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Lu H, Li J, Yang NS, Lam LCW, Ma SL, Wing YK, Zhang L. Using gamma-band transcranial alternating current stimulation (tACS) to improve sleep quality and cognition in patients with mild neurocognitive disorders due to Alzheimer's disease: A study protocol for a randomized controlled trial. PLoS One 2023; 18:e0289591. [PMID: 37540692 PMCID: PMC10403094 DOI: 10.1371/journal.pone.0289591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/21/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Sleep disturbances are highly prevalent in patients with age-related neurodegenerative diseases, which severely affect cognition and even lead to accumulated β-amyloid. Encouraging results from recent studies on transcranial direct current stimulation (tDCS) showed moderate positive effects on sleep quality in preclinical Alzheimer's disease (AD). Compared to tDCS, transcranial alternating current stimulation (tACS) enables the entrainment of neuronal activity with optimized focality through injecting electric current with a specific frequency and has significant enhancement effects on slow wave activities. METHODS AND DESIGN This is a randomized, double-blind, sham-controlled clinical trial comparing 40 Hz tACS with tDCS in mild neurocognitive disorders due to AD with sleep disturbances. Magnetic resonance imaging (MRI) data is used to construct personalized realistic head model. Treatment outcomes, including sleep quality, cognitive performance and saliva Aβ levels will be conducted at baseline, 4th week, 8th week, 12th week and 24th week. CONCLUSIONS It is expected that the repeated gamma-band tACS will show significant improvements in sleep quality and cognitive functions compared to tDCS and sham tDCS. The findings will provide high-level evidence and guide further advanced studies in the field of neurodegenerative diseases and sleep medicine. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05544201.
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Affiliation(s)
- Hanna Lu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jing Li
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Natalie Shu Yang
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Linda Chiu Wa Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Suk Ling Ma
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yun Kwok Wing
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Zhang
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
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Kim N, Jamison K, Jaywant A, Garetti J, Blunt E, RoyChoudhury A, Butler T, Dams-O'Connor K, Khedr S, Chen CC, Shetty T, Winchell R, Hill NJ, Schiff ND, Kuceyeski A, Shah SA. Comparisons of electrophysiological markers of impaired executive attention after traumatic brain injury and in healthy aging. Neuroimage 2023; 274:120126. [PMID: 37191655 PMCID: PMC10286242 DOI: 10.1016/j.neuroimage.2023.120126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/10/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Executive attention impairments are a persistent and debilitating consequence of traumatic brain injury (TBI). To make headway towards treating and predicting outcomes following heterogeneous TBI, cognitive impairment specific pathophysiology first needs to be characterized. In a prospective observational study, we measured EEG during the attention network test aimed at detecting alerting, orienting, executive attention and processing speed. The sample (N = 110) of subjects aged 18-86 included those with and without traumatic brain injury: n = 27, complicated mild TBI; n = 5, moderate TBI; n = 10, severe TBI; n = 63, non-brain-injured controls. Subjects with TBI had impairments in processing speed and executive attention. Electrophysiological markers of executive attention processing in the midline frontal regions reveal that, as a group, those with TBI and elderly non-brain-injured controls have reduced responses. We also note that those with TBI and elderly controls have responses that are similar for both low and high-demand trials. In subjects with moderate-severe TBI, reductions in frontal cortical activation and performance profiles are both similar to that of controls who are ∼4 to 7 years older. Our specific observations of frontal response reductions in subjects with TBI and in older adults is consistent with the suggested role of the anterior forebrain mesocircuit as underlying cognitive impairments. Our results provide novel correlative data linking specific pathophysiological mechanisms underlying domain-specific cognitive deficits following TBI and with normal aging. Collectively, our findings provide biomarkers that may serve to track therapeutic interventions and guide development of targeted therapeutics following brain injuries.
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Affiliation(s)
- Nayoung Kim
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Keith Jamison
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Abhishek Jaywant
- Department of Psychiatry, Weill Cornell Medicine, New York, NY 10065, United States; Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, NY 10065, United States; NewYork-Presbyterian Hospital, New York, NY 10065, United States
| | - Jacob Garetti
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Emily Blunt
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Arindam RoyChoudhury
- Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, United States
| | - Tracy Butler
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Shahenda Khedr
- Department of Surgery, NewYork-Presbyterian Queens Hospital, Queens, NY 11355, United States
| | - Chun-Cheng Chen
- Department of Surgery, NewYork-Presbyterian Queens Hospital, Queens, NY 11355, United States; Department of Surgery, Weill Cornell Medicine, New York, NY 10065, United States
| | - Teena Shetty
- Department of Neurology, Hospital for Special Surgery, New York, NY, 10021 United States
| | - Robert Winchell
- Department of Surgery, Weill Cornell Medicine, New York, NY 10065, United States
| | - N Jeremy Hill
- National Center for Adaptive Neurotechnologies, Stratton VA Medical Center, Albany, NY 12208, United States; Electrical & Computer Engineering Department, State University of New York at Albany, NY 12226, United States
| | - Nicholas D Schiff
- Department of BMRI & Neurology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States
| | - Sudhin A Shah
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, United States; Department of BMRI & Neurology, Weill Cornell Medicine, New York, NY 10065, United States.
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Hsieh S, Chen EH. Specific but not general declines in attention and executive function with aging: Converging cross-sectional and longitudinal evidence across the adult lifespan. Front Psychol 2023; 14:1108725. [PMID: 37008838 PMCID: PMC10050892 DOI: 10.3389/fpsyg.2023.1108725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 02/24/2023] [Indexed: 03/17/2023] Open
Abstract
ObjectiveAttention and executive function (EF) are vulnerable to aging. However, whether all these functions generally decline with aging is not known. Furthermore, most evidence is based on cross-sectional data and fewer follow-up data are available in the literature. Longitudinal follow-up studies are necessary to characterize individualized and precise changes in cognitive function. Additionally, relatively few aging studies have included middle-aged adults to examine age-related differences in attention and EF. Therefore, this study aims to examine whether general or specific attention and EF decline with aging from adulthood to old age by combining cross-sectional and longitudinal follow-up approaches.MethodsThis study recruited 253 participants aged 20 to 78 years. passing a prescreening procedure (see main text for detail) for the baseline session, and 123 of them were invited to return 1 ~ 2 years after their first visit to participate in the follow-up session. The participants completed a series of attention and EF tasks at both the baseline and follow-up sessions, which measured alerting, orienting, conflict control, stopping, memory updating, and switching abilities. We applied linear and nonlinear regression models to evaluate the cross-sectional age effect on attention and EF and employed a modified Brinley plot to inspect follow-up performance against baseline in attention and EF.ResultsThe results of cross-sectional data showed that older adults exhibited decreased efficiency in alerting, stopping, and memory updating but paradoxically increased efficiency in conflict control and switching abilities and no changes in orienting efficiency with age. However, the results of longitudinal data showed that only alerting and memory updating continued to show decreased efficiency. Furthermore, conflict control and switching showed increased efficiency with aging, whereas the orienting network, and stopping no longer showed decreased efficiency.ConclusionThus, converging the cross-sectional and longitudinal data showed that the alerting and memory updating function exhibited the most robust deficit with age (cross-sectional) and aging (longitudinal). Alerting and memory updating abilities are crucial survival skills for human beings. Therefore, developing methods to prevent and improve an individual’s alertness and working memory ability is an important practical issue in aging research.
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Affiliation(s)
- Shulan Hsieh
- Cognitive Electrophysiology Laboratory: Control, Aging, Sleep, and Emotion (CASE), Department of Psychology, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan
- *Correspondence: Shulan Hsieh,
| | - En-Ho Chen
- Cognitive Electrophysiology Laboratory: Control, Aging, Sleep, and Emotion (CASE), Department of Psychology, National Cheng Kung University, Tainan, Taiwan
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Veríssimo J, Verhaeghen P, Goldman N, Weinstein M, Ullman MT. Evidence that ageing yields improvements as well as declines across attention and executive functions. Nat Hum Behav 2022; 6:97-110. [PMID: 34413509 DOI: 10.1038/s41562-021-01169-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
Many but not all cognitive abilities decline during ageing. Some even improve due to lifelong experience. The critical capacities of attention and executive functions have been widely posited to decline. However, these capacities are composed of multiple components, so multifaceted ageing outcomes might be expected. Indeed, prior findings suggest that whereas certain attention/executive functions clearly decline, others do not, with hints that some might even improve. We tested ageing effects on the alerting, orienting and executive (inhibitory) networks posited by Posner and Petersen's influential theory of attention, in a cross-sectional study of a large sample (N = 702) of participants aged 58-98. Linear and nonlinear analyses revealed that whereas the efficiency of the alerting network decreased with age, orienting and executive inhibitory efficiency increased, at least until the mid-to-late 70s. Sensitivity analyses indicated that the patterns were robust. The results suggest variability in age-related changes across attention/executive functions, with some declining while others improve.
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Affiliation(s)
- João Veríssimo
- Center of Linguistics, School of Arts and Humanities, University of Lisbon, Lisbon, Portugal. .,Department of Linguistics, University of Potsdam, Potsdam, Germany.
| | - Paul Verhaeghen
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Noreen Goldman
- Office of Population Research, Princeton University, Princeton, NJ, USA
| | - Maxine Weinstein
- Center for Population and Health, Georgetown University, Washington, DC, USA
| | - Michael T Ullman
- Department of Neuroscience, Georgetown University, Washington, DC, USA.
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5
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Soares VN, Yoshida HM, Magna TS, Sampaio RAC, Fernandes PT. Comparison of exergames versus conventional exercises on the cognitive skills of older adults: a systematic review with meta-analysis. Arch Gerontol Geriatr 2021; 97:104485. [PMID: 34293715 DOI: 10.1016/j.archger.2021.104485] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/29/2021] [Accepted: 07/08/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the effects of exergames versus conventional physical training on the cognitive skills of older adults. MATERIALS AND METHODS Scientific studies published in PubMed, Web of Science, and Cochrane Library databases were searched. Individual studies were assessed using the Cochrane Risk-of-bias tool for randomized trials (RoB 2). The quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE Pro). The cognitive outcomes were Trail Making Test (TMT)-A, TMT-B, Stroop Word-Color test, Mini Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA). RESULTS We identified 256 studies, in which 13 studies were included in the systematic review and 11 in the meta-analysis. The majority of the exergame interventions were based on the Xbox 360's Kinect, followed by the Impact Dance Platform, Nintendo Wii, and the Bike Labyrinth. We observed heterogeneity in the conventional exercise group and in the duration of training, which ranged from 12 to 52 sessions. There was no statistically significant difference between groups in TMT-A (p=0.083), TMT-B (p=0.122), and Stroop (p=0.191). There were differences in favor of exergames in MMSE (raw mean difference=-1.58, 95% CI: -2.87 to -0.28, p<0.001) and MoCA (raw mean difference=-1.22, 95% CI: -2.24 to -0.20, p=0.019). CONCLUSIONS Despite statistical differences in MMSE and MoCA, these results should be interpreted with caution due to methodological heterogeneity. Some studies reported possible neurophysiological benefits induced by exergames, which should be explored in future investigations.
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Affiliation(s)
- Vinícius Nagy Soares
- State University of Campinas, Graduate Program in Gerontology, Faculty of Medical Sciences. Group of Studies in Sport Psychology and Neurosciences (GEPEN). Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas-SP, 13083-970, Brazil.
| | - Hélio Mamoru Yoshida
- State University of Campinas, Department of Sports Sciences, Faculty of Physical Education. Group of Studies in Sport Psychology and Neurosciences (GEPEN). Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas-SP, 13083-970, Brazil.
| | - Thaís Sporkens Magna
- State University of Campinas, Graduate Program in Gerontology, Faculty of Medical Sciences. Group of Studies in Sport Psychology and Neurosciences (GEPEN). Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas-SP, 13083-970, Brazil.
| | - Ricardo Aurélio Carvalho Sampaio
- Federal University of Sergipe, Department of Physical Education. Marechal Rondon, s/n, Jardim Rosa Elze, São Cristóvão-SE, 49100-000, Brazil.
| | - Paula Teixeira Fernandes
- State University of Campinas, Graduate Program in Gerontology, Faculty of Medical Sciences. State University of Campinas, Department of Sports Sciences, Faculty of Physical Education. Group of Studies in Sport Psychology and Neurosciences (GEPEN). Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas-SP, 13083-970, Brazil.
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6
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Feltmate BBT, Hurst AJ, Klein RM. Effects of fatigue on attention and vigilance as measured with a modified attention network test. Exp Brain Res 2020; 238:2507-2519. [PMID: 32860512 DOI: 10.1007/s00221-020-05902-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 08/11/2020] [Indexed: 11/29/2022]
Abstract
As part of a larger study on the effects of fatigue on various attentional and behavioural measures, we had participants complete a modified version of Luna et al.'s (J Neurosci Methods 306:77-87, Luna et al., J Neurosci Methods 306:77-87, 2018) ANTI-Vea task (mANTI-Vea) at the beginning and end (pre/post) of each of two 8-h testing sessions. Between these administrations of the mANTI-Vea our participants spent ~ 6 h performing an intervening task. Our intent in this project was two-fold: first, to replicate the pattern of effects reported in Luna et al.'s original presentation of the ANTI-Vea; second, to assay the impact of fatigue on vigilance and attention by observing shifts in mANTI-Vea performance as a function of time on task and before versus after the intervening task. With time-on-task (the mANTI-Vea is divided into six sub-blocks) we observed that participants became increasingly conservative in their biases to respond towards infrequent targets, showed a decline in sensitivity, and lapsed in responding in the psychomotor vigilance task with greater frequency. In the pre/post comparison, we observed an increase in the proportion of lapses, but not in participants' response biases. Attentional network scores were found to be somewhat insensitive to our fatigue manipulations; the effect of time-on-task was only significant for orienting scores on RT, and our pre/post comparison was only significant for RT derived executive functioning scores.
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Affiliation(s)
- Brett B T Feltmate
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
| | - Austin J Hurst
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Raymond M Klein
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
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7
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Liu M, Zhang J, Jia W, Chang Q, Shan S, Hu Y, Wang D. Enhanced executive attention efficiency after adaptive force control training: Behavioural and physiological results. Behav Brain Res 2019; 376:111859. [DOI: 10.1016/j.bbr.2019.03.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/07/2019] [Accepted: 03/15/2019] [Indexed: 10/27/2022]
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8
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Gilsoul J, Simon J, Hogge M, Collette F. Do attentional capacities and processing speed mediate the effect of age on executive functioning? AGING NEUROPSYCHOLOGY AND COGNITION 2018; 26:282-317. [DOI: 10.1080/13825585.2018.1432746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Jessica Gilsoul
- GIGA-CRC in Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition, University of Liège, Liège, Belgium
| | - Jessica Simon
- GIGA-CRC in Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition, University of Liège, Liège, Belgium
| | - Michaël Hogge
- Psychology and Neuroscience of Cognition, University of Liège, Liège, Belgium
| | - Fabienne Collette
- GIGA-CRC in Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition, University of Liège, Liège, Belgium
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9
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Lu H, Chan SSM, Fung AWT, Lam LCW. Beyond a Differential Diagnosis: Cognitive and Morphometric Decoding of Information Processing Speed in Senior Adults with DSM-5 Mild Neurocognitive Disorders. J Alzheimers Dis 2017; 58:927-937. [PMID: 28527207 DOI: 10.3233/jad-161122] [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: 11/15/2022]
Abstract
BACKGROUND Processing speed has been highlighted as a diagnostic item for neurocognitive disorders (NCD) in DSM-5. The utility of information processing speed (IPS) enclosed with multiscale constructs in the diagnosis of NCD warrants exploration. OBJECTIVE We aimed to investigate the IPS with two types of measurements in the patients with NCD due to vascular disease (NCD-vascular) and NCD due to Alzheimer's disease (NCD-AD), and examine the associations between IPS measures and morphometric features. METHODS The IPS was evaluated using trail making test (TMT) and flanker test (n = 204). Direct scores, derived scores, and reaction time (RT) were used as IPS measures. Further, surface-based morphometry cortical volume was calculated in a subsample (n = 44) with structural MRI data. RESULTS All IPS measures showed a significant value to differentiate NCD patients from healthy subjects. Only mean RT could distinguish NCD-AD from NCD-vascular groups. TMT-B score and difference score were correlated with gray matter volume (GMV) of inferior frontal gyrus, precuneus and superior temporal cortex. Mean RT was associated with the GMV of post-central gyrus (r = -0.327, p = 0.035), and executive speed was associated with inferior frontal cortex (r = -0.475, p = 0.001), cingulate gyrus (r = -0.497, p = 0.001), and superior temporal gyrus (r = -0.36, p = 0.019). CONCLUSION The cognitive and morphometric correlates of IPS measures indicate that complex IPS might be decomposed into the domain-specific components with corresponding neural underpinnings. Our findings may also provide essential insights into the diagnostic item of NCD.
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Affiliation(s)
- Hanna Lu
- Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, China.,Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Sandra S M Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, China
| | - Ada W T Fung
- Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, China
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10
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Haller S, Montandon ML, Rodriguez C, Ackermann M, Herrmann FR, Giannakopoulos P. APOE* E4 Is Associated with Gray Matter Loss in the Posterior Cingulate Cortex in Healthy Elderly Controls Subsequently Developing Subtle Cognitive Decline. AJNR Am J Neuroradiol 2017; 38:1335-1342. [PMID: 28495939 DOI: 10.3174/ajnr.a5184] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 02/17/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE The presence of apolipoprotein E4 (APOE*E4) is the strongest currently known genetic risk factor for Alzheimer disease and is associated with brain gray matter loss, notably in areas involved in Alzheimer disease pathology. Our objective was to assess the effect of APOE*E4 on brain structures in healthy elderly controls who subsequently developed subtle cognitive decline. MATERIALS AND METHODS This prospective study included 382 community-dwelling elderly controls. At baseline, participants underwent MR imaging at 3T, extensive neuropsychological testing, and genotyping. After neuropsychological follow-up at 18 months, participants were classified into cognitively stable controls and cognitively deteriorating controls. Data analysis included whole-brain voxel-based morphometry and ROI analysis of GM. RESULTS APOE*E4-related GM loss at baseline was found only in the cognitively deteriorating controls in the posterior cingulate cortex. There was no APOE*E4-related effect in the hippocampus, mesial temporal lobe, or brain areas not involved in Alzheimer disease pathology. Controls in the cognitively deteriorating group had slightly lower GM concentration in the hippocampus at baseline. Higher GM densities in the hippocampus, middle temporal lobe, and amygdala were associated with a decreased risk for cognitively deteriorating group status at follow-up. CONCLUSIONS APOE*E4-related GM loss in the posterior cingulate cortex (an area involved in Alzheimer disease pathology) was found only in those elderly controls who subsequently developed subtle cognitive decline but not in cognitively stable controls. This finding might explain the partially conflicting results of previous studies that typically did not include detailed neuropsychological assessment and follow-up. Most important, APOE*E4 status had no impact on GM density in areas affected early by neurofibrillary tangle formation such as the hippocampus and mesial temporal lobe.
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Affiliation(s)
- S Haller
- From the Affidea Centre de Diagnostic Radiologique de Carouge (S.H.), Geneva, Switzerland .,Faculty of Medicine (S.H., M.-L.M., F.R.H., P.G.), University of Geneva, Switzerland.,Departments of Surgical Sciences and Radiology (S.H.), Uppsala University, Uppsala, Sweden.,Department of Neuroradiology (S.H.), University Hospital Freiburg, Freiburg, Germany
| | - M-L Montandon
- Faculty of Medicine (S.H., M.-L.M., F.R.H., P.G.), University of Geneva, Switzerland.,Department of Mental Health and Psychiatry (M.-L.M., M.A.)
| | - C Rodriguez
- Division of Institutional Measures, Medical Direction (C.R., P.G.)
| | - M Ackermann
- Department of Mental Health and Psychiatry (M.-L.M., M.A.)
| | - F R Herrmann
- Faculty of Medicine (S.H., M.-L.M., F.R.H., P.G.), University of Geneva, Switzerland.,Division of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics (F.R.H.), University Hospitals of Geneva, Geneva, Switzerland
| | - P Giannakopoulos
- Faculty of Medicine (S.H., M.-L.M., F.R.H., P.G.), University of Geneva, Switzerland.,Division of Institutional Measures, Medical Direction (C.R., P.G.)
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Aberrant interhemispheric functional connectivity within default mode network and its relationships with neurocognitive features in cognitively normal APOE ε 4 elderly carriers. Int Psychogeriatr 2017; 29:805-814. [PMID: 28351449 DOI: 10.1017/s1041610216002477] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Default mode network (DMN) is vulnerable to the effects of APOE genotype. Given the reduced brain volumes and APOE ε 4-related brain changes in elderly carriers, it is less known that whether these changes would influence the functional connectivity and to what extent. This study aimed to examine the functional connectivity within DMN, and its diagnostic value with age-related morphometric alterations considered. METHODS Whole brain and seed-based resting-state functional connectivity (RSFC) analysis were conducted in cognitively normal APOE ε 4 carriers and matched non-carriers (N=38). The absolute values of mean correlation coefficients (z-values) were used as a measure of functional connectivity strength (FCS) between DMN subregions, which were also used to estimate their diagnostic value by receiver-operating characteristic (ROC) curves. RESULTS APOE ε 4 carriers demonstrated decreased interhemispheric FCS, particularly between right hippocampal formation (R.HF) and left inferior parietal lobular (L.IPL) (t=3.487, p<0.001). ROC analysis showed that the FCS of R.HF and L.IPL could differentiate APOE ε 4 carriers from healthy counterparts (AUC value=0.734, p=0.025). Moreover, after adjusting the impact of morphometry, the differentiated value of FCS of R.HF and L.IPL was markedly improved (AUC value=0.828, p=0.002). CONCLUSIONS Our findings suggest that APOE ε 4 allele affects the functional connectivity within posterior DMN, particularly the atrophy-corrected interhemispheric FCS before the clinical expression of neurodegenerative disease.
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12
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Lu H, Chan SSM, Lam LCW. 'Two-level' measurements of processing speed as cognitive markers in the differential diagnosis of DSM-5 mild neurocognitive disorders (NCD). Sci Rep 2017; 7:521. [PMID: 28364127 PMCID: PMC5428878 DOI: 10.1038/s41598-017-00624-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 03/08/2017] [Indexed: 12/21/2022] Open
Abstract
Processing speed is an updated diagnostic factor for neurocognitive disorders (NCD) in DSM-5. This study investigated the characteristics of processing speed and their diagnostic values in NCD patients. A flanker test was conducted in 31 adults with NCD due to vascular disease (NCD-vascular), 36 patients with NCD due to Alzheimer's disease (NCD-AD), and 137 healthy controls. The processing speed was evaluated using two measurements: mean reaction time (RT) and intra-individual variability of RT. Mean RT represents the global processing speed. Intra-individual variability of RT is the short-term fluctuation of RT and consists of two indices, which are intra-individual coefficient of variation of reaction time (ICV-RT) and intra-individual standard deviations (iSD). We observed elevated ICV-RT and iSD in NCD-AD and NCD-vascular patients. Additionally, there was a slowed RT in NCD-AD patients. The intra-individual variability of RT had a moderate power to differentiate NCD subgroups. The mean RT was able to discriminate the NCD-AD from NCD-vascular patients. Our findings highlight the clinical utility of the combined 'two-level' measurements of processing speed to distinguish between individuals with different cognitive status. Furthermore, the 'two-level' features of processing speed embedded in the psychometric property may also reflect the diverse aetiology underlying certain 'disease-specific' neurocognitive disorders.
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Affiliation(s)
- Hanna Lu
- Guangzhou Brain Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Sandra S M Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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Lu H, Lam LCW. Impacts of 'two-level' variability on the differential power for Montreal Cognitive Assessment (MoCA) in prodromal dementia. J Neurol Neurosurg Psychiatry 2017; 88:186-187. [PMID: 27521376 DOI: 10.1136/jnnp-2016-314435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 07/20/2016] [Indexed: 11/04/2022]
Affiliation(s)
- Hanna Lu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China.,Department of Psychiatry, Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Linda C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
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14
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Lu H, Chan SSM, Fung AWT, Lam LCW. Efficiency of Attentional Components in Elderly with Mild Neurocognitive Disorders Shown by the Attention Network Test. Dement Geriatr Cogn Disord 2016; 41:93-8. [PMID: 26741695 DOI: 10.1159/000441350] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2015] [Indexed: 11/19/2022] Open
Abstract
AIMS Complex attention, serving as a main diagnostic item of mild neurocognitive disorders (NCD), has been reported to be susceptible to pathological ageing. This study aimed to evaluate the attention network functions in older adults with subtypes of NCD. METHODS 36 adults with NCD due to Alzheimer's disease (NCD-AD), 31 adults with NCD due to vascular disease (NCD-vascular) and 137 healthy controls were recruited. Attention Network Test (ANT) was conducted to assess the efficiency of alerting, orienting and executive control. RESULTS Significant between-group differences were found in executive control (conventional score: F = 11.472, p < 0.001; ratio score: F = 8.430, p < 0.001) and processing speed (F = 4.958, p = 0.008). NCD subgroups demonstrated poorer performance on the ANT, particularly on executive control (healthy 59.9 ± 45.9, NCD-vascular 88.9 ± 44.8, NCD-AD 97.0 ± 53.9). Moreover, the NCD-AD group showed both less efficient executive control and prominent slowing processing speed (reaction time: healthy 687.5 ± 106.0 ms, NCD-vascular 685.3 ± 97.1 ms, NCD-AD 750.6 ± 132.6 ms). CONCLUSIONS The NCD-vascular group appeared to be less efficient in executive control, while the NCD-AD group demonstrated less effective executive control and also slower processing speed. These results suggest that the characterized performance of ANT, processing speed and executive control in particular, might help differentiate adults at risk of different forms of cognitive impairment.
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Affiliation(s)
- Hanna Lu
- Department of Psychiatry, The Chinese University of Hong Kong, G/F, Multi-Centre, Tai Po Hospital, Hong Kong, SAR, China
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Williams DP, Thayer JF, Koenig J. Resting cardiac vagal tone predicts intraindividual reaction time variability during an attention task in a sample of young and healthy adults. Psychophysiology 2016; 53:1843-1851. [DOI: 10.1111/psyp.12739] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 07/15/2016] [Indexed: 12/24/2022]
Affiliation(s)
| | - Julian F. Thayer
- Department of Psychology; The Ohio State University; Columbus Ohio USA
| | - Julian Koenig
- Department of Psychology; The Ohio State University; Columbus Ohio USA
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, and Department of Child and Adolescent Psychiatry; Centre for Psychosocial Medicine, University of Heidelberg; Heidelberg Germany
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Associations between Intra-Individual Variability of Reaction Time and Cognitive Function in Cognitively Normal Senior Adults: Still beyond Good or Bad? Geriatrics (Basel) 2016; 1:geriatrics1020013. [PMID: 31022807 PMCID: PMC6371142 DOI: 10.3390/geriatrics1020013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/29/2016] [Accepted: 05/31/2016] [Indexed: 12/04/2022] Open
Abstract
Background: Intra-individual (IIV) of reaction time (RT), as the short-term fluctuations of RT-based performance, has been reported to be susceptible to cognitive ageing. The current study aimed to examine IIV of RT and its relationships with cognitive performance in cognitively normal senior adults. Methods: We evaluated 137 community-dwelling elderly (mean age: 72.41 ± 3.99) with a comprehensive neuropsychological battery and a RT-based test. Intraindividual coefficient of variation of reaction time (ICV-RT) was used to evaluate the IIV. Pearson’s correlation and hierarchical multiple regression analyses were employed to assess the relationships between IIV and the scores of cognitive function. Results: Advancing age was accompanied with declined cognitive function and increased IIV. ICV-RT was negatively correlated with the score of Montreal Cognitive Assessment Hong Kong version (HK MoCA) across three types of flanker. Hierarchical multiple regression showed that ICV-RT was a significant predictor of HK MoCA (β = −0.294, p = 0.001). Conclusion: Increased IIV is consistently associated with and contributed to the age-related decline of cognitive performance in senior adults. The utility of IIV in predicting further deterioration should be carefully postulated with prospective studies.
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