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Péron JA. Challenges and prospects in advancing clinical neuropsychology. Cortex 2024; 179:261-270. [PMID: 39213778 DOI: 10.1016/j.cortex.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 08/07/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
In the ever-evolving field of clinical neuropsychology, significant methodological and conceptual limitations hinder progress. To ensure the continued relevance of this discipline amidst remarkable advancements in neuroscience, medicine, and methodology, these obstacles must be addressed. This opinion article identifies inherent limitations within current clinical neuropsychology, including issues such as multi-collinearity in neuropsychological assessments, lack of validated tools reflecting contemporary cognitive function models, and the use of divergent theoretical frameworks in evaluations, leading to a gap between theory and practice. The disconnect between behavior and biomarkers, particularly evident in neurodegenerative diseases but also relevant for other pathologies, together with the rise of genetic analyses, necessitate change. Methodological improvements are crucial for ensuring the discipline's future relevance. Looking ahead, key perspectives and challenges are outlined, emphasizing the need for a holistic approach to cognitive functioning and congruent tools, patient engagement in experimental studies, rectification of biases, and exploration of variables like personality. Training professionals to bridge the gap between practice and research is essential. By addressing these challenges, clinical neuropsychology can not only adapt to the evolving landscape but also shape it, ensuring a brighter future for the field.
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Affiliation(s)
- Julie Anne Péron
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Switzerland.
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Liu Y, Liu JE, Shi TY, Bai LX, Yang AL, Li RL, Su YL, Wang PL, Liu J, Zhang L. Factors associated with perceived cognitive function in breast cancer patients treated with chemotherapy: A multicenter cross-sectional study. Eur J Oncol Nurs 2024; 71:102623. [PMID: 38880040 DOI: 10.1016/j.ejon.2024.102623] [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: 08/30/2023] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE This study aimed to investigate the factors associated with perceived cognitive function among breast cancer patients treated with chemotherapy in China. METHODS The study was a multicenter cross-sectional design. Data were collected from 10 public hospitals in China between April 2022 and February 2023. A total of 741 participants completed questionnaires assessing sociodemographic and medical characteristics, perceived cognitive function, sleep quality, fatigue, anxiety, and depression. Hierarchical multiple regression analysis was used to assess the determinants of cognitive function. RESULTS The hierarchical multiple regression model accounted for 31.5% of variation in perceived cognitive function (sociodemographic 4.5%; medical 6.6%; exercise frequency 6.6%; sleep quality 2.1%; fatigue 2.8%; anxiety combined with depression 9.0%). Education level, chemotherapy type, number of chemotherapy cycles, and cyclophosphamide drug use were significant predisposing factors of perceived cognitive function (p < 0.001). Exercising ≥3 times/week (p < 0.001) was a significant factor positively influencing perceived cognitive function, meanwhile, anxiety (p < 0.001) and depression (p < 0 0.001) were negative factors. CONCLUSION Our findings suggest that patients with low education levels, postoperative chemotherapy, cyclophosphamide treatment, and a greater number of chemotherapy cycles need more assessment. Sedentary patients, those who have never exercised, and those with anxiety or depression all showed greater cognitive decline. By identifying susceptible populations, encouraging regular exercise, and addressing anxiety and depression, healthcare professionals can contribute significantly to prevent patients' cognitive decline throughout chemotherapy.
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Affiliation(s)
- Yu Liu
- School of Nursing, Capital Medical University, You an Men, Beijing, 100069, PR China
| | - Jun-E Liu
- School of Nursing, Capital Medical University, You an Men, Beijing, 100069, PR China.
| | - Tie-Ying Shi
- Nursing Department, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, PR China
| | - Li-Xiao Bai
- Department of Breast Cancer, The Fifth Medical Centre of Chinese People's Liberation Army (PLA) General Hospital, Beijing, PR China
| | - Ai-Ling Yang
- Department of Breast Cancer, The Fifth Medical Centre of Chinese People's Liberation Army (PLA) General Hospital, Beijing, PR China
| | - Ruo-Lin Li
- School of Nursing, Capital Medical University, You an Men, Beijing, 100069, PR China
| | - Ya-Li Su
- Department of Breast Oncology, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring Road West, Beijing, 100050, PR China
| | - Pi-Lin Wang
- Department of Breast Oncology, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring Road West, Beijing, 100050, PR China
| | - Juan Liu
- Department of Breast Oncology, Beijing Shijitan Hospital, Capital Medical University, 10th Tieyi Road, Beijing, 100038, PR China
| | - Ling Zhang
- School of Public Health, Capital Medical University, You an Men, Beijing, 100069, PR China
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Li QY, Fu Y, Cui XJ, Wang ZT, Tan L. Association of modified dementia risk score with cerebrospinal fluid biomarkers and cognition in adults without dementia. Front Aging Neurosci 2024; 16:1339163. [PMID: 39081396 PMCID: PMC11286572 DOI: 10.3389/fnagi.2024.1339163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction This study aimed to investigate the cognitive profile and prospective cognitive changes in non-demented adults with elevated Modified Dementia Risk Scores (MDRS), while also exploring the potential relationship between these associations and cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD) pathology and neuroinflammation. Methods Within the Chinese Alzheimer's Biomarker and LifestylE (CABLE) database, 994 participants without dementia were assessed on MDRS, CSF biomarkers and cognition. We examined the associations of the MDRS with CSF biomarkers and cognitive scores using linear regressions. Causal mediation analyses were conducted to analyze the associations among MDRS, brain pathologies, and cognition. The Alzheimer's Disease Neuroimaging Initiative (ADNI) study was used to validate the mediation effects and to investigate the longitudinal association between MDRS and cognitive decline. Results The results revealed that higher MDRS were linked to poorer cognitive performance (Model 1: PFDR < 0.001; Model 2: PFDR < 0.001) and increases in CSF levels of phosphorylated tau (P-tau, Model 1: PFDR < 0.001; Model 2: PFDR < 0.001), total tau (T-tau, Model 1: PFDR < 0.001; Model 2: PFDR < 0.001), P-tau/Aβ42 ratio (Model 1: PFDR = 0.023; Model 2: PFDR = 0.028), T-tau/Aβ42 ratio (Model 1: PFDR < 0.001; Model 2: PFDR < 0.001) and soluble triggering receptor expressed on myeloid cells 2 (sTrem2, Model 1: PFDR < 0.001; Model 2: PFDR < 0.001) in the CABLE study. The impact of MDRS on cognition was partially mediated by neuroinflammation and tau pathology. These mediation effects were replicated in the ADNI study. Baseline MDRS were significantly associated with future cognitive decline, as indicated by lower scores on the Mini-Mental State Examination (MMSE, Model 1: PFDR = 0.045; Model 2: PFDR < 0.001), ADNI composite memory score (ADNI-MEM, Model 1: PFDR = 0.005; Model 2: PFDR < 0.001), ADNI composite executive function score (ADNI-EF, Model 1: PFDR = 0.045; Model 2: PFDR < 0.001), and higher score on the Alzheimer's Disease Assessment Scale (ADAS13, Model 1: PFDR = 0.045; Model 2: PFDR < 0.001). Discussion The findings of this study revealed significant associations between MDRS and cognitive decline, suggesting a potential role of tau pathology and neuroinflammation in the link between MDRS and poorer cognitive performance in individuals without dementia. Consequently, the MDRS holds promise as a tool for targeted preventive interventions in individuals at high risk of cognitive impairment.
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Affiliation(s)
- Qiong-Yao Li
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan Fu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Xin-Jing Cui
- Department of Outpatient, Qingdao Municipal Hospital, Qingdao, China
| | - Zuo-Teng Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
- Department of Neurology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
- Department of Neurology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
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Boyle R, Townsend DL, Klinger HM, Scanlon CE, Yuan Z, Coughlan GT, Seto M, Shirzadi Z, Yau WYW, Jutten RJ, Schneider C, Farrell ME, Hanseeuw BJ, Mormino EC, Yang HS, Papp KV, Amariglio RE, Jacobs HIL, Price JC, Chhatwal JP, Schultz AP, Properzi MJ, Rentz DM, Johnson KA, Sperling RA, Hohman TJ, Donohue MC, Buckley RF. Identifying longitudinal cognitive resilience from cross-sectional amyloid, tau, and neurodegeneration. Alzheimers Res Ther 2024; 16:148. [PMID: 38961512 PMCID: PMC11220971 DOI: 10.1186/s13195-024-01510-y] [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: 04/09/2024] [Accepted: 06/20/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Leveraging Alzheimer's disease (AD) imaging biomarkers and longitudinal cognitive data may allow us to establish evidence of cognitive resilience (CR) to AD pathology in-vivo. Here, we applied latent class mixture modeling, adjusting for sex, baseline age, and neuroimaging biomarkers of amyloid, tau and neurodegeneration, to a sample of cognitively unimpaired older adults to identify longitudinal trajectories of CR. METHODS We identified 200 Harvard Aging Brain Study (HABS) participants (mean age = 71.89 years, SD = 9.41 years, 59% women) who were cognitively unimpaired at baseline with 2 or more timepoints of cognitive assessment following a single amyloid-PET, tau-PET and structural MRI. We examined latent class mixture models with longitudinal cognition as the dependent variable and time from baseline, baseline age, sex, neocortical Aβ, entorhinal tau, and adjusted hippocampal volume as independent variables. We then examined group differences in CR-related factors across the identified subgroups from a favored model. Finally, we applied our favored model to a dataset from the Alzheimer's Disease Neuroimaging Initiative (ADNI; n = 160, mean age = 73.9 years, SD = 7.6 years, 60% women). RESULTS The favored model identified 3 latent subgroups, which we labelled as Normal (71% of HABS sample), Resilient (22.5%) and Declining (6.5%) subgroups. The Resilient subgroup exhibited higher baseline cognitive performance and a stable cognitive slope. They were differentiated from other groups by higher levels of verbal intelligence and past cognitive activity. In ADNI, this model identified a larger Normal subgroup (88.1%), a smaller Resilient subgroup (6.3%) and a Declining group (5.6%) with a lower cognitive baseline. CONCLUSION These findings demonstrate the value of data-driven approaches to identify longitudinal CR groups in preclinical AD. With such an approach, we identified a CR subgroup who reflected expected characteristics based on previous literature, higher levels of verbal intelligence and past cognitive activity.
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Affiliation(s)
- Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Diana L Townsend
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hannah M Klinger
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Catherine E Scanlon
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ziwen Yuan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gillian T Coughlan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mabel Seto
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Zahra Shirzadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Wai-Ying Wendy Yau
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Roos J Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Christoph Schneider
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michelle E Farrell
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Bernard J Hanseeuw
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Institute of Neuroscience, Cliniques Universitaires SaintLuc, Université Catholique de Louvain, Brussels, Belgium
| | - Elizabeth C Mormino
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Wu Tsai Neuroscience Institute, Stanford, CA, USA
| | - Hyun-Sik Yang
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn V Papp
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Heidi I L Jacobs
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Julie C Price
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Timothy J Hohman
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael C Donohue
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.
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Nataf S, Guillen M, Pays L. The Immunometabolic Gene N-Acetylglucosamine Kinase Is Uniquely Involved in the Heritability of Multiple Sclerosis Severity. Int J Mol Sci 2024; 25:3803. [PMID: 38612613 PMCID: PMC11011344 DOI: 10.3390/ijms25073803] [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: 02/23/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
The clinical severity of multiple sclerosis (MS), an autoimmune disorder of the central nervous system, is thought to be determined by environmental and genetic factors that have not yet been identified. In a recent genome-wide association study (GWAS), a single nucleotide polymorphism (SNP), rs10191329, has been associated with MS severity in two large independent cohorts of patients. Different approaches were followed by the authors to prioritize the genes that are transcriptionally regulated by such an SNP. It was concluded that the identified SNP regulates a group of proximal genes involved in brain resilience and cognitive abilities rather than immunity. Here, by conducting an alternative strategy for gene prioritization, we reached the opposite conclusion. According to our re-analysis, the main target of rs10191329 is N-Acetylglucosamine Kinase (NAGK), a metabolic gene recently shown to exert major immune functions via the regulation of the nucleotide-binding oligomerization domain-containing protein 2 (NOD2) pathway. To gain more insights into the immunometabolic functions of NAGK, we analyzed the currently known list of NAGK protein partners. We observed that NAGK integrates a dense network of human proteins that are involved in glucose metabolism and are highly expressed by classical monocytes. Our findings hold potentially major implications for the understanding of MS pathophysiology.
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Affiliation(s)
- Serge Nataf
- Bank of Tissues and Cells, Hospices Civils de Lyon, Hôpital Edouard Herriot, Place d’Arsonval, F-69003 Lyon, France
- Stem-Cell and Brain Research Institute, 18 Avenue du Doyen Lépine, F-69500 Bron, France
- Lyon-Est School of Medicine, University Claude Bernard Lyon 1, 43 Bd du 11 Novembre 1918, F-69100 Villeurbanne, France
| | - Marine Guillen
- Bank of Tissues and Cells, Hospices Civils de Lyon, Hôpital Edouard Herriot, Place d’Arsonval, F-69003 Lyon, France
- Stem-Cell and Brain Research Institute, 18 Avenue du Doyen Lépine, F-69500 Bron, France
| | - Laurent Pays
- Bank of Tissues and Cells, Hospices Civils de Lyon, Hôpital Edouard Herriot, Place d’Arsonval, F-69003 Lyon, France
- Stem-Cell and Brain Research Institute, 18 Avenue du Doyen Lépine, F-69500 Bron, France
- Lyon-Est School of Medicine, University Claude Bernard Lyon 1, 43 Bd du 11 Novembre 1918, F-69100 Villeurbanne, France
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Liu Y, Li RL, Chen L, Zhao FY, Su YL, Jin S, Liu JE. Construction and validation of a risk-prediction model for chemotherapy-related cognitive impairment in patients with breast cancer. J Cancer Surviv 2024:10.1007/s11764-024-01566-7. [PMID: 38512563 DOI: 10.1007/s11764-024-01566-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To identify risk factors of chemotherapy-related cognitive impairment (CRCI) and construct and validate a visual prediction model of such for patients with breast cancer. METHODS A multicenter, descriptive, and cross-sectional design was adopted. Data were collected from ten public tertiary hospitals in China. Cognitive function was assessed by using Functional Assessment of Cancer Therapy-cognitive function. Socio-demographic, clinical, psychological, and physical indicators were also assessed. The logistic prediction model was constructed by fivefold cross-validation. Then, a nomogram was utilized to visualize the prediction model, which was also evaluated via discrimination, calibration, and decision curve analysis. RESULTS A total of 71 breast cancer patients had CRCI with a prevalence of 9.58%. This visual prediction model was constructed based on education background, exercise frequency, chemotherapy times, and fatigue and demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.882. The calibration curve indicated good agreement between experimental and projected values, and the decision curve proved good clinical applicability. CONCLUSION Education background, exercise frequency, chemotherapy times, and fatigue were associated with high incidence of CRCI. The prediction model exhibits superior performance and has promise as a useful instrument for assessing the likelihood of CRCI in breast cancer patients. IMPLICATIONS FOR CANCER SURVIVORS Our findings could provide breast cancer survivors with risk screening based on CRCI predictors to implement prevention and early intervention, and help patients integrate into society and achieve comprehensive recovery.
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Affiliation(s)
- Yu Liu
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Ruo-Lin Li
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Lu Chen
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Fu-Yun Zhao
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Ya-Li Su
- Department of Breast Oncology, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring Road West, 100050, Beijing, China
| | - Shuai Jin
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Jun-E Liu
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China.
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Coleman MM, Keith CM, Wilhelmsen K, Mehta RI, Vieira Ligo Teixeira C, Miller M, Ward M, Navia RO, McCuddy WT, D'Haese PF, Haut MW. Surface-based correlates of cognition along the Alzheimer's continuum in a memory clinic population. Front Neurol 2023; 14:1214083. [PMID: 37731852 PMCID: PMC10508059 DOI: 10.3389/fneur.2023.1214083] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/07/2023] [Indexed: 09/22/2023] Open
Abstract
Composite cognitive measures in large-scale studies with biomarker data for amyloid and tau have been widely used to characterize Alzheimer's disease (AD). However, little is known about how the findings from these studies translate to memory clinic populations without biomarker data, using single measures of cognition. Additionally, most studies have utilized voxel-based morphometry or limited surface-based morphometry such as cortical thickness, to measure the neurodegeneration associated with cognitive deficits. In this study, we aimed to replicate and extend the biomarker, composite study relationships using expanded surface-based morphometry and single measures of cognition in a memory clinic population. We examined 271 clinically diagnosed symptomatic individuals with mild cognitive impairment (N = 93) and Alzheimer's disease dementia (N = 178), as well as healthy controls (N = 29). Surface-based morphometry measures included cortical thickness, sulcal depth, and gyrification index within the "signature areas" of Alzheimer's disease. The cognitive variables pertained to hallmark features of Alzheimer's disease including verbal learning, verbal memory retention, and language, as well as executive function. The results demonstrated that verbal learning, language, and executive function correlated with the cortical thickness of the temporal, frontal, and parietal areas. Verbal memory retention was correlated to the thickness of temporal regions and gyrification of the inferior temporal gyrus. Language was related to the temporal regions and the supramarginal gyrus' sulcal depth and gyrification index. Executive function was correlated with the medial temporal gyrus and supramarginal gyrus sulcal depth, and the gyrification index of temporal regions and supramarginal gyrus, but not with the frontal areas. Predictions of each of these cognitive measures were dependent on a combination of structures and each of the morphometry measurements, and often included medial temporal gyrus thickness and sulcal depth. Overall, the results demonstrated that the relationships between cortical thinning and cognition are widespread and can be observed using single measures of cognition in a clinically diagnosed AD population. The utility of sulcal depth and gyrification index measures may be more focal to certain brain areas and cognitive measures. The relative importance of temporal, frontal, and parietal regions in verbal learning, language, and executive function, but not verbal memory retention, was replicated in this clinic cohort.
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Affiliation(s)
- Michelle M. Coleman
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Cierra M. Keith
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
| | - Kirk Wilhelmsen
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
- Department of Neurology, West Virginia University, Morgantown, WV, United States
| | - Rashi I. Mehta
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
- Department of Neuroradiology, West Virginia University, Morgantown, WV, United States
| | | | - Mark Miller
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
| | - Melanie Ward
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
- Department of Neurology, West Virginia University, Morgantown, WV, United States
| | - Ramiro Osvaldo Navia
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
- Department of Medicine, West Virginia University, Morgantown, WV, United States
| | - William T. McCuddy
- Department of Neuropsychology, St. Joseph Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Pierre-François D'Haese
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
- Department of Neurology, West Virginia University, Morgantown, WV, United States
| | - Marc W. Haut
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, United States
- Department of Neurology, West Virginia University, Morgantown, WV, United States
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8
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Fortel I, Zhan L, Ajilore O, Wu Y, Mackin S, Leow A. Disrupted excitation-inhibition balance in cognitively normal individuals at risk of Alzheimer's disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.21.554061. [PMID: 37662359 PMCID: PMC10473582 DOI: 10.1101/2023.08.21.554061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Background Sex differences impact Alzheimer's disease (AD) neuropathology, but cell-to-network level dysfunctions in the prodromal phase are unclear. Alterations in hippocampal excitation-inhibition balance (EIB) have recently been linked to early AD pathology. Objective Examine how AD risk factors (age, APOE-ɛ4, amyloid-β) relate to hippocampal EIB in cognitively normal males and females using connectome-level measures. Methods Individuals from the OASIS-3 cohort (age 42-95) were studied (N = 437), with a subset aged 65+ undergoing neuropsychological testing (N = 231). Results In absence of AD risk factors (APOE-ɛ4/Aβ+), whole-brain EIB decreases with age more significantly in males than females (p = 0.021, β = -0.007). Regression modeling including APOE-ɛ4 allele carriers (Aβ-) yielded a significant positive AGE-by-APOE interaction in the right hippocampus for females only (p = 0.013, β = 0.014), persisting with inclusion of Aβ+ individuals (p = 0.012, β = 0.014). Partial correlation analyses of neuropsychological testing showed significant associations with EIB in females: positive correlations between right hippocampal EIB with categorical fluency and whole-brain EIB with the trail-making test (p < 0.05). Conclusion Sex differences in EIB emerge during normal aging and progresses differently with AD risk. Results suggest APOE-ɛ4 disrupts hippocampal balance more than amyloid in females. Increased excitation correlates positively with neuropsychological performance in the female group, suggesting a duality in terms of potential beneficial effects prior to cognitive impairment. This underscores the translational relevance of APOE-ɛ4 related hyperexcitation in females, potentially informing therapeutic targets or early interventions to mitigate AD progression in this vulnerable population.
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Affiliation(s)
- Igor Fortel
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL
| | - Liang Zhan
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
| | - Yichao Wu
- Department of Math, Statistics and Computer Science, University of Illinois at Chicago, Chicago, IL
| | - Scott Mackin
- Department of Psychiatry, University of California - San Francisco, San Francisco, CA
| | - Alex Leow
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
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Fountain-Zaragoza S, Liu H, Benitez A. Functional Network Alterations Associated with Cognition in Pre-Clinical Alzheimer's Disease. Brain Connect 2023; 13:275-286. [PMID: 36606679 PMCID: PMC10280291 DOI: 10.1089/brain.2022.0032] [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] [Indexed: 01/07/2023] Open
Abstract
Objective: Accumulation of cerebral amyloid-β (Aβ) is a risk factor for cognitive decline and defining feature of Alzheimer's disease (AD). Aβ is implicated in brain network disruption, but the extent to which these changes correspond with observable cognitive deficits in pre-clinical AD has not been tested. This study utilized individual-specific functional parcellations to sensitively evaluate the relationship between network connectivity and cognition in adults with and without Aβ deposition. Participants and Methods: Cognitively unimpaired adults ages 45-85 completed amyloid positron emission tomography, resting-state-functional magnetic resonance imaging (fMRI), and neuropsychological tests of episodic memory and executive function (EF). Participants in the upper tertile of mean standard uptake value ratio were considered Aβ+ (n = 50) while others were Aβ- (n = 99). Individualized functional network parcellations were generated from resting-state fMRI data. We examined the effects of group, network, and group-by-network interactions on memory and EF. Results: We observed several interactions such that within the Aβ+ group, preserved network integrity (i.e., greater connectivity within specific networks) was associated with better cognition, whereas network desegregation (i.e., greater connectivity between relative to within networks) was associated with worse cognition. This dissociation was most apparent for cognitive networks (frontoparietal, dorsal and ventral attention, limbic, and default mode), with connectivity relating to EF in the Aβ+ group specifically. Conclusions: Using an innovative approach to constructing individual-specified resting-state functional connectomes, we were able to detect differences in brain-cognition associations in pre-clinical AD. Our findings provide novel insight into specific functional network alterations occurring in the presence of Aβ that relate to cognitive function in asymptomatic individuals. Impact statement Elevated cerebral amyloid-β is a biomarker of pre-clinical Alzheimer's disease (AD). Associations between amyloidosis, functional network disruption, and cognitive impairment are evident in the later stages of AD, but these effects have not been substantiated in pre-clinical AD. Using individual-specific parcellations that maximally localize functional networks, we identify network alterations that relate to cognition in pre-clinical AD that have not been previously reported. We demonstrate that these effects localize to networks implicated in cognition. Our findings suggest that there may be subtle, amyloid-related alterations in the functional connectome that are detectable in pre-clinical AD, with potential implications for cognition in asymptomatic individuals.
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Affiliation(s)
- Stephanie Fountain-Zaragoza
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina, USA
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Hesheng Liu
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Andreana Benitez
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA
- Department of Neurology, and Medical University of South Carolina, Charleston, South Carolina, USA
- Department of Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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10
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Kurkinen M, Fułek M, Fułek K, Beszłej JA, Kurpas D, Leszek J. The Amyloid Cascade Hypothesis in Alzheimer’s Disease: Should We Change Our Thinking? Biomolecules 2023; 13:biom13030453. [PMID: 36979388 PMCID: PMC10046826 DOI: 10.3390/biom13030453] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/15/2023] [Accepted: 02/18/2023] [Indexed: 03/05/2023] Open
Abstract
Old age increases the risk of Alzheimer’s disease (AD), the most common neurodegenerative disease, a devastating disorder of the human mind and the leading cause of dementia. Worldwide, 50 million people have the disease, and it is estimated that there will be 150 million by 2050. Today, healthcare for AD patients consumes 1% of the global economy. According to the amyloid cascade hypothesis, AD begins in the brain by accumulating and aggregating Aβ peptides and forming β-amyloid fibrils (Aβ42). However, in clinical trials, reducing Aβ peptide production and amyloid formation in the brain did not slow cognitive decline or improve daily life in AD patients. Prevention studies in cognitively unimpaired people at high risk or genetically destined to develop AD also have not slowed cognitive decline. These observations argue against the amyloid hypothesis of AD etiology, its development, and disease mechanisms. Here, we look at other avenues in the research of AD, such as the presenilin hypothesis, synaptic glutamate signaling, and the role of astrocytes and the glutamate transporter EAAT2 in the development of AD.
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Affiliation(s)
| | - Michał Fułek
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Katarzyna Fułek
- Department and Clinic of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, 50-556 Wroclaw, Poland
- Correspondence: (K.F.); (J.L.)
| | | | - Donata Kurpas
- Department of Family Medicine, Wroclaw Medical University, 51-141 Wroclaw, Poland
| | - Jerzy Leszek
- Department and Clinic of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
- Correspondence: (K.F.); (J.L.)
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11
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Fortel I, Zhan L, Ajilore O, Wu Y, Mackin S, Leow A. Disrupted Excitation-Inhibition Balance in Cognitively Normal Individuals at Risk of Alzheimer's Disease. J Alzheimers Dis 2023; 95:1449-1467. [PMID: 37718795 PMCID: PMC11260287 DOI: 10.3233/jad-230035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Sex differences impact Alzheimer's disease (AD) neuropathology, but cell-to-network level dysfunctions in the prodromal phase are unclear. Alterations in hippocampal excitation-inhibition balance (EIB) have recently been linked to early AD pathology. OBJECTIVE Examine how AD risk factors (age, APOEɛ4, amyloid-β) relate to hippocampal EIB in cognitively normal males and females using connectome-level measures. METHODS Individuals from the OASIS-3 cohort (age 42-95) were studied (N = 437), with a subset aged 65+ undergoing neuropsychological testing (N = 231). RESULTS In absence of AD risk factors (APOEɛ4/Aβ+), whole-brain EIB decreases with age more significantly in males than females (p = 0.021, β= -0.007). Regression modeling including APOEɛ4 allele carriers (Aβ-) yielded a significant positive AGE-by-APOE interaction in the right hippocampus for females only (p = 0.013, β= 0.014), persisting with inclusion of Aβ+ individuals (p = 0.012, β= 0.014). Partial correlation analyses of neuropsychological testing showed significant associations with EIB in females: positive correlations between right hippocampal EIB with categorical fluency and whole-brain EIB with the Trail Making Test (p < 0.05). CONCLUSIONS Sex differences in EIB emerge during normal aging and progresses differently with AD risk. Results suggest APOEɛ4 disrupts hippocampal balance more than amyloid in females. Increased excitation correlates positively with neuropsychological performance in the female group, suggesting a duality in terms of potential beneficial effects prior to cognitive impairment. This underscores the translational relevance of APOEɛ4 related hyperexcitation in females, potentially informing therapeutic targets or early interventions to mitigate AD progression in this vulnerable population.
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Affiliation(s)
- Igor Fortel
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Liang Zhan
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Yichao Wu
- Department of Math, Statistics and Computer Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Scott Mackin
- Department of Psychiatry, University of California – San Francisco, San Francisco, CA, USA
| | - Alex Leow
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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12
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Caillaud M, Maltezos S, Hudon C, Mellah S, Belleville S. Hippocampal Volume and Episodic Associative Memory Identify Memory Risk in Subjective Cognitive Decline Individuals in the CIMA-Q Cohort, Regardless of Cognitive Reserve Level and APOE4 Status. J Alzheimers Dis 2023; 94:1047-1056. [PMID: 37355896 PMCID: PMC10473077 DOI: 10.3233/jad-230131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) was proposed to identify older adults who complain about their memory but perform within a normal range on standard neuropsychological tests. Persons with SCD are at increased risk of dementia meaning that some SCD individuals experience subthreshold memory decline due to an underlying progression of Alzheimer's disease (AD). OBJECTIVE Our main goal was to determine whether hippocampal volume and APOE4, which represent typical AD markers, predict inter-individual differences in memory performance among SCD individuals and can be used to identify a meaningful clinical subgroup. METHODS Neuropsychological assessment, structural MRI, and genetic testing for APOE4 were administered to one hundred and twenty-five older adults over the age of 65 from the CIMAQ cohort: 66 SCD, 29 individuals with mild cognitive impairment (MCI), and 30 cognitively intact controls (CTRLS). Multiple regression models were first used to identify which factor (hippocampal volume, APOE4 allele, or cognitive reserve) best predicted inter-individual differences in a Face-name association memory task within the SCD group. RESULTS Hippocampal volume was found to be the only and best predictor of memory performance. We then compared the demographic, clinical and cognitive characteristics of two SCD subgroups, one with small hippocampal volume (SCD/SH) and another with normal hippocampal volume (SCD/NH), with MCI and CTRLS. SCD/SH were comparable to MCI on neuropsychological tasks evaluating memory (i.e., test of delayed word recall), whereas SCD/NH were comparable to CTRLS. CONCLUSION Thus, using hippocampal volume allows identification of an SCD subgroup with a cognitive profile consistent with a higher risk of conversion to AD.
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Affiliation(s)
- Marie Caillaud
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Samantha Maltezos
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Carol Hudon
- CERVO Brain Research Centre, Institut Universitaire en Santé Mentale de Québec, Québec City, Québec, Canada
- VITAM Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale-Nationale, Québec City, Québec, Canada
- Department of Psychology, Université de Laval, Québec City, Québec, Canada
| | - Samira Mellah
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - the Consortium for the Early Identification of Alzheimer’s Disease-Quebec
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- CERVO Brain Research Centre, Institut Universitaire en Santé Mentale de Québec, Québec City, Québec, Canada
- VITAM Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale-Nationale, Québec City, Québec, Canada
- Department of Psychology, Université de Laval, Québec City, Québec, Canada
| | - Sylvie Belleville
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
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13
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Kleineidam L, Wolfsgruber S, Weyrauch AS, Zulka LE, Forstmeier S, Roeske S, van den Bussche H, Kaduszkiewicz H, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Brettschneider C, König HH, Weeg D, Bickel H, Luppa M, Rodriguez FS, Freiesleben SD, Erdogan S, Unterfeld C, Peters O, Spruth EJ, Altenstein S, Lohse A, Priller J, Fliessbach K, Kobeleva X, Schneider A, Bartels C, Schott BH, Wiltfang J, Maier F, Glanz W, Incesoy EI, Butryn M, Düzel E, Buerger K, Janowitz D, Ewers M, Rauchmann BS, Perneczky R, Kilimann I, Görß D, Teipel S, Laske C, Munk MHJ, Spottke A, Roy N, Brosseron F, Heneka MT, Ramirez A, Yakupov R, Scherer M, Maier W, Jessen F, Riedel-Heller SG, Wagner M. Midlife occupational cognitive requirements protect cognitive function in old age by increasing cognitive reserve. Front Psychol 2022; 13:957308. [PMID: 36571008 PMCID: PMC9773841 DOI: 10.3389/fpsyg.2022.957308] [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: 05/30/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them. Methods We systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the O*NET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE). Results Regarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM. Discussion Our results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology.
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Affiliation(s)
- Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,*Correspondence: Luca Kleineidam
| | | | - Anne-Sophie Weyrauch
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Linn E. Zulka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,Department of Psychology and Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Simon Forstmeier
- Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen, Siegen, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanna Kaduszkiewicz
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Medical Faculty, Institute of General Practice, University of Kiel, Kiel, Germany
| | - Birgitt Wiese
- Center for Information Management, Hannover Medical School, Hanover, Germany
| | - Siegfried Weyerer
- Medical Faculty, Central Institute of Mental Health, Mannheim/Heidelberg University, Heidelberg, Germany
| | - Jochen Werle
- Medical Faculty, Central Institute of Mental Health, Mannheim/Heidelberg University, Heidelberg, Germany
| | - Angela Fuchs
- Medical Faculty, Centre for Health and Society (CHS), Institute of General Practice (ifam), Heinrich Heine University, Düsseldorf, Germany
| | - Michael Pentzek
- Medical Faculty, Centre for Health and Society (CHS), Institute of General Practice (ifam), Heinrich Heine University, Düsseldorf, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dagmar Weeg
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Horst Bickel
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Melanie Luppa
- Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Francisca S. Rodriguez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Silka Dawn Freiesleben
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
| | - Selin Erdogan
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
| | - Chantal Unterfeld
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Benjamin Franklin, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
| | - Eike J. Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea Lohse
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Josef Priller
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany,University of Edinburgh and UK DRI, Edinburgh, United Kingdom
| | - Klaus Fliessbach
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Xenia Kobeleva
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Anja Schneider
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
| | - Björn H. Schott
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany,Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany,Department of Medical Sciences, Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Franziska Maier
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Enise I. Incesoy
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany,Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Michaela Butryn
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany,Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany,Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, United Kingdom,Sheeld Institute for Translational Neuroscience (SITraN), University of Sheeld, Sheeld, United Kingdom
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Doreen Görß
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany,Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Matthias H. J. Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany,Department of Biology, Technische Universität Darmstadt, Darmstadt, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Department of Neurology, University of Bonn, Bonn, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | | | - Michael T. Heneka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Alfredo Ramirez
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany,Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany,Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, United States
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Steffi G. Riedel-Heller
- Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
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14
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Song S, Gaynor AM, Gazes Y, Lee S, Xu Q, Habeck C, Stern Y, Gu Y. Physical activity moderates the association between white matter hyperintensity burden and cognitive change. Front Aging Neurosci 2022; 14:945645. [PMID: 36313016 PMCID: PMC9610117 DOI: 10.3389/fnagi.2022.945645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/20/2022] [Indexed: 01/11/2023] Open
Abstract
Objective Greater physical activity (PA) could delay cognitive decline, yet the underlying mechanisms remain unclear. White matter hyperintensity (WMH) burden is one of the key brain pathologies that have been shown to predict faster cognitive decline at a late age. One possible pathway is that PA may help maintain cognition by mitigating the detrimental effects of brain pathologies, like WMH, on cognitive change. This study aims to examine whether PA moderates the association between WMH burden and cognitive change. Materials and methods This population-based longitudinal study included 198 dementia-free adults aged 20-80 years. Leisure-time physical activity (LTPA) was assessed by a self-reported questionnaire. Occupational physical activity (OPA) was a factor score measuring the physical demands of each job. Total physical activity (TPA) was operationalized as the average of z-scores of LTPA and OPA. Outcome variables included 5-year changes in global cognition and in four reference abilities (fluid reasoning, processing speed, memory, and vocabulary). Multivariable linear regression models were used to estimate the moderation effect of PA on the association between white matter hyperintensities and cognitive change, adjusting for age, sex, education, and baseline cognition. Results Over approximately 5 years, global cognition (p < 0.001), reasoning (p < 0.001), speed (p < 0.001), and memory (p < 0.05) scores declined, and vocabulary (p < 0.001) increased. Higher WMH burden was correlated with more decline in global cognition (Spearman's rho = -0.229, p = 0.001), reasoning (rho = -0.402, p < 0.001), and speed (rho = -0.319, p < 0.001), and less increase in vocabulary (rho = -0.316, p < 0.001). Greater TPA attenuated the association between WMH burden and changes in reasoning (βTPA^*WMH = 0.029, 95% CI = 0.006-0.052, p = 0.013), speed (βTPA^*WMH = 0.035, 95% CI = -0.004-0.065, p = 0.028), and vocabulary (βTPA^*WMH = 0.034, 95% CI = 0.004-0.065, p = 0.029). OPA seemed to be the factor that exerted a stronger moderation on the relationship between WMH burden and cognitive change. Conclusion Physical activity may help maintain reasoning, speed, and vocabulary abilities in face of WMH burden. The cognitive reserve potential of PA warrants further examination.
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Affiliation(s)
- Suhang Song
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States
| | - Alexandra M. Gaynor
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
| | - Yunglin Gazes
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
- Division of Cognitive Neuroscience, Department of Neurology, Columbia University, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
| | - Seonjoo Lee
- Department of Psychiatry and Biostatistics, Columbia University, New York, NY, United States
- Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States
| | - Qianhui Xu
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Christian Habeck
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
- Division of Cognitive Neuroscience, Department of Neurology, Columbia University, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
| | - Yaakov Stern
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
- Division of Cognitive Neuroscience, Department of Neurology, Columbia University, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Yian Gu
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, United States
- Division of Cognitive Neuroscience, Department of Neurology, Columbia University, New York, NY, United States
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, United States
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15
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Almeida-Meza P, Richards M, Cadar D. Moderating Role of Cognitive Reserve Markers Between Childhood Cognition and Cognitive Aging: Evidence From the 1946 British Birth Cohort. Neurology 2022; 99:e1239-e1250. [PMID: 35922143 PMCID: PMC9576292 DOI: 10.1212/wnl.0000000000200928] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/19/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES As the population ages, differences in cognitive abilities become more evident. We investigated key genetic and life course influences on cognitive state at age 69 years, building on previous work using the longitudinal Medical Research Council National Survey of Health and Development (the British 1946 birth cohort). METHODS Multivariable regressions investigated the association between 4 factors: (1) childhood cognition at age 8 years; (2) a Cognitive Reserve Index (CRI) composed of 3 markers: (i) educational attainment by age 26 years, (ii) engagement in leisure activities at age 43 years, and (iii) occupation up to age 53 years; (3) reading ability assessed by the National Adult Reading Test (NART) at age 53 years; and (4) APOE genotype in relation to cognitive state measured at age 69 years with Addenbrooke's Cognitive Examination, third edition (ACE-III). We then investigated the modifying role of the CRI, NART, and APOE in the association between childhood cognition and the ACE-III. RESULTS The analytical sample comprised 1,184 participants. Higher scores in childhood cognition, CRI, and NART were associated with higher scores in the ACE-III. We found that the CRI and NART modified the association between childhood cognition and the ACE-III: for 30 additional points in the CRI or 20 additional points in the NART, the simple slope of childhood cognition decreased by approximately 0.10 points (CRI = 70: marginal effects (MEs) 0.22, 95% CI 0.12-0.32, p < 0.001 vs CRI = 100: MEs 0.12, 95% CI 0.06-0.17, p < 0.001; NART = 15: MEs 0.22, 95% CI 0.09-0.35, p = 0.001, vs NART = 35: MEs 0.11, 95% CI 0.05-0.17, p < 0.001). The association between childhood cognition and the ACE-III was nonsignificant at high levels of the CRI or NART. Furthermore, the e4 allele of the APOE gene was associated with lower scores in the ACE-III (β = -0.71, 95% CI -1.36 to -0.06, p = 0.03) but did not modify the association between childhood cognition and cognitive state in later life. DISCUSSION The CRI and NART are independent measures of cognitive reserve because both modify the association between childhood cognition and cognitive state.
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Affiliation(s)
- Pamela Almeida-Meza
- From the Department of Behavioural Science and Health (P.A.-M., D.C.), University College London; MRC Unit for Lifelong Health and Ageing, University College London; and Centre for Dementia Studies (D.C.), Department of Neuroscience, Brighton and Sussex Medical School, UK.
| | - Marcus Richards
- From the Department of Behavioural Science and Health (P.A.-M., D.C.), University College London; MRC Unit for Lifelong Health and Ageing, University College London; and Centre for Dementia Studies (D.C.), Department of Neuroscience, Brighton and Sussex Medical School, UK
| | - Dorina Cadar
- From the Department of Behavioural Science and Health (P.A.-M., D.C.), University College London; MRC Unit for Lifelong Health and Ageing, University College London; and Centre for Dementia Studies (D.C.), Department of Neuroscience, Brighton and Sussex Medical School, UK
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16
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Kato T, Nishita Y, Otsuka R, Inui Y, Nakamura A, Kimura Y, Ito K. Effect of cognitive reserve on amnestic mild cognitive impairment due to Alzheimer’s disease defined by fluorodeoxyglucose-positron emission tomography. Front Aging Neurosci 2022; 14:932906. [PMID: 36034127 PMCID: PMC9399434 DOI: 10.3389/fnagi.2022.932906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the effect of cognitive reserve (CR) on the rate of cognitive decline and cerebral glucose metabolism in amnestic mild cognitive impairment (MCI) using the Study on Diagnosis of Early Alzheimer’s Disease-Japan (SEAD-J) dataset. The patients in SEAD-J underwent cognitive tests and fluorodeoxyglucose-positron emission tomography (FDG-PET). MCI to be studied was classified as amnestic MCI due to Alzheimer’s disease (AD) with neurodegeneration. A total of 57 patients were visually interpreted as having an AD pattern (P1 pattern, Silverman’s classification). The 57 individuals showing the P1 pattern were divided into a high-education group (years of school education ≥13, N = 18) and a low-education group (years of school education ≤12, N = 39). Voxel-based statistical parametric mapping revealed more severe hypometabolism in the high-education group than in the low-education group. Glucose metabolism in the hippocampus and temporoparietal area was inversely associated with the years of school education in the high- and low-education groups (N = 57). General linear mixed model analyses demonstrated that cognitive decline was more rapid in the high-education group during 3-year follow-up. These results suggest that the cerebral glucose metabolism is lower and cognitive function declines faster in patients with high CR of amnestic MCI due to AD defined by FDG-PET.
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Affiliation(s)
- Takashi Kato
- Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Aichi, Japan
- *Correspondence: Takashi Kato,
| | - Yukiko Nishita
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Rei Otsuka
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Yoshitaka Inui
- Department of Radiology, Fujita Health University School of Medicine, Aichi, Japan
| | - Akinori Nakamura
- Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Aichi, Japan
- Department of Biomarker Research, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Yasuyuki Kimura
- Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kengo Ito
- Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - SEAD-J Study GroupFukuyamaHidenaoSendaMichioIshiiKenjiIshiiKazunariMaedaKiyoshiYamamotoYasujiOuchiYasuomiOkamuraAyumuArahataYutakaWashimiYukihikoMeguroKenichiIkedaMitsuruKyoto University, Kyoto, Japan; Institute of Biomedical Research and Innovation, Kobe, Japan; Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan; Kindai University, Osaka, Japan; Kobe Gakuin University, Kobe, Japan; Kobe University Graduate School of Medicine, Kobe, Japan; Hamamatsu University School of Medicine, Hamamatsu, Japan; Kizawa Memorial Hospital, Gifu, Japan; National Center for Geriatrics and Gerontology, Aichi, Japan; National Center for Geriatrics and Gerontology, Aichi, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Nagoya University School of Health Sciences, Nagoya, Japan
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17
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Cognitive reserve proxies, Alzheimer pathologies, and cognition. Neurobiol Aging 2022; 110:88-95. [PMID: 34879329 PMCID: PMC9234822 DOI: 10.1016/j.neurobiolaging.2021.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 10/09/2021] [Accepted: 10/10/2021] [Indexed: 02/03/2023]
Abstract
This study aimed to explore the moderating effects of the frequently used cognitive reserve (CR) proxies [i.e., education, premorbid intelligence quotient (pIQ), occupational complexity (OC), and lifetime cognitive activity (LCA)] on the relationships between various in vivo Alzheimer's disease (AD) pathologies and cognition. In total, 351 [268 cognitively unimpaired (CU), 83 cognitive impaired (CI)] older adults underwent multi-modal brain imaging to measure AD pathologies and cognitive assessments, and information on CR proxies was obtained. For overall participants, only education moderated the relationship between Aβ deposition and cognition. Education, pIQ, and LCA, but not OC, showed moderating effect on the relationship between AD-signature cerebral hypometabolism and cognition. In contrast, only OC had a moderating effect on the relationship between cortical atrophy of the AD-signature regions and cognition. Such moderation effects of the CR proxies were similarly observed in CI individuals, but most of them were not in CU individuals. The findings suggest that the proposed CR proxies have different moderating effects on the relationships between specific AD pathologies and cognition.
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18
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Segen V, Ying J, Morgan E, Brandon M, Wolbers T. Path integration in normal aging and Alzheimer's disease. Trends Cogn Sci 2021; 26:142-158. [PMID: 34872838 DOI: 10.1016/j.tics.2021.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 12/20/2022]
Abstract
In this review we discuss converging evidence from human and rodent research demonstrating how path integration (PI) is impaired in healthy aging and Alzheimer's disease (AD), and point to the neural mechanisms that underlie these deficits. Importantly, we highlight that (i) the grid cell network in the entorhinal cortex is crucial for PI in both humans and rodents, (ii) PI deficits are present in healthy aging and are significantly more pronounced in patients with early-stage AD, (iii) compromised entorhinal grid cell computations in healthy older adults and in young adults at risk of AD are linked to PI deficits, and (iv) PI and grid cell deficits may serve as sensitive markers for pathological decline in early AD.
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Affiliation(s)
- Vladislava Segen
- Aging and Cognition Research Group, German Center for Neurodegenerative Diseases (DZNE), Magdeburg 39120, Germany.
| | - Johnson Ying
- Douglas Hospital Research Center, McGill University, Montreal, QC, Canada
| | - Erik Morgan
- Douglas Hospital Research Center, McGill University, Montreal, QC, Canada
| | - Mark Brandon
- Douglas Hospital Research Center, McGill University, Montreal, QC, Canada
| | - Thomas Wolbers
- Aging and Cognition Research Group, German Center for Neurodegenerative Diseases (DZNE), Magdeburg 39120, Germany.
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19
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Qin Q, Fu L, Wang R, Lyu J, Ma H, Zhan M, Zhou A, Wang F, Zuo X, Wei C. Prominent Striatum Amyloid Retention in Early-Onset Familial Alzheimer's Disease With PSEN1 Mutations: A Pilot PET/MR Study. Front Aging Neurosci 2021; 13:732159. [PMID: 34603009 PMCID: PMC8480470 DOI: 10.3389/fnagi.2021.732159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022] Open
Abstract
Background: With the advancements of amyloid imaging in recent years, this new imaging diagnostic method has aroused great interest from researchers. Till now, little is known regarding amyloid deposition specialty in patients with early-onset familial Alzheimer's disease (EOFAD), and even less is known about its role in cognitive impairments. Objectives: Our study aimed to evaluate the amyloid deposition in five patients with EOFAD, 15 patients with late-onset sporadic AD, and 12 healthy subjects utilizing 11C-labeled Pittsburgh compound-B (11C-PiB) amyloid PET imaging. Moreover, we figured out the correlation between striatal and cortical standardized uptake value ratios (SUVRs). We also investigated the correlation between 11C-PiB retention and cognitive presentation. Results: All patients with EOFAD showed high amyloid deposition in the striatum, a pattern that is not usually seen in patients with late-onset sporadic AD. The SUVR in the striatum, especially in the amygdala, showed significant correlations with cortex SUVR in EOFAD. However, neither striatal nor cortical 11C-PiB retention was related to cognitive decline. Conclusions: The amyloid distribution in patients with EOFAD differs from late-onset sporadic AD, with higher amyloid deposits in the striatum. Our study also demonstrated positive correlations in 11C-PiB retention between the striatum and other cortical areas. We revealed that the distribution of amyloid in the brain is not random but diffuses following the functional and anatomical connections. However, the degree and pattern of amyloid deposition were not correlated with cognitive deficits.
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Affiliation(s)
- Qi Qin
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Liping Fu
- Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing, China.,Department of Nuclear Medicine, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ruimin Wang
- Department of Nuclear Medicine, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jihui Lyu
- Center for Cognitive Disorders, Beijing Geriatric Hospital, Beijing, China
| | - Huixuan Ma
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Minmin Zhan
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Aihong Zhou
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Fen Wang
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Xiumei Zuo
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Cuibai Wei
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
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20
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Espay AJ, Sturchio A, Schneider LS, Ezzat K. Soluble Amyloid-β Consumption in Alzheimer's Disease. J Alzheimers Dis 2021; 82:1403-1415. [PMID: 34151810 DOI: 10.3233/jad-210415] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Brain proteins function in their soluble, native conformation and cease to function when transformed into insoluble aggregates, also known as amyloids. Biophysically, the soluble-to-insoluble phase transformation represents a process of polymerization, similar to crystallization, dependent on such extrinsic factors as concentration, pH, and a nucleation surface. The resulting cross-β conformation of the insoluble amyloid is markedly stable, making it an unlikely source of toxicity. The spread of brain amyloidosis can be fully explained by mechanisms of spontaneous or catalyzed polymerization and phase transformation instead of active replication, which is an enzyme- and energy-requiring process dependent on a specific nucleic acid code for the transfer of biological information with high fidelity. Early neuronal toxicity in Alzheimer's disease may therefore be mediated to a greater extent by a reduction in the pool of soluble, normal-functioning protein than its accumulation in the polymerized state. This alternative loss-of-function hypothesis of pathogenicity can be examined by assessing the clinical and neuroimaging effects of administering non-aggregating peptide analogs to replace soluble amyloid-β levels above the threshold below which neuronal toxicity may occur. Correcting the depletion of soluble amyloid-β, however, would only exemplify 'rescue medicine.' Precision medicine will necessitate identifying the pathogenic factors catalyzing the protein aggregation in each affected individual. Only then can we stratify patients for etiology-specific treatments and launch precision medicine for Alzheimer's disease and other neurodegenerative disorders.
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Affiliation(s)
- Alberto J Espay
- James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Andrea Sturchio
- James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA.,Department of Clinical Neuroscience, Neuro Svenningsson, Karolinska Institute, 171 76 Stockholm, Sweden
| | - Lon S Schneider
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kariem Ezzat
- Department of Laboratory Medicine, Clinical Research Center, Karolinska Institutet, Stockholm, Sweden
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21
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Kwak S, Kim H, Kim H, Youm Y, Chey J. Distributed functional connectivity predicts neuropsychological test performance among older adults. Hum Brain Mapp 2021; 42:3305-3325. [PMID: 33960591 PMCID: PMC8193511 DOI: 10.1002/hbm.25436] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 01/30/2023] Open
Abstract
Neuropsychological test is an essential tool in assessing cognitive and functional changes associated with late-life neurocognitive disorders. Despite the utility of the neuropsychological test, the brain-wide neural basis of the test performance remains unclear. Using the predictive modeling approach, we aimed to identify the optimal combination of functional connectivities that predicts neuropsychological test scores of novel individuals. Resting-state functional connectivity and neuropsychological tests included in the OASIS-3 dataset (n = 428) were used to train the predictive models, and the identified models were iteratively applied to the holdout internal test set (n = 216) and external test set (KSHAP, n = 151). We found that the connectivity-based predicted score tracked the actual behavioral test scores (r = 0.08-0.44). The predictive models utilizing most of the connectivity features showed better accuracy than those composed of focal connectivity features, suggesting that its neural basis is largely distributed across multiple brain systems. The discriminant and clinical validity of the predictive models were further assessed. Our results suggest that late-life neuropsychological test performance can be formally characterized with distributed connectome-based predictive models, and further translational evidence is needed when developing theoretically valid and clinically incremental predictive models.
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Affiliation(s)
- Seyul Kwak
- Department of PsychologySeoul National UniversitySeoulRepublic of Korea
| | - Hairin Kim
- Department of PsychologySeoul National UniversitySeoulRepublic of Korea
| | - Hoyoung Kim
- Department of PsychologyChonbuk National UniversityJeonjuRepublic of Korea
| | - Yoosik Youm
- Department of SociologyYonsei UniversitySeoulRepublic of Korea
| | - Jeanyung Chey
- Department of PsychologySeoul National UniversitySeoulRepublic of Korea
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22
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Busatto GF, de Gobbi Porto FH, Faria DDP, Squarzoni P, Coutinho AM, Garcez AT, Rosa PGP, da Costa NA, Carvalho CL, Torralbo L, de Almeida Hernandes JR, Ono CR, Brucki SMD, Nitrini R, Buchpiguel CA, Souza Duran FL, Forlenza OV. In vivo imaging evidence of poor cognitive resilience to Alzheimer's disease pathology in subjects with very low cognitive reserve from a low-middle income environment. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12122. [PMID: 33426265 PMCID: PMC7780143 DOI: 10.1002/dad2.12122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/09/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Reduced cognitive reserve (CR) due to very low educational (VLE) levels may influence high dementia rates in low-middle income environments, leading to decreased cognitive resilience (RES) to Alzheimer´s disease (AD) pathology. However, in vivo findings in VLE groups confirming this prediction are lacking. METHODS Cognitively impaired patients (with clinically defined AD dementia or amnestic mild cognitive impairment) and cognitively unimpaired older adults (n = 126) were recruited for a positron emission tomography (PET) and magnetic resonance imaging (MRI) investigation in Brazil, including 37 VLE individuals (≤5 years of education). A CR score was generated combining educational attainment and vocabulary knowledge. RES indices to AD pathology were calculated using standardized residuals from linear regression models relating current cognitive performance (episodic memory or overall cognition) to amyloid beta (Aβ) burden Pittsburgh compound-B ([11C]PiB-PET). RESULTS Aβ burden was lower in VLE relative to highly-educated subjects (controlling for age, sex, and Mini-Mental Status Exam [MMSE] scores) in the overall cognitively impaired sample, and in dementia subjects when the three clinically defined groups were evaluated separately. In bivariate regression analyses for the overall sample, the RES index based on a composite cognitive score was predicted by CR, socioeconomic status, and hippocampal volume (but not white matter hyperintensities or intracranial volume [ICV]); in the multivariate model, only CR retained significance (and similar results were obtained in the Aβ-positive subsample). In the multivariate model for the overall sample using the RES index based on memory performance, CR, hippocampal volume, and ICV were significant predictors, whereas only CR retained significance in Aβ-positive subjects. DISCUSSION Lower CR consistently predicted less resilience to AD pathology in older adults from a low-middle income environment.
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Affiliation(s)
- Geraldo F. Busatto
- Laboratory of Psychiatric Neuroimaging (LIM 21)Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Fabio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM 21)Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Daniele de Paula Faria
- Laboratory of Nuclear Medicine (LIM43)Department of Radiology and OncologyFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Paula Squarzoni
- Laboratory of Psychiatric Neuroimaging (LIM 21)Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Artur Martins Coutinho
- Laboratory of Nuclear Medicine (LIM43)Department of Radiology and OncologyFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Alexandre Teles Garcez
- Laboratory of Nuclear Medicine (LIM43)Department of Radiology and OncologyFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Pedro Gomes Penteado Rosa
- Laboratory of Psychiatric Neuroimaging (LIM 21)Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Naomi Antunes da Costa
- Laboratory of Psychiatric Neuroimaging (LIM 21)Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Cleudiana Lima Carvalho
- Laboratory of Psychiatric Neuroimaging (LIM 21)Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Leticia Torralbo
- Laboratory of Psychiatric Neuroimaging (LIM 21)Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Jullie Rosana de Almeida Hernandes
- Laboratory of Psychiatric Neuroimaging (LIM 21)Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Carla Rachel Ono
- Laboratory of Nuclear Medicine (LIM43)Department of Radiology and OncologyFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | | | - Ricardo Nitrini
- Department of NeurologyFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine (LIM43)Department of Radiology and OncologyFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Fabio Luis Souza Duran
- Laboratory of Psychiatric Neuroimaging (LIM 21)Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
| | - Orestes Vicente Forlenza
- Laboratory of Neuroscience (LIM 27)Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloBrazil
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23
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Bartrés‐Faz D, Arenaza‐Urquijo E, Ewers M, Belleville S, Chételat G, Franzmeier N, Gonneaud J, de Echevarri JMG, Okonkwo O, Schultz S, Valenzuela M, Stern Y, Vemuri P. Theoretical frameworks and approaches used within the Reserve, Resilience and Protective Factors professional interest area of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12115. [PMID: 33204812 PMCID: PMC7656169 DOI: 10.1002/dad2.12115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Reserve, resilience, maintenance, and related concepts are intensely debated in aging and Alzheimer's disease research. METHODS Through a short survey, we gathered information about theoretical concepts and methodologies used among research groups of the Reserve, Resilience, and Protective Factors Professional Interest Area of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment. RESULTS Overall 53 research groups responded. Reserve and resilience were the most frequently used conceptual frameworks. Education, occupation, leisure, and social activities were frequently used as measures, as were longitudinal designs. Neuropsychological assessments were almost universal, and usage of imaging biomarkers was frequent. In observational-epidemiological study designs, resilience and reserve together (vs reserve alone) were commonly used as theoretical frameworks. DISCUSSION We provide a first description of concepts and methodologies used among reserve and resilience researchers. This will inform initiatives aiming to reach consensus on terminology and applications to establish common definitions.
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Affiliation(s)
- David Bartrés‐Faz
- Department of MedicineFaculty of Medicine and Health SciencesInstitute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
- Guttmann Brain Health InstituteInstitut Universitari de Neurorehabilitació GuttmannAutonomous University of BarcelonaBadalonaSpain
| | | | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD)University HospitalLMU MunichMunichGermany
| | - Sylvie Belleville
- Research CenterInstitut Universitaire de Gériatrie de Montréal and Department of PsychologyUniversité de MontréalMontrealCanada
| | - Gaël Chételat
- UNICAENINSERMU1237PhIND “Physiopathology and Imaging of Neurological Disorders,”Normandie UniversityParisFrance
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD)University HospitalLMU MunichMunichGermany
| | - Julie Gonneaud
- Douglas Mental Health InstituteMcGill UniversityMontrealCanada
| | | | - Ozioma Okonkwo
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Stephanie Schultz
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Michael Valenzuela
- School of Psychiatry, MedicineUniversity of New South WalesSydneyAustralia
| | - Yaakov Stern
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityNew YorkNew YorkUSA
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Hohman TJ, Kaczorowski CC. Modifiable Lifestyle Factors in Alzheimer Disease: An Opportunity to Transform the Therapeutic Landscape Through Transdisciplinary Collaboration. JAMA Neurol 2020; 77:1207-1209. [PMID: 32597936 DOI: 10.1001/jamaneurol.2020.1114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Timothy J Hohman
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
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25
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Wallace LMK, Theou O, Darvesh S, Bennett DA, Buchman AS, Andrew MK, Kirkland SA, Fisk JD, Rockwood K. Neuropathologic burden and the degree of frailty in relation to global cognition and dementia. Neurology 2020; 95:e3269-e3279. [PMID: 32989103 DOI: 10.1212/wnl.0000000000010944] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 08/06/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To test the hypothesis that degree of frailty and neuropathologic burden independently contribute to global cognition and odds of dementia. METHODS This was a secondary analysis of a prospective cohort study of older adults living in Illinois. Participants underwent an annual neuropsychological and clinical evaluation. We included 625 participants (mean age 89.7 ± 6.1 years; 67.5% female) who died and underwent autopsy. We quantified neuropathology using an index measure of 10 neuropathologic features: β-amyloid deposition, hippocampal sclerosis, Lewy bodies, tangle density, TDP-43, cerebral amyloid angiopathy, arteriolosclerosis, atherosclerosis, and gross and chronic cerebral infarcts. Clinical consensus determined dementia status, which we coded as no cognitive impairment, mild cognitive impairment, or dementia. A battery of 19 tests spanning multiple domains quantified global cognition. We operationalized frailty using a 41-item frailty index. We employed regression analyses to model relationships between neuropathology, frailty, and dementia. RESULTS Both frailty and a neuropathology index were independently associated with global cognition and dementia status. These results held after controlling for traditional pathologic measures in a sample of participants with Alzheimer clinical syndrome. Frailty improved the fit of the model for dementia status (χ2[2] 72.64; p < 0.0001) and explained an additional 11%-12% of the variance in the outcomes. CONCLUSION Dementia is a multiply determined condition, to which both general health, as captured by frailty, and neuropathology significantly contribute. This integrative view of dementia and health has implications for prevention and therapy; specifically, future research should evaluate frailty as a means of dementia risk reduction.
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Affiliation(s)
- Lindsay M K Wallace
- From the Departments of Medicine (L.M.K.W., O.T., S.D., M.K.A., J.D.F., K.R.), Physiotherapy (O.T.), Community Health and Epidemiology (S.K.), and Psychiatry (J.D.F.), Dalhousie University, Halifax, Canada; and Rush Alzheimer's Disease Center (D.A.B., A.S.B.), Rush University Medical Center, Chicago, IL
| | - Olga Theou
- From the Departments of Medicine (L.M.K.W., O.T., S.D., M.K.A., J.D.F., K.R.), Physiotherapy (O.T.), Community Health and Epidemiology (S.K.), and Psychiatry (J.D.F.), Dalhousie University, Halifax, Canada; and Rush Alzheimer's Disease Center (D.A.B., A.S.B.), Rush University Medical Center, Chicago, IL
| | - Sultan Darvesh
- From the Departments of Medicine (L.M.K.W., O.T., S.D., M.K.A., J.D.F., K.R.), Physiotherapy (O.T.), Community Health and Epidemiology (S.K.), and Psychiatry (J.D.F.), Dalhousie University, Halifax, Canada; and Rush Alzheimer's Disease Center (D.A.B., A.S.B.), Rush University Medical Center, Chicago, IL
| | - David A Bennett
- From the Departments of Medicine (L.M.K.W., O.T., S.D., M.K.A., J.D.F., K.R.), Physiotherapy (O.T.), Community Health and Epidemiology (S.K.), and Psychiatry (J.D.F.), Dalhousie University, Halifax, Canada; and Rush Alzheimer's Disease Center (D.A.B., A.S.B.), Rush University Medical Center, Chicago, IL
| | - Aron S Buchman
- From the Departments of Medicine (L.M.K.W., O.T., S.D., M.K.A., J.D.F., K.R.), Physiotherapy (O.T.), Community Health and Epidemiology (S.K.), and Psychiatry (J.D.F.), Dalhousie University, Halifax, Canada; and Rush Alzheimer's Disease Center (D.A.B., A.S.B.), Rush University Medical Center, Chicago, IL
| | - Melissa K Andrew
- From the Departments of Medicine (L.M.K.W., O.T., S.D., M.K.A., J.D.F., K.R.), Physiotherapy (O.T.), Community Health and Epidemiology (S.K.), and Psychiatry (J.D.F.), Dalhousie University, Halifax, Canada; and Rush Alzheimer's Disease Center (D.A.B., A.S.B.), Rush University Medical Center, Chicago, IL
| | - Susan A Kirkland
- From the Departments of Medicine (L.M.K.W., O.T., S.D., M.K.A., J.D.F., K.R.), Physiotherapy (O.T.), Community Health and Epidemiology (S.K.), and Psychiatry (J.D.F.), Dalhousie University, Halifax, Canada; and Rush Alzheimer's Disease Center (D.A.B., A.S.B.), Rush University Medical Center, Chicago, IL
| | - John D Fisk
- From the Departments of Medicine (L.M.K.W., O.T., S.D., M.K.A., J.D.F., K.R.), Physiotherapy (O.T.), Community Health and Epidemiology (S.K.), and Psychiatry (J.D.F.), Dalhousie University, Halifax, Canada; and Rush Alzheimer's Disease Center (D.A.B., A.S.B.), Rush University Medical Center, Chicago, IL
| | - Kenneth Rockwood
- From the Departments of Medicine (L.M.K.W., O.T., S.D., M.K.A., J.D.F., K.R.), Physiotherapy (O.T.), Community Health and Epidemiology (S.K.), and Psychiatry (J.D.F.), Dalhousie University, Halifax, Canada; and Rush Alzheimer's Disease Center (D.A.B., A.S.B.), Rush University Medical Center, Chicago, IL.
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Cognitive and neuropsychological examination of the elderly. HANDBOOK OF CLINICAL NEUROLOGY 2020. [PMID: 31753159 DOI: 10.1016/b978-0-12-804766-8.00006-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
Neuropsychological assessment plays a prominent role in the evaluation and care of patients with neurodegenerative diseases throughout the dynamic course of disease. As a biomarker of disease, neuropsychological measurement can distinguish normal from pathologic aging processes. Further, neuropsychological data can help distinguish and classify underlying pathologies in dementing diseases, augmenting imaging and biofluid markers in this area. Neuropsychological data can predict increased or reduced risk for dementia conferred by multiple factors, and describe disease trajectory in affected individuals. Cognitive evaluation can also estimate and address functional outcomes that are most important to patients and their loved ones and that are clinically relevant to diagnostic staging. In informing intervention and patient care needs, areas of cognitive weakness highlight targets for support/intervention, while areas of cognitive strength can be capitalized upon to modify the clinical course of disease. These functions can be accomplished through the complementary use of brief screening tools and comprehensive test batteries. However, for neuropsychological data to serve these functions, it is critical to understand neuropsychological test properties and nondisease factors that can account for variance in test performance. This chapter concludes with directions for future research.
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27
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Lee Y, Yi D, Seo EH, Han JY, Joung H, Byun MS, Lee JH, Jun J, Lee DY. Resting State Glucose Utilization and Adult Reading Test Performance. Front Aging Neurosci 2020; 12:48. [PMID: 32194392 PMCID: PMC7066080 DOI: 10.3389/fnagi.2020.00048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/11/2020] [Indexed: 12/02/2022] Open
Abstract
Adult reading tests (ART) have been widely used in both research and clinical settings as a measure of premorbid cognitive abilities or cognitive reserve. However, the neural substrates underlying ART performance are largely unknown. Furthermore, it has not yet been examined whether the neural substrates of ART performance reflect the cortical regions associated with premorbid intelligence or cognitive reserve. The aim of the study is to identify the functional neural correlates of ART performance using 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging in the cognitively normal (CN) middle- and old-aged adults. Voxel-wise analyses revealed positive correlations between glucose metabolism and ART performance in the frontal and primary somatosensory regions, more specifically the lateral frontal cortex, anterior cingulate cortex and postcentral gyrus (PCG). When conducted again only for amyloid-β (Aβ)-negative individuals, the voxel-wise analysis showed significant correlations in broader areas of the frontal and primary somatosensory regions. This is the first neuroimaging study to directly demonstrate the cerebral resting-state glucose utilization associated with ART performance. Our findings provide important evidence at the neural level that ART predicts premorbid general intelligence and cognitive reserve, as brain areas that showed significant correlations with ART performance correspond to regions that have been associated with general intelligence and cognitive reserve.
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Affiliation(s)
- Younghwa Lee
- Interdisciplinary Program of Cognitive Science, Seoul National University, Seoul, South Korea
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea
| | - Eun Hyun Seo
- Premedical Science, College of Medicine, Chosun University, Gwangju, South Korea
| | - Ji Young Han
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Haejung Joung
- Interdisciplinary Program of Cognitive Science, Seoul National University, Seoul, South Korea
| | - Min Soo Byun
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Sungnam, South Korea
| | - Jun Ho Lee
- Department of Geriatric Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Jongho Jun
- Department of Linguistics, Seoul National University, Seoul, South Korea
| | - Dong Young Lee
- Interdisciplinary Program of Cognitive Science, Seoul National University, Seoul, South Korea.,Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea
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Alm KH, Faria AV, Moghekar A, Pettigrew C, Soldan A, Mori S, Albert M, Bakker A. Medial temporal lobe white matter pathway variability is associated with individual differences in episodic memory in cognitively normal older adults. Neurobiol Aging 2020; 87:78-88. [PMID: 31874745 PMCID: PMC7064393 DOI: 10.1016/j.neurobiolaging.2019.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/01/2019] [Accepted: 11/16/2019] [Indexed: 11/29/2022]
Abstract
Significant evidence demonstrates that aging is associated with variability in cognitive performance, even among individuals who are cognitively normal. In this study, we examined measures from magnetic resonance imaging and cerebrospinal fluid (CSF) to investigate which measures, alone or in combination, were associated with individual differences in episodic memory performance. Using hierarchical linear regressions, we compared the ability of diffusion tensor imaging (DTI) metrics, CSF measures of amyloid and tau, and gray matter volumes to explain variability in memory performance in a cohort of cognitively normal older adults. Measures of DTI microstructure were significantly associated with variance in memory performance, even after accounting for the contribution of the CSF and magnetic resonance imaging gray matter volume measures. Significant associations were found between DTI measures of the hippocampal cingulum and fornix with individual differences in memory. No such relationships were found between memory performance and CSF markers or gray matter volumes. These findings suggest that DTI metrics may be useful in identifying changes associated with aging or age-related diseases.
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Affiliation(s)
- Kylie H Alm
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Andreia V Faria
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Abhay Moghekar
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Corinne Pettigrew
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Anja Soldan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Susumu Mori
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Arnold Bakker
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
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Challenges and Opportunities with Causal Discovery Algorithms: Application to Alzheimer's Pathophysiology. Sci Rep 2020; 10:2975. [PMID: 32076020 PMCID: PMC7031278 DOI: 10.1038/s41598-020-59669-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/28/2020] [Indexed: 12/20/2022] Open
Abstract
Causal Structure Discovery (CSD) is the problem of identifying causal relationships from large quantities of data through computational methods. With the limited ability of traditional association-based computational methods to discover causal relationships, CSD methodologies are gaining popularity. The goal of the study was to systematically examine whether (i) CSD methods can discover the known causal relationships from observational clinical data and (ii) to offer guidance to accurately discover known causal relationships. We used Alzheimer's disease (AD), a complex progressive disease, as a model because the well-established evidence provides a "gold-standard" causal graph for evaluation. We evaluated two CSD methods, Fast Causal Inference (FCI) and Fast Greedy Equivalence Search (FGES) in their ability to discover this structure from data collected by the Alzheimer's Disease Neuroimaging Initiative (ADNI). We used structural equation models (which is not designed for CSD) as control. We applied these methods under three scenarios defined by increasing amounts of background knowledge provided to the methods. The methods were evaluated by comparing the resulting causal relationships with the "gold standard" graph that was constructed from literature. Dedicated CSD methods managed to discover graphs that nearly coincided with the gold standard. For best results, CSD algorithms should be used with longitudinal data providing as much prior knowledge as possible.
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Atayde AL, Fischer CE, Schweizer TA, Munoz DG. Neuropsychiatric Inventory-Assessed Nighttime Behavior Accompanies, but Does Not Precede, Progressive Cognitive Decline Independent of Alzheimer's Disease Histopathology. J Alzheimers Dis 2020; 74:839-850. [PMID: 32116249 DOI: 10.3233/jad-190907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The relationship between sleep, neuropathology, and clinical manifestations of Alzheimer's disease (AD) remains controversial. OBJECTIVE To determine whether nighttime behaviors (NTB) are associated with the development of AD histopathology or cognitive decline. METHODS We compared NTB prevalence in subjects with or without AD lesions, and with or without progressive cognitive decline. Subjects with either absent or severe plaques and tangles were identified from the National Alzheimer's Disease Coordinating Center data sets and classified as cognitively declining if the standard deviation from their individual mean Mini-Mental Status Examination score was ≥2, and stable if <2 regardless of their initial score. NTB was assessed using the Neuropsychiatric Inventory Questionnaire Quick Version (NPI-Q). RESULTS NTB was significantly greater in decliners than stable subjects in the group with severe histopathology as determined by frequent plaques (p = 0.003) or high Braak stage (p = 0.002). A similar significant trend was observed in subjects with absent plaques (p = 0.019) or tangles (p = 0.006). The prevalence of NTB was comparable between stable AD and non-AD subjects. NTB severity scores showed a similar pattern. CONCLUSION The development of NTB as assessed by NPI-Q in subjects with or without AD lesions occurred concurrently with cognitive decline. Among cognitively stable subjects, the presence of AD histopathology did not alter NTB prevalence. Thus, NTB disruptions at the gross granularity level assessed by NPI-Q were much more closely related to cognitive decline than the formation of pathological lesions. Factors other than AD histopathology may mediate the association between NTB and cognitive decline.
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Affiliation(s)
- Adrienne L Atayde
- Keenan Research Centre for Biomedical Research, the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Research, the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Tom A Schweizer
- Keenan Research Centre for Biomedical Research, the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
- Department of Surgery, Division of Neurosurgery, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Neurosurgery, St. Michael's Hospital, Toronto, Canada
| | - David G Munoz
- Keenan Research Centre for Biomedical Research, the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Division of Pathology, St. Michael's Hospital, Toronto, Canada
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Bauer CE, Brown CA, Gold BT. Education does not protect cognitive function from brain pathology in the ADNI 2 cohort. Neurobiol Aging 2019; 90:147-149. [PMID: 31889559 DOI: 10.1016/j.neurobiolaging.2019.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/30/2019] [Accepted: 11/22/2019] [Indexed: 01/08/2023]
Abstract
Educational attainment is widely accepted as a cognitive reserve variable. However, few studies have demonstrated that education statistically moderates the effects of pathology on cognition. Here, we explored this issue in a sample of 441 Alzheimer's disease (AD) and mild cognitive impairment participants from the Alzheimer's Disease Neuroimaging Initiative cohort who had AD markers (Aβ42, tau, structural brain volumes) at baseline and underwent cognitive testing at baseline and at 6-month, 12-month, and 24-month time points. An AD-related biomarker (atrophy/pathology) composite at baseline was developed using stepwise backward linear regression. Potential moderation effects of education on the relationship between AD biomarkers and cognition were explored using linear mixed models. Education was positively correlated with cognition, and biomarkers were negatively correlated with cognition, across domains and diagnostic groups. However, education generally did not moderate the effects of biomarkers on baseline or longitudinal cognition. Our results do not support the hypothesis that education protects cognitive function from brain pathology in the Alzheimer's Disease Neuroimaging Initiative cohort, questioning its accepted status as a reserve variable.
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Affiliation(s)
| | | | - Brian T Gold
- Department of Neuroscience, Lexington, KY, USA; University of Kentucky and Sanders-Brown Center on Aging, Lexington, KY, USA.
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Menardi A, Pascual-Leone A, Fried PJ, Santarnecchi E. The Role of Cognitive Reserve in Alzheimer's Disease and Aging: A Multi-Modal Imaging Review. J Alzheimers Dis 2019; 66:1341-1362. [PMID: 30507572 DOI: 10.3233/jad-180549] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Comforts in modern society have generally been associated with longer survival rates, enabling individuals to reach advanced age as never before in history. With the increase in longevity, however, the incidence of neurodegenerative diseases, especially Alzheimer's disease, has also doubled. Nevertheless, most of the observed variance, in terms of time of clinical diagnosis and progression, often remains striking. Only recently, differences in the social, educational and occupational background of the individual, as proxies of cognitive reserve (CR), have been hypothesized to play a role in accounting for such discrepancies. CR is a well-established concept in literature; lots of studies have been conducted in trying to better understand its underlying neural substrates and associated biomarkers, resulting in an incredible amount of data being produced. Here, we aimed to summarize recent relevant published work addressing the issue, gathering evidence for the existence of a common path across research efforts that might ease future investigations by providing a general perspective on the actual state of the arts. An innovative model is hereby proposed, addressing the role of CR across structural and functional evidences, as well as the potential implementation of non-invasive brain stimulation techniques in the causal validation of such theoretical frame.
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Affiliation(s)
- Arianna Menardi
- Brain Investigation and Neuromodulation Lab, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy.,Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Emiliano Santarnecchi
- Brain Investigation and Neuromodulation Lab, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy.,Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Wang L, Heywood A, Stocks J, Bae J, Ma D, Popuri K, Toga AW, Kantarci K, Younes L, Mackenzie IR, Zhang F, Beg MF, Rosen H. Grant Report on PREDICT-ADFTD: Multimodal Imaging Prediction of AD/FTD and Differential Diagnosis. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2019; 4:e190017. [PMID: 31754634 PMCID: PMC6868780 DOI: 10.20900/jpbs.20190017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We report on the ongoing project "PREDICT-ADFTD: Multimodal Imaging Prediction of AD/FTD and Differential Diagnosis" describing completed and future work supported by this grant. This project is a multi-site, multi-study collaboration effort with research spanning seven sites across the US and Canada. The overall goal of the project is to study neurodegeneration within Alzheimer's Disease, Frontotemporal Dementia, and related neurodegenerative disorders, using a variety of brain imaging and computational techniques to develop methods for the early and accurate prediction of disease and its course. The overarching goal of the project is to develop the earliest and most accurate biomarker that can differentiate clinical diagnoses to inform clinical trials and patient care. In its third year, this project has already completed several projects to achieve this goal, focusing on (1) structural MRI (2) machine learning and (3) FDG-PET and multimodal imaging. Studies utilizing structural MRI have identified key features of underlying pathology by studying hippocampal deformation that is unique to clinical diagnosis and also post-mortem confirmed neuropathology. Several machine learning experiments have shown high classification accuracy in the prediction of disease based on Convolutional Neural Networks utilizing MRI images as input. In addition, we have also achieved high accuracy in predicting conversion to DAT up to five years in the future. Further, we evaluated multimodal models that combine structural and FDG-PET imaging, in order to compare the predictive power of multimodal to unimodal models. Studies utilizing FDG-PET have shown significant predictive ability in the prediction and progression of disease.
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Affiliation(s)
- Lei Wang
- Northwestern University Feinberg School of Medicine, Chicago, 60611 IL, USA
| | - Ashley Heywood
- Northwestern University Feinberg School of Medicine, Chicago, 60611 IL, USA
| | - Jane Stocks
- Northwestern University Feinberg School of Medicine, Chicago, 60611 IL, USA
| | - Jinhyeong Bae
- Northwestern University Feinberg School of Medicine, Chicago, 60611 IL, USA
| | - Da Ma
- School of Engineering Science, Simon Fraser University, Burnaby, V6A1S6 BC, Canada
| | - Karteek Popuri
- School of Engineering Science, Simon Fraser University, Burnaby, V6A1S6 BC, Canada
| | - Arthur W. Toga
- Keck School of Medicine of University of Southern California, Los Angeles, 90033 CA, USA
| | - Kejal Kantarci
- Departments of Neurology and Radiology, Mayo Clinic, Rochester, 55905 MN, USA
| | - Laurent Younes
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, 21218 MD, USA
| | - Ian R. Mackenzie
- Department of Pathology and Lab Medicine, University of British Columbia, Vancouver, B6T1Z4 BC, Canada
| | - Fengqing Zhang
- Department of Psychology, Drexel University, Philadelphia, 19104 PA, USA
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, V6A1S6 BC, Canada
| | - Howard Rosen
- Department of Neurology, University of California, San Francisco, 94143 CA, USA
| | - Alzheimer’s Disease Neuroimaging Initiative
- Data used in preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (http://adni.loni.usc.edu/). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNIAcknowledgement_List.pdf
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Franzmeier N, Düzel E, Jessen F, Buerger K, Levin J, Duering M, Dichgans M, Haass C, Suárez-Calvet M, Fagan AM, Paumier K, Benzinger T, Masters CL, Morris JC, Perneczky R, Janowitz D, Catak C, Wolfsgruber S, Wagner M, Teipel S, Kilimann I, Ramirez A, Rossor M, Jucker M, Chhatwal J, Spottke A, Boecker H, Brosseron F, Falkai P, Fliessbach K, Heneka MT, Laske C, Nestor P, Peters O, Fuentes M, Menne F, Priller J, Spruth EJ, Franke C, Schneider A, Kofler B, Westerteicher C, Speck O, Wiltfang J, Bartels C, Araque Caballero MÁ, Metzger C, Bittner D, Weiner M, Lee JH, Salloway S, Danek A, Goate A, Schofield PR, Bateman RJ, Ewers M. Left frontal hub connectivity delays cognitive impairment in autosomal-dominant and sporadic Alzheimer's disease. Brain 2019; 141:1186-1200. [PMID: 29462334 PMCID: PMC5888938 DOI: 10.1093/brain/awy008] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 12/01/2017] [Indexed: 12/02/2022] Open
Abstract
Patients with Alzheimer’s disease vary in their ability to sustain cognitive abilities in the presence of brain pathology. A major open question is which brain mechanisms may support higher reserve capacity, i.e. relatively high cognitive performance at a given level of Alzheimer’s pathology. Higher functional MRI-assessed functional connectivity of a hub in the left frontal cortex is a core candidate brain mechanism underlying reserve as it is associated with education (i.e. a protective factor often associated with higher reserve) and attenuated cognitive impairment in prodromal Alzheimer’s disease. However, no study has yet assessed whether such hub connectivity of the left frontal cortex supports reserve throughout the evolution of pathological brain changes in Alzheimer’s disease, including the presymptomatic stage when cognitive decline is subtle. To address this research gap, we obtained cross-sectional resting state functional MRI in 74 participants with autosomal dominant Alzheimer’s disease, 55 controls from the Dominantly Inherited Alzheimer’s Network and 75 amyloid-positive elderly participants, as well as 41 amyloid-negative cognitively normal elderly subjects from the German Center of Neurodegenerative Diseases multicentre study on biomarkers in sporadic Alzheimer’s disease. For each participant, global left frontal cortex connectivity was computed as the average resting state functional connectivity between the left frontal cortex (seed) and each voxel in the grey matter. As a marker of disease stage, we applied estimated years from symptom onset in autosomal dominantly inherited Alzheimer’s disease and cerebrospinal fluid tau levels in sporadic Alzheimer’s disease cases. In both autosomal dominant and sporadic Alzheimer’s disease patients, higher levels of left frontal cortex connectivity were correlated with greater education. For autosomal dominant Alzheimer’s disease, a significant left frontal cortex connectivity × estimated years of onset interaction was found, indicating slower decline of memory and global cognition at higher levels of connectivity. Similarly, in sporadic amyloid-positive elderly subjects, the effect of tau on cognition was attenuated at higher levels of left frontal cortex connectivity. Polynomial regression analysis showed that the trajectory of cognitive decline was shifted towards a later stage of Alzheimer’s disease in patients with higher levels of left frontal cortex connectivity. Together, our findings suggest that higher resilience against the development of cognitive impairment throughout the early stages of Alzheimer’s disease is at least partially attributable to higher left frontal cortex-hub connectivity.
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Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377 Munich, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Psychiatry, University of Cologne, Medical Faculty, Kerpener Strasse 62, 50924 Cologne, Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377 Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377 Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377 Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Biomedical Center, Biochemistry, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Marc Suárez-Calvet
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Biomedical Center, Biochemistry, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Anne M Fagan
- Department of Radiology, Washington University in St Louis, St Louis, Missouri, USA.,Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA
| | - Katrina Paumier
- Department of Radiology, Washington University in St Louis, St Louis, Missouri, USA
| | - Tammie Benzinger
- Department of Radiology, Washington University in St Louis, St Louis, Missouri, USA.,Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA
| | - Colin L Masters
- The Florey Institute, The University of Melbourne, Parkville, Victoria, Australia
| | - John C Morris
- Department of Radiology, Washington University in St Louis, St Louis, Missouri, USA.,Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Nußbaumstr. 7, 80336 Munich, Germany.,Neuroepidemiology and Ageing Research Unit, School of Public Health, The Imperial College of Science, Technology and Medicine, Exhibition Road, SW7 2AZ London, UK.,West London Mental Health Trust, 13 Uxbridge Road, UB1 3EU London, UK
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377 Munich, Germany
| | - Cihan Catak
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377 Munich, Germany
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.,Department of Neurodegeneration and Geriatric Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic, University of Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - Ingo Kilimann
- Department of Neurodegeneration and Geriatric Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Alfredo Ramirez
- Department of Psychiatry, University of Cologne, Medical Faculty, Kerpener Strasse 62, 50924 Cologne, Germany.,Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.,Institute of Human Genetics, University of Bonn, 53127, Bonn, Germany
| | - Martin Rossor
- Dementia Research Centre, University College London, Queen Square, London, UK
| | - Mathias Jucker
- Hertie Institute for Clinical Brain Research, Tübingen, Germany and German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Jasmeer Chhatwal
- Departments of Neurology, Massachusetts General Hospital, Charlestown HealthCare Center, Charlestown, Massachusetts 02129, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown HealthCare Center, Charlestown, Massachusetts 02129, USA
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Neurology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Henning Boecker
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Frederic Brosseron
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Neurodegeneration and Geriatric Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Peter Falkai
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Nußbaumstr. 7, 80336 Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Neurodegeneration and Geriatric Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Michael T Heneka
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Neurodegeneration and Geriatric Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Christoph Laske
- Dementia Research Centre, University College London, Queen Square, London, UK.,Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Peter Nestor
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Psychiatry and Psychotherapy, Charité, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Manuel Fuentes
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Felix Menne
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Psychiatry and Psychotherapy, Charité, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Neuropsychiatry, Charite - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Eike J Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Neuropsychiatry, Charite - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Christiana Franke
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Neuropsychiatry, Charite - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Neurodegeneration and Geriatric Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Barbara Kofler
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Christine Westerteicher
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Sigmund-Freud-Str. 27, 53127 Bonn, Germany.,Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Oliver Speck
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany.,Department of Biomedical Magnetic Resonance, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Von-Siebold-Str. 5, 37075 Goettingen, Germany.,iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - Miguel Ángel Araque Caballero
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377 Munich, Germany
| | - Coraline Metzger
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Daniel Bittner
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Michael Weiner
- University of California at San Francisco, 505 Parnassus Ave, San Francisco, CA94143, USA
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Stephen Salloway
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Adrian Danek
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Alison Goate
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Ronald M. Loeb Center for Alzheimer's Disease, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Peter R Schofield
- Neuroscience Research Australia, Barker Street Randwick, Sydney 2031, Australia.,School of Medical Sciences, University of New South Wales, Sydney 2052, Australia
| | - Randall J Bateman
- Department of Radiology, Washington University in St Louis, St Louis, Missouri, USA.,Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377 Munich, Germany
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van den Berg E, Geerlings MI, Biessels GJ, Nederkoorn PJ, Kloppenborg RP. White Matter Hyperintensities and Cognition in Mild Cognitive Impairment and Alzheimer's Disease: A Domain-Specific Meta-Analysis. J Alzheimers Dis 2019; 63:515-527. [PMID: 29630548 DOI: 10.3233/jad-170573] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND White matter hyperintensities (WMHs) are related to cognitive dysfunction in the general population. The clinical relevance of WMHs in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) is, however, unclear. OBJECTIVE This meta-analysis aimed to quantify the association of WMHs and specific cognitive domains in patients with MCI or AD. METHODS PubMed (January 1990-January 2017) was searched for studies that used MRI to quantify WMHs, and measured cognitive functioning (≥1 predefined cognitive domain with ≥1 test) in a well-defined population of persons diagnosed with MCI or AD. Fischer's Z was used as the common metric for effect size. Modifying effects of demographics, MMSE, and WMH location were examined. RESULTS Twelve cross-sectional studies on AD (total n = 1,370, median age 75 years) and 10 studies on MCI (9 cross-sectional, 1 longitudinal; total n = 2,286, median age 73 years) were included. The association between WMHs and overall cognition was significantly stronger for MCI (-0.25, -0.36 to -0.14) than for AD (-0.11, -0.14 to -0.08; QM = 10.7, p < 0.05). For both groups, largest effect sizes were found in attention and executive functions (-0.26, -0.36 to -0.15) and processing speed (-0.21, -0.35 to -0.12). No significant modifying effects of age and gender were found. CONCLUSION WMHs have a medium-sized association with different cognitive functions in patients with MCI and a small, but statistically significant, association with cognition in AD. These result underscore the role of co-occurring vascular brain damage in MCI and AD.
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Affiliation(s)
- Esther van den Berg
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul J Nederkoorn
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
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Wang Y, Du Y, Li J, Qiu C. Lifespan Intellectual Factors, Genetic Susceptibility, and Cognitive Phenotypes in Aging: Implications for Interventions. Front Aging Neurosci 2019; 11:129. [PMID: 31214016 PMCID: PMC6554280 DOI: 10.3389/fnagi.2019.00129] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/16/2019] [Indexed: 12/28/2022] Open
Abstract
Along with rapid global population aging, the age-related cognitive disorders such as mild cognitive impairment (MCI) and dementia have posed a serious threat to public health, health care system, and sustainable economic and societal development of all countries. In this narrative review, we seek to summarize the major epidemiological studies from the life-course perspective that investigate the influence of genetic susceptibility [e.g., apolipoprotein (APOE) ε4 allele] and intellectual or psychosocial factors (e.g., educational attainments and leisure activities) as well as their interactions on cognitive phenotypes in aging. Numerous population-based studies have suggested that early-life educational attainments and socioeconomic status, midlife work complexity and social engagements, late-life leisure activities (social, physical, and mentally-stimulating activities), certain personality traits (e.g., high neuroticism and low conscientiousness), and depression significantly affect late-life cognitive phenotypes. Furthermore, certain intellectual or psychosocial factors (e.g., leisure activities and depression) may interact with genetic susceptibility (e.g., APOE ε4 allele) to affect the phenotypes of cognitive aging such that risk or beneficial effects of these factors on cognitive function may vary by carrying the susceptibility genes. Current evidence from the randomized controlled trials that support the cognitive benefits of cognitive training among cognitive healthy older adults remains limited. The cognitive reserve hypothesis has been proposed to partly explain the beneficial effects of lifetime intellectual and psychosocial factors on late-life cognitive function. This implies that, from a life-course perspective, preventive intervention strategies targeting multiple modifiable intellectual and psychosocial factors could interfere with clinical expression of cognitive disorders in old age and delay the onset of dementia syndrome, and thus, may help achieve healthy brain aging.
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Affiliation(s)
- Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Juan Li
- Center on Aging Psychology, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Department of Neurobiology, Care Sciences and Society, Aging Research Center and Center for Alzheimer's Research, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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38
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Hernaiz Alonso C, Tanner JJ, Wiggins ME, Sinha P, Parvataneni HK, Ding M, Seubert CN, Rice MJ, Garvan CW, Price CC. Proof of principle: Preoperative cognitive reserve and brain integrity predicts intra-individual variability in processed EEG (Bispectral Index Monitor) during general anesthesia. PLoS One 2019; 14:e0216209. [PMID: 31120896 PMCID: PMC6532861 DOI: 10.1371/journal.pone.0216209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 04/16/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Preoperative cognitive reserve and brain integrity may explain commonly observed intraoperative fluctuations seen on a standard anesthesia depth monitor used ubiquitously in operating rooms throughout the nation. Neurophysiological variability indicates compromised regulation and organization of neural networks. Based on theories of neuronal integrity changes that accompany aging, we assessed the relative contribution of: 1) premorbid cognitive reserve, 2) current brain integrity (gray and white matter markers of neurodegenerative disease), and 3) current cognition (specifically domains of processing speed/working memory, episodic memory, and motor function) on intraoperative neurophysiological variability as measured from a common intraoperative tool, the Bispectral Index Monitor (BIS). METHODS This sub-study included participants from a parent study of non-demented older adults electing unilateral Total Knee Arthroplasty (TKA) with the same surgeon and anesthesia protocol, who also completed a preoperative neuropsychological assessment and preoperative 3T brain magnetic resonance imaging scan. Left frontal two-channel derived EEG via the BIS was acquired preoperatively (un-medicated and awake) and continuously intraoperatively with time from tourniquet up to tourniquet down. Data analyses used correlation and regression modeling. RESULTS Fifty-four participants met inclusion criteria for the sub-study. The mean (SD) age was 69.5 (7.4) years, 54% were male, 89% were white, and the mean (SD) American Society of Anesthesiologists score was 2.76 (0.47). We confirmed that brain integrity positively and significantly associated with each of the cognitive domains of interest. EEG intra-individual variability (squared deviation from the mean BIS value between tourniquet up and down) was significantly correlated with cognitive reserve (r = -.40, p = .003), brain integrity (r = -.37, p = .007), and a domain of processing speed/working memory (termed cognitive efficiency; r = -.31, p = .021). Hierarchical regression models that sequentially included age, propofol bolus dose, cognitive reserve, brain integrity, and cognitive efficiency found that intraoperative propofol bolus dose (p = .001), premorbid cognitive reserve (p = .008), and current brain integrity (p = .004) explained a significant portion of intraoperative intra-individual variability from the BIS monitor. CONCLUSIONS Older adults with higher premorbid reserve and less brain disease were more stable intraoperatively on a depth of anesthesia monitor. Researchers need to replicate findings within larger cohorts and other surgery types.
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Affiliation(s)
- Carlos Hernaiz Alonso
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, Florida, United States of America
| | - Jared J. Tanner
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, Florida, United States of America
| | - Margaret E. Wiggins
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, Florida, United States of America
| | - Preeti Sinha
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, Florida, United States of America
| | - Hari K. Parvataneni
- Department of Orthopedic Surgery, University of Florida College of Medicine; Gainesville, Florida, United States of America
| | - Mingzhou Ding
- Department of Biomedical Engineering, University of Florida Herbert Wertheim College of Engineering, Gainesville, Florida, United States of America
| | - Christoph N. Seubert
- Department of Anesthesiology, University of Florida, Gainesville, Florida, United States of America
| | - Mark J. Rice
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Cynthia W. Garvan
- Department of Anesthesiology, University of Florida, Gainesville, Florida, United States of America
| | - Catherine C. Price
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, Florida, United States of America
- Department of Anesthesiology, University of Florida, Gainesville, Florida, United States of America
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39
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Arenaza-Urquijo EM, Przybelski SA, Lesnick TL, Graff-Radford J, Machulda MM, Knopman DS, Schwarz CG, Lowe VJ, Mielke MM, Petersen RC, Jack CR, Vemuri P. The metabolic brain signature of cognitive resilience in the 80+: beyond Alzheimer pathologies. Brain 2019; 142:1134-1147. [PMID: 30851100 PMCID: PMC6439329 DOI: 10.1093/brain/awz037] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/04/2018] [Accepted: 12/21/2018] [Indexed: 11/14/2022] Open
Abstract
Research into cognitive resilience imaging markers may help determine the clinical significance of Alzheimer's disease pathology among older adults over 80 years (80+). In this study, we aimed to identify a fluorodeoxyglucose (FDG)-PET based imaging marker of cognitive resilience. We identified 457 participants ≥ 80 years old (357 cognitively unimpaired, 118 cognitively impaired at baseline, mean age of 83.5 ± 3.2 years) from the population-based Mayo Clinic Study of Aging (MCSA) with baseline MRI, Pittsburgh compound B-PET and FDG-PET scans and neuropsychological evaluation. We identified a subset of 'resilient' participants (cognitively stable 80+, n = 192) who maintained normal cognition for an average of 5 years (2-10 years). Global PIB ratio, FDG-PET ratio and cortical thickness from Alzheimer's disease signature regions were used as Alzheimer's disease imaging biomarker outcomes and global cognitive z-score was used as a cognitive outcome. First, using voxel-wise multiple regression analysis, we identified the metabolic areas underlying cognitive resilience in cognitively stable 80+ participants, which we call the 'resilience signature'. Second, using multivariate linear regression models, we evaluated the association of risk and protective factors with the resilience signature and its added value for predicting global cognition beyond established Alzheimer's disease imaging biomarkers in the full 80+ sample. Third, we evaluated the utility of the resilience signature in conjunction with amyloidosis in predicting longitudinal cognition using linear mixed effect models. Lastly, we assessed the utility of the resilience signature in an independent cohort using ADNI (n = 358, baseline mean age of 80 ± 3.8). Our main findings were: (i) FDG-PET uptake in the bilateral anterior cingulate cortex and anterior temporal pole was associated with baseline global cognition in cognitively stable 80+ (the resilience signature); (ii) established Alzheimer's disease imaging biomarkers did not predict baseline global cognition in this subset of participants; (iii) in the full MCSA 80+ and ADNI cohorts, amyloid burden and FDG-PET in the resilience signature were the stronger predictors of baseline global cognition; (iv) sex and systemic vascular health predicted FDG-PET in the resilience signature, suggesting vascular health maintenance as a potential pathway to preserve the metabolism of these areas; and (v) the resilience signature provided significant information about global longitudinal cognitive change even when considering amyloid status in both the MCSA and ADNI cohorts. The FDG-PET resilience signature may be able to provide important information in conjunction with other Alzheimer's disease biomarkers for the determination of clinical prognosis. It may also facilitate identification of disease targeting modifiable risk factors such as vascular health maintenance.
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Affiliation(s)
| | | | | | | | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle M Mielke
- Health Science Research, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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40
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James BD, Bennett DA. Causes and Patterns of Dementia: An Update in the Era of Redefining Alzheimer's Disease. Annu Rev Public Health 2019; 40:65-84. [PMID: 30642228 DOI: 10.1146/annurev-publhealth-040218-043758] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The burden of dementia continues to increase as the population ages, with no disease-modifying treatments available. However, dementia risk appears to be decreasing, and progress has been made in understanding its multifactorial etiology. The 2018 National Institute on Aging-Alzheimer's Association (NIA-AA) research framework for Alzheimer's disease (AD) defines AD as a biological process measured by brain pathology or biomarkers, spanning the cognitive spectrum from normality to dementia. This framework facilitates interventions in the asymptomatic space and accommodates knowledge that many additional pathologies (e.g., cerebrovascular) contribute to the Alzheimer's dementia syndrome. The framework has implications for how we think about risk factors for "AD": Many commonly accepted risk factors are not related to AD pathology and would no longer be considered risk factors for AD. They may instead be related to other pathologies or resilience to pathology. This review updates what is known about causes, risk factors, and changing patterns of dementia, addressing whether they are related to AD pathology/biomarkers, other pathologies, or resilience.
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Affiliation(s)
- Bryan D James
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois 60612, USA; .,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois 60612, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois 60612, USA; .,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois 60612, USA
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41
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Abstract
PURPOSE OF REVIEW The aim of this review is to summarize current conceptual models of cognitive reserve (CR) and related concepts and to discuss evidence for these concepts within the context of aging and Alzheimer's disease. RECENT FINDINGS Evidence to date supports the notion that higher levels of CR, as measured by proxy variables reflective of lifetime experiences, are associated with better cognitive performance, and with a reduced risk of incident mild cognitive impairment/dementia. However, the impact of CR on longitudinal cognitive trajectories is unclear and may be influenced by a number of factors. Although there is promising evidence that some proxy measures of CR may influence structural brain measures, more research is needed. The protective effects of CR may provide an important mechanism for preserving cognitive function and cognitive well-being with age, in part because it can be enhanced throughout the lifespan. However, more research on the mechanisms by which CR is protective is needed.
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Affiliation(s)
- Corinne Pettigrew
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD, 21205, USA
| | - Anja Soldan
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD, 21205, USA.
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42
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Sapkota S, Ramirez J, Stuss DT, Masellis M, Black SE. Clinical dementia severity associated with ventricular size is differentially moderated by cognitive reserve in men and women. ALZHEIMERS RESEARCH & THERAPY 2018; 10:89. [PMID: 30185213 PMCID: PMC6123907 DOI: 10.1186/s13195-018-0419-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/07/2018] [Indexed: 01/08/2023]
Abstract
Background Interindividual differences in cognitive reserve (CR) are associated with complex and dynamic clinical phenotypes observed in cognitive impairment and dementia. We tested whether (1) CR early in life (E-CR; measured by education and IQ), (2) CR later in life (L-CR; measured by occupation), and (3) CR panel (CR-P) with the additive effects of E-CR and L-CR, act as moderating factors between baseline ventricular size and clinical dementia severity at baseline and across 2 years. We further examined whether this moderation is differentially represented by sex. Methods We examined a longitudinal model using patients (N = 723; mean age = 70.8 ± 9.4 years; age range = 38–90 years; females = 374) from the Sunnybrook Dementia Study. The patients represented Alzheimer’s disease (n = 439), mild cognitive impairment (n = 77), vascular cognitive impairment (n = 52), Lewy body disease (n = 30), and frontotemporal dementia (n = 125). Statistical analyses included (1) latent growth modeling to determine how clinical dementia severity changes over 2 years (measured by performance on the Dementia Rating Scale), (2) confirmatory factor analysis to establish a baseline E-CR factor, and (3) path analysis to predict dementia severity. Baseline age (continuous) and Apolipoprotein E status (ɛ4−/ɛ4+) were included as covariates. Results The association between higher baseline ventricular size and dementia severity was moderated by (1) E-CR and L-CR and (2) CR-P. This association was differentially represented in men and women. Specifically, men in only the low CR-P had higher baseline clinical dementia severity with larger baseline ventricular size. However, women in the low CR-P showed the (1) highest baseline dementia severity and (2) fastest 2-year decline with larger baseline ventricular size. Conclusions Clinical dementia severity associated with ventricular size may be (1) selectively moderated by complex and additive CR networks and (2) differentially represented by sex. Trials registration ClinicalTrials.gov, NCT01800214. Registered on 27 February 2013. Electronic supplementary material The online version of this article (10.1186/s13195-018-0419-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shraddha Sapkota
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, M6-192, Toronto, ON, M4N 3M5, Canada.
| | - Joel Ramirez
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, M6-192, Toronto, ON, M4N 3M5, Canada
| | - Donald T Stuss
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, M6-192, Toronto, ON, M4N 3M5, Canada.,Departments of Medicine, University of Toronto, 190 Elizabeth Street, R. Fraser Elliot Building, 3-805, Toronto, ON, M5G 2C4, Canada.,Department of Psychology, University of Toronto, 100 St. George Street, 4th Floor, Sidney Smith Hall, Toronto, ON, M5S 3G3, Canada.,Rotman Research Institute of Baycrest Centre, 3560 Bathurst Street, Toronto, ON, M6H 4A6, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, M6-192, Toronto, ON, M4N 3M5, Canada.,Department of Medicine (Neurology), University of Toronto, 190 Elizabeth Street, R. Fraser Elliot Building, 3-805, Toronto, ON, M5G 2C4, Canada
| | - Sandra E Black
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, M6-192, Toronto, ON, M4N 3M5, Canada.,Department of Medicine (Neurology), University of Toronto, 190 Elizabeth Street, R. Fraser Elliot Building, 3-805, Toronto, ON, M5G 2C4, Canada
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Ramakrishnan S, Mekala S, Mamidipudi A, Yareeda S, Mridula R, Bak TH, Alladi S, Kaul S. Comparative Effects of Education and Bilingualism on the Onset of Mild Cognitive Impairment. Dement Geriatr Cogn Disord 2018; 44:222-231. [PMID: 29207387 DOI: 10.1159/000479791] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Increasing evidence suggests that life course factors such as education and bilingualism may have a protective role against dementia due to Alzheimer disease. This study aimed to compare the effects of education and bilingualism on the onset of cognitive decline at the stage of mild cognitive impairment (MCI). METHODS A total of 115 patients with MCI evaluated in a specialty memory clinic in Hyderabad, India, formed the cohort. MCI was diagnosed according to Petersen's criteria following clinical evaluation and brain imaging. Age at onset of MCI was compared between bilinguals and monolinguals, and across subjects with high and low levels of education, adjusting for possible confounding variables. RESULTS The bilingual MCI patients were found to have a clinical onset of cognitive complaints 7.4 years later than monolinguals (65.2 vs. 58.1 years; p = 0.004), while years of education was not associated with delayed onset (1-10 years of education, 59.1 years; 11-15 years of education, 62.6 years; >15 years of education, 62.2 years; p = 0.426). CONCLUSION The effect of bilingualism is protective against cognitive decline, and lies along a continuum from normal to pathological states. In comparison, the role of years of education is less robust.
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Affiliation(s)
- Subasree Ramakrishnan
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Ecay-Torres M, Estanga A, Tainta M, Izagirre A, Garcia-Sebastian M, Villanua J, Clerigue M, Iriondo A, Urreta I, Arrospide A, Díaz-Mardomingo C, Kivipelto M, Martinez-Lage P. Increased CAIDE dementia risk, cognition, CSF biomarkers, and vascular burden in healthy adults. Neurology 2018; 91:e217-e226. [PMID: 29898969 DOI: 10.1212/wnl.0000000000005824] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/11/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the cognitive profile of healthy individuals with increased Cardiovascular Risk Factors, Aging and Dementia (CAIDE) dementia risk score and to explore whether this association is related to vascular burden and CSF biomarkers of amyloidosis and neurodegeneration. METHOD Cognitively normal participants (mean age 57.6 years) from the Gipuzkoa Alzheimer Project study were classified as having high risk (HR; n = 82) or low risk (LR; n = 293) for dementia according to a CAIDE score cutoff of 9. Cognitive composites were compared between groups. We explored using generalized linear models the role of APOE genotype, MRI white matter hyperintensities (WMH), and CSF (n = 218) levels of β-amyloid1-42 (Aβ1-42), total tau (t-tau), and phosphorylated tau (p-tau) in the association between CAIDE score and cognition. RESULTS HR participants obtained lower scores on executive function (EF) (p = 0.001) and visual perception and construction (VPC) (p < 0.001) composites. EF composite was associated with CAIDE score × p-tau (p = 0.001), CAIDE score × t-tau (p = 0.001), and WMH (p = 0.003). VPC composite was associated with APOE (p = 0.001), Aβ1-42 (p = 0.004), the interaction APOE × Aβ1-42 (p = 0.003), and WMH (p = 0.004). Performance on global memory was associated with Aβ1-42 (p = 0.006), APOE (p = 0.008), and their interaction (p = 0.006). Analyses were adjusted for age, education, sex, premorbid intelligence, and stress. CONCLUSION Healthy participants at increased dementia risk based on CAIDE scores show lower performance in EF and VPC. This difference is related to APOE, WMH, and Alzheimer biomarkers.
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Affiliation(s)
- Mirian Ecay-Torres
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Ainara Estanga
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Mikel Tainta
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Andrea Izagirre
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Maite Garcia-Sebastian
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Jorge Villanua
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Montserrat Clerigue
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Ane Iriondo
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Iratxe Urreta
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Arantzazu Arrospide
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Carmen Díaz-Mardomingo
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Miia Kivipelto
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Pablo Martinez-Lage
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden.
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Vemuri P. "Exceptional brain aging" without Alzheimer's disease: triggers, accelerators, and the net sum game. ALZHEIMERS RESEARCH & THERAPY 2018; 10:53. [PMID: 29859131 PMCID: PMC5984828 DOI: 10.1186/s13195-018-0373-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background As human longevity increases and Alzheimer’s disease (AD) increasingly becomes a significant societal burden, finding pathways or protective factors that facilitate exceptional brain aging without AD pathophysiologies (ADP) will be critical. The goal of this viewpoint is two-fold: 1) to present evidence for “exceptional brain aging” without ADP; and 2) to bring together ideas and observations from the literature and present them as testable hypotheses for biomarker studies to discover protective factors for “exceptional brain aging” without ADP and AD dementia. Discovering pathways to exceptional aging There are three testable hypotheses. First, discovering and quantifying links between risk factor(s) and early ADP changes in midlife using longitudinal biomarker studies will be fundamental to understanding why the majority of individuals deviate from normal aging to the AD pathway. Second, a risk factor may have quantifiably greater impact as a trigger and/or accelerator on a specific component of the biomarker cascade (amyloid, tau, neurodegeneration). Finally, and most importantly, while each risk factor may have a different mechanism of action on AD biomarkers, “exceptional aging” and protection against AD dementia will come from “net sum” protection against all components of the biomarker cascade. The knowledge of the mechanism of action of risk factor(s) from hypotheses 1 and 2 will aid in better characterization of their effect on outcomes, identification of subpopulations that would benefit, and the timing at which the risk factor(s) would have the maximal impact. Additionally, hypothesis 3 highlights the importance of multifactorial or multi-domain approaches to “exceptional aging” as well as prevention of AD dementia. Conclusion While important strides have been made in identifying risk factors for AD dementia incidence, further efforts are needed to translate these into effective preventive strategies. Using biomarker studies for understanding the mechanism of action, effect size estimation, selection of appropriate end-points, and better subject recruitment based on subpopulation effects are fundamental for better design and success of prevention trials.
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Affiliation(s)
- Prashanthi Vemuri
- Department of Radiology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN, 55905, USA.
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Arenaza-Urquijo EM, Vemuri P. Resistance vs resilience to Alzheimer disease: Clarifying terminology for preclinical studies. Neurology 2018; 90:695-703. [PMID: 29592885 DOI: 10.1212/wnl.0000000000005303] [Citation(s) in RCA: 228] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/02/2018] [Indexed: 11/15/2022] Open
Abstract
Preventing or delaying Alzheimer disease (AD) through lifestyle interventions will come from a better understanding of the mechanistic underpinnings of (1) why a significant proportion of elderly remain cognitively normal with AD pathologies (ADP), i.e., amyloid or tau; and (2) why some elderly individuals do not have significant ADP. In the last decades, concepts such as brain reserve, cognitive reserve, and more recently brain maintenance have been proposed along with more general notions such as (neuro)protection and compensation. It is currently unclear how to effectively apply these concepts in the new field of preclinical AD specifically separating the 2 distinct mechanisms of coping with pathology vs avoiding pathology. We propose a simplistic conceptual framework that builds on existing concepts using the nomenclature of resistance in the context of avoiding pathology, i.e., remaining cognitively normal without significant ADP, and resilience in the context of coping with pathology, i.e., remaining cognitively normal despite significant ADP. In the context of preclinical AD studies, we (1) define these concepts and provide recommendations (and common scenarios) for their use; (2) discuss how to employ this terminology in the context of investigating mechanisms and factors; (3) highlight the complementarity and clarity they provide to existing concepts; and (4) discuss different study designs and methodologies. The application of the proposed framework for framing hypotheses, study design, and interpretation of results and mechanisms can provide a consistent framework and nomenclature for researchers to reach consensus on identifying factors that may prevent ADP or delay the onset of cognitive impairment.
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Affiliation(s)
- Eider M Arenaza-Urquijo
- From INSERM UMR-S U1237 (E.M.A.-U.), Université de Caen-Normandie, Caen, Normandy, France; and Department of Radiology (P.V.), Mayo Clinic, Rochester, MN.
| | - Prashanthi Vemuri
- From INSERM UMR-S U1237 (E.M.A.-U.), Université de Caen-Normandie, Caen, Normandy, France; and Department of Radiology (P.V.), Mayo Clinic, Rochester, MN
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Chiang ACA, Fowler SW, Reddy R, Pletnikova O, Troncoso JC, Sherman MA, Lesne SE, Jankowsky JL. Discrete Pools of Oligomeric Amyloid-β Track with Spatial Learning Deficits in a Mouse Model of Alzheimer Amyloidosis. THE AMERICAN JOURNAL OF PATHOLOGY 2018; 188:739-756. [PMID: 29248459 PMCID: PMC5840490 DOI: 10.1016/j.ajpath.2017.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/24/2017] [Accepted: 11/02/2017] [Indexed: 01/08/2023]
Abstract
Despite increasing appreciation that oligomeric amyloid-β (Aβ) may contribute to cognitive decline of Alzheimer disease, defining the most critical forms has been thwarted by the changeable nature of these aggregates and the varying methods used for detection. Herein, using a broad approach, we quantified Aβ oligomers during the evolution of cognitive deficits in an aggressive model of Aβ amyloidosis. Amyloid precursor protein/tetracycline transactivator mice underwent behavioral testing at 3, 6, 9, and 12 months of age to evaluate spatial learning and memory, followed by histologic assessment of amyloid burden and biochemical characterization of oligomeric Aβ species. Transgenic mice displayed progressive impairments in acquisition and immediate recall of the trained platform location. Biochemical analysis of cortical extracts from behaviorally tested mice revealed distinct age-dependent patterns of accumulation in multiple oligomeric species. Dot blot analysis demonstrated that nonfibrillar Aβ oligomers were highly soluble and extracted into a fraction enriched for extracellular proteins, whereas prefibrillar species required high-detergent conditions to retrieve, consistent with membrane localization. Low-detergent extracts tested by 82E1 enzyme-linked immunosorbent assay confirmed the presence of bona fide Aβ oligomers, whereas immunoprecipitation-Western blotting using high-detergent extracts revealed a variety of SDS-stable low-n species. These findings show that different Aβ oligomers vary in solubility, consistent with distinct localization, and identify nonfibrillar Aβ oligomer-positive aggregates as tracking most closely with cognitive decline in this model.
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Affiliation(s)
- Angie C A Chiang
- Department of Neuroscience, Huffington Center on Aging, Baylor College of Medicine, Houston, Texas
| | - Stephanie W Fowler
- Department of Neuroscience, Huffington Center on Aging, Baylor College of Medicine, Houston, Texas
| | - Rohit Reddy
- Department of Neuroscience, Huffington Center on Aging, Baylor College of Medicine, Houston, Texas; Department of Cognitive Science, Rice University, Houston, Texas
| | - Olga Pletnikova
- Division of Neuropathology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Juan C Troncoso
- Division of Neuropathology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mathew A Sherman
- Department of Neuroscience, N. Bud Grossman Center for Memory Research and Care, Institute for Translational Neuroscience, University of Minnesota, Minneapolis, Minnesota
| | - Sylvain E Lesne
- Department of Neuroscience, N. Bud Grossman Center for Memory Research and Care, Institute for Translational Neuroscience, University of Minnesota, Minneapolis, Minnesota
| | - Joanna L Jankowsky
- Department of Neuroscience, Huffington Center on Aging, Baylor College of Medicine, Houston, Texas; Department of Neurology and Neurosurgery, Huffington Center on Aging, Baylor College of Medicine, Houston, Texas.
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48
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Franzmeier N, Caballero MÁA, Taylor ANW, Simon-Vermot L, Buerger K, Ertl-Wagner B, Mueller C, Catak C, Janowitz D, Baykara E, Gesierich B, Duering M, Ewers M. Resting-state global functional connectivity as a biomarker of cognitive reserve in mild cognitive impairment. Brain Imaging Behav 2018; 11:368-382. [PMID: 27709513 DOI: 10.1007/s11682-016-9599-1] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cognitive reserve (CR) shows protective effects in Alzheimer's disease (AD) and reduces the risk of dementia. Despite the clinical significance of CR, a clinically useful diagnostic biomarker of brain changes underlying CR in AD is not available yet. Our aim was to develop a fully-automated approach applied to fMRI to produce a biomarker associated with CR in subjects at increased risk of AD. We computed resting-state global functional connectivity (GFC), i.e. the average connectivity strength, for each voxel within the cognitive control network, which may sustain CR due to its central role in higher cognitive function. In a training sample including 43 mild cognitive impairment (MCI) subjects and 24 healthy controls (HC), we found that MCI subjects with high CR (> median of years of education, CR+) showed increased frequency of high GFC values compared to MCI-CR- and HC. A summary index capturing such a surplus frequency of high GFC was computed (called GFC reserve (GFC-R) index). GFC-R discriminated MCI-CR+ vs. MCI-CR-, with the area under the ROC = 0.84. Cross-validation in an independently recruited test sample of 23 MCI subjects showed that higher levels of the GFC-R index predicted higher years of education and an alternative questionnaire-based proxy of CR, controlled for memory performance, gray matter of the cognitive control network, white matter hyperintensities, age, and gender. In conclusion, the GFC-R index that captures GFC changes within the cognitive control network provides a biomarker candidate of functional brain changes of CR in patients at increased risk of AD.
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Affiliation(s)
- N Franzmeier
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany.
| | - M Á Araque Caballero
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - A N W Taylor
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - L Simon-Vermot
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - K Buerger
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - B Ertl-Wagner
- Institute for Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilian University, Marchioninistraße 15, 81377, Munich, Germany
| | - C Mueller
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - C Catak
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - D Janowitz
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - E Baykara
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - B Gesierich
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - M Duering
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - M Ewers
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
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49
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Belathur Suresh M, Fischl B, Salat DH. Factors influencing accuracy of cortical thickness in the diagnosis of Alzheimer's disease. Hum Brain Mapp 2017; 39:1500-1515. [PMID: 29271096 DOI: 10.1002/hbm.23922] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 11/28/2017] [Accepted: 12/07/2017] [Indexed: 02/04/2023] Open
Abstract
There is great value to use of structural neuroimaging in the assessment of Alzheimer's disease (AD). However, to date, predictive value of structural imaging tend to range between 80% and 90% in accuracy and it is unclear why this is the case given that structural imaging should parallel the pathologic processes of AD. There is a possibility that clinical misdiagnosis relative to the gold standard pathologic diagnosis and/or additional brain pathologies are confounding factors contributing to reduced structural imaging classification accuracy. We examined potential factors contributing to misclassification of individuals with clinically diagnosed AD purely from cortical thickness measures. Correctly classified and incorrectly classified groups were compared across a range of demographic, biological, and neuropsychological data including cerebrospinal fluid biomarkers, amyloid imaging, white matter hyperintensity (WMH) volume, cognitive, and genetic factors. Individual subject analyses suggested that at least a portion of the control individuals misclassified as AD from structural imaging additionally harbor substantial AD biomarker pathology and risk, yet are relatively resistant to cognitive symptoms, likely due to "cognitive reserve," and therefore clinically unimpaired. In contrast, certain clinical control individuals misclassified as AD from cortical thickness had increased WMH volume relative to other controls in the sample, suggesting that vascular conditions may contribute to classification accuracy from cortical thickness measures. These results provide examples of factors that contribute to the accuracy of structural imaging in predicting a clinical diagnosis of AD, and provide important information about considerations for future work aimed at optimizing structural based diagnostic classifiers for AD.
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Affiliation(s)
- Mahanand Belathur Suresh
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Information Science and Engineering, Sri Jayachamarajendra College of Engineering, Mysuru, Karnataka, India
| | - Bruce Fischl
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - David H Salat
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, Massachusetts
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50
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Adapting the concepts of brain and cognitive reserve to post-stroke cognitive deficits: Implications for understanding neglect. Cortex 2017; 97:327-338. [DOI: 10.1016/j.cortex.2016.12.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/03/2016] [Accepted: 12/04/2016] [Indexed: 01/17/2023]
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