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Yao Z, Wang J, Zhang T, Ai H, Abdelrahman Z, Wu X, Wang D, Chen F, Zhang Z, Wang X, Liu Z, Chen Z. Age, sex, and APOE gene-specific associations between dynapenic obesity and dementia in a large cohort. J Nutr Health Aging 2024; 28:100313. [PMID: 38986174 DOI: 10.1016/j.jnha.2024.100313] [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: 03/17/2024] [Revised: 06/27/2024] [Accepted: 06/27/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE To investigate the associations between dynapenic obesity and the risk of dementia, and the modifying effects of age, sex, and the APOE gene, using a large population-based cohort. METHODS 279,884 participants aged 55 and above from the UK Biobank were included. The participants were classified into four categories based on body mass index and hand grip strength: healthy, obesity, dynapenia, and dynapenic obesity. The incident dementia was identified based on linked hospital records and death register data. Cox proportional hazards regression models were used to estimate the associations, followed by age-, sex-, and apolipoprotein E (APOE) gene-stratified analyses. RESULTS During the median follow-up of 12.4 years, 5,170 (1.8%) participants developed dementia. Compared with the healthy group, participants with dynapenic obesity had 67% higher dementia risk (hazard ratio [HR]: 1.67, 95% confidence interval [CI]: 1.44-1.94). Compared with the healthy group, higher risks of dementia in participants with dynapenic obesity were respectively observed in male (HR: 2.03, 95% CI: 1.65-2.50), younger (<65 years, HR: 1.97, 95% CI: 1.55-2.50), and non-ε4-carrier (HR: 1.97, 95% CI: 1.60-2.44) (all P for interaction <0.05). In participants under 65 years and non-ε4-carrier, those with dynapenic obesity had the highest risk of dementia (HR: 2.63, 95% CI: 1.91-3.62), compared with the healthy group (P for second order interaction = 0.026). CONCLUSIONS Dynapenic obesity is associated with increased risks of dementia, especially in participants under 65 years and non-ε4-carrier, suggesting the importance of managing dynapenic obesity in the prevention of cognition-related disorders.
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Affiliation(s)
- Zhao Yao
- Department of Rehabilitation Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China
| | - Jie Wang
- Affiliate Hospital of Shandong University of Traditional Chinese Medicine, Shandong, 250012, China
| | - Tianfang Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China
| | - Hongjing Ai
- Biomedical Informatics Research Lab, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Zeinab Abdelrahman
- Centre for Public Health, Queen's University Belfast, Belfast BT12 6BA, UK
| | - Xiaohong Wu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China
| | - Daming Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China
| | - Fenfen Chen
- Department of Rehabilitation Medicine, Taizhou Hospital Affiliated to Wenzhou Medical University, China
| | - Ziwei Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China
| | - Xiaosheng Wang
- Biomedical Informatics Research Lab, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 211198, China.
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China.
| | - Zuobing Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China.
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Bhattarai P, Thakuri DS, Nie Y, Chand GB. Explainable AI-based Deep-SHAP for mapping the multivariate relationships between regional neuroimaging biomarkers and cognition. Eur J Radiol 2024; 174:111403. [PMID: 38452732 PMCID: PMC11157778 DOI: 10.1016/j.ejrad.2024.111403] [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: 11/02/2023] [Revised: 01/16/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Mild cognitive impairment (MCI)/Alzheimer's disease (AD) is associated with cognitive decline beyond normal aging and linked to the alterations of brain volume quantified by magnetic resonance imaging (MRI) and amyloid-beta (Aβ) quantified by positron emission tomography (PET). Yet, the complex relationships between these regional imaging measures and cognition in MCI/AD remain unclear. Explainable artificial intelligence (AI) may uncover such relationships. METHOD We integrate the AI-based deep learning neural network and Shapley additive explanations (SHAP) approaches and introduce the Deep-SHAP method to investigate the multivariate relationships between regional imaging measures and cognition. After validating this approach on simulated data, we apply it to real experimental data from MCI/AD patients. RESULTS Deep-SHAP significantly predicted cognition using simulated regional features and identified the ground-truth simulated regions as the most significant multivariate predictors. When applied to experimental MRI data, Deep-SHAP revealed that the insula, lateral occipital, medial frontal, temporal pole, and occipital fusiform gyrus are the primary contributors to global cognitive decline in MCI/AD. Furthermore, when applied to experimental amyloid Pittsburgh compound B (PiB)-PET data, Deep-SHAP identified the key brain regions for global cognitive decline in MCI/AD as the inferior temporal, parahippocampal, inferior frontal, supratemporal, and lateral frontal gray matter. CONCLUSION Deep-SHAP method uncovered the multivariate relationships between regional brain features and cognition, offering insights into the most critical modality-specific brain regions involved in MCI/AD mechanisms.
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Affiliation(s)
- Puskar Bhattarai
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Deepa Singh Thakuri
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; University of Missouri, School of Medicine, Columbia, MO, USA
| | - Yuzheng Nie
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Institute for Informatics, Data Science and Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Ganesh B Chand
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Imaging Core, Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Institute of Clinical and Translational Sciences, Washington University School of Medicine, St. Louis, MO, USA; NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO, USA.
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Vega F, Addeh A, Ganesh A, Smith EE, MacDonald ME. Image Translation for Estimating Two-Dimensional Axial Amyloid-Beta PET From Structural MRI. J Magn Reson Imaging 2024; 59:1021-1031. [PMID: 37921361 DOI: 10.1002/jmri.29070] [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: 03/01/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Amyloid-beta and brain atrophy are hallmarks for Alzheimer's Disease that can be targeted with positron emission tomography (PET) and MRI, respectively. MRI is cheaper, less-invasive, and more available than PET. There is a known relationship between amyloid-beta and brain atrophy, meaning PET images could be inferred from MRI. PURPOSE To build an image translation model using a Conditional Generative Adversarial Network able to synthesize Amyloid-beta PET images from structural MRI. STUDY TYPE Retrospective. POPULATION Eight hundred eighty-two adults (348 males/534 females) with different stages of cognitive decline (control, mild cognitive impairment, moderate cognitive impairment, and severe cognitive impairment). Five hundred fifty-two subjects for model training and 331 for testing (80%:20%). FIELD STRENGTH/SEQUENCE 3 T, T1-weighted structural (T1w). ASSESSMENT The testing cohort was used to evaluate the performance of the model using the Structural Similarity Index Measure (SSIM) and Peak Signal-to-Noise Ratio (PSNR), comparing the likeness of the overall synthetic PET images created from structural MRI with the overall true PET images. SSIM was computed in the overall image to include the luminance, contrast, and structural similarity components. Experienced observers reviewed the images for quality, performance and tried to determine if they could tell the difference between real and synthetic images. STATISTICAL TESTS Pixel wise Pearson correlation was significant, and had an R2 greater than 0.96 in example images. From blinded readings, a Pearson Chi-squared test showed that there was no significant difference between the real and synthetic images by the observers (P = 0.68). RESULTS A high degree of likeness across the evaluation set, which had a mean SSIM = 0.905 and PSNR = 2.685. The two observers were not able to determine the difference between the real and synthetic images, with accuracies of 54% and 46%, respectively. CONCLUSION Amyloid-beta PET images can be synthesized from structural MRI with a high degree of similarity to the real PET images. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Fernando Vega
- Department of Biomedical, University of Calgary, Calgary, Alberta, Canada
- Department of Electrical and Software Engineering, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Abdoljalil Addeh
- Department of Biomedical, University of Calgary, Calgary, Alberta, Canada
- Department of Electrical and Software Engineering, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Aravind Ganesh
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada
| | - Eric E Smith
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada
| | - M Ethan MacDonald
- Department of Biomedical, University of Calgary, Calgary, Alberta, Canada
- Department of Electrical and Software Engineering, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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Na S, Lee C, Ho S, Hong YJ, Jeong JH, Park KH, Kim S, Wang MJ, Choi SH, Han S, Kang SW, Kang S, Yang DW. A Longitudinal Study on Memory Enhancement in Subjective Cognitive Decline Patients: Clinical and Neuroimaging Perspectives. J Alzheimers Dis 2024; 97:193-204. [PMID: 38108349 DOI: 10.3233/jad-230667] [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] [Indexed: 12/19/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) refers to the self-reported persistent cognitive decline despite normal objective testing, increasing the risk of dementia compared to cognitively normal individuals. OBJECTIVE This study aims to investigate the attributes of SCD patients who demonstrated memory function improvement. METHODS In this prospective study of SCD, a total of 120 subjects were enrolled as part of a multicenter cohort study aimed at identifying predictors for the clinical progression to mild cognitive impairment or dementia (CoSCo study). All subjects underwent 18F-florbetaben PET and brain MRI scans at baseline and annual neuropsychological tests. At the 24-month follow-up, we classified SCD patients based on changes in memory function, the z-score of the Seoul verbal learning test delayed recall. RESULTS Of the 120 enrolled patients, 107 successfully completed the 24-month follow-up assessment. Among these, 80 patients (74.8%) with SCD exhibited memory function improvements. SCD patients with improved memory function had a lower prevalence of coronary artery disease at baseline and performed better in the trail-making test part B compared to those without improvement. Anatomical and biomarker analysis showed a lower frequency of amyloid PET positivity and larger volumes in the left and right superior parietal lobes in subjects with improved memory function. CONCLUSIONS Our prospective study indicates that SCD patients experiencing memory improvement over a 24-month period had a lower amyloid burden, fewer cardiovascular risk factors, and superior executive cognitive function. Identifying these key factors associated with cognitive improvement may assist clinicians in predicting future memory function improvements in SCD patients.
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Affiliation(s)
- Seunghee Na
- Department of Neurology, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, South Korea
| | - Chonghwee Lee
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
| | - SeongHee Ho
- Department of Neurology, Hanyang University Hanmaeum Changwon Hospital, Changwon, Korea
| | - Yun Jeong Hong
- Department of Neurology, College of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, South Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, South Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | | | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, South Korea
| | | | - Seung Wan Kang
- Data Center for Korean EEG, College of Nursing, Seoul National University, Seoul, South Korea
- iMediSync Inc. Seoul, South Korea
| | - Sungmin Kang
- Research and Development, PeopleBio Inc., Seongnam-si, Gyeonggi-do, South Korea
| | - Dong Won Yang
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
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Weng XF, Liu SW, Li M, Zhang Y, Zhang YC, Liu CF, Zhu JT, Hu H. Relationship between sarcopenic obesity and cognitive function in patients with mild to moderate Alzheimer's disease. Psychogeriatrics 2023; 23:944-953. [PMID: 37652079 DOI: 10.1111/psyg.13015] [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: 07/16/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Previous research has linked sarcopenic obesity (SO) to cognitive function; however, the relationship between cognitive performance and SO Alzheimer's disease (AD) patients remains unclear. This study aimed to investigate their relationship in AD patients. METHODS One hundred and twenty mild to moderate AD patients and 56 normal controls were recruited. According to sarcopenia or obesity status, AD patients were classified into subgroups: normal, obesity, sarcopenia, and SO. Body composition, demographics, and sarcopenia parameters were assessed. Cognitive performance was evaluated using neuropsychological scales. RESULTS Among the 176 participants, the prevalence of SO in the moderate AD group was higher than in the normal control group. The moderate AD group had the lowest appendicular skeletal muscle mass index (ASMI) and the highest percentage of body fat (PBF). Hypertension and diabetes were more prevalent in the SO group than in the normal group among the subgroups. The sarcopenia and SO groups exhibited worse global cognitive function compared to the normal and obesity groups. Partial correlation analysis revealed that ASMI, PBF, and visceral fat area were associated with multiple cognitive domains scores. In logistic regression analysis, after adjusting for confounders, obesity was not found to be associated with AD. However, sarcopenia (odds ratio (OR) = 5.35, 95% CI: 1.27-22.46) and SO (OR = 5.84, 95% CI: 1.26-27.11) were identified as independent risk factors for AD. CONCLUSIONS SO was associated with cognitive dysfunction in AD patients. Moreover, the impact of SO on cognitive decline was greater than that of sarcopenia. Early identification and intervention for SO may have a positive effect on the occurrence and progression of AD.
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Affiliation(s)
- Xiao-Fen Weng
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Geriatric Medicine, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Shan-Wen Liu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Meng Li
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yu Zhang
- School of Life Sciences and Technology, Changchun University of Science and Technology, Changchun, China
| | - Ying-Chun Zhang
- Department of Ultrasonography, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chun-Feng Liu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiang-Tao Zhu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hua Hu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Mak E, Zhang L, Tan CH, Reilhac A, Shim HY, Wen MOQ, Wong ZX, Chong EJY, Xu X, Stephenson M, Venketasubramanian N, Zhou JH, O’Brien JT, Chen CLH. Longitudinal associations between β-amyloid and cortical thickness in mild cognitive impairment. Brain Commun 2023; 5:fcad192. [PMID: 37483530 PMCID: PMC10358322 DOI: 10.1093/braincomms/fcad192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/25/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023] Open
Abstract
How beta-amyloid accumulation influences brain atrophy in Alzheimer's disease remains contentious with conflicting findings. We aimed to elucidate the correlations of regional longitudinal atrophy with cross-sectional regional and global amyloid in individuals with mild cognitive impairment and no cognitive impairment. We hypothesized that greater cortical thinning over time correlated with greater amyloid deposition, particularly within Alzheimer's disease characteristic regions in mild cognitive impairment, and weaker or no correlations in those with no cognitive impairment. 45 patients with mild cognitive impairment and 12 controls underwent a cross-sectional [11C]-Pittsburgh Compound B PET and two retrospective longitudinal structural imaging (follow-up: 23.65 ± 2.04 months) to assess global/regional amyloid and regional cortical thickness, respectively. Separate linear mixed models were constructed to evaluate relationships of either global or regional amyloid with regional cortical thinning longitudinally. In patients with mild cognitive impairment, regional amyloid in the right banks of the superior temporal sulcus was associated with longitudinal cortical thinning in the right medial orbitofrontal cortex (P = 0.04 after False Discovery Rate correction). In the mild cognitive impairment group, greater right banks amyloid burden and less cortical thickness in the right medial orbitofrontal cortex showed greater visual and verbal memory decline over time, which was not observed in controls. Global amyloid was not associated with longitudinal cortical thinning in any locations in either group. Our findings indicate an increasing influence of amyloid on neurodegeneration and memory along the preclinical to prodromal spectrum. Future multimodal studies that include additional biomarkers will be well-suited to delineate the interplay between various pathological processes and amyloid and memory decline, as well as clarify their additive or independent effects along the disease deterioration.
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Affiliation(s)
- Elijah Mak
- Correspondence to: Elijah Mak, PhD Department of Psychiatry, University of Cambridge Hills Road, Cambridge, Cambridgeshire, CB20QQ, United Kingdom E-mail:
| | | | - Chin Hong Tan
- Division of Psychology, Nanyang Technological University, Singapore, 637331, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232, Singapore
| | - Anthonin Reilhac
- Clinical Imaging Research Centre, the Agency for Science, Technology and Research, and National University of Singapore, Singapore, 117599, Singapore
| | - Hee Youn Shim
- Memory Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Marcus Ong Qin Wen
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Zi Xuen Wong
- Memory Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Eddie Jun Yi Chong
- Memory Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Xin Xu
- Memory Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- School of Public Health, and the 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 311100, China
| | - Mary Stephenson
- Centre for Translational MR Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117549, Singapore
| | | | - Juan Helen Zhou
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Centre for Translational MR Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117549, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, 119077, Singapore
| | - John T O’Brien
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 2QQ, United Kingdom
| | - Christopher Li-Hsian Chen
- Memory Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
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Park HJ, Lee JY, Yang JJ, Kim HJ, Kim YS, Kim JY, Choi YY. Prediction of Amyloid β-Positivity with both MRI Parameters and Cognitive Function Using Machine Learning. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:638-652. [PMID: 37325007 PMCID: PMC10265247 DOI: 10.3348/jksr.2022.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/05/2022] [Accepted: 10/02/2022] [Indexed: 06/17/2023]
Abstract
Purpose To investigate the MRI markers for the prediction of amyloid β (Aβ)-positivity in mild cognitive impairment (MCI) and Alzheimer's disease (AD), and to evaluate the differences in MRI markers between Aβ-positive (Aβ [+]) and -negative groups using the machine learning (ML) method. Materials and Methods This study included 139 patients with MCI and AD who underwent amyloid PET-CT and brain MRI. Patients were divided into Aβ (+) (n = 84) and Aβ-negative (n = 55) groups. Visual analysis was performed with the Fazekas scale of white matter hyperintensity (WMH) and cerebral microbleeds (CMB) scores. The WMH volume and regional brain volume were quantitatively measured. The multivariable logistic regression and ML using support vector machine, and logistic regression were used to identify the best MRI predictors of Aβ-positivity. Results The Fazekas scale of WMH (p = 0.02) and CMB scores (p = 0.04) were higher in Aβ (+). The volumes of hippocampus, entorhinal cortex, and precuneus were smaller in Aβ (+) (p < 0.05). The third ventricle volume was larger in Aβ (+) (p = 0.002). The logistic regression of ML showed a good accuracy (81.1%) with mini-mental state examination (MMSE) and regional brain volumes. Conclusion The application of ML using the MMSE, third ventricle, and hippocampal volume is helpful in predicting Aβ-positivity with a good accuracy.
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Namsrai T, Ambikairajah A, Cherbuin N. Poorer sleep impairs brain health at midlife. Sci Rep 2023; 13:1874. [PMID: 36725955 PMCID: PMC9892039 DOI: 10.1038/s41598-023-27913-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 01/10/2023] [Indexed: 02/03/2023] Open
Abstract
Sleep is an emerging risk factor for dementia but its association with brain health remains unclear. This study included UK Biobank (n = 29,545; mean age = 54.65) participants at imaging visit with sleep measures and brain scans, and a subset (n = 14,206) with cognitive measures. Multiple linear regression analyses were conducted to study the associations between sleep and brain health. Every additional hour of sleep above 7 h/day was associated with 0.10-0.25% lower brain volumes. In contrast, a negative non-linear association was observed between sleep duration, grey matter, and hippocampal volume. Both longer (> 9 h/day) and shorter sleep (< 6 h/day) durations were associated with lower brain volumes and cognitive measures (memory, reaction time, fluid intelligence). Additionally, daytime dozing was associated with lower brain volumes (grey matter and left hippocampus volume) and lower cognitive measures (reaction time and fluid intelligence). Poor sleep (< 6 h/day, > 9 h/day, daytime dozing) at midlife was associated with lower brain health. Sleep may be an important target to improve brain health into old age and delay the onset of dementia.
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Affiliation(s)
- Tergel Namsrai
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia
| | - Ananthan Ambikairajah
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia.,Discipline of Psychology, Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia.
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Gait Indicators Contribute to Screening Cognitive Impairment: A Single- and Dual-Task Gait Study. Brain Sci 2023; 13:brainsci13010154. [PMID: 36672137 PMCID: PMC9856295 DOI: 10.3390/brainsci13010154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/23/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Screening cognitive impairment is complex and not an appliance for early screening. Gait performance is strongly associated with cognitive impairment. Objectives: We aimed to explore gait indicators that could potentially screen cognitive dysfunction. Methods: A total of 235 subjects were recruited from June 2021 to June 2022. Four gait tasks, including the walking test, the timed “Up & Go” test (TUG), foot pressure balance (FPB), and one-legged standing with eyes closed test (OLS-EC), were performed. Moreover, in the walking test, participants were instructed to walk at their usual pace for the single-gait test. For the dual-task tests, participants walked at their usual pace while counting backward from 100 by 1s. The data were analyzed by the independent sample t-test, univariate and multivariate logistic regression, a linear trend, stratified and interaction analysis, the receiver operating characteristic (ROC) curve, and Pearson’s correlations. Results: Among the 235 participants, 81 (34.5%) were men and 154 (65.5%) were women. The mean age of participants was 72 ± 7.836 years. The control, MCI, mild AD, and severe AD groups had means of 71, 63, 71, and 30, respectively. After adjusting for age, sex, education, and body mass index (BMI), the dual-task toe-off-ground angle (TOA) (odds ratio (OR) = 0.911, 95% confidence interval (CI): 0.847, 0.979), single-task TOA (OR = 0.904, 95% CI: 0.841−0.971), and the timed “Up & Go” time (TUGT) (OR = 1.515, 95% CI: 1.243−1.846) were significantly associated with an increased risk of cognitive impairment. In addition, the trend test and stratified analysis results had no significant differences (all p > 0.05). The area under the roc curve (AUC) values of TOA in the dual-task and TUGT were 0.812 and 0.847, respectively. Additionally, TOA < 36.75° in the dual-task, TOA < 38.90° in the single-task, and TUGT > 9.83 seconds (s) are likely to indicate cognitive impairment. The cognitive assessment scale scores were significantly correlated with TOA (all r > 0.3, p < 0.001) and TUGT (all r > 0.2), respectively. Conclusion: TOA and TUGT scores are, in some circumstances, associated with cognitive impairment; therefore, they can be used as simple initial screenings to identify patients at risk.
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Chang HI, Hsu SW, Kao ZK, Lee CC, Huang SH, Lin CH, Liu MN, Chang CC. Impact of Amyloid Pathology in Mild Cognitive Impairment Subjects: The Longitudinal Cognition and Surface Morphometry Data. Int J Mol Sci 2022; 23:ijms232314635. [PMID: 36498962 PMCID: PMC9738566 DOI: 10.3390/ijms232314635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
The amyloid framework forms the central medical theory related to Alzheimer disease (AD), and the in vivo demonstration of amyloid positivity is essential for diagnosing AD. On the basis of a longitudinal cohort design, the study investigated clinical progressive patterns by obtaining cognitive and structural measurements from a group of patients with amnestic mild cognitive impairment (MCI); the measurements were classified by the positivity (Aβ+) or absence (Aβ-) of the amyloid biomarker. We enrolled 185 patients (64 controls, 121 patients with MCI). The patients with MCI were classified into two groups on the basis of their [18F]flubetaben or [18F]florbetapir amyloid positron-emission tomography scan (Aβ+ vs. Aβ-, 67 vs. 54 patients) results. Data from annual cognitive measurements and three-dimensional T1 magnetic resonance imaging scans were used for between-group comparisons. To obtain longitudinal cognitive test scores, generalized estimating equations were applied. A linear mixed effects model was used to compare the time effect of cortical thickness degeneration. The cognitive decline trajectory of the Aβ+ group was obvious, whereas the Aβ- and control groups did not exhibit a noticeable decline over time. The group effects of cortical thickness indicated decreased entorhinal cortex in the Aβ+ group and supramarginal gyrus in the Aβ- group. The topology of neurodegeneration in the Aβ- group was emphasized in posterior cortical regions. A comparison of the changes in the Aβ+ and Aβ- groups over time revealed a higher rate of cortical thickness decline in the Aβ+ group than in the Aβ- group in the default mode network. The Aβ+ and Aβ- groups experienced different APOE ε4 effects. For cortical-cognitive correlations, the regions associated with cognitive decline in the Aβ+ group were mainly localized in the perisylvian and anterior cingulate regions. By contrast, the degenerative topography of Aβ- MCI was scattered. The memory learning curves, cognitive decline patterns, and cortical degeneration topographies of the two MCI groups were revealed to be different, suggesting a difference in pathophysiology. Longitudinal analysis may help to differentiate between these two MCI groups if biomarker access is unavailable in clinical settings.
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Affiliation(s)
- Hsin-I Chang
- Department of Neurology, Cognition and Aging Center, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Shih-Wei Hsu
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Zih-Kai Kao
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Chen-Chang Lee
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Shu-Hua Huang
- Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Ching-Heng Lin
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan 333, Taiwan
| | - Mu-N Liu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Correspondence: (M.-N.L.); (C.-C.C.)
| | - Chiung-Chih Chang
- Department of Neurology, Cognition and Aging Center, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
- Correspondence: (M.-N.L.); (C.-C.C.)
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11
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Brill E, Krebs C, Falkner M, Peter J, Henke K, Züst M, Minkova L, Brem AK, Klöppel S. Can a serious game-based cognitive training attenuate cognitive decline related to Alzheimer's disease? Protocol for a randomized controlled trial. BMC Psychiatry 2022; 22:552. [PMID: 35962371 PMCID: PMC9373273 DOI: 10.1186/s12888-022-04131-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/12/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is a major public health issue. Cognitive interventions such as computerized cognitive trainings (CCT) are effective in attenuating cognitive decline in AD. However, in those at risk of dementia related to AD, results are heterogeneous. Efficacy and feasibility of CCT needs to be explored in depth. Moreover, underlying mechanisms of CCT effects on the three cognitive domains typically affected by AD (episodic memory, semantic memory and spatial abilities) remain poorly understood. METHODS In this bi-centric, randomized controlled trial (RCT) with parallel groups, participants (planned N = 162, aged 60-85 years) at risk for AD and with at least subjective cognitive decline will be randomized to one of three groups. We will compare serious game-based CCT against a passive wait list control condition and an active control condition (watching documentaries). Training will consist of daily at-home sessions for 10 weeks (50 sessions) and weekly on-site group meetings. Subsequently, the CCT group will continue at-home training for an additional twenty-weeks including monthly on-site booster sessions. Investigators conducting the cognitive assessments will be blinded. Group leaders will be aware of participants' group allocations. Primarily, we will evaluate change using a compound value derived from the comprehensive cognitive assessment for each of three cognitive domains. Secondary, longitudinal functional and structural magnetic resonance imaging (MRI) and evaluation of blood-based biomarkers will serve to investigate neuronal underpinnings of expected training benefits. DISCUSSION The present study will address several shortcomings of previous CCT studies. This entails a comparison of serious game-based CCT with both a passive and an active control condition while including social elements crucial for training success and adherence, the combination of at-home and on-site training, inclusion of booster sessions and assessment of physiological markers. Study outcomes will provide information on feasibility and efficacy of serious game-based CCT in older adults at risk for AD and will potentially generalize to treatment guidelines. Moreover, we set out to investigate physiological underpinnings of CCT induced neuronal changes to form the grounds for future individually tailored interventions and neuro-biologically informed trainings. TRIAL REGISTRATION This RCT was registered 1st of July 2020 at clinicaltrials.gov (Identifier NCT04452864).
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Affiliation(s)
- Esther Brill
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland.
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Christine Krebs
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Michael Falkner
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Jessica Peter
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Katharina Henke
- Cognitive Neuroscience of Memory and Consciousness, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Marc Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lora Minkova
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Anna-Katharine Brem
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
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12
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Kannappan B, Gunasekaran TI, te Nijenhuis J, Gopal M, Velusami D, Kothandan G, Lee KH. Polygenic score for Alzheimer’s disease identifies differential atrophy in hippocampal subfield volumes. PLoS One 2022; 17:e0270795. [PMID: 35830443 PMCID: PMC9278752 DOI: 10.1371/journal.pone.0270795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/20/2022] [Indexed: 01/18/2023] Open
Abstract
Hippocampal subfield atrophy is a prime structural change in the brain, associated with cognitive aging and neurodegenerative diseases such as Alzheimer’s disease. Recent developments in genome-wide association studies (GWAS) have identified genetic loci that characterize the risk of hippocampal volume loss based on the processes of normal and abnormal aging. Polygenic risk scores are the genetic proxies mimicking the genetic role of the pre-existing vulnerabilities of the underlying mechanisms influencing these changes. Discriminating the genetic predispositions of hippocampal subfield atrophy between cognitive aging and neurodegenerative diseases will be helpful in understanding the disease etiology. In this study, we evaluated the polygenic risk of Alzheimer’s disease (AD PGRS) for hippocampal subfield atrophy in 1,086 individuals (319 cognitively normal (CN), 591 mild cognitively impaired (MCI), and 176 Alzheimer’s disease dementia (ADD)). Our results showed a stronger association of AD PGRS effect on the left hemisphere than on the right hemisphere for all the hippocampal subfield volumes in a mixed clinical population (CN+MCI+ADD). The subfields CA1, CA4, hippocampal tail, subiculum, presubiculum, molecular layer, GC-ML-DG, and HATA showed stronger AD PGRS associations with the MCI+ADD group than with the CN group. The subfields CA3, parasubiculum, and fimbria showed moderately higher AD PGRS associations with the MCI+ADD group than with the CN group. Our findings suggest that the eight subfield regions, which were strongly associated with AD PGRS are likely involved in the early stage ADD and a specific focus on the left hemisphere could enhance the early prediction of ADD.
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Affiliation(s)
- Balaji Kannappan
- Gwangju Alzheimer’s & Related Dementia Cohort Research Center, Chosun University, Gwangju, Republic of Korea
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea
| | - Tamil Iniyan Gunasekaran
- Gwangju Alzheimer’s & Related Dementia Cohort Research Center, Chosun University, Gwangju, Republic of Korea
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea
| | - Jan te Nijenhuis
- Gwangju Alzheimer’s & Related Dementia Cohort Research Center, Chosun University, Gwangju, Republic of Korea
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea
- * E-mail: (JN); (KHL)
| | - Muthu Gopal
- Health Systems Research & MRHRU, ICMR-National Institute of Epidemiology, Tirunelveli, Tamil Nadu, India
| | - Deepika Velusami
- Department of Physiology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, Tamil Nadu, India
| | - Gugan Kothandan
- Biopolymer Modeling and Protein Chemistry Laboratory, Centre of Advanced Study in Crystallography and Biophysics, University of Madras, Chennai, Tamil Nadu, India
| | - Kun Ho Lee
- Gwangju Alzheimer’s & Related Dementia Cohort Research Center, Chosun University, Gwangju, Republic of Korea
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea
- Korea Brain Research Institute, Daegu, Republic of Korea
- * E-mail: (JN); (KHL)
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13
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Stocks J, Popuri K, Heywood A, Tosun D, Alpert K, Beg MF, Rosen H, Wang L. Network-wise concordance of multimodal neuroimaging features across the Alzheimer's disease continuum. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12304. [PMID: 35496375 PMCID: PMC9043119 DOI: 10.1002/dad2.12304] [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] [Received: 12/29/2021] [Revised: 02/17/2022] [Accepted: 02/25/2022] [Indexed: 01/18/2023]
Abstract
Background Concordance between cortical atrophy and cortical glucose hypometabolism within distributed brain networks was evaluated among cerebrospinal fluid (CSF) biomarker-defined amyloid/tau/neurodegeneration (A/T/N) groups. Method We computed correlations between cortical thickness and fluorodeoxyglucose metabolism within 12 functional brain networks. Differences among A/T/N groups (biomarker normal [BN], Alzheimer's disease [AD] continuum, suspected non-AD pathologic change [SNAP]) in network concordance and relationships to longitudinal change in cognition were assessed. Results Network-wise markers of concordance distinguish SNAP subjects from BN subjects within the posterior multimodal and language networks. AD-continuum subjects showed increased concordance in 9/12 networks assessed compared to BN subjects, as well as widespread atrophy and hypometabolism. Baseline network concordance was associated with longitudinal change in a composite memory variable in both SNAP and AD-continuum subjects. Conclusions Our novel study investigates the interrelationships between atrophy and hypometabolism across brain networks in A/T/N groups, helping disentangle the structure-function relationships that contribute to both clinical outcomes and diagnostic uncertainty in AD.
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Affiliation(s)
- Jane Stocks
- Department of Psychiatry and Behavioral SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Karteek Popuri
- School of Engineering ScienceSimon Fraser UniversityBurnabyBritish ColumbiaCanada
| | - Ashley Heywood
- Department of Psychiatry and Behavioral SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Duygu Tosun
- School of MedicineUniversity of CaliforniaSan Francisco, CaliforniaUSA
| | - Kate Alpert
- Department of Psychiatry and Behavioral SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Mirza Faisal Beg
- School of Engineering ScienceSimon Fraser UniversityBurnabyBritish ColumbiaCanada
| | - Howard Rosen
- School of MedicineUniversity of CaliforniaSan Francisco, CaliforniaUSA
| | - Lei Wang
- Department of Psychiatry and Behavioral SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Department of Psychiatry and Behavioral HealthOhio State University Wexner Medical CenterColumbusOhioUSA
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14
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Fu Z, Zhao M, He Y, Wang X, Lu J, Li S, Li X, Kang G, Han Y, Li S. Divergent Connectivity Changes in Gray Matter Structural Covariance Networks in Subjective Cognitive Decline, Amnestic Mild Cognitive Impairment, and Alzheimer's Disease. Front Aging Neurosci 2021; 13:686598. [PMID: 34483878 PMCID: PMC8415752 DOI: 10.3389/fnagi.2021.686598] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 07/19/2021] [Indexed: 01/18/2023] Open
Abstract
Alzheimer’s disease (AD) has a long preclinical stage that can last for decades prior to progressing toward amnestic mild cognitive impairment (aMCI) and/or dementia. Subjective cognitive decline (SCD) is characterized by self-experienced memory decline without any evidence of objective cognitive decline and is regarded as the later stage of preclinical AD. It has been reported that the changes in structural covariance patterns are affected by AD pathology in the patients with AD and aMCI within the specific large-scale brain networks. However, the changes in structural covariance patterns including normal control (NC), SCD, aMCI, and AD are still poorly understood. In this study, we recruited 42 NCs, 35 individuals with SCD, 43 patients with aMCI, and 41 patients with AD. Gray matter (GM) volumes were extracted from 10 readily identifiable regions of interest involved in high-order cognitive function and AD-related dysfunctional structures. The volume values were used to predict the regional densities in the whole brain by using voxel-based statistical and multiple linear regression models. Decreased structural covariance and weakened connectivity strength were observed in individuals with SCD compared with NCs. Structural covariance networks (SCNs) seeding from the default mode network (DMN), salience network, subfields of the hippocampus, and cholinergic basal forebrain showed increased structural covariance at the early stage of AD (referring to aMCI) and decreased structural covariance at the dementia stage (referring to AD). Moreover, the SCN seeding from the executive control network (ECN) showed a linearly increased extent of the structural covariance during the early and dementia stages. The results suggest that changes in structural covariance patterns as the order of NC-SCD-aMCI-AD are divergent and dynamic, and support the structural disconnection hypothesis in individuals with SCD.
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Affiliation(s)
- Zhenrong Fu
- School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Mingyan Zhao
- Department of Neurology, Tangshan Gongren Hospital, Tangshan, China.,Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Yirong He
- School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Xuetong Wang
- School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Jiadong Lu
- School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Shaoxian Li
- School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Xin Li
- School of Electrical Engineering, Yanshan University, Qinhuangdao, China.,Measurement Technology and Instrumentation Key Laboratory of Hebei Province, Qinhuangdao, China
| | - Guixia Kang
- School of Information and Communication Engineering, Beijing University of Posts and Telecommunications, Beijing, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.,Biomedical Engineering Institute, Hainan University, Haikou, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Shuyu Li
- School of Biological Science and Medical Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
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15
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Raj A. Graph Models of Pathology Spread in Alzheimer's Disease: An Alternative to Conventional Graph Theoretic Analysis. Brain Connect 2021; 11:799-814. [PMID: 33858198 DOI: 10.1089/brain.2020.0905] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background: Graph theory and connectomics are new techniques for uncovering disease-induced changes in the brain's structural network. Most prior studied have focused on network statistics as biomarkers of disease. However, an emerging body of work involves exploring how the network serves as a conduit for the propagation of disease factors in the brain and has successfully mapped the functional and pathological consequences of disease propagation. In Alzheimer's disease (AD), progressive deposition of misfolded proteins amyloid and tau is well-known to follow fiber projections, under a "prion-like" trans-neuronal transmission mechanism, through which misfolded proteins cascade along neuronal pathways, giving rise to network spread. Methods: In this review, we survey the state of the art in mathematical modeling of connectome-mediated pathology spread in AD. Then we address several open questions that are amenable to mathematically precise parsimonious modeling of pathophysiological processes, extrapolated to the whole brain. We specifically identify current formal models of how misfolded proteins are produced, aggregate, and disseminate in brain circuits, and attempt to understand how this process leads to stereotyped progression in Alzheimer's and other related diseases. Conclusion: This review serves to unify current efforts in modeling of AD progression that together have the potential to explain observed phenomena and serve as a test-bed for future hypothesis generation and testing in silico. Impact statement Graph theory is a powerful new approach that is transforming the study of brain processes. There do not exist many focused reviews of the subfield of graph modeling of how Alzheimer's and other dementias propagate within the brain network, and how these processes can be mapped mathematically. By providing timely and topical review of this subfield, we fill a critical gap in the community and present a unified view that can serve as an in silico test-bed for future hypothesis generation and testing. We also point to several open and unaddressed questions and controversies that future practitioners can tackle.
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Affiliation(s)
- Ashish Raj
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
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16
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Tosun D, Veitch D, Aisen P, Jack CR, Jagust WJ, Petersen RC, Saykin AJ, Bollinger J, Ovod V, Mawuenyega KG, Bateman RJ, Shaw LM, Trojanowski JQ, Blennow K, Zetterberg H, Weiner MW. Detection of β-amyloid positivity in Alzheimer's Disease Neuroimaging Initiative participants with demographics, cognition, MRI and plasma biomarkers. Brain Commun 2021; 3:fcab008. [PMID: 33842885 PMCID: PMC8023542 DOI: 10.1093/braincomms/fcab008] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 01/18/2023] Open
Abstract
In vivo gold standard for the ante-mortem assessment of brain β-amyloid pathology is currently β-amyloid positron emission tomography or cerebrospinal fluid measures of β-amyloid42 or the β-amyloid42/β-amyloid40 ratio. The widespread acceptance of a biomarker classification scheme for the Alzheimer's disease continuum has ignited interest in more affordable and accessible approaches to detect Alzheimer's disease β-amyloid pathology, a process that often slows down the recruitment into, and adds to the cost of, clinical trials. Recently, there has been considerable excitement concerning the value of blood biomarkers. Leveraging multidisciplinary data from cognitively unimpaired participants and participants with mild cognitive impairment recruited by the multisite biomarker study of Alzheimer's Disease Neuroimaging Initiative, here we assessed to what extent plasma β-amyloid42/β-amyloid40, neurofilament light and phosphorylated-tau at threonine-181 biomarkers detect the presence of β-amyloid pathology, and to what extent the addition of clinical information such as demographic data, APOE genotype, cognitive assessments and MRI can assist plasma biomarkers in detecting β-amyloid-positivity. Our results confirm plasma β-amyloid42/β-amyloid40 as a robust biomarker of brain β-amyloid-positivity (area under curve, 0.80-0.87). Plasma phosphorylated-tau at threonine-181 detected β-amyloid-positivity only in the cognitively impaired with a moderate area under curve of 0.67, whereas plasma neurofilament light did not detect β-amyloid-positivity in either group of participants. Clinical information as well as MRI-score independently detected positron emission tomography β-amyloid-positivity in both cognitively unimpaired and impaired (area under curve, 0.69-0.81). Clinical information, particularly APOE ε4 status, enhanced the performance of plasma biomarkers in the detection of positron emission tomography β-amyloid-positivity by 0.06-0.14 units of area under curve for cognitively unimpaired, and by 0.21-0.25 units for cognitively impaired; and further enhancement of these models with an MRI-score of β-amyloid-positivity yielded an additional improvement of 0.04-0.11 units of area under curve for cognitively unimpaired and 0.05-0.09 units for cognitively impaired. Taken together, these multi-disciplinary results suggest that when combined with clinical information, plasma phosphorylated-tau at threonine-181 and neurofilament light biomarkers, and an MRI-score could effectively identify β-amyloid+ cognitively unimpaired and impaired (area under curve, 0.80-0.90). Yet, when the MRI-score is considered in combination with clinical information, plasma phosphorylated-tau at threonine-181 and plasma neurofilament light have minimal added value for detecting β-amyloid-positivity. Our systematic comparison of β-amyloid-positivity detection models identified effective combinations of demographics, APOE, global cognition, MRI and plasma biomarkers. Promising minimally invasive and low-cost predictors such as plasma biomarkers of β-amyloid42/β-amyloid40 may be improved by age and APOE genotype.
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Affiliation(s)
- Duygu Tosun
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Dallas Veitch
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Paul Aisen
- Alzheimer’s Therapeutic Research Institute (ATRI), Keck School of Medicine, University of Southern California, San Diego, CA, USA
| | | | - William J Jagust
- School of Public Health and Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Ronald C Petersen
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James Bollinger
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Vitaliy Ovod
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Kwasi G Mawuenyega
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Michael W Weiner
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
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17
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O’Dell RS, Mecca AP, Chen MK, Naganawa M, Toyonaga T, Lu Y, Godek TA, Harris JE, Bartlett HH, Banks ER, Kominek VL, Zhao W, Nabulsi NB, Ropchan J, Ye Y, Vander Wyk BC, Huang Y, Arnsten AFT, Carson RE, van Dyck CH. Association of Aβ deposition and regional synaptic density in early Alzheimer's disease: a PET imaging study with [ 11C]UCB-J. Alzheimers Res Ther 2021; 13:11. [PMID: 33402201 PMCID: PMC7786921 DOI: 10.1186/s13195-020-00742-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/07/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Attempts to associate amyloid-β (Aβ) pathogenesis with synaptic loss in Alzheimer's disease (AD) have thus far been limited to small numbers of postmortem studies. Aβ plaque burden is not well-correlated with indices of clinical severity or neurodegeneration-at least in the dementia stage-as deposition of Aβ reaches a ceiling. In this study, we examined in vivo the association between fibrillar Aβ deposition and synaptic density in early AD using positron emission tomography (PET). We hypothesized that global Aβ deposition would be more strongly inversely associated with hippocampal synaptic density in participants with amnestic mild cognitive impairment (aMCI; a stage of continued Aβ accumulation) compared to those with dementia (a stage of relative Aβ plateau). METHODS We measured SV2A binding ([11C]UCB-J) and Aβ deposition ([11C]PiB) in 14 participants with aMCI due to AD and 24 participants with mild AD dementia. Distribution volume ratios (DVR) with a cerebellar reference region were calculated for both tracers to investigate the association between global Aβ deposition and SV2A binding in hippocampus. Exploratory analyses examined correlations between both global and regional Aβ deposition and SV2A binding across a broad range of brain regions using both ROI- and surface-based approaches. RESULTS We observed a significant inverse association between global Aβ deposition and hippocampal SV2A binding in participants with aMCI (r = - 0.55, P = 0.04), but not mild dementia (r = 0.05, P = 0.82; difference statistically significant by Fisher z = - 1.80, P = 0.04). Exploratory analyses across other ROIs and whole brain analyses demonstrated no broad or consistent associations between global Aβ deposition and regional SV2A binding in either diagnostic group. ROI-based analyses of the association between regional Aβ deposition and SV2A binding also revealed no consistent pattern but suggested a "paradoxical" positive association between local Aβ deposition and SV2A binding in the hippocampus. CONCLUSIONS Our findings lend support to a model in which fibrillar Aβ is still accumulating in the early stages of clinical disease but approaching a relative plateau, a point at which Aβ may uncouple from neurodegenerative processes including synaptic loss. Future research should investigate the relationship between Aβ deposition and synaptic loss in larger cohorts beginning preclinically and followed longitudinally in conjunction with other biomarkers.
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Affiliation(s)
- Ryan S. O’Dell
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Adam P. Mecca
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Ming-Kai Chen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Mika Naganawa
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Yihuan Lu
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Tyler A. Godek
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Joanna E. Harris
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Hugh H. Bartlett
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Emmie R. Banks
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Victoria L. Kominek
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Wenzhen Zhao
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Nabeel B. Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Jim Ropchan
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Yunpeng Ye
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Brent C. Vander Wyk
- Program on Aging, Yale University School of Medicine, P.O. Box 207900, New Haven, CT 06520 USA
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Amy F. T. Arnsten
- Department of Neuroscience, Yale University School of Medicine, P.O. Box 208001, New Haven, CT 06520 USA
| | - Richard E. Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Christopher H. van Dyck
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
- Department of Neuroscience, Yale University School of Medicine, P.O. Box 208001, New Haven, CT 06520 USA
- Department of Neurology, Yale University School of Medicine, P.O. Box 208018, New Haven, CT 06520 USA
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18
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Kang KM, Sohn CH, Byun MS, Lee JH, Yi D, Lee Y, Lee JY, Kim YK, Sohn BK, Yoo RE, Yun TJ, Choi SH, Kim JH, Lee DY. Prediction of Amyloid Positivity in Mild Cognitive Impairment Using Fully Automated Brain Segmentation Software. Neuropsychiatr Dis Treat 2020; 16:1745-1754. [PMID: 32801709 PMCID: PMC7383107 DOI: 10.2147/ndt.s252293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/03/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To assess the predictive ability of regional volume information provided by fully automated brain segmentation software for cerebral amyloid positivity in mild cognitive impairment (MCI). METHODS This study included 130 subjects with amnestic MCI who participated in the Korean brain aging study of early diagnosis and prediction of Alzheimer's disease, an ongoing prospective cohort. All participants underwent comprehensive clinical assessment as well as 11C-labeled Pittsburgh compound PET/MRI scans. The predictive ability of volumetric results provided by automated brain segmentation software was evaluated using binary logistic regression and receiver operating characteristic curve analysis. RESULTS Subjects were divided into two groups: one with Aβ deposition (58 subjects) and one without Aβ deposition (72 subjects). Among the varied volumetric information provided, the hippocampal volume percentage of intracranial volume (%HC/ICV), normative percentiles of hippocampal volume (HCnorm), and gray matter volume were associated with amyloid-β (Aβ) positivity (all P < 0.01). Multivariate analyses revealed that both %HC/ICV and HCnorm were independent significant predictors of Aβ positivity (all P < 0.001). In addition, prediction scores derived from %HC/ICV with age and HCnorm showed moderate accuracy in predicting Aβ positivity in MCI subjects (the areas under the curve: 0.739 and 0.723, respectively). CONCLUSION Relative hippocampal volume measures provided by automated brain segmentation software can be useful for screening cerebral Aβ positivity in clinical practice for patients with amnestic MCI. The information may also help clinicians interpret structural MRI to predict outcomes and determine early intervention for delaying the progression to Alzheimer's disease dementia.
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Affiliation(s)
- Koung Mi Kang
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Min Soo Byun
- Medical Research Center Seoul National University, Institute of Human Behavioral Medicine, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dahyun Yi
- Medical Research Center Seoul National University, Institute of Human Behavioral Medicine, Seoul, Republic of Korea
| | - Younghwa Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jun-Young Lee
- Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bo Kyung Sohn
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Roh-Eul Yoo
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Tae Jin Yun
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji-Hoon Kim
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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19
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Zhao S, Rangaprakash D, Liang P, Deshpande G. Deterioration from healthy to mild cognitive impairment and Alzheimer's disease mirrored in corresponding loss of centrality in directed brain networks. Brain Inform 2019; 6:8. [PMID: 31792630 PMCID: PMC6888786 DOI: 10.1186/s40708-019-0101-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/11/2019] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE It is important to identify brain-based biomarkers that progressively deteriorate from healthy to mild cognitive impairment (MCI) to Alzheimer's disease (AD). Cortical thickness, amyloid-ß deposition, and graph measures derived from functional connectivity (FC) networks obtained using functional MRI (fMRI) have been previously identified as potential biomarkers. Specifically, in the latter case, betweenness centrality (BC), a nodal graph measure quantifying information flow, is reduced in both AD and MCI. However, all such reports have utilized BC calculated from undirected networks that characterize synchronization rather than information flow, which is better characterized using directed networks. METHODS Therefore, we estimated BC from directed networks using Granger causality (GC) on resting-state fMRI data (N = 132) to compare the following populations (p < 0.05, FDR corrected for multiple comparisons): normal control (NC), early MCI (EMCI), late MCI (LMCI) and AD. We used an additional metric called middleman power (MP), which not only characterizes nodal information flow as in BC, but also measures nodal power critical for information flow in the entire network. RESULTS MP detected more brain regions than BC that progressively deteriorated from NC to EMCI to LMCI to AD, as well as exhibited significant associations with behavioral measures. Additionally, graph measures obtained from conventional FC networks could not identify a single node, underscoring the relevance of GC. CONCLUSION Our findings demonstrate the superiority of MP over BC as well as GC over FC in our case. MP obtained from GC networks could serve as a potential biomarker for progressive deterioration of MCI and AD.
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Affiliation(s)
- Sinan Zhao
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr, Suite 266D, Auburn, AL, 36849, USA
| | - D Rangaprakash
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr, Suite 266D, Auburn, AL, 36849, USA
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Peipeng Liang
- School of Psychology, Capital Normal University, Beijing, China
| | - Gopikrishna Deshpande
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, 560 Devall Dr, Suite 266D, Auburn, AL, 36849, USA.
- Department of Psychology, Auburn University, Auburn, AL, USA.
- Alabama Advanced Imaging Consortium, Auburn, AL, USA.
- Center for Neuroscience, Auburn University, Auburn, AL, USA.
- Center for Health Ecology and Equity Research, Auburn University, Auburn, AL, USA.
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
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20
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Abstract
Technologies for imaging the pathophysiology of Alzheimer disease (AD) now permit studies of the relationships between the two major proteins deposited in this disease - amyloid-β (Aβ) and tau - and their effects on measures of neurodegeneration and cognition in humans. Deposition of Aβ in the medial parietal cortex appears to be the first stage in the development of AD, although tau aggregates in the medial temporal lobe (MTL) precede Aβ deposition in cognitively healthy older people. Whether aggregation of tau in the MTL is the first stage in AD or a fairly benign phenomenon that may be transformed and spread in the presence of Aβ is a major unresolved question. Despite a strong link between Aβ and tau, the relationship between Aβ and neurodegeneration is weak; rather, it is tau that is associated with brain atrophy and hypometabolism, which, in turn, are related to cognition. Although there is support for an interaction between Aβ and tau resulting in neurodegeneration that leads to dementia, the unknown nature of this interaction, the strikingly different patterns of brain Aβ and tau deposition and the appearance of neurodegeneration in the absence of Aβ and tau are challenges to this model that ultimately must be explained.
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21
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Machado TC, Carregosa AA, Santos MS, Ribeiro NMDS, Melo A. Efficacy of motor imagery additional to motor-based therapy in the recovery of motor function of the upper limb in post-stroke individuals: a systematic review. Top Stroke Rehabil 2019; 26:548-553. [PMID: 31264520 DOI: 10.1080/10749357.2019.1627716] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background. Motor imagery (MI) consists of the mental simulation of repetitive movements with the intention of promoting the learning of a motor skill. It seems to be an additional useful tool for motor-based therapy to potentiate the rehabilitation of the upper limb function of post-stroke individuals. Objective. To investigate whether MI combined with motor-based therapy is effective in recovering motor deficits of upper limbs from post-stroke individuals. Method. A systematic review of the literature was performed in the PEDro, LILACS, Cochrane, SCOPUS, Medline/PubMed and SciELO databases. Randomized controlled trials (RCTs) investigating the efficacy of MI associated with motor-based therapy compared with isolated motor-based therapy were included. The included outcomes were gross motor function and functional activities of the upper limb of post-stroke individuals. The physiotherapy evidence database scale was applied for evaluation of methodological quality. Results. Four RCTs were included, with a total of 104 participants, with methodological quality varying from moderate to high. There was a statistically significant improvement in upper limb motor function in all studies. Gross motor function was higher in MI associated with motor-based therapy compared to controls, but only in one study there was superiority in the results of functional activities of the upper limb. Conclusion. There is evidence showing that MI associated with motor-based therapy is an effective tool in improving the motor function of upper limbs of post-stroke individuals. However, more studies are needed to establish criteria for frequency and duration of intervention, and what better type of MI should be used.
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Affiliation(s)
- Tácia Cotinguiba Machado
- Grupo de Pesquisa em Reabilitação Neurofuncional, Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia , Salvador , Brasil.,Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia , Salvador , Brasil
| | - Adriani Andrade Carregosa
- Grupo de Pesquisa em Reabilitação Neurofuncional, Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia , Salvador , Brasil
| | - Matheus S Santos
- Grupo de Pesquisa em Reabilitação Neurofuncional, Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia , Salvador , Brasil.,Programa de Pós-Graduação em Processos Interativos dos Órgãos e Sistemas, Instituto de Ciências da Saúde, Universidade Federal da Bahia , Salvador , Brasil
| | - Nildo Manoel da Silva Ribeiro
- Grupo de Pesquisa em Reabilitação Neurofuncional, Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia , Salvador , Brasil.,Departamento de Fisioterapia, Instituto de Ciências da Saúde, Universidade Federal da Bahia , Salvador , Brasil
| | - Ailton Melo
- Departamento de Neurociências e Saúde Mental, Instituto de Ciências da Saúde, Universidade Federal da Bahia , Salvador , Brasil
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22
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Li Y, Yao Z, Yu Y, Zou Y, Fu Y, Hu B. Brain network alterations in individuals with and without mild cognitive impairment: parallel independent component analysis of AV1451 and AV45 positron emission tomography. BMC Psychiatry 2019; 19:165. [PMID: 31159754 PMCID: PMC6547610 DOI: 10.1186/s12888-019-2149-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/17/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Amyloid β (Aβ) and tau proteins are considered as critical factors that affect Alzheimer's disease (AD) and mild cognitive impairment (MCI). Although many studies have conducted on these two proteins, little study has investigated the relationship between their spatial distributions. This study aims to explore the associations of spatial patterns between Aβ deposition and tau deposition in patients with MCI and normal control (NC). METHODS We used multimodality positron emission tomography (PET) data from a clinically heterogeneous population of patients with MCI and NC. All data were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database containing information of 65 patients with MCI and 75 NC who both had undergone AV45 (Aβ) and AV1451 (tau) PET. To assess the spatial distribution of Aβ and tau deposition, we employed parallel independent component analysis (pICA), which enabled the joint analysis of multimodal imaging data. pICA was conducted to identify the significant difference and correlation relationship of brain networks between Aβ PET and tau PET in MCI and NC groups. RESULTS Our results revealed the strongly correlated network between Aβ PET and tau PET were colocalized with the default-mode network (DMN). Simultaneously, in comparison of the spatial distribution between Aβ PET and tau PET, it was found that the significant differences between MCI and NC were mainly distributed in DMN, cognitive control network and visual networks. The altered brain networks obtained from pICA analysis are consistent with the abnormalities of brain network in MCI patients. CONCLUSIONS Findings suggested the abnormal spatial distribution regions of tau PET were correlated with the abnormal spatial distribution regions of Aβ PET, and both of which were located in DMN network. This study revealed that combining pICA with multimodal imaging data is an effective approach for distinguishing MCI patients from NC group.
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Affiliation(s)
- Yuan Li
- grid.410585.dSchool of Information Science and Engineering, Shandong Normal University, Jinan, Shandong Province 250358 People’s Republic of China
| | - Zhijun Yao
- 0000 0000 8571 0482grid.32566.34School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province China
| | - Yue Yu
- 0000 0000 8571 0482grid.32566.34School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province China
| | - Ying Zou
- 0000 0000 8571 0482grid.32566.34School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province China
| | - Yu Fu
- 0000 0000 8571 0482grid.32566.34School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province China
| | - Bin Hu
- School of Information Science and Engineering, Shandong Normal University, Jinan, Shandong Province, 250358, People's Republic of China. .,School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, China.
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23
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Zetterberg H, Winblad B, Bernick C, Yaffe K, Majdan M, Johansson G, Newcombe V, Nyberg L, Sharp D, Tenovuo O, Blennow K. Head trauma in sports - clinical characteristics, epidemiology and biomarkers. J Intern Med 2019; 285:624-634. [PMID: 30481401 DOI: 10.1111/joim.12863] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Traumatic brain injury (TBI) is clinically divided into a spectrum of severities, with mild TBI being the least severe form and a frequent occurrence in contact sports, such as ice hockey, American football, rugby, horse riding and boxing. Mild TBI is caused by blunt nonpenetrating head trauma that causes movement of the brain and stretching and tearing of axons, with diffuse axonal injury being a central pathogenic mechanism. Mild TBI is in principle synonymous with concussion; both have similar criteria in which the most important elements are acute alteration or loss of consciousness and/or post-traumatic amnesia following head trauma and no apparent brain changes on standard neuroimaging. Symptoms in mild TBI are highly variable and there are no validated imaging or fluid biomarkers to determine whether or not a patient with a normal computerized tomography scan of the brain has neuronal damage. Mild TBI typically resolves within a few weeks but 10-15% of concussion patients develop postconcussive syndrome. Repetitive mild TBI, which is frequent in contact sports, is a risk factor for a complicated recovery process. This overview paper discusses the relationships between repetitive head impacts in contact sports, mild TBI and chronic neurological symptoms. What are these conditions, how common are they, how are they linked and can they be objectified using imaging or fluid-based biomarkers? It gives an update on the current state of research on these questions with a specific focus on clinical characteristics, epidemiology and biomarkers.
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Affiliation(s)
- H Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,UK Dementia Research Institute at UCL, London, UK.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
| | - B Winblad
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden.,Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - C Bernick
- Neurological Institute, Cleveland Clinic, Las Vegas, NV, USA
| | - K Yaffe
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.,San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.,Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - M Majdan
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
| | - G Johansson
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden.,Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - V Newcombe
- Division of Anaesthesia, University of Cambridge, Addenbrookes Hospital, Cambridge, Cambs, UK
| | - L Nyberg
- Centre for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - D Sharp
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - O Tenovuo
- Turku Brain Injury Centre, Turku University Hospital, Turku, Finland.,Department of Neurology, University of Turku, Turku, Finland
| | - K Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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24
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Armstrong NM, Huang CW, Williams OA, Bilgel M, An Y, Doshi J, Erus G, Davatzikos C, Wong DF, Ferrucci L, Resnick SM. Sex differences in the association between amyloid and longitudinal brain volume change in cognitively normal older adults. NEUROIMAGE-CLINICAL 2019; 22:101769. [PMID: 30927602 PMCID: PMC6444285 DOI: 10.1016/j.nicl.2019.101769] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/22/2019] [Accepted: 03/10/2019] [Indexed: 01/19/2023]
Abstract
Objective Amyloid positivity is a biomarker of AD pathology, yet the associations between amyloid positivity and brain volumetric changes, especially in the hippocampus, are inconsistent. We hypothesize that sex differences in associations may contribute to inconsistent findings among cognitively normal older adults. Methods Using linear mixed effects models, we examined the association of amyloid positivity with prospective volumetric changes (mean = 3.3 visits) of parahippocampal gyrus (phg), hippocampus, entorhinal cortex (erc), precuneus, and fusiform gyrus among 171 Baltimore Longitudinal Study of Aging participants aged ≥55 years. Amyloid positivity was defined by a mean 11C-Pittsburgh Compound B (PiB) distribution volume ratio (DVR) cut-off of 1.062. All analyses included age, race, sex, education, APOE e4 carrier status, and two-way interactions of these covariates with time. Two-way interaction between sex and PiB+/− status and three-way interaction of sex and PiB+/− status with time were added to assess whether sex modified associations. Results PiB+ status was associated with greater volumetric declines in the phg (β = −0.036, SE = 0.011, p = 0.001) and erc (β = −0.019, SE = 0.009, p = 0.045). Sex modified the association of PiB+ status and rates of volumetric declines in fusiform (β = −0.117, SE = 0.049, p = 0.019). PiB+ males had steeper rates of volumetric declines in phg (β = −0.051, SE = 0.013, p < 0.001) and erc (β = −0.029, SE = 0.012, p = 0.014) than PiB- males, while there was no difference in rates of volumetric change between PiB+ and PiB- females. Conclusions Amyloidosis is a marker of entorhinal and parahippocampal volume loss. Amyloid positivity is a predictor of volume loss in brain regions affected by early AD pathology in men, but not women. Amyloid positivity is related to volume loss in regions of early AD pathology. Sex modified the association of amyloid positivity and brain volumetric changes. Amyloid-positive males were vulnerable to volume loss in regions of early AD. Females with and without amyloid positivity had similar volume changes.
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Affiliation(s)
- Nicole M Armstrong
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Chiung-Wei Huang
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Owen A Williams
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Jimit Doshi
- Section of Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Guray Erus
- Section of Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Christos Davatzikos
- Section of Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Dean F Wong
- Section of High Resolution Brain PET, Departments of Neurology, Psychiatry, Neuroscience, and Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Luigi Ferrucci
- Translational Gerontology Branch, Longitudinal Studies Section, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America.
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25
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Lawrence TP, Steel A, Ezra M, Speirs M, Pretorius PM, Douaud G, Sotiropoulos S, Cadoux-Hudson T, Emir UE, Voets NL. MRS and DTI evidence of progressive posterior cingulate cortex and corpus callosum injury in the hyper-acute phase after Traumatic Brain Injury. Brain Inj 2019; 33:854-868. [PMID: 30848964 PMCID: PMC6619394 DOI: 10.1080/02699052.2019.1584332] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The posterior cingulate cortex (PCC) and corpus callosum (CC) are susceptible to trauma, but injury often evades detection. PCC Metabolic disruption may predict CC white matter tract injury and the secondary cascade responsible for progression. While the time frame for the secondary cascade remains unclear in humans, the first 24 h (hyper-acute phase) are crucial for life-saving interventions. Objectives: To test whether Magnetic Resonance Imaging (MRI) markers are detectable in the hyper-acute phase and progress after traumatic brain injury (TBI) and whether alterations in these parameters reflect injury severity. Methods: Spectroscopic and diffusion-weighted MRI data were collected in 18 patients with TBI (within 24 h and repeated 7–15 days following injury) and 18 healthy controls (scanned once). Results: Within 24 h of TBI N-acetylaspartate was reduced (F = 11.43, p = 0.002) and choline increased (F = 10.67, p = 0.003), the latter driven by moderate-severe injury (F = 5.54, p = 0.03). Alterations in fractional anisotropy (FA) and axial diffusivity (AD) progressed between the two time-points in the splenium of the CC (p = 0.029 and p = 0.013). Gradual reductions in FA correlated with progressive increases in choline (p = 0.029). Conclusions: Metabolic disruption and structural injury can be detected within hours of trauma. Metabolic and diffusion parameters allow identification of severity and provide evidence of injury progression.
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Affiliation(s)
- Tim P Lawrence
- a FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences , University of Oxford , Oxford , United Kingdom.,b Department of Neuroscience , Oxford University Hospitals NHS Foundation Trust , Oxford , United Kingdom
| | - Adam Steel
- a FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences , University of Oxford , Oxford , United Kingdom.,c Laboratory of Brain and Cognition , National Institute of Mental Health, National Institutes of Health , Bethesda , MD , USA
| | - Martyn Ezra
- a FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences , University of Oxford , Oxford , United Kingdom
| | - Mhairi Speirs
- b Department of Neuroscience , Oxford University Hospitals NHS Foundation Trust , Oxford , United Kingdom
| | - Pieter M Pretorius
- b Department of Neuroscience , Oxford University Hospitals NHS Foundation Trust , Oxford , United Kingdom
| | - Gwenaelle Douaud
- a FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences , University of Oxford , Oxford , United Kingdom
| | - Stamatios Sotiropoulos
- a FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences , University of Oxford , Oxford , United Kingdom.,d Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham , Nottingham , UK.,e National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Queens Medical Centre , Nottingham , UK
| | - Tom Cadoux-Hudson
- b Department of Neuroscience , Oxford University Hospitals NHS Foundation Trust , Oxford , United Kingdom
| | - Uzay E Emir
- a FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences , University of Oxford , Oxford , United Kingdom.,f School of Health Sciences , Purdue University , West Lafayette , IN , USA
| | - Natalie L Voets
- a FMRIB Centre, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences , University of Oxford , Oxford , United Kingdom.,b Department of Neuroscience , Oxford University Hospitals NHS Foundation Trust , Oxford , United Kingdom
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26
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Martikainen IK, Kemppainen N, Johansson J, Teuho J, Helin S, Liu Y, Helisalmi S, Soininen H, Parkkola R, Ngandu T, Kivipelto M, Rinne JO. Brain β-Amyloid and Atrophy in Individuals at Increased Risk of Cognitive Decline. AJNR Am J Neuroradiol 2018; 40:80-85. [PMID: 30545837 DOI: 10.3174/ajnr.a5891] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 10/12/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE The relationship between brain β-amyloid and regional atrophy is still incompletely understood in elderly individuals at risk of dementia. Here, we studied the associations between brain β-amyloid load and regional GM and WM volumes in older adults who were clinically evaluated as being at increased risk of cognitive decline based on cardiovascular risk factors. MATERIALS AND METHODS Forty subjects (63-81 years of age) were recruited as part of a larger study, the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability. Neuroimaging consisted of PET using 11C Pittsburgh compound-B and T1-weighted 3D MR imaging for the measurement of brain β-amyloid and GM and WM volumes, respectively. All subjects underwent clinical, genetic, and neuropsychological evaluations for the assessment of cognitive function and the identification of cardiovascular risk factors. RESULTS Sixteen subjects were visually evaluated as showing cortical β-amyloid (positive for β-amyloid). In the voxel-by-voxel analyses, no significant differences were found in GM and WM volumes between the samples positive and negative for β-amyloid. However, in the sample positive for β-amyloid, increases in 11C Pittsburgh compound-B uptake were associated with reductions in GM volume in the left prefrontal (P = .02) and right temporal lobes (P = .04). CONCLUSIONS Our results show a significant association between increases in brain β-amyloid and reductions in regional GM volume in individuals at increased risk of cognitive decline. This evidence is consistent with a model in which increases in β-amyloid incite neurodegeneration in memory systems before cognitive impairment manifests.
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Affiliation(s)
- I K Martikainen
- From the Department of Radiology (I.K.M.), Medical Imaging Center, Tampere University Hospital, Tampere, Finland
| | - N Kemppainen
- Division of Clinical Neurosciences (N.K., J.O.R.), Turku University Hospital, Turku, Finland.,Turku PET Centre (N.K., J.J., J.T., S. Helin, J.O.R.), University of Turku, Turku, Finland
| | - J Johansson
- Turku PET Centre (N.K., J.J., J.T., S. Helin, J.O.R.), University of Turku, Turku, Finland
| | - J Teuho
- Turku PET Centre (N.K., J.J., J.T., S. Helin, J.O.R.), University of Turku, Turku, Finland
| | - S Helin
- Turku PET Centre (N.K., J.J., J.T., S. Helin, J.O.R.), University of Turku, Turku, Finland
| | - Y Liu
- Department of Neurology (Y.L., S. Helisalmi, H.S., M.K.), University of Eastern Finland, Kuopio, Finland.,Neurocenter (Y.L., H.S., M.K.), Neurology, Kuopio University Hospital, Kuopio, Finland
| | - S Helisalmi
- Department of Neurology (Y.L., S. Helisalmi, H.S., M.K.), University of Eastern Finland, Kuopio, Finland
| | - H Soininen
- Department of Neurology (Y.L., S. Helisalmi, H.S., M.K.), University of Eastern Finland, Kuopio, Finland.,Neurocenter (Y.L., H.S., M.K.), Neurology, Kuopio University Hospital, Kuopio, Finland
| | - R Parkkola
- Department of Radiology (R.P.), University of Turku and Turku University Hospital, Turku, Finland
| | - T Ngandu
- Department of Public Health Solutions (T.N., M.K.), Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics (T.N., M.K.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - M Kivipelto
- Department of Neurology (Y.L., S. Helisalmi, H.S., M.K.), University of Eastern Finland, Kuopio, Finland.,Neurocenter (Y.L., H.S., M.K.), Neurology, Kuopio University Hospital, Kuopio, Finland.,Department of Public Health Solutions (T.N., M.K.), Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics (T.N., M.K.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - J O Rinne
- Division of Clinical Neurosciences (N.K., J.O.R.), Turku University Hospital, Turku, Finland.,Turku PET Centre (N.K., J.J., J.T., S. Helin, J.O.R.), University of Turku, Turku, Finland
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27
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Li Q, Li L. Integrative linear discriminant analysis with guaranteed error rate improvement. Biometrika 2018; 105:917-930. [PMID: 31762476 DOI: 10.1093/biomet/asy047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Multiple types of data measured on a common set of subjects arise in many areas. Numerous empirical studies have found that integrative analysis of such data can result in better statistical performance in terms of prediction and feature selection. However, the advantages of integrative analysis have mostly been demonstrated empirically. In the context of two-class classification, we propose an integrative linear discriminant analysis method and establish a theoretical guarantee that it achieves a smaller classification error than running linear discriminant analysis on each data type individually. We address the issues of outliers and missing values, frequently encountered in integrative analysis, and illustrate our method through simulations and a neuroimaging study of Alzheimer's disease.
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Affiliation(s)
- Quefeng Li
- Department of Biostatistics, University of North Carolina at Chapel Hill, 3105D McGavran-Greenberg Hall, Chapel Hill, North Carolina 27599, U.S.A
| | - Lexin Li
- Division of Biostatistics, University of California at Berkeley, 50 University Hall 7360, Berkeley, California 94720, U.S.A
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Kim S, Bae HW, Park CK, Lee K, Lee SY, Seong GJ, Kim CY. Nomogram Using Optical Coherence Tomography and Visual Field Parameters to Predict Brain Lesions in Patients with Bitemporal Hemianopia. Curr Eye Res 2018; 44:89-95. [DOI: 10.1080/02713683.2018.1518460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Sangah Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoung Won Bae
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Chan Keum Park
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Kwanghyun Lee
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Yeop Lee
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Gong Je Seong
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Chan Yun Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
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29
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Villemagne VL, Doré V, Burnham SC, Masters CL, Rowe CC. Imaging tau and amyloid-β proteinopathies in Alzheimer disease and other conditions. Nat Rev Neurol 2018; 14:225-236. [DOI: 10.1038/nrneurol.2018.9] [Citation(s) in RCA: 230] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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30
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Preziosa P, Pagani E, Mesaros S, Riccitelli GC, Dackovic J, Drulovic J, Filippi M, Rocca MA. Progression of regional atrophy in the left hemisphere contributes to clinical and cognitive deterioration in multiple sclerosis: A 5-year study. Hum Brain Mapp 2017; 38:5648-5665. [PMID: 28792103 DOI: 10.1002/hbm.23755] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/22/2017] [Accepted: 07/25/2017] [Indexed: 01/18/2023] Open
Abstract
In this longitudinal study, we investigated the regional patterns of focal lesions accumulation, and gray (GM) and white matter (WM) atrophy progression over a five-year follow-up (FU) in multiple sclerosis (MS) patients and their association with clinical and cognitive deterioration. Neurological, neuropsychological and brain MRI (dual-echo and 3D T1-weighted sequences) assessments were prospectively performed at baseline (T0) and after a median FU of 4.9 years from 66 MS patients (including relapse-onset and primary progressive MS) and 16 matched controls. Lesion probability maps were obtained. Longitudinal changes of GM and WM volumes and their association with clinical and cognitive deterioration were assessed using tensor-based morphometry and SPM12. At FU, 36/66 (54.5%) MS patients showed a significant disability worsening, 14/66 (21.2%) evolved to a worse clinical phenotype, and 18/63 (28.6%) developed cognitive deterioration. At T0, compared to controls, MS patients showed a widespread pattern of GM atrophy, involving cortex, deep GM and cerebellum, and atrophy of the majority of WM tracts, which further progressed at FU (P < 0.001, uncorrected). Compared to stable patients, those with clinical and cognitive worsening showed a left-lateralized pattern of GM and WM atrophy, involving deep GM, fronto-temporo-parieto-occipital regions, cerebellum, and several WM tracts (P < 0.001, uncorrected).GM and WM atrophy of relevant brain regions occur in MS after 5 years. A different vulnerability of the two brain hemispheres to irreversible structural damage may be among the factors contributing to clinical and cognitive worsening in these patients. Hum Brain Mapp 38:5648-5665, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Paolo Preziosa
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Sarlota Mesaros
- Neurology Clinic, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Gianna C Riccitelli
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Jelena Dackovic
- Neurology Clinic, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Drulovic
- Neurology Clinic, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Sepulcre J, Grothe MJ, Sabuncu M, Chhatwal J, Schultz AP, Hanseeuw B, El Fakhri G, Sperling R, Johnson KA. Hierarchical Organization of Tau and Amyloid Deposits in the Cerebral Cortex. JAMA Neurol 2017; 74:813-820. [PMID: 28558094 DOI: 10.1001/jamaneurol.2017.0263] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Importance Abnormal accumulation of tau and amyloid-β (Aβ) proteins in the human brain are 2 pathologic hallmarks of Alzheimer disease (AD). Because pathologic processes begin decades before the onset of the clinical manifestations, the study of the cortical distribution of early-stage pathologic alterations is critical in understanding the underpinnings of the disease. Objectives To identify the in vivo brain spatial distributions of tau and Aβ deposits in a sample of cognitively normal participants in the Harvard Aging Brain Study, determine spatial patterns of pathologic alterations, and provide means for improved individual in vivo staging. Design, Setting, and Participants Eighty-eight individuals from the general community underwent flortaucipir 18 T807 (18F-T807) and carbon 11-labeled Pittsburgh Compound B (11C-PiB) positron emission tomographic (PET) imaging. A voxel-level hierarchical clustering approach was used to obtain the main clustering partitions corresponding to the cortical distribution maps of 18F-T807 and 11C-PiB. Hierarchical relationships between areas of distinctive pathologic deposits were then studied. Using cerebellar gray reference, 18F-T807 data were expressed as standardized uptake value ratio, and 11C-PiB were given as distribution volume ratio. Main Outcomes and Measures Main in vivo and hierarchically organized tau and Aβ deposits in the elderly brain. Results Of the 88 study participants, 39 (44%) were men, with a mean (SD) age of 76.2 (6.2) years. The tau and Aβ maps both displayed optimal cortical partitions at 4 clusters. The tau deposits were grouped in the temporal lobe, distributed in heteromodal areas, medial and visual regions, and primary somatomotor cortex; the Aβ deposits were clustered in the heteromodal areas and rather patchy in distributed regions involving the primary cortices, medial structures, and temporal areas. Moreover, tau deposits in the temporal lobe and distributed heteromodal areas were tightly nested. Conclusions and Relevance Tau and Aβ deposits in the elderly brain generally display well-defined hierarchical cortical relationships as well as overlaps between the principal clusters of both pathologic alterations in the heteromodal association regions. These findings represent systematic, large-scale mechanisms of early AD pathology.
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Affiliation(s)
- Jorge Sepulcre
- Gordon Center for Medical Imaging, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts2Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts
| | - Michel J Grothe
- German Center for Neurodegenerative Diseases, Rostock, Germany
| | - Mert Sabuncu
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts
| | - Jasmeer Chhatwal
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts
| | - Aaron P Schultz
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts
| | - Bernard Hanseeuw
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts
| | - Georges El Fakhri
- Gordon Center for Medical Imaging, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Reisa Sperling
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts4Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts5Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Keith A Johnson
- Gordon Center for Medical Imaging, Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts4Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts5Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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32
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Yang C, Sun X, Tao W, Li X, Zhang J, Jia J, Chen K, Zhang Z. Multistage Grading of Amnestic Mild Cognitive Impairment: The Associated Brain Gray Matter Volume and Cognitive Behavior Characterization. Front Aging Neurosci 2017; 8:332. [PMID: 28119601 PMCID: PMC5222841 DOI: 10.3389/fnagi.2016.00332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 12/22/2016] [Indexed: 01/19/2023] Open
Abstract
Background and Purpose: It is well known that there is a wide range of different pathological stages related to Alzheimer's disease (AD) among patients with amnestic mild cognitive impairment (aMCI). Further refinement of the stages based on neuropsychological and neuroimaging methods is important for earlier disease detection, as well as for the development and evaluation of disease-modifying interventions. Materials and Methods: In this cross-sectional study, 125 aMCI patients were classified into declined progressively three stages of mild, moderate and severe, utilizing the extreme groups approach (EGA) based on their memory function. Fifty-two patients, in addition to 24 cognitively normal subjects, were included in further structural MRI analyses. Characteristics of cognitive functions and brain structures across these newly defined stages were explored through general linear models. Results: Almost all the non-memory cognitive functions showed progressive decline as memory function deteriorated. In addition, medial structures including the right hippocampus, right lingual and left fusiform gyrus, presented with greater gray matter (GM) atrophy during the later stages of aMCI (corrected p < 0.05). Correlations were found between GM volume of the lingual gyrus and processing speed (r = 0.419, p = 0.003) and between the fusiform gyrus and general cognitive function (r = 0.281, p = 0.046). Moreover, both cognitive function and GM volume presented non-linear trajectories over stages of aMCI. Conclusion: Our study characterized the cognitive profiles along with the degree of episodic memory impairment, and these three stages of aMCI showed non-linear progressive decline in cognitive functions and GM volumes.
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Affiliation(s)
- Caishui Yang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China
| | - Xuan Sun
- Department of Geriatric Neurology, Chinese PLA General Hospital Beijing, China
| | - Wuhai Tao
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China
| | - Junying Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China
| | - Jianjun Jia
- Department of Geriatric Neurology, Chinese PLA General Hospital Beijing, China
| | - Kewei Chen
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China; Banner Alzheimer's InstitutePhoenix, AZ, USA
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China
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Villemagne VL, Doré V, Bourgeat P, Burnham SC, Laws S, Salvado O, Masters CL, Rowe CC. Aβ-amyloid and Tau Imaging in Dementia. Semin Nucl Med 2017; 47:75-88. [DOI: 10.1053/j.semnuclmed.2016.09.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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34
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Chung JK, Plitman E, Nakajima S, Chakravarty MM, Caravaggio F, Gerretsen P, Iwata Y, Graff-Guerrero A. Cortical Amyloid β Deposition and Current Depressive Symptoms in Alzheimer Disease and Mild Cognitive Impairment. J Geriatr Psychiatry Neurol 2016; 29:149-59. [PMID: 26400248 PMCID: PMC4870393 DOI: 10.1177/0891988715606230] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 07/29/2015] [Indexed: 01/18/2023]
Abstract
Depressive symptoms are frequently seen in patients with dementia and mild cognitive impairment (MCI). Evidence suggests that there may be a link between current depressive symptoms and Alzheimer disease (AD)-associated pathological changes, such as an increase in cortical amyloid-β (Aβ). However, limited in vivo studies have explored the relationship between current depressive symptoms and cortical Aβ in patients with MCI and AD. Our study, using a large sample of 455 patients with MCI and 153 patients with AD from the Alzheimer's disease Neuroimaging Initiatives, investigated whether current depressive symptoms are related to cortical Aβ deposition. Depressive symptoms were assessed using the Geriatric Depression Scale and Neuropsychiatric Inventory-depression/dysphoria. Cortical Aβ was quantified using positron emission tomography with the Aβ probe(18)F-florbetapir (AV-45).(18)F-florbetapir standardized uptake value ratio (AV-45 SUVR) from the frontal, cingulate, parietal, and temporal regions was estimated. A global AV-45 SUVR, defined as the average of frontal, cingulate, precuneus, and parietal cortex, was also used. We observed that current depressive symptoms were not related to cortical Aβ, after controlling for potential confounds, including history of major depression. We also observed that there was no difference in cortical Aβ between matched participants with high and low depressive symptoms, as well as no difference between matched participants with the presence and absence of depressive symptoms. The association between depression and cortical Aβ deposition does not exist, but the relationship is highly influenced by stressful events in the past, such as previous depressive episodes, and complex interactions of different pathways underlying both depression and dementia.
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Affiliation(s)
- Jun Ku Chung
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada Multimodal Imaging Group-Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Eric Plitman
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada Multimodal Imaging Group-Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Shinichiro Nakajima
- Multimodal Imaging Group-Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - M Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Mental Health Institute, McGill University, Montreal, Quebec, Canada Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - Fernando Caravaggio
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada Multimodal Imaging Group-Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Philip Gerretsen
- Multimodal Imaging Group-Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Yusuke Iwata
- Multimodal Imaging Group-Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
| | - Ariel Graff-Guerrero
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada Multimodal Imaging Group-Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada Geriatric Mental Health Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Tosun D, Chen YF, Yu P, Sundell KL, Suhy J, Siemers E, Schwarz AJ, Weiner MW. Amyloid status imputed from a multimodal classifier including structural MRI distinguishes progressors from nonprogressors in a mild Alzheimer's disease clinical trial cohort. Alzheimers Dement 2016; 12:977-986. [PMID: 27109039 DOI: 10.1016/j.jalz.2016.03.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 02/18/2016] [Accepted: 03/18/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Mild-Alzheimer's disease (AD) subjects without significant Aβ pathology represent a confounding finding for clinical trials because they may not progress clinically on the expected trajectory, adding variance into analyses where slowing of progression is being measured. METHODS A prediction model based on structural magnetic resonance imaging (MRI) in combination with baseline demographics and clinical measurements was used to impute Aβ status of a placebo-treated mild-AD sub-cohort (N = 385) of patients participating in global phase 3 trials. The clinical trajectories of this cohort were evaluated over 18 months duration of the trial, stratified by imputed Aβ status within a mixed-model repeated measures statistical framework. RESULTS In the imputed Aβ-positive cohort, both cognitive (ADAS-Cog14 and MMSE) and functional (ADCS-iADL) measures declined more rapidly than in the undifferentiated population. DISCUSSION Our results demonstrate imputing Aβ status from MRI scans in mild-AD subjects may be a useful screening tool in global clinical trials if amyloid measurement is not available.
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Affiliation(s)
- Duygu Tosun
- Department Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA.
| | | | - Peng Yu
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | | | | | | | - Michael W Weiner
- Department Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA
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Lorenzi M, Simpson IJ, Mendelson AF, Vos SB, Cardoso MJ, Modat M, Schott JM, Ourselin S. Multimodal Image Analysis in Alzheimer's Disease via Statistical Modelling of Non-local Intensity Correlations. Sci Rep 2016; 6:22161. [PMID: 27064442 PMCID: PMC4827392 DOI: 10.1038/srep22161] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 02/04/2016] [Indexed: 02/01/2023] Open
Abstract
The joint analysis of brain atrophy measured with magnetic resonance imaging (MRI) and hypometabolism measured with positron emission tomography with fluorodeoxyglucose (FDG-PET) is of primary importance in developing models of pathological changes in Alzheimer's disease (AD). Most of the current multimodal analyses in AD assume a local (spatially overlapping) relationship between MR and FDG-PET intensities. However, it is well known that atrophy and hypometabolism are prominent in different anatomical areas. The aim of this work is to describe the relationship between atrophy and hypometabolism by means of a data-driven statistical model of non-overlapping intensity correlations. For this purpose, FDG-PET and MRI signals are jointly analyzed through a computationally tractable formulation of partial least squares regression (PLSR). The PLSR model is estimated and validated on a large clinical cohort of 1049 individuals from the ADNI dataset. Results show that the proposed non-local analysis outperforms classical local approaches in terms of predictive accuracy while providing a plausible description of disease dynamics: early AD is characterised by non-overlapping temporal atrophy and temporo-parietal hypometabolism, while the later disease stages show overlapping brain atrophy and hypometabolism spread in temporal, parietal and cortical areas.
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Affiliation(s)
| | | | | | - Sjoerd B. Vos
- Translational Imaging Group, CMIC, UCL, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, UK
| | | | - Marc Modat
- Translational Imaging Group, CMIC, UCL, London, UK
| | - Jonathan M. Schott
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, UK
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Jack CR, Barnes J, Bernstein MA, Borowski BJ, Brewer J, Clegg S, Dale AM, Carmichael O, Ching C, DeCarli C, Desikan RS, Fennema-Notestine C, Fjell AM, Fletcher E, Fox NC, Gunter J, Gutman BA, Holland D, Hua X, Insel P, Kantarci K, Killiany RJ, Krueger G, Leung KK, Mackin S, Maillard P, Malone IB, Mattsson N, McEvoy L, Modat M, Mueller S, Nosheny R, Ourselin S, Schuff N, Senjem ML, Simonson A, Thompson PM, Rettmann D, Vemuri P, Walhovd K, Zhao Y, Zuk S, Weiner M. Magnetic resonance imaging in Alzheimer's Disease Neuroimaging Initiative 2. Alzheimers Dement 2016; 11:740-56. [PMID: 26194310 DOI: 10.1016/j.jalz.2015.05.002] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 04/28/2015] [Accepted: 05/05/2015] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Alzheimer's Disease Neuroimaging Initiative (ADNI) is now in its 10th year. The primary objective of the magnetic resonance imaging (MRI) core of ADNI has been to improve methods for clinical trials in Alzheimer's disease (AD) and related disorders. METHODS We review the contributions of the MRI core from present and past cycles of ADNI (ADNI-1, -Grand Opportunity and -2). We also review plans for the future-ADNI-3. RESULTS Contributions of the MRI core include creating standardized acquisition protocols and quality control methods; examining the effect of technical features of image acquisition and analysis on outcome metrics; deriving sample size estimates for future trials based on those outcomes; and piloting the potential utility of MR perfusion, diffusion, and functional connectivity measures in multicenter clinical trials. DISCUSSION Over the past decade the MRI core of ADNI has fulfilled its mandate of improving methods for clinical trials in AD and will continue to do so in the future.
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Affiliation(s)
| | - Josephine Barnes
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | | | | | - James Brewer
- Department of Neuroscience, University of California at San Diego, La Jolla, CA, USA
| | - Shona Clegg
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Anders M Dale
- Department of Neuroscience, University of California at San Diego, La Jolla, CA, USA
| | - Owen Carmichael
- Department of Neurology, University of California at Davis, Davis, CA, USA
| | - Christopher Ching
- Department of Neurology, Imaging Genetics Center, Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Davis, CA, USA; Center for Neuroscience, University of California at Davis, Davis, CA, USA
| | - Rahul S Desikan
- Department of Radiology, University of California at San Diego, La Jolla, CA, USA
| | - Christine Fennema-Notestine
- Department of Radiology, University of California at San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California at San Diego, La Jolla, CA, USA
| | - Anders M Fjell
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Evan Fletcher
- Department of Neurology, University of California at Davis, Davis, CA, USA; Center for Neuroscience, University of California at Davis, Davis, CA, USA
| | - Nick C Fox
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Jeff Gunter
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Boris A Gutman
- Department of Neurology, Imaging Genetics Center, Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - Dominic Holland
- Department of Neuroscience, University of California at San Diego, La Jolla, CA, USA
| | - Xue Hua
- Department of Neurology, Imaging Genetics Center, Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - Philip Insel
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Ron J Killiany
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | | | - Kelvin K Leung
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Scott Mackin
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Pauline Maillard
- Department of Neurology, University of California at Davis, Davis, CA, USA; Center for Neuroscience, University of California at Davis, Davis, CA, USA
| | - Ian B Malone
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Niklas Mattsson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | - Linda McEvoy
- Department of Radiology, University of California at San Diego, La Jolla, CA, USA
| | - Marc Modat
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK; Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Susanne Mueller
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Radiology, University of California at San Francisco, San Francisco, CA, USA
| | - Rachel Nosheny
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Radiology, University of California at San Francisco, San Francisco, CA, USA
| | - Sebastien Ourselin
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK; Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Norbert Schuff
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Radiology, University of California at San Francisco, San Francisco, CA, USA
| | | | - Alix Simonson
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Paul M Thompson
- Department of Neurology, Imaging Genetics Center, Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - Dan Rettmann
- MR Applications and Workflow, GE Healthcare, Rochester, MN, USA
| | | | | | | | - Samantha Zuk
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Michael Weiner
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA; Department of Radiology, University of California at San Francisco, San Francisco, CA, USA; Department of Medicine, University of California at San Francisco, San Francisco, CA, USA; Department of Neurology, University of California at San Francisco, San Francisco, CA, USA
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Knopman DS, Jack CR, Lundt ES, Wiste HJ, Weigand SD, Vemuri P, Lowe VJ, Kantarci K, Gunter JL, Senjem ML, Mielke MM, Machulda MM, Roberts RO, Boeve BF, Jones DT, Petersen RC. Role of β-Amyloidosis and Neurodegeneration in Subsequent Imaging Changes in Mild Cognitive Impairment. JAMA Neurol 2016; 72:1475-83. [PMID: 26437123 DOI: 10.1001/jamaneurol.2015.2323] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
IMPORTANCE To understand how a model of Alzheimer disease pathophysiology based on β-amyloidosis and neurodegeneration predicts the regional anatomic expansion of hypometabolism and atrophy in persons with mild cognitive impairment (MCI). OBJECTIVE To define the role of β-amyloidosis and neurodegeneration in the subsequent progression of topographic cortical structural and metabolic changes in MCI. DESIGN, SETTING, AND PARTICIPANTS Longitudinal, observational study with serial brain imaging conducted from March 28, 2006, to January 6, 2015, using a population-based cohort. A total of 96 participants with MCI (all aged >70 years) with serial imaging biomarkers from the Mayo Clinic Study of Aging or Mayo Alzheimer's Disease Research Center were included. Participants were characterized initially as having elevated or not elevated brain β-amyloidosis (A+ or A-) based on 11C-Pittsburgh compound B positron emission tomography. They were further characterized initially by the presence or absence of neurodegeneration (N+ or N-), where the presence of neurodegeneration was defined by abnormally low hippocampal volume or hypometabolism in an Alzheimer disease-like pattern on 18fluorodeoxyglucose (FDG)-positron emission tomography. MAIN OUTCOMES AND MEASURES Regional FDG standardized uptake value ratio (SUVR) and gray matter volumes in medial temporal, lateral temporal, lateral parietal, and medial parietal regions. RESULTS In the primary regions of interest (ROI), the A+N+ group (n = 45) had lower FDG SUVR at baseline compared with the A+N- group (n = 17) (all 4 ROIs; P < .001). The A+N+ group also had lower FDG SUVR at baseline (all 4 ROIs; P < .01) compared with the A-N- group (n = 12). The A+N+ group had lower medial temporal gray matter volume at baseline (P < .001) compared with either the A+N- group or A-N- group. The A+N+ group showed large longitudinal declines in FDG SUVR (P < .05 for medial temporal, lateral temporal, and medial parietal regions) and gray matter volumes (P < .05 for medial temporal and lateral temporal regions) compared with the A-N+ group (n = 22). The A+N+ group also showed large longitudinal declines compared with the A-N- group on FDG SUVR (P < .05 for medial temporal and lateral parietal regions) and gray matter volumes (all 4 ROIs; P < .05) compared with the A+N- group. The A-N+ group did not show declines in FDG SUVR or gray matter volume compared with the A+N- or A-N- groups. CONCLUSIONS AND RELEVANCE Persons with MCI who were A+N+ demonstrated volumetric and metabolic worsening in temporal and parietal association areas, consistent with the expectation that the MCI stage in the Alzheimer pathway heralds incipient isocortical involvement. The A-N+ group, those with suspected non-Alzheimer pathophysiology, lacked a distinctive longitudinal volumetric or metabolic profile.
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Affiliation(s)
- David S Knopman
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota2Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Clifford R Jack
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, Minnesota3Department of Radiology, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Emily S Lundt
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Heather J Wiste
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Stephen D Weigand
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Prashanthi Vemuri
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Val J Lowe
- Department of Radiology, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Jeffrey L Gunter
- Department of Radiology, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Matthew L Senjem
- Department of Radiology, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Michelle M Mielke
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota5Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Mary M Machulda
- Division of Psychology, Department of Psychiatry, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Rosebud O Roberts
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota5Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota2Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, Minnesota
| | - David T Jones
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota2Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, Minnesota3Department of Radiology, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Ronald C Petersen
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota2Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, Minnesota5Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic and F
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Scott G, Ramlackhansingh AF, Edison P, Hellyer P, Cole J, Veronese M, Leech R, Greenwood RJ, Turkheimer FE, Gentleman SM, Heckemann RA, Matthews PM, Brooks DJ, Sharp DJ. Amyloid pathology and axonal injury after brain trauma. Neurology 2016; 86:821-8. [PMID: 26843562 PMCID: PMC4793784 DOI: 10.1212/wnl.0000000000002413] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 09/03/2015] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To image β-amyloid (Aβ) plaque burden in long-term survivors of traumatic brain injury (TBI), test whether traumatic axonal injury and Aβ are correlated, and compare the spatial distribution of Aβ to Alzheimer disease (AD). METHODS Patients 11 months to 17 years after moderate-severe TBI underwent (11)C-Pittsburgh compound B ((11)C-PiB)-PET, structural and diffusion MRI, and neuropsychological examination. Healthy aged controls and patients with AD underwent PET and structural MRI. Binding potential (BPND) images of (11)C-PiB, which index Aβ plaque density, were computed using an automatic reference region extraction procedure. Voxelwise and regional differences in BPND were assessed. In TBI, a measure of white matter integrity, fractional anisotropy, was estimated and correlated with (11)C-PiB BPND. RESULTS Twenty-eight participants (9 with TBI, 9 controls, 10 with AD) were assessed. Increased (11)C-PiB BPND was found in TBI vs controls in the posterior cingulate cortex and cerebellum. Binding in the posterior cingulate cortex increased with decreasing fractional anisotropy of associated white matter tracts and increased with time since injury. Compared to AD, binding after TBI was lower in neocortical regions but increased in the cerebellum. CONCLUSIONS Increased Aβ burden was observed in TBI. The distribution overlaps with, but is distinct from, that of AD. This suggests a mechanistic link between TBI and the development of neuropathologic features of dementia, which may relate to axonal damage produced by the injury.
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Affiliation(s)
- Gregory Scott
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - Anil F Ramlackhansingh
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - Paul Edison
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - Peter Hellyer
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - James Cole
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - Mattia Veronese
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - Rob Leech
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - Richard J Greenwood
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - Federico E Turkheimer
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - Steve M Gentleman
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - Rolf A Heckemann
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - Paul M Matthews
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - David J Brooks
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark
| | - David J Sharp
- From the Division of Brain Sciences (G.S., A.F.R., P.E., P.H., J.C., R.L., S.M.G., R.A.H., P.M.M., D.J.B., D.J.S.), Department of Medicine, Imperial College London; Institute of Psychiatry, Psychology & Neuroscience (P.H., M.V., F.E.T.), King's College London; Institute of Neurology (R.J.G.), University College London, UK; MedTech West at Sahlgrenska University Hospital (R.A.H.), University of Gothenburg, Sweden; and Institute of Clinical Medicine (D.J.B.), Aarhus University, Denmark.
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Sepulcre J, Masdeu JC. Advanced Neuroimaging Methods Towards Characterization of Early Stages of Alzheimer's Disease. Methods Mol Biol 2016; 1303:509-519. [PMID: 26235088 DOI: 10.1007/978-1-4939-2627-5_31] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In the past 5 years, imaging network properties in the brain of patients with Alzheimer's disease (AD) has revolutionized our understanding of this disorder. Postmortem data had already suggested that the damage spreads along functional neural networks, but postmortem studies do not provide information on the temporal evolution of the damage in the same patient, essential to determine spreading. These data can be provided by functional and structural neuroimaging, which allow for the visualization over time of the progressive damage inflicted by AD. Functional networks can be mapped by determining the synchrony across brain regions of the blood oxygenation level dependence (BOLD) signal on functional magnetic resonance imaging (MRI) during quiet wakefulness. Other less extensively used techniques are also useful. For instance, amyloid deposition can be imaged and its progression mapped to determine whether it follows brain networks, and, if so, which are affected earliest. Network patterns of neurobiological changes, including tau deposition, may prove critical to our understanding of the neurobiology of AD and therefore open the way for therapeutic interventions.
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Affiliation(s)
- Jorge Sepulcre
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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41
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Chang YL, Yen YS, Chen TF, Yan SH, Tseng WYI. Clinical Dementia Rating Scale Detects White Matter Changes in Older Adults at Risk for Alzheimer's Disease. J Alzheimers Dis 2015; 50:411-23. [PMID: 26639963 DOI: 10.3233/jad-150599] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This study investigated the putative changes in regional gray matter and cingulum bundle segments in mild cognitive impairment (MCI) by using two diagnostic criteria. Participants comprised 50 older adults with MCI and 22 healthy older controls (HC). The older adults with MCI were further divided into two groups defined by a global Clinical Dementia Rating (CDR) score of 0.5 and with (the CDR/NPT MCI group) or without (the CDR MCI group) objective cognitive impairments determined using neuropsychological tests (NPTs). Comparable regional gray matter integrity was observed among the three groups. However, the integrity of the right inferior segment of the cingulum bundle in the two MCI groups was more reduced than that in the HC group, and the CDR/NPT MCI group exhibited additional disruption in the left inferior cingulum bundle. The results also demonstrated that neuropsychological measures have greater predictive value for changes in white matter beyond the contribution of an informant-based instrument alone. Overall, the findings confirm the utility of informant-based assessment in detecting microstructural brain changes in high-risk older adults, even before objective cognitive impairment is evident. The findings also suggest that combining the neuropsychological measures with the informant-based assessment provided the greatest predictive value in assessing white matter disruption. The essential role of the white matter measurement as a biomarker for detecting individuals at a high risk of developing dementia was highlighted.
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Affiliation(s)
- Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan.,Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Yu-Shiuan Yen
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sui-Hing Yan
- Section of Neurology, Renai Branch, Taipei City Hospital, Taipei, Taiwan
| | - Wen-Yih Isaac Tseng
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Medical Imaging, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Oh H, Steffener J, Razlighi QR, Habeck C, Liu D, Gazes Y, Janicki S, Stern Y. Aβ-related hyperactivation in frontoparietal control regions in cognitively normal elderly. Neurobiol Aging 2015; 36:3247-3254. [PMID: 26382734 PMCID: PMC4788982 DOI: 10.1016/j.neurobiolaging.2015.08.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 01/18/2023]
Abstract
The accumulation of amyloid-beta (Aβ) peptides, a pathologic hallmark of Alzheimer's disease, has been associated with functional alterations in cognitively normal elderly, most often in the context of episodic memory with a particular emphasis on the medial temporal lobes. The topography of Aβ deposition, however, highly overlaps with frontoparietal control (FPC) regions implicated in cognitive control/working memory. To examine Aβ-related functional alternations in the FPC regions during a working memory task, we imaged 42 young and 57 cognitively normal elderly using functional magnetic resonance imaging during a letter Sternberg task with varying load. Based on (18)F-florbetaben-positron emission tomography scan, we determined older subjects' amyloid positivity (Aβ+) status. Within brain regions commonly recruited by all subject groups during the delay period, age and Aβ deposition were independently associated with load-dependent frontoparietal hyperactivation, whereas additional compensatory Aβ-related hyperactivity was found beyond the FPC regions. The present results suggest that Aβ-related hyperactivation is not specific to the episodic memory system but occurs in the PFC regions as well.
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Affiliation(s)
- Hwamee Oh
- Cognitive Neuroscience Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
| | - Jason Steffener
- Cognitive Neuroscience Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Qolamreza R Razlighi
- Cognitive Neuroscience Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Christian Habeck
- Cognitive Neuroscience Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Dan Liu
- Cognitive Neuroscience Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Yunglin Gazes
- Cognitive Neuroscience Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Sarah Janicki
- Division of Aging and Dementia, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Grothe MJ, Teipel SJ. Spatial patterns of atrophy, hypometabolism, and amyloid deposition in Alzheimer's disease correspond to dissociable functional brain networks. Hum Brain Mapp 2015; 37:35-53. [PMID: 26441321 DOI: 10.1002/hbm.23018] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/18/2015] [Accepted: 09/23/2015] [Indexed: 01/18/2023] Open
Abstract
Recent neuroimaging studies of Alzheimer's disease (AD) have emphasized topographical similarities between AD-related brain changes and a prominent cortical association network called the default-mode network (DMN). However, the specificity of distinct imaging abnormalities for the DMN compared to other intrinsic connectivity networks (ICNs) of the limbic and heteromodal association cortex has not yet been examined systematically. We assessed regional amyloid load using AV45-PET, neuronal metabolism using FDG-PET, and gray matter volume using structural MRI in 473 participants from the Alzheimer's Disease Neuroimaging Initiative, including preclinical, predementia, and clinically manifest AD stages. Complementary region-of-interest and voxel-based analyses were used to assess disease stage- and modality-specific changes within seven principle ICNs of the human brain as defined by a standardized functional connectivity atlas. Amyloid deposition in AD dementia showed a preference for the DMN, but high effect sizes were also observed for other neocortical ICNs, most notably the frontoparietal-control network. Atrophic changes were most specific for an anterior limbic network, followed by the DMN, whereas other neocortical networks were relatively spared. Hypometabolism appeared to be a mixture of both amyloid- and atrophy-related profiles. Similar patterns of modality-dependent network specificity were also observed in the predementia and, for amyloid deposition, in the preclinical stage. These quantitative data confirm a high vulnerability of the DMN for multimodal imaging abnormalities in AD. However, rather than being selective for the DMN, imaging abnormalities more generally affect higher order cognitive networks and, importantly, the vulnerability profiles of these networks markedly differ for distinct aspects of AD pathology.
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Affiliation(s)
- Michel J Grothe
- German Center for Neurodegenerative Diseases (DZNE), Gehlsheimer Str. 20, Rostock, 18147, Germany
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Gehlsheimer Str. 20, Rostock, 18147, Germany.,Department of Psychosomatic Medicine, University of Rostock, Gehlsheimer Str. 20, Rostock, 18147, Germany
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Son SJ, Kim J, Seo J, Lee JM, Park H. Connectivity analysis of normal and mild cognitive impairment patients based on FDG and PiB-PET images. Neurosci Res 2015; 98:50-8. [DOI: 10.1016/j.neures.2015.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 04/02/2015] [Accepted: 04/08/2015] [Indexed: 01/18/2023]
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18F-FDG and 18F-florbetapir PET in clinical practice: regional analysis in mild cognitive impairment and Alzheimer disease. Clin Nucl Med 2015; 40:e111-6. [PMID: 25549345 DOI: 10.1097/rlu.0000000000000666] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The aim of this study is to compare regional cerebral metabolic rate of glucose metabolism and amyloid-β density in patients with Alzheimer disease (AD), mild cognitive impairment (MCI), and healthy elderly subjects. METHODS Eighteen patients (including 6 AD, 5 amnestic MCI, and 7 controls) were enrolled at the University Hospital of Tours, France, and submitted to clinical, neuropsychological, and MRI examinations. PET images using F-florbetapir (266 MBq) and F-FDG (185 MBq) were acquired. SUV ratios in specific regions were defined using PMOD3.2 software. RESULTS The mean values of F-FDG SUV ratio were significantly lower in frontal, anterior cingulate, and temporal regions in MCI patients than in normal elderly (-15%, -22%, and -11%, respectively). Alzheimer disease patients showed global cerebral metabolic rate of glucose metabolism decrease, especially in parietal and precuneus regions (-15% and -13% compared with healthy control subjects). Only precuneus cortex showed an increased F-florbetapir uptake in AD. There was no other significant regional difference in the amyloid-β density. CONCLUSIONS In this study, we observed regional brain metabolic changes between MCI, AD, and controls, whereas only precuneus showed an increased amyloid-β density in AD. F-florbetapir PET analysis needs to be visual and global, whereas F-FDG analysis can be regional.
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Morphometric and histologic substrates of cingulate integrity in elders with exceptional memory capacity. J Neurosci 2015; 35:1781-91. [PMID: 25632151 DOI: 10.1523/jneurosci.2998-14.2015] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
This human study is based on an established cohort of "SuperAgers," 80+-year-old individuals with episodic memory function at a level equal to, or better than, individuals 20-30 years younger. A preliminary investigation using structural brain imaging revealed a region of anterior cingulate cortex that was thicker in SuperAgers compared with healthy 50- to 65-year-olds. Here, we investigated the in vivo structural features of cingulate cortex in a larger sample of SuperAgers and conducted a histologic analysis of this region in postmortem specimens. A region-of-interest MRI structural analysis found cingulate cortex to be thinner in cognitively average 80+ year olds (n = 21) than in the healthy middle-aged group (n = 18). A region of the anterior cingulate cortex in the right hemisphere displayed greater thickness in SuperAgers (n = 31) compared with cognitively average 80+ year olds and also to the much younger healthy 50-60 year olds (p < 0.01). Postmortem investigations were conducted in the cingulate cortex in five SuperAgers, five cognitively average elderly individuals, and five individuals with amnestic mild cognitive impairment. Compared with other subject groups, SuperAgers showed a lower frequency of Alzheimer-type neurofibrillary tangles (p < 0.05). There were no differences in total neuronal size or count between subject groups. Interestingly, relative to total neuronal packing density, there was a higher density of von Economo neurons (p < 0.05), particularly in anterior cingulate regions of SuperAgers. These findings suggest that reduced vulnerability to the age-related emergence of Alzheimer pathology and higher von Economo neuron density in anterior cingulate cortex may represent biological correlates of high memory capacity in advanced old age.
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Insights into cognitive aging and Alzheimer’s disease using amyloid PET and structural MRI scans. Clin Transl Imaging 2015. [DOI: 10.1007/s40336-015-0110-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Klupp E, Grimmer T, Tahmasian M, Sorg C, Yakushev I, Yousefi BH, Drzezga A, Förster S. Prefrontal hypometabolism in Alzheimer disease is related to longitudinal amyloid accumulation in remote brain regions. J Nucl Med 2015; 56:399-404. [PMID: 25678488 DOI: 10.2967/jnumed.114.149302] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
UNLABELLED In PET studies of patients with Alzheimer disease (AD), prominent hypometabolism can occur in brain regions without major amyloid load. These hypometabolism-only (HO) areas may not be explained easily as a consequence of local amyloid toxicity. The aim of this longitudinal multimodal imaging study was the investigation of locoregional and remote relationships between metabolism in HO areas and longitudinal amyloid increase in functionally connected brain areas, with a particular focus on intrinsic functional connectivity as a relevant linking mechanism between pathology and dysfunction. METHODS Fifteen AD patients underwent longitudinal examinations with (11)C-Pittsburgh compound B ((11)C-PiB) and (18)F-FDG PET (mean follow-up period, 2 y). The peak HO region was identified by the subtraction of equally thresholded statistical T maps (hypometabolism minus amyloid burden), resulting from voxel-based statistical parametric mapping group comparisons between the AD patients and 15 healthy controls. Then functionally connected and nonconnected brain networks were identified by means of seed-based intrinsic functional connectivity analysis of the resting-state functional MRI data of healthy controls. Finally, network-based, region-of-interest-based, and voxel-based correlations were calculated between longitudinal changes of normalized (11)C-PiB binding and (18)F-FDG metabolism. RESULTS Positive voxel-based and region-of-interest-based correlations were demonstrated between longitudinal (11)C-PiB increases in the HO-connected network, encompassing bilateral temporoparietal and frontal brain regions, and metabolic changes in the peak HO region as well as locoregionally within several AD-typical brain regions. CONCLUSION Our results indicate that in AD amyloid accumulation in remote but functionally connected brain regions may significantly contribute to longitudinally evolving hypometabolism in brain regions not strongly affected by local amyloid pathology, supporting the amyloid- and network-degeneration hypothesis.
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Affiliation(s)
- Elisabeth Klupp
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Masoud Tahmasian
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany Technische Universität München Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany Department of Neurology, University Hospital of Cologne, Cologne, Germany
| | - Christian Sorg
- Technische Universität München Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany; and
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany Technische Universität München Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Behrooz H Yousefi
- Technische Universität München Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany Pharmaceutical Radiochemistry, Technische Universität München, Garching, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - Stefan Förster
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany Technische Universität München Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
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Raj A, LoCastro E, Kuceyeski A, Tosun D, Relkin N, Weiner M. Network Diffusion Model of Progression Predicts Longitudinal Patterns of Atrophy and Metabolism in Alzheimer's Disease. Cell Rep 2015; 10:359-369. [PMID: 25600871 DOI: 10.1016/j.celrep.2014.12.034] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/08/2014] [Accepted: 12/15/2014] [Indexed: 01/18/2023] Open
Abstract
Alzheimer's disease pathology (AD) originates in the hippocampus and subsequently spreads to temporal, parietal, and prefrontal association cortices in a relatively stereotyped progression. Current evidence attributes this orderly progression to transneuronal transmission of misfolded proteins along the projection pathways of affected neurons. A network diffusion model was recently proposed to mathematically predict disease topography resulting from transneuronal transmission on the brain's connectivity network. Here, we use this model to predict future patterns of regional atrophy and metabolism from baseline regional patterns of 418 subjects. The model accurately predicts end-of-study regional atrophy and metabolism starting from baseline data, with significantly higher correlation strength than given by the baseline statistics directly. The model's rate parameter encapsulates overall atrophy progression rate; group analysis revealed this rate to depend on diagnosis as well as baseline cerebrospinal fluid (CSF) biomarker levels. This work helps validate the model as a prognostic tool for Alzheimer's disease assessment.
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Affiliation(s)
- Ashish Raj
- Department of Radiology, Weill Medical College of Cornell University, 515 East 71 Street, Suite S123, New York, NY 10021, USA.
| | - Eve LoCastro
- Department of Radiology, Weill Medical College of Cornell University, 515 East 71 Street, Suite S123, New York, NY 10021, USA
| | - Amy Kuceyeski
- Department of Radiology, Weill Medical College of Cornell University, 515 East 71 Street, Suite S123, New York, NY 10021, USA
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, University of California, San Francisco, 4150 Clement Street (114M), San Francisco, CA 94121, USA
| | - Norman Relkin
- Department of Neurology and Neuroscience, Memory Disorders Program, Weill Medical College of Cornell University, 428 East 72nd Street, Suite 500, New York, NY 10021, USA
| | - Michael Weiner
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, University of California, San Francisco, 4150 Clement Street (114M), San Francisco, CA 94121, USA
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Raamana PR, Weiner MW, Wang L, Beg MF. Thickness network features for prognostic applications in dementia. Neurobiol Aging 2015; 36 Suppl 1:S91-S102. [PMID: 25444603 PMCID: PMC5849081 DOI: 10.1016/j.neurobiolaging.2014.05.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 05/09/2014] [Accepted: 05/16/2014] [Indexed: 01/18/2023]
Abstract
Regional analysis of cortical thickness has been studied extensively in building imaging biomarkers for early detection of Alzheimer's disease but not its interregional covariation of thickness. We present novel features based on the inter-regional covariation of cortical thickness. Initially, the cortical labels of each subject are partitioned into small patches (graph nodes) by spatial k-means clustering. A graph is then constructed by establishing a link between 2 nodes if the difference in thickness between the nodes is below a certain threshold. From this binary graph, a thickness network is computed using nodal degree, betweenness, and clustering coefficient measures. Fusing them with multiple kernel learning, it is observed that thickness network features discriminate mild cognitive impairment (MCI) converters from controls (CN) with an area under curve (AUC) of 0.83, 74% sensitivity and 76% specificity on a large subset obtained from the Alzheimer's Disease Neuroimaging Initiative data set. A comparison of predictive utility in Alzheimer's disease and/or CN classification (AUC of 0.92, 80% sensitivity [SENS] and 90% specificity [SPEC]), in discriminating CN from MCI (converters and nonconverters combined; AUC of 0.75, SENS and SPEC of 64% and 73%, respectively) and in discriminating between MCI nonconverters and MCI converters (AUC of 0.68, SENS and SPEC of 65% and 64%) is also presented. ThickNet features as defined here are novel, can be derived from a single magnetic resonance imaging scan, and demonstrate the potential for the computer-aided prognostic applications.
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Affiliation(s)
- Pradeep Reddy Raamana
- Department of Engineering Science, School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Michael W Weiner
- Department of Radiology, Center for Imaging of Neurodegenerative Diseases, University of California, San Francisco, CA, USA
| | - Lei Wang
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mirza Faisal Beg
- Department of Engineering Science, School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada.
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