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Barbosa BJAP, Souza-Talarico JND, Jesus MCFD, Mota GPS, Oliveira MOD, Cassimiro L, Avolio IMB, Trés ES, Borges CR, Teixeira TBM, Brucki SMD. Allostatic load measures in older adults with subjective cognitive decline and mild cognitive impairment: A cross-sectional analysis from the Brazilian Memory and Aging Study. Clin Neurol Neurosurg 2024; 243:108365. [PMID: 38852227 DOI: 10.1016/j.clineuro.2024.108365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/27/2024] [Accepted: 06/01/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION An increasing body of research suggests that stress and allostatic load are related to cognitive dysfunction and neurodegeneration. OBJECTIVES to determine the relationship between allostatic load (AL) and cognitive status in older adults classified with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). METHODOLOGY Using the Brazilian Memory and Aging Study (BRAMS) database, we analyzed data from 57 older adults with SCD and MCI. Blood neuroendocrine (cortisol, DHEA-s), inflammatory (C-reactive protein, fibrinogen), metabolic (HbA1c, HDL-cholesterol, total cholesterol, creatinine), and cardiovascular (blood pressure, waist/hip ratio) were transformed into an AL index. RESULTS Despite a significant difference in the univariate analysis between waist/hip ratio (0.94 in the MCI group vs. 0, 88 in the SCD group, p = 0.03), total cholesterol levels (194 vs. 160, p = 0.02), and AL index (36.9 % in the MCI group vs. 27.2 % in the SCD group, p = 0.04), AL was not associated with SCD or MCI in the multivariate analysis. CONCLUSION Our data suggest that different profiles of AL in MCI compared to individuals with SCD could be due to cofounding factors. These findings need to be confirmed in longitudinal studies investigating profiles of AL changes at preclinical and prodromal stages of Alzheimer's disease.
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Affiliation(s)
- Breno José Alencar Pires Barbosa
- University of São Paulo, School of Medicine, Department of Neurology, São Paulo, Brazil; Federal University of Pernambuco, Centro de Ciências Médicas, Área Acadêmica de Neuropsiquiatria, Recife, Brazil.
| | - Juliana Nery de Souza-Talarico
- University of São Paulo, School of Nursing, Department of Medical-Surgical Nursing, São Paulo, Brazil; The University of Iowa, College of Nursing, IA, USA.
| | | | | | | | - Luciana Cassimiro
- University of São Paulo, School of Medicine, Department of Neurology, São Paulo, Brazil.
| | | | | | - Conrado Regis Borges
- University of São Paulo, School of Medicine, Department of Neurology, São Paulo, Brazil.
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Feng L, Ye Z, Du Z, Pan Y, Canida T, Ke H, Liu S, Chen S, Hong LE, Kochunov P, Chen J, Lei DK, Shenassa E, Ma T. Association between allostatic load and accelerated white matter brain aging: findings from the UK Biobank. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.26.24301793. [PMID: 38343822 PMCID: PMC10854327 DOI: 10.1101/2024.01.26.24301793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
White matter (WM) brain age, a neuroimaging-derived biomarker indicating WM microstructural changes, helps predict dementia and neurodegenerative disorder risks. The cumulative effect of chronic stress on WM brain aging remains unknown. In this study, we assessed cumulative stress using a multi-system composite allostatic load (AL) index based on inflammatory, anthropometric, respiratory, lipidemia, and glucose metabolism measures, and investigated its association with WM brain age gap (BAG), computed from diffusion tensor imaging data using a machine learning model, among 22 951 European ancestries aged 40 to 69 (51.40% women) from UK Biobank. Linear regression, Mendelian randomization, along with inverse probability weighting and doubly robust methods, were used to evaluate the impact of AL on WM BAG adjusting for age, sex, socioeconomic, and lifestyle behaviors. We found increasing one AL score unit significantly increased WM BAG by 0.29 years in association analysis and by 0.33 years in Mendelian analysis. The age- and sex-stratified analysis showed consistent results among participants 45-54 and 55-64 years old, with no significant sex difference. This study demonstrated that higher chronic stress was significantly associated with accelerated brain aging, highlighting the importance of stress management in reducing dementia and neurodegenerative disease risks.
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Affiliation(s)
- Li Feng
- Department of Nutrition and Food Science, College of Agriculture & Natural Resources, University of Maryland, College Park, Maryland, United States of America
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - Zhenyao Ye
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Zewen Du
- Department of Biostatistics, School of Global Public Health, New York University, New York, New York, United States of America
| | - Yezhi Pan
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Travis Canida
- Department of Mathematics, The college of Computer, Mathematical, and Natural Sciences, University of Maryland, College Park, Maryland, United States of America
| | - Hongjie Ke
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - Song Liu
- School of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, China
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - L. Elliot Hong
- Louis A. Faillace Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Peter Kochunov
- Louis A. Faillace Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Jie Chen
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - David K.Y. Lei
- Department of Nutrition and Food Science, College of Agriculture & Natural Resources, University of Maryland, College Park, Maryland, United States of America
| | - Edmond Shenassa
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
- Maternal & Child Health Program, School of Public Health, University of Maryland, College Park, Maryland, United States of America
- Department of Epidemiology, School of Public Health, Brown University, Rhode Island, United States of America
- Department of Epidemiology & Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Tianzhou Ma
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
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Yang W, Craig SL, Anderson JAE, Ross LE, Muntaner C. Sexual orientation and cognition in aging populations: Results from the Canadian Longitudinal Study on Aging. Acta Psychol (Amst) 2024; 242:104117. [PMID: 38134682 DOI: 10.1016/j.actpsy.2023.104117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
The current study utilized the Canadian Longitudinal Study on Aging (CLSA) data to investigate the relationship between sexual orientation and cognitive health of the aging population. Cognitive flexibility and verbal fluency were examined as outcome variables in the study. A total of 45,993 respondents were included in the analyses. Each model had social support or social participation as a mediator. A series of mediation analysis, stratified by gender, revealed that aging gay men performed better in cognitive tasks related to cognitive flexibility when compared to their heterosexual counterparts. The results also indicated that social support is a protective factor for cognitive health in aging lesbian women. This study provides an opportunity to consider how clinical and social services can strategize to build inclusive environments for the aging sexual minority population.
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Affiliation(s)
- Wook Yang
- Rongxiang Xu College of Health and Human Services, California State University Los Angeles, 5151 State University Drive, Los Angeles, CA 90032, USA
| | - Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada
| | - John A E Anderson
- Department of Cognitive Science, Carleton University, 2202A Dunton Tower, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada
| | - Lori E Ross
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada
| | - Carles Muntaner
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada
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Buller-Peralta I, Gregory S, Low A, Dounavi ME, Bridgeman K, Ntailianis G, Lawlor B, Naci L, Koychev I, Malhotra P, O'Brien JT, Ritchie CW, Muniz-Terrera G. Comprehensive allostatic load risk index is associated with increased frontal and left parietal white matter hyperintensities in mid-life cognitively healthy adults. Sci Rep 2024; 14:573. [PMID: 38177228 PMCID: PMC10766612 DOI: 10.1038/s41598-023-49656-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024] Open
Abstract
To date, there is a considerable heterogeneity of methods to score Allostatic Load (AL). Here we propose a comprehensive algorithm (ALCS) that integrates commonly used approaches to generate AL risk categories and assess associations to brain structure deterioration. In a cohort of cognitively normal mid-life adults (n = 620, age 51.3 ± 5.48 years), we developed a comprehensive composite for AL scoring incorporating gender and age differences, high quartile approach, clinical reference values, and current medications, to then generate AL risk categories. Compared to the empirical approach (ALES), ALCS showed better model fit criteria and a strong association with age and sex. ALSC categories were regressed against brain and white matter hyperintensity (WMH) volumes. Higher AL risk categories were associated with increased total, periventricular, frontal, and left parietal WMH volumes, also showing better fit compared to ALES. When cardiovascular biomarkers were removed from the ALSC algorithm, only left-frontal WMHV remained associated with AL, revealing a strong vascular burden influencing the index. Our results agree with previous evidence and suggest that sustained stress exposure enhances brain deterioration in mid-life adults. Showing better fit than ALES, our comprehensive algorithm can provide a more accurate AL estimation to explore how stress exposure enhances age-related health decline.
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Affiliation(s)
- Ingrid Buller-Peralta
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK.
| | - Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
| | - Audrey Low
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Level E4, Box 189, Cambridge, CB2 0QQ, UK
| | - Maria-Eleni Dounavi
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Level E4, Box 189, Cambridge, CB2 0QQ, UK
| | - Katie Bridgeman
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
| | - Georgios Ntailianis
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
| | - Brian Lawlor
- Trinity College Institute of Neuroscience, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Ireland
- Global Brain Health Institute, Trinity College Dublin, GBHI Office Room 0.60, Lloyd Building Trinity College Dublin, Dublin 2, Ireland
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Ireland
- Global Brain Health Institute, Trinity College Dublin, GBHI Office Room 0.60, Lloyd Building Trinity College Dublin, Dublin 2, Ireland
| | - Ivan Koychev
- Department of Psychiatry, Warneford Hospital, Oxford University, Warneford Ln, Headington, Oxford, OX3 7JX, UK
| | - Paresh Malhotra
- Department of Brain Sciences, Imperial College London, Burlington Danes, The Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK
| | - John T O'Brien
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Level E4, Box 189, Cambridge, CB2 0QQ, UK
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
- Scottish Brain Sciences, Gyleview House, 3 Redheughs Rigg, South Gyle, Edinburgh, EH12 9DQ, UK
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
- Ohio University Heritage College of Osteopathic Medicine, 191 W Union St, Athens, OH, 45701, USA
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Blöchl M, Schaare HL, Kumral D, Gaebler M, Nestler S, Villringer A. Vascular risk factors, white matter microstructure, and depressive symptoms: a longitudinal analysis in the UK Biobank. Psychol Med 2024; 54:125-135. [PMID: 37016768 DOI: 10.1017/s0033291723000697] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
BACKGROUND Cumulative burden from vascular risk factors (VRFs) has been associated with an increased risk of depressive symptoms in mid- and later life. It has been hypothesised that this association arises because VRFs disconnect fronto-subcortical white matter tracts involved in mood regulation, which puts older adults at higher risk of developing depressive symptoms. However, evidence for the hypothesis that disconnection of white matter tracts underlies the association between VRF burden and depressive symptoms from longitudinal studies is scarce. METHODS This preregistered study analysed longitudinal data from 6,964 middle-aged and older adults from the UK Biobank who participated in consecutive assessments of VRFs, brain imaging, and depressive symptoms. Using mediation modelling, we directly tested to what extend white matter microstructure mediates the longitudinal association between VRF burden and depressive symptoms. RESULTS VRF burden showed a small association with depressive symptoms at follow-up. However, there was no evidence that fractional anisotropy (FA) of white matter tracts mediated this association. Additional analyses also yielded no mediating effects using alternative operationalisations of VRF burden, mean diffusivity (MD) of single tracts, or overall average of tract-based white matter microstructure (global FA, global MD, white matter hyperintensity volume). CONCLUSIONS Our results lend no support to the hypothesis that disconnection of white matter tracts underlies the association between VRF burden and depressive symptoms, while highlighting the relevance of using longitudinal data to directly test pathways linking vascular and mental health.
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Affiliation(s)
- Maria Blöchl
- Department for Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- International Max Planck Research School: Neuroscience of Communication: Structure, Function, and Plasticity, Leipzig, Germany
- Department of Psychology, University of Münster, Münster, Germany
| | - H Lina Schaare
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour) Research Centre Jülich, Germany
| | - Deniz Kumral
- Institute of Psychology, Neuropsychology, University of Freiburg, Freiburg, Germany
- Clinical Psychology and Psychotherapy Unit, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Michael Gaebler
- Department for Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin School of Mind and Brain, MindBrainBody Institute
- Max Planck Dahlem Campus of Cognition, Berlin, Germany
| | - Steffen Nestler
- Department of Psychology, University of Münster, Münster, Germany
| | - Arno Villringer
- Department for Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Clinic Leipzig, Leipzig, Germany
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Demnitz N, Hulme OJ, Siebner HR, Kjaer M, Ebmeier KP, Boraxbekk CJ, Gillan CM. Characterising the covariance pattern between lifestyle factors and structural brain measures: a multivariable replication study of two independent ageing cohorts. Neurobiol Aging 2023; 131:115-123. [PMID: 37619515 DOI: 10.1016/j.neurobiolaging.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/12/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023]
Abstract
Modifiable lifestyle factors have been shown to promote healthy brain ageing. However, studies have typically focused on a single factor at a time. Given that lifestyle factors do not occur in isolation, multivariable analyses provide a more realistic model of the lifestyle-brain relationship. Here, canonical correlation analyses (CCA) examined the relationship between nine lifestyle factors and seven MRI-derived indices of brain structure. The resulting covariance pattern was further explored with Bayesian regressions. CCA analyses were first conducted on a Danish cohort of older adults (n = 251) and then replicated in a British cohort (n = 668). In both cohorts, the latent factors of lifestyle and brain structure were positively correlated (UK: r = .37, p < 0.001; Denmark: r = .27, p < 0.001). In the cross-validation study, the correlation between lifestyle-brain latent factors was r = .10, p = 0.008. However, the pattern of associations differed between datasets. These findings suggest that baseline characterisation and tailoring towards the study sample may be beneficial for achieving targeted lifestyle interventions.
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Affiliation(s)
- Naiara Demnitz
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark.
| | - Oliver J Hulme
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark; London Mathematical Laboratory, London, UK; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark; Department of Neurology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark; Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Kjaer
- Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Klaus P Ebmeier
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Carl-Johan Boraxbekk
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark; Department of Neurology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark; Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark; Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark; Department of Radiation Sciences, Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Claire M Gillan
- School of Psychology, Trinity College Dublin, Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Fani N, Eghbalzad L, Harnett NG, Carter SE, Price M, Stevens JS, Ressler KJ, van Rooij SJH, Bradley B. Racial discrimination associates with lower cingulate cortex thickness in trauma-exposed black women. Neuropsychopharmacology 2022; 47:2230-2237. [PMID: 36100659 PMCID: PMC9630426 DOI: 10.1038/s41386-022-01445-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/14/2022] [Accepted: 08/24/2022] [Indexed: 11/09/2022]
Abstract
Racial discrimination (RD) has been consistently linked to adverse brain health outcomes. These may be due in part to RD effects on neural networks involved with threat appraisal and regulation; RD has been linked to altered activity in the rostral anterior cingulate cortex (rACC) and structural decrements in the anterior cingulum bundle and hippocampus. In the present study, we examined associations of RD with cingulate, hippocampus and amygdala gray matter morphology in a sample of trauma-exposed Black women. Eighty-one Black women aged 19-62 years were recruited as part of an ongoing study of trauma. Participants completed assessments of RD, trauma exposure, and posttraumatic stress disorder (PTSD), and underwent T1-weighted anatomical imaging. Cortical thickness, surface area and gray matter volume were extracted from subregions of cingulate cortex, and gray matter volume was extracted from amygdala and hippocampus, and entered into partial correlation analyses that included RD and other socio-environmental variables. After correction for multiple comparisons and accounting for variance associated with other stressors and socio-environmental factors, participants with more RD exposure showed proportionally lower cortical thickness in the left rACC, caudal ACC, and posterior cingulate cortex (ps < = 0.01). These findings suggest that greater experiences of RD are linked to compromised cingulate gray matter thickness. In the context of earlier findings indicating that RD produces increased response in threat neurocircuitry, our data suggest that RD may increase vulnerability for brain health problems via cingulate cortex alterations. Further research is needed to elucidate biological mechanisms for these changes.
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Affiliation(s)
- Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
| | - Leyla Eghbalzad
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Sierra E Carter
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Matthew Price
- Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
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The association between allostatic load and brain: A systematic review. Psychoneuroendocrinology 2022; 145:105917. [PMID: 36113380 DOI: 10.1016/j.psyneuen.2022.105917] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 11/22/2022]
Abstract
Allostatic load (AL) refers to prolonged dysregulation related to chronic stress that affects brain regions such as the hippocampus, amygdala, and prefrontal cortex (PFC). Higher levels of AL have been associated with poor health outcomes, including psychiatric disorders, cognitive decline, and chronic somatic conditions. However, still little is known about the relationship between AL and the brain, and the mechanisms explaining the damaging effects of stress-related biological dysregulations. Therefore, we aimed to perform a systematic review of studies investigating the association of the AL index with brain structure and functioning in adult populations. PubMed/MEDLINE, CINAHL, Academic Search Complete and Web of Science were searched from their inception until August, 9th 2021. A total of 13 studies were included in the qualitative synthesis. There was a high between-study heterogeneity with respect to the methods used to calculate the AL index and brain parameters. All studies confirmed the associations between a higher AL index and alterations in various brain areas, especially: 1) the hippocampus, white matter volume, gray matter volume, and density in the older adults; 2) the cortex, fornix, hippocampus and choroid plexus in patients with schizophrenia spectrum disorders; and 3) whole-brain white matter tracts, cortical gray matter volume, and cortical thickness in overweight subjects. Overall, the findings of this systematic review imply that an elevated AL index might be associated with various neurostructural and neurofunctional alterations. Some of these associations may appear regardless of clinical or non-clinical populations being investigated (e.g., white matter tracts), whereas others may appear in specific populations (e.g., cortical thinning in overweight/obesity and schizophrenia spectrum disorders). However, additional studies utilizing a consistent approach to calculating the AL index are needed to extend these findings and indicate populations that are most vulnerable to the damaging effects of AL.
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Feng P, Lin L, Wang Y, Chen L, Min J, Xie Y, Liu M, Wei S, Lin S, Yu Q. Impacts of menopause hormone therapy on mood disorders among postmenopausal women. Climacteric 2022; 25:579-585. [PMID: 36179737 DOI: 10.1080/13697137.2022.2026915] [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: 11/03/2022]
Abstract
OBJECTIVE This study aimed to explore the modulatory effects of menopause hormone therapy (MHT) on mood disorders among postmenopausal women. METHODS A cross-sectional study was conducted to recruit postmenopausal women, including patients (arranged MHT for over 3 years as the medication group) and non-MHT controls. All participants were asked to respond to the Center for Epidemiological Studies Depression Scale (CES-D) and Generalized Anxiety Disorder Screener (GAD-7) questionnaires to assess their depression and anxiety status. RESULTS A total of 230 cases from the two groups were determined based on propensity score matching analysis by matching the menopausal age and menopausal durations. We found that MHT served as a favorable modulator in the depression status of postmenopausal women. Among the four factors of the CES-D questionnaire, our data indicated that the differences between the two groups fell primarily into two aspects: depressive emotion, and somatic symptoms or retarded activities. MHT was mainly involved in improving the depression of overweight women. However, no substantial effects of MHT were observed on the regulation of anxiety. CONCLUSION Postmenopausal women, especially the overweight population, who have experienced MHT exhibited an improved depressive status but not their anxiety condition.
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Affiliation(s)
- P Feng
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - L Lin
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Department of Obstetrics and Gynecology, the Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Y Wang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - L Chen
- Division of Prevention and Community Health, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - J Min
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| | - Y Xie
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - M Liu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - S Wei
- Department of Obstetrics and Gynecology, Fangchenggang Maternal and Child Health Care Hospital, Guangxi, China
| | - S Lin
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Q Yu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Kotkowski E, Price LR, DeFronzo RA, Franklin CG, Salazar M, Garrett AS, Woolsey M, Blangero J, Duggirala R, Glahn DC, Fox PT. Metabolic syndrome predictors of brain gray matter volume in an age-stratified community sample of 776 Mexican- American adults: Results from the genetics of brain structure image archive. Front Aging Neurosci 2022; 14:999288. [PMID: 36204553 PMCID: PMC9531122 DOI: 10.3389/fnagi.2022.999288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction This project aimed to investigate the association between biometric components of metabolic syndrome (MetS) with gray matter volume (GMV) obtained with magnetic resonance imaging (MRI) from a large cohort of community-based adults (n = 776) subdivided by age and sex and employing brain regions of interest defined previously as the "Neural Signature of MetS" (NS-MetS). Methods Lipid profiles, biometrics, and regional brain GMV were obtained from the Genetics of Brain Structure (GOBS) image archive. Participants underwent T1-weighted MR imaging. MetS components (waist circumference, fasting plasma glucose, triglycerides, HDL cholesterol, and blood pressure) were defined using the National Cholesterol Education Program Adult Treatment Panel III. Subjects were grouped by age: early adult (18-25 years), young adult (26-45 years), and middle-aged adult (46-65 years). Linear regression modeling was used to investigate associations between MetS components and GMV in five brain regions comprising the NS-MetS: cerebellum, brainstem, orbitofrontal cortex, right insular/limbic cluster and caudate. Results In both men and women of each age group, waist circumference was the single component most strongly correlated with decreased GMV across all NS-MetS regions. The brain region most strongly correlated to all MetS components was the posterior cerebellum. Conclusion The posterior cerebellum emerged as the region most significantly associated with MetS individual components, as the only region to show decreased GMV in young adults, and the region with the greatest variance between men and women. We propose that future studies investigating neurological effects of MetS and its comorbidities-namely diabetes and obesity-should consider the NS-MetS and the differential effects of age and sex.
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Affiliation(s)
- Eithan Kotkowski
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Larry R. Price
- Departments of Mathematics and Education, Texas State University, San Marcos, TX, United States
| | - Ralph A. DeFronzo
- Diabetes Research Unit and Diabetes Division, Texas Diabetes Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Crystal G. Franklin
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Maximino Salazar
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Amy S. Garrett
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Mary Woolsey
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - John Blangero
- Genomics Computing Center, South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Ravindranath Duggirala
- Genomics Computing Center, South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - David C. Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT, United States
| | - Peter T. Fox
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- South Texas Veterans Health Care System, San Antonio, TX, United States
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11
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Birba A, Santamaría-García H, Prado P, Cruzat J, Ballesteros AS, Legaz A, Fittipaldi S, Duran-Aniotz C, Slachevsky A, Santibañez R, Sigman M, García AM, Whelan R, Moguilner S, Ibáñez A. Allostatic-Interoceptive Overload in Frontotemporal Dementia. Biol Psychiatry 2022; 92:54-67. [PMID: 35491275 PMCID: PMC11184918 DOI: 10.1016/j.biopsych.2022.02.955] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND The predictive coding theory of allostatic-interoceptive load states that brain networks mediating autonomic regulation and interoceptive-exteroceptive balance regulate the internal milieu to anticipate future needs and environmental demands. These functions seem to be distinctly compromised in behavioral variant frontotemporal dementia (bvFTD), including alterations of the allostatic-interoceptive network (AIN). Here, we hypothesize that bvFTD is typified by an allostatic-interoceptive overload. METHODS We assessed resting-state heartbeat evoked potential (rsHEP) modulation as well as its behavioral and multimodal neuroimaging correlates in patients with bvFTD relative to healthy control subjects and patients with Alzheimer's disease (N = 94). We measured 1) resting-state electroencephalography (to assess the rsHEP, prompted by visceral inputs and modulated by internal body sensing), 2) associations between rsHEP and its neural generators (source location), 3) cognitive disturbances (cognitive state, executive functions, facial emotion recognition), 4) brain atrophy, and 5) resting-state functional magnetic resonance imaging functional connectivity (AIN vs. control networks). RESULTS Relative to healthy control subjects and patients with Alzheimer's disease, patients with bvFTD presented more negative rsHEP amplitudes with sources in critical hubs of the AIN (insula, amygdala, somatosensory cortex, hippocampus, anterior cingulate cortex). This exacerbated rsHEP modulation selectively predicted the patients' cognitive profile (including cognitive decline, executive dysfunction, and emotional impairments). In addition, increased rsHEP modulation in bvFTD was associated with decreased brain volume and connectivity of the AIN. Machine learning results confirmed AIN specificity in predicting the bvFTD group. CONCLUSIONS Altogether, these results suggest that bvFTD may be characterized by an allostatic-interoceptive overload manifested in ongoing electrophysiological markers, brain atrophy, functional networks, and cognition.
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Affiliation(s)
- Agustina Birba
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Hernando Santamaría-García
- PhD Neuroscience Program, Physiology and Psychiatry Departments, Pontificia Universidad Javeriana, Bogotá, Colombia; Memory and Cognition Center Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
| | - Pavel Prado
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Josefina Cruzat
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
| | | | - Agustina Legaz
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Sol Fittipaldi
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Andrea Slachevsky
- Center for Geroscience, Brain Health and Metabolism, Santiago, Chile; Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Institute of Biomedical Sciences, Santiago, Chile; Memory and Neuropsychiatric Clinic, Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile; Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Rodrigo Santibañez
- Neurology Service, Hospital Dr. Sótero del Río, Santiago, Chile; Neurology Department, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mariano Sigman
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Laboratorio de Neurociencia, Universidad Torcuato Di Tella, Buenos Aires, Argentina; Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
| | - Adolfo M García
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
| | - Robert Whelan
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Sebastián Moguilner
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Agustín Ibáñez
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
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12
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Ridderinkhof KR, Krugers HJ. Horizons in Human Aging Neuroscience: From Normal Neural Aging to Mental (Fr)Agility. Front Hum Neurosci 2022; 16:815759. [PMID: 35845248 PMCID: PMC9277589 DOI: 10.3389/fnhum.2022.815759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
While aging is an important risk factor for neurodegenerative disorders such as Alzheimer’s disease and Parkinson’s disease, age-related cognitive decline can also manifest without apparent neurodegenerative changes. In this review, we discuss molecular, cellular, and network changes that occur during normal aging in the absence of neurodegenerative disease. Emerging findings reveal that these changes include metabolic alterations, oxidative stress, DNA damage, inflammation, calcium dyshomeostasis, and several other hallmarks of age-related neural changes that do not act on their own, but are often interconnected and together may underlie age-related alterations in brain plasticity and cognitive function. Importantly, age-related cognitive decline may not be reduced to a single neurobiological cause, but should instead be considered in terms of a densely connected system that underlies age-related cognitive alterations. We speculate that a decline in one hallmark of neural aging may trigger a decline in other, otherwise thus far stable subsystems, thereby triggering a cascade that may at some point also incur a decline of cognitive functions and mental well-being. Beyond studying the effects of these factors in isolation, considerable insight may be gained by studying the larger picture that entails a representative collection of such factors and their interactions, ranging from molecules to neural networks. Finally, we discuss some potential interventions that may help to prevent these alterations, thereby reducing cognitive decline and mental fragility, and enhancing mental well-being, and healthy aging.
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Affiliation(s)
- K Richard Ridderinkhof
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Center for Brain and Cognition (ABC), University of Amsterdam, Amsterdam, Netherlands
| | - Harm J Krugers
- Amsterdam Center for Brain and Cognition (ABC), University of Amsterdam, Amsterdam, Netherlands
- SILS-CNS, Faculty of Science, University of Amsterdam, Amsterdam, Netherlands
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13
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Fani N, Harnett NG, Bradley B, Mekawi Y, Powers A, Stevens JS, Ressler KJ, Carter SE. Racial Discrimination and White Matter Microstructure in Trauma-Exposed Black Women. Biol Psychiatry 2022; 91:254-261. [PMID: 34776124 PMCID: PMC8714668 DOI: 10.1016/j.biopsych.2021.08.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/26/2021] [Accepted: 08/16/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Experiences of racial discrimination are linked to a range of negative brain health outcomes, but little is known about how these experiences impact neural architecture, including white matter microstructure, which may partially mediate these outcomes. Our goal was to examine associations between racially discriminatory experiences and white matter structural integrity in a sample of Black American women. METHODS We recruited 116 Black American women as part of a long-standing study of trauma. Participants completed assessments of racial discrimination, trauma exposure, and posttraumatic stress disorder and underwent diffusion tensor imaging. Fractional anisotropy and mean diffusivity values were extracted from major white matter tracts throughout the brain. RESULTS Experiences of racial discrimination were associated with significantly lower fractional anisotropy in multiple white matter tracts, including the corpus callosum, cingulum, and superior longitudinal fasciculus (ps < .004), even after accounting for variance associated with trauma, posttraumatic stress disorder, and demographic- and scanner-related factors. CONCLUSIONS These findings suggest that experiences of racial discrimination are independently related to decrements in white matter microarchitecture throughout the brain. In individuals who have experienced other types of adversity, racial discrimination clearly has additive and distinctive deleterious effects on white matter structure. Our findings suggest a pathway through which racial discrimination can contribute to brain health disparities in Black Americans; the deleterious contributions of racial discrimination on the microstructure of major white matter pathways may increase vulnerability for the development of neurodegenerative disorders as well as the development of mental health problems.
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Affiliation(s)
- Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia; Atlanta VA Medical Center, Decatur, Georgia
| | - Yara Mekawi
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia; Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Sierra E Carter
- Department of Psychology, Georgia State University, Atlanta, Georgia
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14
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Faraji J, Metz GAS. Aging, Social Distancing, and COVID-19 Risk: Who is more Vulnerable and Why? Aging Dis 2021; 12:1624-1643. [PMID: 34631211 PMCID: PMC8460299 DOI: 10.14336/ad.2021.0319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 03/19/2021] [Indexed: 01/08/2023] Open
Abstract
Perceived social support represents an important predictor of healthy aging. The global COVID-19 pandemic has dramatically changed the face of social relationships and revealed elderly to be particularly vulnerable to the effects of social isolation. Social distancing may represent a double-edged sword for older adults, protecting them against COVID-19 infection while also sacrificing personal interaction and attention at a critical time. Here, we consider the moderating role of social relationships as a potential influence on stress resilience, allostatic load, and vulnerability to infection and adverse health outcomes in the elderly population. Understanding the mechanisms how social support enhances resilience to stress and promotes mental and physical health into old age will enable new preventive strategies. Targeted social interventions may provide effective relief from the impact of COVID-19-related isolation and loneliness. In this regard, a pandemic may also offer a window of opportunity for raising awareness and mobilizing resources for new strategies that help build resilience in our aging population and future generations.
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Affiliation(s)
- Jamshid Faraji
- 1Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada.,2Faculty of Nursing & Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gerlinde A S Metz
- 1Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
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15
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Roeckner AR, Oliver KI, Lebois LAM, van Rooij SJH, Stevens JS. Neural contributors to trauma resilience: a review of longitudinal neuroimaging studies. Transl Psychiatry 2021; 11:508. [PMID: 34611129 PMCID: PMC8492865 DOI: 10.1038/s41398-021-01633-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 09/02/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022] Open
Abstract
Resilience in the face of major life stressors is changeable over time and with experience. Accordingly, differing sets of neurobiological factors may contribute to an adaptive stress response before, during, and after the stressor. Longitudinal studies are therefore particularly effective in answering questions about the determinants of resilience. Here we provide an overview of the rapidly-growing body of longitudinal neuroimaging research on stress resilience. Despite lingering gaps and limitations, these studies are beginning to reveal individual differences in neural circuit structure and function that appear protective against the emergence of future psychopathology following a major life stressor. Here we outline a neural circuit model of resilience to trauma. Specifically, pre-trauma biomarkers of resilience show that an ability to modulate activity within threat and salience networks predicts fewer stress-related symptoms. In contrast, early post-trauma biomarkers of subsequent resilience or recovery show a more complex pattern, spanning a number of major circuits including attention and cognitive control networks as well as primary sensory cortices. This novel synthesis suggests stress resilience may be scaffolded by stable individual differences in the processing of threat cues, and further buttressed by post-trauma adaptations to the stressor that encompass multiple mechanisms and circuits. More attention and resources supporting this work will inform the targets and timing of mechanistic resilience-boosting interventions.
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Affiliation(s)
- Alyssa R. Roeckner
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Katelyn I. Oliver
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Lauren A. M. Lebois
- grid.240206.20000 0000 8795 072XDivision of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Sanne J. H. van Rooij
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Jennifer S. Stevens
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
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16
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Spooner RK, Taylor BK, L'Heureux E, Schantell M, Arif Y, May PE, Morsey B, Wang T, Ideker T, Fox HS, Wilson TW. Stress-induced aberrations in sensory processing predict worse cognitive outcomes in healthy aging adults. Aging (Albany NY) 2021; 13:19996-20015. [PMID: 34410999 PMCID: PMC8436901 DOI: 10.18632/aging.203433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/03/2021] [Indexed: 01/06/2023]
Abstract
It is well recognized that not all individuals age equivalently, with functional dependence attributable, at least in part, to stress accumulated across the lifespan. Amongst these dependencies are age-related declines in cognitive function, which may be the result of impaired inhibitory processing (e.g., sensory gating). Herein, we examined the unique roles of life and biological stress on somatosensory gating dynamics in 74 adults (22-72 years old). Participants completed a sensory gating paired-pulse electrical stimulation paradigm of the right median nerve during magnetoencephalography (MEG) and data were subjected to advanced oscillatory and time-domain analysis methods. We observed separable mechanisms by which increasing levels of life and biological stress predicted higher oscillatory gating ratios, indicative of age-related impairments in inhibitory function. Specifically, elevations in life stress significantly modulated the neural response to the first stimulation in the pair, while elevations in biological stress significantly modulated the neural response to the second stimulation in the pair. In contrast, neither elevations in life nor biological stress significantly predicted the gating of time-domain neural activity in the somatosensory cortex. Finally, our study is the first to link stress-induced decline in sensory gating to cognitive dysfunction, suggesting that gating paradigms may hold promise for detecting discrepant functional trajectories in age-related pathologies in the future.
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Affiliation(s)
- Rachel K Spooner
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE 68010, USA.,College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Brittany K Taylor
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE 68010, USA
| | - Emma L'Heureux
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Mikki Schantell
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE 68010, USA.,College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Yasra Arif
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE 68010, USA.,College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Pamela E May
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Brenda Morsey
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Tina Wang
- Department of Medicine, University of California San Diego, La Jolla, CA 92161, USA
| | - Trey Ideker
- Department of Medicine, University of California San Diego, La Jolla, CA 92161, USA
| | - Howard S Fox
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE 68010, USA.,College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
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17
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de Lange AMG, Kaufmann T, Quintana DS, Winterton A, Andreassen OA, Westlye LT, Ebmeier KP. Prominent health problems, socioeconomic deprivation, and higher brain age in lonely and isolated individuals: A population-based study. Behav Brain Res 2021; 414:113510. [PMID: 34358570 DOI: 10.1016/j.bbr.2021.113510] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 01/12/2023]
Abstract
Loneliness is linked to increased risk for Alzheimer's disease, but little is known about factors potentially contributing to adverse brain health in lonely individuals. In this study, we used data from 24,867 UK Biobank participants to investigate risk factors related to loneliness and estimated brain age based on neuroimaging data. The results showed that on average, individuals who self-reported loneliness on a single yes/no item scored higher on neuroticism, depression, social isolation, and socioeconomic deprivation, performed less physical activity, and had higher BMI compared to individuals who did not report loneliness. In line with studies pointing to a genetic overlap of loneliness with neuroticism and depression, permutation feature importance ranked these factors as the most important for classifying lonely vs. not lonely individuals (ROC AUC = 0.83). While strongly linked to loneliness, neuroticism and depression were not associated with brain age estimates. Conversely, objective social isolation showed a main effect on brain age, and individuals reporting both loneliness and social isolation showed higher brain age relative to controls - as part of a prominent risk profile with elevated scores on socioeconomic deprivation and unhealthy lifestyle behaviours, in addition to neuroticism and depression. While longitudinal studies are required to determine causality, this finding may indicate that the combination of social isolation and a genetic predisposition for loneliness involves a risk for adverse brain health. Importantly, the results underline the complexity in associations between loneliness and adverse health outcomes, where observed risks likely depend on a combination of interlinked variables including genetic as well as social, behavioural, physical, and socioeconomic factors.
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Affiliation(s)
- Ann-Marie G de Lange
- Department of Psychiatry, University of Oxford, Oxford, UK; NORMENT, Institute of Clinical Medicine, University of Oslo, & Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
| | - Tobias Kaufmann
- NORMENT, Institute of Clinical Medicine, University of Oslo, & Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Tübingen Center for Mental Health, Dept. of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Daniel S Quintana
- NORMENT, Institute of Clinical Medicine, University of Oslo, & Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Adriano Winterton
- NORMENT, Institute of Clinical Medicine, University of Oslo, & Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Institute of Clinical Medicine, University of Oslo, & Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- NORMENT, Institute of Clinical Medicine, University of Oslo, & Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
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18
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Pascual-Leone A, Bartres-Faz D. Human Brain Resilience: A Call to Action. Ann Neurol 2021; 90:336-349. [PMID: 34219268 DOI: 10.1002/ana.26157] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/03/2021] [Accepted: 07/03/2021] [Indexed: 01/01/2023]
Abstract
At present, resilience refers to a highly heterogeneous concept with ill-defined determinants, mechanisms, and outcomes. This call for action argues for the need to define resilience as a person-centered multidimensional metric, informed by a dynamic lifespan perspective and combining observational and interventional experimental studies to identify specific neural markers and correlated behavioral measures. The coronavirus disease 2019 (COVID-19) pandemic highlights the urgent need of such an effort with the ultimate goal of defining a new vital sign, an individual index of resilience, as a life-long metric with the capacity to predict an individual's risk for disability in the face of a stressor, insult, injury, or disease. ANN NEUROL 2021.
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Affiliation(s)
- Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health at Hebrew SeniorLife, Boston, MA, USA.,Institut Guttmann de Neurorehabilitació, Guttmann Brain Health Institute, Barcelona, Spain
| | - David Bartres-Faz
- Institut Guttmann de Neurorehabilitació, Guttmann Brain Health Institute, Barcelona, Spain.,Department de Medicina, Facultat de Medicina i Ciències de la Salut - Campus Clínic, Universitat de Barcelona, Barcelona, Spain
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19
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Mathew A, Doorenbos AZ, Li H, Jang MK, Park CG, Bronas UG. Allostatic Load in Cancer: A Systematic Review and Mini Meta-Analysis. Biol Res Nurs 2021; 23:341-361. [PMID: 33138637 PMCID: PMC8755951 DOI: 10.1177/1099800420969898] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Individuals with cancer experience stress throughout the cancer trajectory. Allostatic load (AL), a cumulative multi-system measure, may have a greater value in stress assessment and the associated biological burden than individual biomarkers. A better understanding of the use of AL and its operationalization in cancer could aid in early detection and prevention or alleviation of AL in this population. PURPOSE To consolidate findings on the operationalization, antecedents, and outcomes of AL in cancer. METHODS Seven databases (CINAHL, Ovid MEDLINE, Web of Science, APA PsycInfo, Scopus, Embase, and Cochrane CENTRAL) were searched for articles published through April 2020. The NIH tools were used to assess study quality. RESULTS Twelve studies met inclusion criteria for this review. Although variability existed in the estimation of AL, biomarkers of cardiovascular, metabolic, and immune systems were mostly used. Associations of AL with cancer-specific variables were examined mostly utilizing population-databases. Significant associations of AL with variables such as cancer-related stress, positive cancer history, post traumatic growth, resilience, tumor pathology, and cancer-specific mortality were found. Mini meta-analysis found that a one-unit increase in AL was associated with a 9% increased risk of cancer-specific mortality. CONCLUSION This review reveals heterogeneity in operationalization of AL in cancer research and lack of clarity regarding causal direction between AL and cancer. Nevertheless, AL holds a significant promise in cancer research and practice. AL could be included as a screening tool for high-risk individuals or a health outcome in cancer. Optimal standardized approaches to measure AL would improve its clinical utility.
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Affiliation(s)
- Asha Mathew
- College of Nursing, University of Illinois, Chicago, IL, USA
- College of Nursing, Christian Medical College, Vellore, India
| | - Ardith Z. Doorenbos
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Hongjin Li
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Min Kyeong Jang
- College of Nursing, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Chang Gi Park
- College of Nursing, University of Illinois, Chicago, IL, USA
- Department of Population Health Nursing Science, Office of Research Facilitation, Chicago, IL, USA
| | - Ulf G. Bronas
- College of Nursing, University of Illinois, Chicago, IL, USA
- Laboratory of Vascular and Cognitive Health, Chicago, IL, USA
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20
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Anatürk M, Kaufmann T, Cole JH, Suri S, Griffanti L, Zsoldos E, Filippini N, Singh‐Manoux A, Kivimäki M, Westlye LT, Ebmeier KP, de Lange AG. Prediction of brain age and cognitive age: Quantifying brain and cognitive maintenance in aging. Hum Brain Mapp 2021; 42:1626-1640. [PMID: 33314530 PMCID: PMC7978127 DOI: 10.1002/hbm.25316] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022] Open
Abstract
The concept of brain maintenance refers to the preservation of brain integrity in older age, while cognitive reserve refers to the capacity to maintain cognition in the presence of neurodegeneration or aging-related brain changes. While both mechanisms are thought to contribute to individual differences in cognitive function among older adults, there is currently no "gold standard" for measuring these constructs. Using machine-learning methods, we estimated brain and cognitive age based on deviations from normative aging patterns in the Whitehall II MRI substudy cohort (N = 537, age range = 60.34-82.76), and tested the degree of correspondence between these constructs, as well as their associations with premorbid IQ, education, and lifestyle trajectories. In line with established literature highlighting IQ as a proxy for cognitive reserve, higher premorbid IQ was linked to lower cognitive age independent of brain age. No strong evidence was found for associations between brain or cognitive age and lifestyle trajectories from midlife to late life based on latent class growth analyses. However, post hoc analyses revealed a relationship between cumulative lifestyle measures and brain age independent of cognitive age. In conclusion, we present a novel approach to characterizing brain and cognitive maintenance in aging, which may be useful for future studies seeking to identify factors that contribute to brain preservation and cognitive reserve mechanisms in older age.
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Affiliation(s)
- Melis Anatürk
- Department of PsychiatryUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Tobias Kaufmann
- NORMENT, Institute of Clinical MedicineUniversity of Oslo, & Division of Mental Health and Addiction, Oslo University HospitalOsloNorway
| | - James H. Cole
- Centre for Medical Image Computing, Department of Computer ScienceUniversity College LondonLondonUK
- Dementia Research Centre, Institute of NeurologyUniversity College LondonLondonUK
| | - Sana Suri
- Department of PsychiatryUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Ludovica Griffanti
- Department of PsychiatryUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Enikő Zsoldos
- Department of PsychiatryUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Nicola Filippini
- Department of PsychiatryUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Archana Singh‐Manoux
- Epidemiology of Ageing and Neurodegenerative diseasesUniversité de Paris, INSERM U1153ParisFrance
- Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Mika Kivimäki
- Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Lars T. Westlye
- NORMENT, Institute of Clinical MedicineUniversity of Oslo, & Division of Mental Health and Addiction, Oslo University HospitalOsloNorway
- Department of PsychologyUniversity of OsloOsloNorway
| | | | - Ann‐Marie G. de Lange
- Department of PsychiatryUniversity of OxfordOxfordUK
- NORMENT, Institute of Clinical MedicineUniversity of Oslo, & Division of Mental Health and Addiction, Oslo University HospitalOsloNorway
- Department of PsychologyUniversity of OsloOsloNorway
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21
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Demnitz N, Anatürk M, Allan CL, Filippini N, Griffanti L, Mackay CE, Mahmood A, Sexton CE, Suri S, Topiwala AG, Zsoldos E, Kivimäki M, Singh-Manoux A, Ebmeier KP. Association of trajectories of depressive symptoms with vascular risk, cognitive function and adverse brain outcomes: The Whitehall II MRI sub-study. J Psychiatr Res 2020; 131:85-93. [PMID: 32949819 PMCID: PMC8063684 DOI: 10.1016/j.jpsychires.2020.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/28/2020] [Accepted: 09/03/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Trajectories of depressive symptoms over the lifespan vary between people, but it is unclear whether these differences exhibit distinct characteristics in brain structure and function. METHODS In order to compare indices of white matter microstructure and cognitive characteristics of groups with different trajectories of depressive symptoms, we examined 774 participants of the Whitehall II Imaging Sub-study, who had completed the depressive subscale of the General Health Questionnaire up to nine times over 25 years. Twenty-seven years after the first examination, participants underwent magnetic resonance imaging to characterize white matter hyperintensities (WMH) and microstructure and completed neuropsychological tests to assess cognition. Twenty-nine years after the first examination, participants completed a further cognitive screening test. OUTCOMES Using K-means cluster modelling, we identified five trajectory groups of depressive symptoms: consistently low scorers ("low"; n = 505, 62·5%), a subgroup with an early peak in depression scores ("early"; n = 123, 15·9%), intermediate scorers ("middle"; n = 89, 11·5%), a late symptom subgroup with an increase in symptoms towards the end of the follow-up period ("late"; n = 29, 3·7%), and consistently high scorers ("high"; n = 28, 3·6%). The late, but not the consistently high scorers, showed higher mean diffusivity, larger volumes of WMH and impaired executive function. In addition, the late subgroup had higher Framingham Stroke Risk scores throughout the follow-up period, indicating a higher load of vascular risk factors. INTERPRETATION Our findings suggest that tracking depressive symptoms in the community over time may be a useful tool to identify phenotypes that show different etiologies and cognitive and brain outcomes.
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Affiliation(s)
- Naiara Demnitz
- Department of Psychiatry, University of Oxford, Oxford, UK,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Melis Anatürk
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Charlotte L. Allan
- Institute of Translational and Clinical Research, Newcastle University, and Tyne and Wear NHS Foundation Trust Cumbria, Northumberland UK
| | - Nicola Filippini
- Wellcome Centre for Integrative Neuroimaging (including Oxford Centre for Human Brain Activity and Functional Magnetic Resonance Imaging of the Brain), University of Oxford, UK
| | - Ludovica Griffanti
- Wellcome Centre for Integrative Neuroimaging (including Oxford Centre for Human Brain Activity and Functional Magnetic Resonance Imaging of the Brain), University of Oxford, UK
| | - Clare E. Mackay
- Department of Psychiatry, University of Oxford, Oxford, UK,Wellcome Centre for Integrative Neuroimaging (including Oxford Centre for Human Brain Activity and Functional Magnetic Resonance Imaging of the Brain), University of Oxford, UK
| | - Abda Mahmood
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Claire E. Sexton
- Department of Psychiatry, University of Oxford, Oxford, UK,Wellcome Centre for Integrative Neuroimaging (including Oxford Centre for Human Brain Activity and Functional Magnetic Resonance Imaging of the Brain), University of Oxford, UK
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Oxford, UK,Wellcome Centre for Integrative Neuroimaging (including Oxford Centre for Human Brain Activity and Functional Magnetic Resonance Imaging of the Brain), University of Oxford, UK
| | | | - Enikő Zsoldos
- Department of Psychiatry, University of Oxford, Oxford, UK,Wellcome Centre for Integrative Neuroimaging (including Oxford Centre for Human Brain Activity and Functional Magnetic Resonance Imaging of the Brain), University of Oxford, UK
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, University College London, London, UK,Université de Paris, INSERM U1153, Paris, France
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22
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de Lange AMG, Anatürk M, Suri S, Kaufmann T, Cole JH, Griffanti L, Zsoldos E, Jensen DEA, Filippini N, Singh-Manoux A, Kivimäki M, Westlye LT, Ebmeier KP. Multimodal brain-age prediction and cardiovascular risk: The Whitehall II MRI sub-study. Neuroimage 2020; 222:117292. [PMID: 32835819 PMCID: PMC8121758 DOI: 10.1016/j.neuroimage.2020.117292] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/21/2022] Open
Abstract
Brain age is becoming a widely applied imaging-based biomarker of neural aging and potential proxy for brain integrity and health. We estimated multimodal and modality-specific brain age in the Whitehall II (WHII) MRI cohort using machine learning and imaging-derived measures of gray matter (GM) morphology, white matter microstructure (WM), and resting state functional connectivity (FC). The results showed that the prediction accuracy improved when multiple imaging modalities were included in the model (R2 = 0.30, 95% CI [0.24, 0.36]). The modality-specific GM and WM models showed similar performance (R2 = 0.22 [0.16, 0.27] and R2 = 0.24 [0.18, 0.30], respectively), while the FC model showed the lowest prediction accuracy (R2 = 0.002 [-0.005, 0.008]), indicating that the FC features were less related to chronological age compared to structural measures. Follow-up analyses showed that FC predictions were similarly low in a matched sub-sample from UK Biobank, and although FC predictions were consistently lower than GM predictions, the accuracy improved with increasing sample size and age range. Cardiovascular risk factors, including high blood pressure, alcohol intake, and stroke risk score, were each associated with brain aging in the WHII cohort. Blood pressure showed a stronger association with white matter compared to gray matter, while no differences in the associations of alcohol intake and stroke risk with these modalities were observed. In conclusion, machine-learning based brain age prediction can reduce the dimensionality of neuroimaging data to provide meaningful biomarkers of individual brain aging. However, model performance depends on study-specific characteristics including sample size and age range, which may cause discrepancies in findings across studies.
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Affiliation(s)
- Ann-Marie G de Lange
- Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychology, University of Oslo, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, & Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Melis Anatürk
- Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Tobias Kaufmann
- NORMENT, Institute of Clinical Medicine, University of Oslo, & Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - James H Cole
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK; Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Ludovica Griffanti
- Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Enikő Zsoldos
- Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Daria E A Jensen
- Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Nicola Filippini
- Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Archana Singh-Manoux
- Epidemiology of Ageing and Neurodegenerative Diseases, Universit de Paris, INSERM U1153, Paris France; Department of Epidemiology and Public Health, University College London, London, UK
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, & Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
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23
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An Exploratory Study of Correlates of Allostatic Load in Older People Living With HIV. J Acquir Immune Defic Syndr 2020; 83:441-449. [PMID: 31914006 DOI: 10.1097/qai.0000000000002293] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Older people living with HIV (PLWH) experience poorer outcomes than seronegative counterparts. Allostatic load (AL) markers have shown utility as indicators of cumulative wear-and-tear of stress on biological systems. However, little is known about correlates of AL in PLWH. METHODS Ninety-six PLWH aged 50+ completed a comprehensive neurobehavioral assessment and blood draw. Select AL markers (ie, 10 blood markers) were available for a subset (n = 75) of seronegative controls. AL was operationalized as a sum of markers in the highest risk quartile for: cortisol, DHEA, IL-6, TNF-alpha, C-reactive protein, glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, albumin, systolic and diastolic blood pressure, and body mass index. RESULTS PLWH had higher risk levels than seronegatives with small-medium effect sizes for several biomarkers. Among HIV+ African Americans (84% of PLWH), higher AL was associated with lower psychological resilience (rho = -0.27, P = 0.02), less physical activity (rho = -0.29, P < 0.01), poorer neurocognitive functioning (rho = -0.26, P = 0.02), greater basic activity of daily living complaints (P < 0.01), and diabetes (P < 0.01). Multivariable regressions within African American PLWH for significant AL-outcome associations (ie, neurocognitive function, basic activity of daily living complaints, diabetes) showed that associations with AL remained significant when adjusting for relevant covariates. Mediation analysis suggested that the association between socioeconomic status and neurocognitive function was mediated by AL. CONCLUSIONS These exploratory findings are consistent with the larger aging literature, suggesting that lower AL may serve as a pathway to better health and functional outcomes, particularly in African American PLWH. Furthermore, resilience and physical activity may reduce AL in this population.
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24
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Acheampong T, Jiang L, Ziogas A, Odegaard AO. Multi-Systemic Biological Risk and Cancer Mortality: The NHANES III Study. Sci Rep 2020; 10:5047. [PMID: 32193496 PMCID: PMC7081240 DOI: 10.1038/s41598-020-61945-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/02/2020] [Indexed: 01/16/2023] Open
Abstract
Multi-systemic biological risk (MSBR), a proxy for allostatic load, is a composite index of biomarkers representing dysregulation due to responses to chronic stress. This study examined the association of an MSBR index with cancer mortality. The sample included n = 13,628 adults aged 20–90 from the NHANES III Linked Mortality File (1988–1994). The MSBR index included autonomic (pulse rate, blood pressure), metabolic (HOMAir, triglycerides, waist circumference), and immune (white blood cell count, C-reactive protein) markers. We fit Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CI) of overall cancer mortality risk, according to quartiles (q) of the index. In multivariable models, compared to those in q1, q4 had a 64% increased risk for cancer mortality (HR = 1.64, 95% CI:1.13–2.40). The immune domain drove the association (HR per unit = 1.19, 95% CI:1.07–1.32). In stratified analyses, the HR for those with a BMI ≥ 25 was 1.12 per unit (95% CI:1.05–1.19) and those with a BMI < 25 was 1.04 per unit (95% CI:0.92–1.18). MSBR is positively associated with risk for cancer mortality in a US sample, particularly among those who are overweight or obese. The utilization of standard clinical measures comprising this index may inform population cancer prevention strategies.
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Affiliation(s)
- Teofilia Acheampong
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th street, New York, NY, 10032, United States
| | - Luohua Jiang
- Department of Epidemiology, University of California-Irvine, Anteater Instruction & Research Building (AIRB), 653 E. Peltason Drive, Suite 3060 E, Irvine, CA, 92697, United States
| | - Argyrios Ziogas
- Department of Epidemiology, University of California-Irvine, Anteater Instruction & Research Building (AIRB), 653 E. Peltason Drive, Suite 3060 E, Irvine, CA, 92697, United States
| | - Andrew O Odegaard
- Department of Epidemiology, University of California-Irvine, Anteater Instruction & Research Building (AIRB), 653 E. Peltason Drive, Suite 3060 E, Irvine, CA, 92697, United States.
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25
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Zsoldos E, Mahmood A, Filippini N, Suri S, Heise V, Griffanti L, Mackay CE, Singh-Manoux A, Kivimäki M, Ebmeier KP. Association of midlife stroke risk with structural brain integrity and memory performance at older ages: a longitudinal cohort study. Brain Commun 2020; 2:fcaa026. [PMID: 32954286 PMCID: PMC7491431 DOI: 10.1093/braincomms/fcaa026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/23/2020] [Accepted: 03/03/2020] [Indexed: 01/13/2023] Open
Abstract
Cardiovascular health in midlife is an established risk factor for cognitive function later in life. Knowing mechanisms of this association may allow preventative steps to be taken to preserve brain health and cognitive performance in older age. In this study, we investigated the association of the Framingham stroke-risk score, a validated multifactorial predictor of 10-year risk of stroke, with brain measures and cognitive performance in stroke-free individuals. We used a large (N = 800) longitudinal cohort of community-dwelling adults of the Whitehall II imaging sub-study with no obvious structural brain abnormalities, who had Framingham stroke risk measured five times between 1991 and 2013 and MRI measures of structural integrity, and cognitive function performed between 2012 and 2016 [baseline mean age 47.9 (5.2) years, range 39.7–62.7 years; MRI mean age 69.81 (5.2) years, range 60.3–84.6 years; 80.6% men]. Unadjusted linear associations were assessed between the Framingham stroke-risk score in each wave and voxelwise grey matter density, fractional anisotropy and mean diffusivity at follow-up. These analyses were repeated including socio-demographic confounders as well as stroke risk in previous waves to examine the effect of residual risk acquired between waves. Finally, we used structural equation modelling to assess whether stroke risk negatively affects cognitive performance via specific brain measures. Higher unadjusted stroke risk measured at each of the five waves over 20 years prior to the MRI scan was associated with lower voxelwise grey and white matter measures. After adjusting for socio-demographic variables, higher stroke risk from 1991 to 2009 was associated with lower grey matter volume in the medial temporal lobe. Higher stroke risk from 1997 to 2013 was associated with lower fractional anisotropy along the corpus callosum. In addition, higher stroke risk from 2012 to 2013, sequentially adjusted for risk measured in 1991–94, 1997–98 and 2002–04 (i.e. ‘residual risks’ acquired from the time of these examinations onwards), was associated with widespread lower fractional anisotropy, and lower grey matter volume in sub-neocortical structures. Structural equation modelling suggested that such reductions in brain integrity were associated with cognitive impairment. These findings highlight the importance of considering cerebrovascular health in midlife as important for brain integrity and cognitive function later in life (ClinicalTrials.gov Identifier: NCT03335696).
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Affiliation(s)
- Enikő Zsoldos
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.,Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.,Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Abda Mahmood
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Nicola Filippini
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.,Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.,Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.,Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Verena Heise
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.,Nuffield Department of Population Health, University of Oxford, Big Data Institute, Oxford OX3 7LF, UK
| | - Ludovica Griffanti
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Clare E Mackay
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.,Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, University College London, London WC1E 7HB, UK.,INSERM, U1153, Epidemiology of Ageing and Neurodegenerative diseases, Université de Paris, Paris, France
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London WC1E 7HB, UK
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
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26
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Kotkowski E, Price LR, Franklin C, Salazar M, Woolsey M, DeFronzo RA, Blangero J, Glahn DC, Fox PT. A neural signature of metabolic syndrome. Hum Brain Mapp 2019; 40:3575-3588. [PMID: 31062906 PMCID: PMC6865471 DOI: 10.1002/hbm.24617] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/18/2019] [Accepted: 04/24/2019] [Indexed: 12/26/2022] Open
Abstract
That metabolic syndrome (MetS) is associated with age-related cognitive decline is well established. The neurobiological changes underlying these cognitive deficits, however, are not well understood. The goal of this study was to determine whether MetS is associated with regional differences in gray-matter volume (GMV) using a cross-sectional, between-group contrast design in a large, ethnically homogenous sample. T1-weighted MRIs were sampled from the genetics of brain structure (GOBS) data archive for 208 Mexican-American participants: 104 participants met or exceeded standard criteria for MetS and 104 participants were age- and sex-matched metabolically healthy controls. Participants ranged in age from 18 to 74 years (37.3 ± 13.2 years, 56.7% female). Images were analyzed in a whole-brain, voxel-wise manner using voxel-based morphometry (VBM). Three contrast analyses were performed, a whole sample analysis of all 208 participants, and two post hoc half-sample analyses split by age along the median (35.5 years). Significant associations between MetS and decreased GMV were observed in multiple, spatially discrete brain regions including the posterior cerebellum, brainstem, orbitofrontal cortex, bilateral caudate nuclei, right parahippocampus, right amygdala, right insula, lingual gyrus, and right superior temporal gyrus. Age, as shown in the post hoc analyses, was demonstrated to be a significant covariate. A further functional interpretation of the structures exhibiting lower GMV in MetS reflected a significant involvement in reward perception, emotional valence, and reasoning. Additional studies are needed to characterize the influence of MetS's individual clinical components on brain structure and to explore the bidirectional association between GMV and MetS.
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Affiliation(s)
- Eithan Kotkowski
- Research Imaging Institute, University of Texas Health Science Center at San AntonioSan AntonioTexas
- Department of RadiologyUniversity of Texas Health Science Center at San AntonioSan AntonioTX
| | - Larry R. Price
- Methodology, Measurement and Statistical Analysis CenterTexas State UniversitySan MarcosTexas
| | - Crystal Franklin
- Research Imaging Institute, University of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Maximino Salazar
- Research Imaging Institute, University of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Mary Woolsey
- Research Imaging Institute, University of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Ralph A. DeFronzo
- Texas Diabetes InstituteSan AntonioTexas
- Diabetes Research Unit and Diabetes DivisionUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
| | - John Blangero
- Genomics Computing Center, South Texas Diabetes and Obesity InstituteUniversity of Texas Rio Grande ValleyBrownsvilleTexas
| | - David C. Glahn
- Department of PsychiatryYale University School of MedicineNew HavenConnecticut
- Olin Neuropsychiatry Research CenterInstitute of Living, Hartford HospitalHartfordConnecticut
| | - Peter T. Fox
- Research Imaging Institute, University of Texas Health Science Center at San AntonioSan AntonioTexas
- Department of RadiologyUniversity of Texas Health Science Center at San AntonioSan AntonioTX
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