018] [Accepted: 08/11/2018] [Indexed: 11/25/2022]
Abstract
Research utilizing magnetic resonance imaging (MRI) has been crucial to the understanding of the neuropathological mechanisms behind and clinical identification of Alzheimer’s disease (AD) and mild cognitive impairment (MCI). MRI modalities show patterns of brain damage that discriminate AD from other brain illnesses and brain abnormalities that are associated with risk of conversion to AD from MCI and other behavioural outcomes. This review discusses the application of various MRI techniques to and their clinical usefulness in AD and MCI. MRI modalities covered include structural MRI, diffusion tensor imaging (DTI), arterial spin labelling (ASL), magnetic resonance spectroscopy (MRS), and functional MRI (fMRI). There is much evidence supporting the validity of MRI as a biomarker for these disorders; however, only traditional structural imaging is currently recommended for routine use in clinical settings. Future research is needed to warrant the inclusion for more advanced MRI methodology in forthcoming revisions to diagnostic criteria for AD and MCI.
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11
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Wu M, Aizenstein HJ. The Multi-Faceted Relationship between White Matter Lesions and Late-Life Depression. Am J Geriatr Psychiatry 2017; 25:1322-1325. [PMID: 29050911 PMCID: PMC10833147 DOI: 10.1016/j.jagp.2017.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 11/20/2022]
Affiliation(s)
- Minjie Wu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.
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Liu QS, Jiang HL, Wang Y, Wang LL, Zhang JX, He CH, Shao S, Zhang TT, Xing JG, Liu R. Total flavonoid extract from Dracoephalum moldavica L. attenuates β-amyloid-induced toxicity through anti-amyloidogenesic and neurotrophic pathways. Life Sci 2017; 193:214-225. [PMID: 29100755 DOI: 10.1016/j.lfs.2017.10.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/29/2017] [Accepted: 10/30/2017] [Indexed: 10/18/2022]
Abstract
AIMS Alzheimer's disease (AD) is an incurable neurodegenerative disorder characterized by global cognitive impairment that involves accumulation of amyloid-beta peptides (Aβ) in the brain. Herbal approaches can be used as alternative medicines to slow the progression of AD. This study aimed to determine the beneficial effects and potential underlying mechanisms of total flavonoid extract from Dracoephalum moldavica L. (TFDM) for attenuating Alzheimer-related deficits induced by Aβ. MAIN METHODS We used amyloid precursor protein (APP) and presenilin 1 (PS1) double transgenic mice and copper-injured APP Swedish mutation overexpressing SH-SY5Y cells to evaluate the beneficial effects of TFDM. Further, identifying the mechanisms of action was conducted on anti-amyloidogenic and neurotrophic transductions. KEY FINDINGS Our results indicated that TFDM treatment ameliorated cognitive impairments and neurodegeneration and improved the antioxidant defense system in APP/PS1 mice. TFDM also reduced Aβ burden by relieving Aβ deposition, decreasing insoluble Aβ levels, and inhibiting β-amyloidogenic processing pathway involving downregulation of β-secretase and β-C-terminal fragment in the brain. In the in vitro model of AD, TFDM treatment protected injured cells, and combined with the beneficial effects of decreasing APP levels, lowered Aβ1-42 and regulated the redox imbalance. Moreover, TFDM preserved the extracellular signal-regulated kinase/cAMP response element-binding protein/brain-derived neurotrophic factor pathway both in vitro and in vivo. SIGNIFICANCE In conclusion, TFDM clearly demonstrated neuroprotective effects by restoring the anti-amyloidogenic and neurotrophic transductions in the context of AD-associated deficits. These findings indicate the potential use of herb-based substances as supplements or potential alternative supplements for attenuating the progression of AD.
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Affiliation(s)
- Qing-Shan Liu
- Key Laboratory of Ministry of Education, College of Pharmacy, Minzu University of China, Beijing, 100081, PR China
| | - Hai-Lun Jiang
- Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, PR China
| | - Yu Wang
- Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, PR China
| | - Lin-Lin Wang
- Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, PR China
| | - Jun-Xia Zhang
- Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, PR China
| | - Cheng-Hui He
- Key Laboratory of Uighur Medicine of Xinjiang Uygur Autonomous Region, Xinjiang, Institute of Materia Medica, Urumqi 830004, PR China
| | - Shuai Shao
- Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, PR China
| | - Tian-Tai Zhang
- Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, PR China
| | - Jian-Guo Xing
- Key Laboratory of Uighur Medicine of Xinjiang Uygur Autonomous Region, Xinjiang, Institute of Materia Medica, Urumqi 830004, PR China.
| | - Rui Liu
- Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, PR China; Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, PR China.
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Oosterman JM, Heringa SM, Kessels RPC, Biessels GJ, Koek HL, Maes JHR, van den Berg E. Rule induction performance in amnestic mild cognitive impairment and Alzheimer's dementia: examining the role of simple and biconditional rule learning processes. J Clin Exp Neuropsychol 2016; 39:231-241. [PMID: 27618141 DOI: 10.1080/13803395.2016.1218444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Rule induction tests such as the Wisconsin Card Sorting Test require executive control processes, but also the learning and memorization of simple stimulus-response rules. In this study, we examined the contribution of diminished learning and memorization of simple rules to complex rule induction test performance in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's dementia (AD). METHOD Twenty-six aMCI patients, 39 AD patients, and 32 control participants were included. A task was used in which the memory load and the complexity of the rules were independently manipulated. This task consisted of three conditions: a simple two-rule learning condition (Condition 1), a simple four-rule learning condition (inducing an increase in memory load, Condition 2), and a complex biconditional four-rule learning condition-inducing an increase in complexity and, hence, executive control load (Condition 3). RESULTS Performance of AD patients declined disproportionately when the number of simple rules that had to be memorized increased (from Condition 1 to 2). An additional increment in complexity (from Condition 2 to 3) did not, however, disproportionately affect performance of the patients. Performance of the aMCI patients did not differ from that of the control participants. In the patient group, correlation analysis showed that memory performance correlated with Condition 1 performance, whereas executive task performance correlated with Condition 2 performance. CONCLUSIONS These results indicate that the reduced learning and memorization of underlying task rules explains a significant part of the diminished complex rule induction performance commonly reported in AD, although results from the correlation analysis suggest involvement of executive control functions as well. Taken together, these findings suggest that care is needed when interpreting rule induction task performance in terms of executive function deficits in these patients.
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Affiliation(s)
- Joukje M Oosterman
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Sophie M Heringa
- b Department of Psychiatry, Brain Center Rudolf Magnus , University Medical Center , Utrecht , the Netherlands
| | - Roy P C Kessels
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,c Department of Medical Psychology & Radboudumc Alzheimer Center , Radboud University Medical Center , Nijmegen , the Netherlands
| | - Geert Jan Biessels
- d Department of Neurology, Brain Center Rudolf Magnus , University Medical Center , Utrecht , the Netherlands
| | - Huiberdina L Koek
- e Department of Geriatrics , University Medical Center Utrecht , Utrecht , the Netherlands
| | - Joseph H R Maes
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Esther van den Berg
- d Department of Neurology, Brain Center Rudolf Magnus , University Medical Center , Utrecht , the Netherlands.,f Experimental Psychology , Utrecht University , Utrecht , The Netherlands.,g Department of Neurology , Erasmus Medical Center , Rotterdam , The Netherlands
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Script Generation and Executive Dysfunction in Patients with Anterior and Posterior Brain Lesions. BRAIN IMPAIR 2016. [DOI: 10.1017/brimp.2016.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Introduction: Studies on script processing have shown inconsistent relations between deficits in script action generation and frontal lobe pathology. Therefore, we investigated which difficulties in script action generation are linked to anterior lesions. Moreover, we explored whether verbal script generation can be predicted by specific executive processes.Methods: Fifty-two patients with acquired brain injury (mean age: 44.23 years, 30 male/22 female) were included, of whom 30 had anterior and 22 had posterior lesions. Several indices of the Everyday Description Task were investigated: relevant central actions (RCAs); relevant trivial actions (RTAs); relevant and irrelevant intrusions (RI & IRI); sequencing (SEs) and perseverative (PEs) errors. Additionally, fivez-composite scores representing planning, response generation, working memory, inhibition and shifting were calculated. Correlations and multiple linear regression analyses were computed.Results: Anteriorly lesioned patients produced significantly less RCAs and more PEs and SEs compared to posteriorly damaged patients. No differences were found with RTAs, RI and IRI. RCAs were predicted by planning, response generation and working memory, RI by response generation and working memory, IRI by inhibition, PEs and SEs by response generation and shifting. None of these executive processes predicted RTAs.Conclusions: Difficulties in RCAs, PEs and SEs are sensitive indicators of anterior brain damage and script generation demands various executive abilities.
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Miao H, Li J, Hu S, He X, Partridge SC, Ren J, Bian Y, Yu Y, Qiu B. Long-term cognitive impairment of breast cancer patients after chemotherapy: A functional MRI study. Eur J Radiol 2016; 85:1053-7. [PMID: 27161051 DOI: 10.1016/j.ejrad.2016.03.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/08/2016] [Accepted: 03/13/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chemotherapy, a prominent treatment for breast cancer (BC), can have detrimental side effects on the patient's cognitive functions including the executive function. However, the neurophysiological mechanism of the cognitive impairment remains unclear. OBJECTIVE The purpose of this study is to explore long-term chemotherapy-related functional connectivity changes using fMRI and the relationship between the connectivity changes and the executive function impairment in breast cancer patients. METHODS In this study, twenty-three breast cancer patients were treated with chemotherapy and twenty-six healthy subjects were recruited as the healthy control (HC) group. The functional connectivity of anterior cingulate cortex (ACC) was calculated from resting-state fMRI of the BC and control groups. The relationship between the functional connectivity of ACC and the executive function was further analyzed based on the patient' response time of the Stroop Interference Test. RESULTS The results show that functional connectivity of ACC in the BC group is significantly lower than that in the control group. The correlation analysis within the BC group indicates that the functional connectivity of ACC was significantly correlated with the executive function. CONCLUSION These findings provide evidence that the functional connectivity changes might be a pathophysiological basis for long-term chemotherapy-related cognitive dysfunction, along with executive function impairment in breast cancer patients.
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Affiliation(s)
- Hui Miao
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui 230027, China
| | - Jingjing Li
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Sheng Hu
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui 230027, China
| | - Xiaoxuan He
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui 230027, China
| | - Savannah C Partridge
- Department of Radiology, University of Washington, 825 Eastlake Ave, Seattle, WA 98109, USA
| | - Jian Ren
- Electrical and Computer Engineering, Rutgers University, New Brunswick, NJ 08854, USA
| | - Yunpeng Bian
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui 230027, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China
| | - Bensheng Qiu
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui 230027, China.
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Tagawa R, Hashimoto H, Nakanishi A, Kawarada Y, Muramatsu T, Matsuda Y, Kataoka K, Shimada A, Uchida K, Yoshida A, Higashiyama S, Kawabe J, Kai T, Shiomi S, Mori H, Inoue K. The Relationship Between Medial Temporal Lobe Atrophy and Cognitive Impairment in Patients With Dementia With Lewy Bodies. J Geriatr Psychiatry Neurol 2015; 28:249-54. [PMID: 26071442 DOI: 10.1177/0891988715590210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The relationship between medial temporal lobe atrophy (MTA) and cognitive impairment in patients with dementia with Lewy bodies (DLB) remains unclear. We examined this relationship using voxel-based specific regional analysis system for Alzheimer disease (VSRAD) advance software, which allowed us to quantify the degree of MTA on images obtained from magnetic resonance imaging (MRI) scans. METHODS Thirty-seven patients diagnosed with DLB were recruited and scanned with a 1.5 Tesla MRI scanner. All MRI data were analyzed using VSRAD advance. The target volume of interest (VOI) included the entire region of the entorhinal cortex, hippocampus, and amygdala. The degree of MTA was obtained from the averaged positive z-score (Z score) on the target VOI, with higher scores indicating more severe MTA. Mini-Mental State Examination (MMSE) and the Revised Hasegawa Dementia Scale (HDS-R), which strengthened the measures of memory and language more than MMSE, were used to assess the presence of cognitive impairment. RESULTS A negative correlation was found between the Z score and MMSE total scores or the HDS-R total scores. A stepwise multiple regression analysis performed to adjust the covariate effects of sex, age, the onset age of the disease, duration of DLB, years of education, and donepezil treatment showed that the HDS-R total scores were independently associated with the Z score, whereas MMSE total scores were not. CONCLUSIONS These results suggest that MTA is related to cognitive impairment in patients with DLB, particularly the regions of orientation, immediate and delayed recall, and word fluency.
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Affiliation(s)
- Ryo Tagawa
- Department of Neuropsychiatry, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hiroshi Hashimoto
- Department of Neuropsychiatry, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Aki Nakanishi
- Department of Neurology and Psychiatry, Osaka City Kousaiin Hospital, Osaka, Japan
| | - Youjirou Kawarada
- Department of Neurology and Psychiatry, Osaka City Kousaiin Hospital, Osaka, Japan
| | - Tomohiro Muramatsu
- Department of Neurology and Psychiatry, Osaka City Kousaiin Hospital, Osaka, Japan
| | - Yasunori Matsuda
- Department of Neuropsychiatry, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kouhei Kataoka
- Department of Psychiatry, Cocoroa Hospital, Osaka, Japan
| | - Aiko Shimada
- Department of Neuropsychiatry, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kentaro Uchida
- Department of Neuropsychiatry, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Atsushi Yoshida
- Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shigeaki Higashiyama
- Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Joji Kawabe
- Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Toshihiro Kai
- Department of Psychiatry, Osaka City General Hospital, Osaka, Japan
| | - Susumu Shiomi
- Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hiroshi Mori
- Department of Neuroscience, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Koki Inoue
- Department of Neuropsychiatry, Graduate School of Medicine, Osaka City University, Osaka, Japan
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Akinyemi RO, Firbank M, Ogbole GI, Allan LM, Owolabi MO, Akinyemi JO, Yusuf BP, Ogunseyinde O, Ogunniyi A, Kalaria RN. Medial temporal lobe atrophy, white matter hyperintensities and cognitive impairment among Nigerian African stroke survivors. BMC Res Notes 2015; 8:625. [PMID: 26519155 PMCID: PMC4628353 DOI: 10.1186/s13104-015-1552-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 10/05/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neuroimaging features associated with vascular cognitive impairment have not been examined in sub-Saharan Africans. We determined magnetic resonance imaging (MRI) features associated with cognitive impairment in a sample of Nigerian stroke survivors. METHODS Stroke survivors underwent brain MRI with standardized assessment of brain volumes and visual rating of medial temporal lobe atrophy (MTA), and white matter hyperintensities (WMH) at 3 months post-stroke. Demographic, clinical and psychometric assessments of global cognitive function, executive function, mental speed and memory were related to changes in structural MRI. RESULTS In our pilot sample of 58 stroke survivors (60.1 ± 10.7 years old) MTA correlated significantly with age (r = 0.525), WMH (r = 0.461), memory (r = -0.702), executive function (r = -0.369) and general cognitive performance (r = -0.378). On univariate analysis, age >60 years (p = 0.016), low educational attainment (p < 0.001 to p < 0.003), total brain volume (p < 0.024 and p < 0.025) and MTA (p < 0.003 to p < 0.007) but not total WMH (p < 0.073, p = 0.610) were associated with cognitive outcome. In a two-step multivariate regression analysis, MTA (p < 0.035 and p < 0.016) and low educational attainment (p < 0.012 and p < 0.019) were sustained as independent statistical predictors of cognitive outcome. CONCLUSIONS Medial temporal lobe atrophy was a significant neuroimaging predictor of early post-stroke cognitive dysfunction in the Nigerian African stroke survivors. These observations have implications for a vascular basis of MTA in older stroke survivors among sub-Saharan Africans.
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Affiliation(s)
- Rufus O Akinyemi
- Division of Neurology, Department of Medicine, Federal Medical Centre Abeokuta, Abeokuta, Nigeria. .,Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
| | - Michael Firbank
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
| | - Godwin I Ogbole
- Department of Radiology, University of Ibadan, Ibadan, Nigeria.
| | - Louise M Allan
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
| | | | - Joshua O Akinyemi
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria.
| | | | | | | | - Raj N Kalaria
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
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Aggarwal NT, Shah RC, Bennett DA. Alzheimer's disease: Unique markers for diagnosis & new treatment modalities. Indian J Med Res 2015; 142:369-82. [PMID: 26609028 PMCID: PMC4683821 DOI: 10.4103/0971-5916.169193] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Indexed: 11/04/2022] Open
Abstract
Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disease. In humans, AD becomes symptomatic only after brain changes occur over years or decades. Three contiguous phases of AD have been proposed: (i) the AD pathophysiologic process, (ii) mild cognitive impairment due to AD, and (iii) AD dementia. Intensive research continues around the world on unique diagnostic markers and interventions associated with each phase of AD. In this review, we summarize the available evidence and new therapeutic approaches that target both amyloid and tau pathology in AD and discuss the biomarkers and pharmaceutical interventions available and in development for each AD phase.
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Affiliation(s)
- Neelum T. Aggarwal
- Department of Neurology, Rush University Medical Center, Chicago, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, USA
| | - Raj C. Shah
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, USA
- Department of Family Medicine, Rush University Medical Center, Chicago, USA
| | - David A. Bennett
- Department of Neurology, Rush University Medical Center, Chicago, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, USA
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Hsu JL, Lee WJ, Liao YC, Lirng JF, Wang SJ, Fuh JL. Posterior Atrophy and Medial Temporal Atrophy Scores Are Associated with Different Symptoms in Patients with Alzheimer's Disease and Mild Cognitive Impairment. PLoS One 2015; 10:e0137121. [PMID: 26372372 PMCID: PMC4570819 DOI: 10.1371/journal.pone.0137121] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 08/12/2015] [Indexed: 12/03/2022] Open
Abstract
Background Whether the occurrence of posterior atrophy (PA) and medial temporal lobe atrophy (MTA) was correlated with cognitive and non-cognitive symptoms in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) patients are unclear. Methods Patients with probable AD and MCI from a medical center outpatient clinic received attention, memory, language, executive function evaluation and Mini-Mental Status Examination (MMSE). The severity of dementia was rated by the Clinical Dementia Rating (CDR) Sum of Box (CDR-SB). The neuropsychiatric inventory (NPI) subscale of agitation/aggression and mood symptoms was also applied. Magnetic resonance imaging (MRI) was scored visually for the MTA, PA and white matter hyperintensity (WMH) scores. Results We recruited 129 AD and 31 MCI (mean age 78.8 years, 48% female) patients. MMSE scores, memory, language and executive function were all significantly decreased in individuals with AD than those with MCI (p < 0.01). MTA and PA scores reflected significant atrophy in AD compared to MCI; however, the WMH scores did not differ. The MTA scores were significantly correlated with the frontal, parieto-occipital and global WMH scores (p < 0.01) while the PA scores showed a correlation with the parieto-occipital and temporal WMH scores (p < 0.01). After adjusting for age, education, APOE4 gene and diagnostic group covariates, the MTA scores showed a significant association with MMSE and CDR-SB, while the right side PA scores were significantly associated with NPI-agitation/aggression subscales (p < 0.01). Conclusion Regional atrophy is related to different symptoms in patients with AD or MCI. PA score is useful as a complementary measure for non-cognitive symptom.
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Affiliation(s)
- Jung-Lung Hsu
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan
- Section of Dementia and Cognitive Impairment, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Brain and Consciousness Research Center, Taipei Medical University, Shuang Ho Hospital, New Taipei City, Taiwan
| | - Wei-Ju Lee
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
| | - Yi-Chu Liao
- Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jiing-Feng Lirng
- Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- * E-mail: (J-LF); (S-JW)
| | - Jong-Ling Fuh
- Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- * E-mail: (J-LF); (S-JW)
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Zhu H, Luo L, Hu S, Dong K, Li G, Zhang T. Treating Alzheimer's disease with Yizhijiannao granules by regulating expression of multiple proteins in temporal lobe. Neural Regen Res 2014; 9:1283-7. [PMID: 25221580 PMCID: PMC4160854 DOI: 10.4103/1673-5374.137575] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2014] [Indexed: 12/17/2022] Open
Abstract
Yizhijiannao granules have been shown to improve cognitive function in Alzheimer's disease patients. The present study sought to explore the mechanisms involved in the cognitive enhancing effects of Yizhijiannao granule. Senescence-accelerated mouse prone 8 mice with learning and memory disorders were intragastrically treated with Yizhijiannao granule for 8 weeks. Mice intragastrically treated with double distilled water for 8 weeks were considered as the control group. 2D gel electrophoresis was used to isolate total protein from the temporal lobe of senescence-accelerated mouse prone 8 mice, and differential protein spots were obtained by mass spectrometry. Thirty-seven differential protein spots were found in the temporal lobe area of both groups. Ten protein spots were identified: high mobility group box 1, dimethylarginine dimethylaminohydrolase-1, neuroglobin, hemoglobin beta adult major chain, peroxiredoxin-6, cofilin-1, flotillin 1, peptidylprolyl isomerase A, voltage-dependent anion channel-2 and chaperonin containing TCP1, and subunit 2. Among other functions, these proteins are separately involved in the regulation of amyloid beta production, oxidative stress, neuroinflammation, regulation of tau phosphorylation, and regulation of neuronal apoptosis. Our results revealed that Yizhijiannao granule can regulate the expression of various proteins in the temporal lobe of senescence-accelerated mouse prone 8 mice, and may be therapeutically beneficial for the treatment of Alzheimer's disease.
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Affiliation(s)
- Hong Zhu
- Department of Traditional Chinese Medicine, Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Liuyang Luo
- Department of Emergency, Bao-an District Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Sihang Hu
- Department of Traditional Chinese Medicine, Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Keli Dong
- Department of Traditional Chinese Medicine, Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Guangcheng Li
- Department of Traditional Chinese Medicine, Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Ting Zhang
- Department of Traditional Chinese Medicine, Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
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Overdorp EJ, Kessels RPC, Claassen JA, Oosterman JM. Cognitive impairments associated with medial temporal atrophy and white matter hyperintensities: an MRI study in memory clinic patients. Front Aging Neurosci 2014; 6:98. [PMID: 24904411 PMCID: PMC4034495 DOI: 10.3389/fnagi.2014.00098] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 05/06/2014] [Indexed: 11/13/2022] Open
Abstract
In this retrospective study, we investigated the independent effects of white matter hyperintensities (WMH) and hippocampal atrophy on cognitive functions in a broad sample of patients seen in a memory clinic. To ensure generalizability, these associations were examined irrespective of diagnosis and with minimal exclusion criteria. Next to these independent effects, interactions between WMH and hippocampal atrophy were examined. Between January 2006 and September 2011 a total of 500 patients visited the memory clinic, 397 of whom were included. Magnetic resonance images of 397 patients were visually analyzed for WMH, medial temporal atrophy (MTA), and global atrophy. We evaluated the association of WMH and MTA with the following cognitive domains: global cognition, episodic memory, working memory, executive function and psychomotor speed. Main effects and interaction effects were examined by means of correlation and regression analyses. In the regression analyses, we controlled for potential confounding effects of global atrophy. The correlational results revealed that WMH were associated with global cognition, executive function and psychomotor speed, whereas a trend was found for episodic memory. MTA was associated with all these four cognitive domains; an additional trend was observed for working memory. Hierarchical regression analyses revealed main independent effects of MTA for episodic memory, executive function, psychomotor speed and global cognition; WMH were only associated with global cognition. The interaction between MTA and WMH was significant for episodic memory only. This study demonstrates that predominantly MTA is an independent predictor not only for memory function, with which is it classically associated, but also for global cognition and executive function. Taken together, MTA may be an important correlate of cognitive deficits found in people attending the memory clinic.
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Affiliation(s)
- Eduard J Overdorp
- Department of Psychiatry, Gelre Medical Centre Zutphen, Netherlands ; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Nijmegen, Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Nijmegen, Netherlands ; Department of Medical Psychology, Radboud University Medical Center-Radboud Alzheimer Center Nijmegen, Netherlands
| | - Jurgen A Claassen
- Department of Medical Psychology, Radboud University Medical Center-Radboud Alzheimer Center Nijmegen, Netherlands ; Department of Geriatric Medicine, Radboud University Medical Center-Radboud Alzheimer Center Nijmegen, Netherlands
| | - Joukje M Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Nijmegen, Netherlands
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Bai X, Edden RAE, Gao F, Wang G, Wu L, Zhao B, Wang M, Chan Q, Chen W, Barker PB. Decreased γ-aminobutyric acid levels in the parietal region of patients with Alzheimer's disease. J Magn Reson Imaging 2014; 41:1326-31. [PMID: 24863149 DOI: 10.1002/jmri.24665] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 05/06/2014] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To determine whether there are in vivo differences of γ-aminobutyric acid (GABA) levels in frontal and parietal regions of Alzheimer's disease (AD) patients, compared with healthy controls using magnetic resonance spectroscopy ((1) H-MRS). MATERIALS AND METHODS Fifteen AD patients and fifteen age- and gender-matched healthy controls underwent (1) H-MRS of the frontal and parietal lobes using the "MEGA-Point Resolved Spectroscopy Sequence" (MEGA-PRESS) technique, and cognitive levels of subjects were evaluated using Mini-Mental State Examination (MMSE) tests. MRS data were processed using the Gannet program. Because the signal detected by MEGA-PRESS includes contributions from GABA, macromolecules and homocarnosine, it is labeled as "GABA+" rather than GABA. Differences of GABA+/Cr ratios between AD patients and controls were tested using covariance analysis, adjusting for gray matter fraction. The relationship between GABA+/Cr and MMSE scores was also analyzed. RESULTS Significant lower GABA+/Cr ratios were found in the parietal region of AD patients compared with controls (P = 0.041). In AD patients, no significant correlations between GABA+/Cr and MMSE scores were found in either the frontal (r = -0.164; P = 0.558) or parietal regions (r = 0.025; P = 0.929). CONCLUSION Decreased GABA+/Cr levels were present in the parietal region of patients with AD in vivo, suggesting that abnormalities of the GABAergic system may be present in the pathogenesis of AD.
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Affiliation(s)
- Xue Bai
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, China
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Simple and complex rule induction performance in young and older adults: contribution of episodic memory and working memory. J Int Neuropsychol Soc 2014; 20:333-41. [PMID: 24559523 DOI: 10.1017/s1355617713001446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study tested the hypothesis that part of the age-related decline in performance on executive function tasks is due to a decline in episodic memory. For this, we developed a rule induction task in which we manipulated the involvement of episodic memory and executive control processes; age effects and neuropsychological predictors of task performance were investigated. Twenty-six younger (mean age, 24.0; range, 19-35 years) and 27 community-dwelling older adults (mean age, 67.5; range, 50-91 years) participated. The neuropsychological predictors consisted of the performance on tests of episodic memory, working memory, switching, inhibition and flexibility. Performance of the older adults was worse for the learning and memorization of simple rules, as well as for the more demanding executive control condition requiring the manipulation of informational content. Episodic memory was the only predictor of performance on the simple learning and memorization task condition whereas an increase in rule induction complexity additionally engaged working memory processes. Together, these findings indicate that part of the age-related decline on rule induction tests may be the result of a decline in episodic memory. Further studies are needed that examine the role of episodic memory in other executive function tasks in aging.
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Abstract
BACKGROUND Executive dysfunction is not uncommon in patients with amnestic mild cognitive impairment (aMCI). This study aimed to investigate the applicability of executive function tests (EFTs) in aMCI as an aid in establishing the diagnosis of multi-domain MCI. METHODS One hundred and twenty (120) aMCI patients, 126 Alzheimer's disease (AD) patients, and 100 normal controls were enrolled. The EFTs evaluated included the trail making test, digit backward span, Stroop color-word test, and design fluency and category fluency tests. RESULTS Of the aMCI participants, 66% exhibited impairment in at least one EFT. Among the five selected EFTs, the category fluency test was the most discriminative in detecting executive dysfunction between patients with aMCI (standardized β = 0.264) or AD (standardized β = 0.361) with the controls, followed by the Stroop test. The performance of aMCI patients with two or more impaired EFTs was significantly different from those of controls but not from those of AD patients. CONCLUSION In the clinical setting, aMCI patients who fail in two or more EFTs may represent a unique population with multi-domain MCI that require close follow-up.
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