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Cui L, Hong H, Wang S, Zeng Q, Jiaerken Y, Yu X, Zhang R, Zhang Y, Xie L, Lin M, Liu L, Luo X, Li K, Liu X, Li J, Huang P, Zhang M. Small vessel disease and cognitive reserve oppositely modulate global network redundancy and cognitive function: A study in middle-to-old aged community participants. Hum Brain Mapp 2024; 45:e26634. [PMID: 38553856 PMCID: PMC10980841 DOI: 10.1002/hbm.26634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/05/2024] [Accepted: 02/08/2024] [Indexed: 04/02/2024] Open
Abstract
Cerebral small vessel disease (SVD) can disrupt the global brain network and lead to cognitive impairment. Conversely, cognitive reserve (CR) can improve one's cognitive ability to handle damaging effects like SVD, partly by optimizing the brain network's organization. Understanding how SVD and CR collectively influence brain networks could be instrumental in preventing cognitive impairment. Recently, brain redundancy has emerged as a critical network protective metric, providing a nuanced perspective of changes in network organization. However, it remains unclear how SVD and CR affect global redundancy and subsequently cognitive function. Here, we included 121 community-dwelling participants who underwent neuropsychological assessments and a multimodal MRI examination. We visually examined common SVD imaging markers and assessed lifespan CR using the Cognitive Reserve Index Questionnaire. We quantified the global redundancy index (RI) based on the dynamic functional connectome. We then conducted multiple linear regressions to explore the specific cognitive domains related to RI and the associations of RI with SVD and CR. We also conducted mediation analyses to explore whether RI mediated the relationships between SVD, CR, and cognition. We found negative correlations of RI with the presence of microbleeds (MBs) and the SVD total score, and a positive correlation of RI with leisure activity-related CR (CRI-leisure). RI was positively correlated with memory and fully mediated the relationships between the MBs, CRI-leisure, and memory. Our study highlights the potential benefits of promoting leisure activities and keeping brain redundancy for memory preservation in older adults, especially those with SVD.
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Affiliation(s)
- Lei Cui
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Hui Hong
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Shuyue Wang
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Qingze Zeng
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Yeerfan Jiaerken
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Xinfeng Yu
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Ruiting Zhang
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Yao Zhang
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Linyun Xie
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Miao Lin
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Lingyun Liu
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Xiao Luo
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Kaicheng Li
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Xiaocao Liu
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Jixuan Li
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Peiyu Huang
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
| | - Minming Zhang
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University, School of MedicineHangzhouChina
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de Paula França Resende E, Lara VP, Santiago ALC, Friedlaender CV, Rosen HJ, Brown JA, Cobigo Y, Silva LLG, de Souza LC, Rincon L, Grinberg LT, Maciel FIP, Caramelli P. Literacy, but not memory, is associated with hippocampal connectivity in illiterate adults. RESEARCH SQUARE 2023:rs.3.rs-3053775. [PMID: 37398238 PMCID: PMC10312990 DOI: 10.21203/rs.3.rs-3053775/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background The influence of hippocampal connectivity on memory performance is well established in individuals with high educational attainment. However, the role of hippocampal connectivity in illiterate populations remains poorly understood. Methods Thirty-five illiterate adults were administered a literacy assessment (Test of Functional Health Literacy in Adults - TOFHLA), structural and resting state functional MRI and an episodic memory test (Free and Cued Selective Reminding Test). Illiteracy was defined as a TOFHLA score below 53. We evaluated the correlation between hippocampal connectivity at rest and both free recall and literacy scores. Results Participants were mostly female (57.1%) and Black (84.8%), with a median age of 50 years. The median TOFHLA literacy score was 28.0 [21.0;42.5] out of 100 points and the median free recall score was 30.0 [26.2;35] out of 48 points. The median gray matter volume of both the left and right hippocampi was 2.3 [2.1; 2.4] cm3. We observed a significant connectivity between both hippocampi and the precuneus and the ventral medial prefrontal cortex. Interestingly, the right hippocampal connectivity positively correlated with the literacy scores (β = 0.58, p = 0.008). There was no significant association between episodic memory and hippocampal connectivity. Neither memory nor literacy scores correlated with hippocampal gray matter volume. Conclusions Low literacy levels correlate with hippocampal connectivity in illiterate adults. The lack of association with memory scores might be associated with low brain reserve in illiterate adults.
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Hakiki B, Pancani S, Romoli AM, Draghi F, Maccanti D, Mannini A, Cecchi F. Cognitive reserve index and long-term disability in patients with severe traumatic brain injury discharged from the intensive rehabilitation unit. Front Neurol 2023; 14:1106989. [PMID: 37213897 PMCID: PMC10197115 DOI: 10.3389/fneur.2023.1106989] [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: 11/24/2022] [Accepted: 03/21/2023] [Indexed: 05/23/2023] Open
Abstract
Objectives The "cognitive reserve" (CR) theory posits that higher premorbid cognitive activities can mitigate the effects of brain damage. This study aimed to investigate the association between CR and long-term functional autonomy in patients surviving a severe traumatic brain injury (sTBI). Setting Data were collected from the database of inpatients with severe acquired brain injury in a rehabilitation unit admitted from August 2012 to May 2020. Participants Patients that had incurred an sTBI, aged 18+ years, completing the phone Glasgow Outcome Scale-Expanded at follow-up (pGOS-E) in absence of previous brain trauma or neurological disease, or cognitive disorders were included. Patients with severe brain injury from non-traumatic etiologies were not included in the study. Design In this longitudinal study, all patients underwent a multidimensional assessment including the cognitive reserve index questionnaire (CRIq), the coma recovery scale-revised, the level of cognitive functioning, the Disability Rating Scale (DRS), and the Galveston Orientation and Amnesia Test at admission. At discharge, functional scales were administered again together with the Glasgow Outcome Scale. The pGOS-E was assessed at follow-up. Main measures pGOS-E. Results A total of 106 patients/caregivers underwent the pGOS-E after 5.8 [3.6] years from the event. Among them, 46 (43.4%) died after discharge, and 60 patients [men: 48 (80%); median age: 54 years; median time post-onset: 37 days; median education level: 10 years; median CRIq total score: 91] were included in the analysis exploring the association between pGOS-E and demographic data, cognitive reserve surrogates, and clinical variables at admission and discharge from the rehabilitation unit. A younger age (B = -0.035, p = 0.004) and a lower DRS category at discharge (B = -0.392, p = 0.029) were significantly related to a higher long-term functional autonomy in the multivariate analysis. Conclusion Long-term functional autonomy was not influenced by CR as assessed through the educational level and the CRIq.
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Affiliation(s)
- Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- *Correspondence: Silvia Pancani
| | | | | | | | | | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Li Y, Wang M, Cong L, Hou T, Song L, Wang X, Shi L, Dekhtyar S, Wang Y, Du Y, Qiu C. Lifelong Cognitive Reserve, Imaging Markers of Brain Aging, and Cognitive Function in Dementia-Free Rural Older Adults: A Population-Based Study. J Alzheimers Dis 2023; 92:261-272. [PMID: 36710675 PMCID: PMC10041437 DOI: 10.3233/jad-220864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Cognitive reserve (CR) partly explains cognitive variability in the presence of pathological brain aging. OBJECTIVE We investigated the interplay of lifelong CR with age, sex, and brain aging markers in cognitive phenotypes among older adults with very limited education. METHODS This population-based cross-sectional study included 179 dementia-free participants (age ≥65 years; 39.7% women; 67.0% had no or elementary education) examined in 2014-2016. We assessed lacunes and volumes of hippocampus, ventricles, grey matter, white matter (WM), and white matter hyperintensities. Lifelong CR score was generated from six lifespan intellectual factors (e.g., education and social support). We used Mini-Mental State Examination (MMSE) score to assess cognition and Petersen's criteria to define mild cognitive impairment (MCI). Data were analyzed using general linear and logistic models. RESULTS The association of higher lifelong CR score (range: -4.0-5.0) with higher MMSE score was stronger in women (multivariable-adjusted β-coefficient and 95% CI: 1.75;0.99-2.51) than in men (0.68;0.33-1.03) (pinteraction = 0.006). The association of higher CR with MCI (multivariable-adjusted odds ratio and 95% CI: 0.77;0.60-0.99) did not vary by age or sex. Among participants with low CR (<1.4[median]), greater hippocampal and WM volumes were related to higher MMSE scores with multivariable-adjusted β-coefficients being 1.77(0.41-3.13) and 0.44(0.15-0.74); the corresponding figures in those with high CR were 0.15(-0.76-1.07) and -0.17(-0.41-0.07) (pinteraction <0.01). There was no statistical interaction of CR with MRI markers on MCI. CONCLUSION Greater lifelong CR capacity is associated with better late-life cognition among people with limited education, possibly by compensating for impact of neurodegeneration.
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Affiliation(s)
- Yuanjing Li
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Mingqi Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
| | - Lin Song
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
| | - Xiang Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR, P.R. China
| | - Serhiy Dekhtyar
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong, P.R. China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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de Resende EDPF, Xia F, Sidney S, Launer LJ, Schreiner PJ, Erus G, Bryan N, Yaffe K. Higher literacy is associated with better white matter integrity and cognition in middle age. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12363. [PMID: 36514538 PMCID: PMC9732896 DOI: 10.1002/dad2.12363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/29/2022] [Accepted: 09/16/2022] [Indexed: 12/13/2022]
Abstract
Introduction Literacy can be a better measure of quality of education. Its association with brain health in midlife has not been thoroughly investigated. Methods We studied, cross-sectionally, 616 middle-aged adults (mean age of 55.1 ± 3.6 years, 53% female and 38% Black) from the Coronary Artery Risk Development in Young Adults (CARDIA) study. We correlated literacy with cognitive tests, gray matter volumes, and fractional anisotropy (FA) values (indirect measures of white matter integrity) using linear regression. Results The higher-literacy group (n = 499) performed better than the low-literacy group (n = 117) on all cognitive tests. There was no association between literacy and gray matter volumes. The higher-literacy group had greater total-brain FA and higher temporal, parietal, and occipital FA values after multivariable adjustments. Discussion Higher literacy is associated with higher white matter integrity as well as with better cognitive performance in middle-aged adults. These results highlight the importance of focusing on midlife interventions to improve literacy skills.
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Affiliation(s)
| | - Feng Xia
- Northern California Institute for ResearchSan FranciscoCaliforniaUSA
| | - Stephen Sidney
- Kaiser Permanente Division of ResearchOaklandCaliforniaUSA
| | | | - Pamela J. Schreiner
- Division of Epidemiology and Community HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Guray Erus
- Department of RadiologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Nick Bryan
- Department of RadiologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Kristine Yaffe
- Global Brain Health InstituteSan Francisco and DublinUSA and Ireland
- Northern California Institute for ResearchSan FranciscoCaliforniaUSA
- Departments of PsychiatryNeurology, and Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
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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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Nissim NR, Harvey DY, Haslam C, Friedman L, Bharne P, Litz G, Phillips JS, Cousins KAQ, Xie SX, Grossman M, Hamilton RH. Through Thick and Thin: Baseline Cortical Volume and Thickness Predict Performance and Response to Transcranial Direct Current Stimulation in Primary Progressive Aphasia. Front Hum Neurosci 2022; 16:907425. [PMID: 35874157 PMCID: PMC9302040 DOI: 10.3389/fnhum.2022.907425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives We hypothesized that measures of cortical thickness and volume in language areas would correlate with response to treatment with high-definition transcranial direct current stimulation (HD-tDCS) in persons with primary progressive aphasia (PPA). Materials and Methods In a blinded, within-group crossover study, PPA patients (N = 12) underwent a 2-week intervention HD-tDCS paired with constraint-induced language therapy (CILT). Multi-level linear regression (backward-fitted models) were performed to assess cortical measures as predictors of tDCS-induced naming improvements, measured by the Western Aphasia Battery-naming subtest, from baseline to immediately after and 6 weeks post-intervention. Results Greater baseline thickness of the pars opercularis significantly predicted naming gains (p = 0.03) immediately following intervention, while greater thickness of the middle temporal gyrus (MTG) and lower thickness of the superior temporal gyrus (STG) significantly predicted 6-week naming gains (p's < 0.02). Thickness did not predict naming gains in sham. Volume did not predict immediate gains for active stimulation. Greater volume of the pars triangularis and MTG, but lower STG volume significantly predicted 6-week naming gains in active stimulation. Greater pars orbitalis and MTG volume, and lower STG volume predicted immediate naming gains in sham (p's < 0.05). Volume did not predict 6-week naming gains in sham. Conclusion Cortical thickness and volume were predictive of tDCS-induced naming improvement in PPA patients. The finding that frontal thickness predicted immediate active tDCS-induced naming gains while temporal areas predicted naming changes at 6-week suggests that a broader network of regions may be important for long-term maintenance of treatment gains. The finding that volume predicted immediate naming performance in the sham condition may reflect the benefits of behavioral speech language therapy and neural correlates of its short-lived treatment gains. Collectively, thickness and volume were predictive of treatment gains in the active condition but not sham, suggesting that pairing HD-tDCS with CILT may be important for maintaining treatment effects.
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Affiliation(s)
- Nicole R. Nissim
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Moss Rehabilitation Research Institute, Elkins Park, PA, United States
| | - Denise Y. Harvey
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher Haslam
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Leah Friedman
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Pandurang Bharne
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Geneva Litz
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Jeffrey S. Phillips
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Katheryn A. Q. Cousins
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Sharon X. Xie
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Roy H. Hamilton
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
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8
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Sandu AL, Waiter GD, Staff RT, Nazlee N, Habota T, McNeil CJ, Chapko D, Williams JH, Fall CHD, Chandak GR, Pene S, Krishna M, McIntosh AM, Whalley HC, Kumaran K, Krishnaveni GV, Murray AD. Sexual dimorphism in the relationship between brain complexity, volume and general intelligence (g): a cross-cohort study. Sci Rep 2022; 12:11025. [PMID: 35773463 PMCID: PMC9247090 DOI: 10.1038/s41598-022-15208-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/20/2022] [Indexed: 01/20/2023] Open
Abstract
Changes in brain morphology have been reported during development, ageing and in relation to different pathologies. Brain morphology described by the shape complexity of gyri and sulci can be captured and quantified using fractal dimension (FD). This measure of brain structural complexity, as well as brain volume, are associated with intelligence, but less is known about the sexual dimorphism of these relationships. In this paper, sex differences in the relationship between brain structural complexity and general intelligence (g) in two diverse geographic and cultural populations (UK and Indian) are investigated. 3D T1-weighted magnetic resonance imaging (MRI) data and a battery of cognitive tests were acquired from participants belonging to three different cohorts: Mysore Parthenon Cohort (MPC); Aberdeen Children of the 1950s (ACONF) and UK Biobank. We computed MRI derived structural brain complexity and g estimated from a battery of cognitive tests for each group. Brain complexity and volume were both positively corelated with intelligence, with the correlations being significant in women but not always in men. This relationship is seen across populations of differing ages and geographical locations and improves understanding of neurobiological sex-differences.
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Affiliation(s)
- Anca-Larisa Sandu
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Lilian Sutton Building, Foresterhill, Aberdeen, AB25 2ZD, UK.
| | - Gordon D Waiter
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Lilian Sutton Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Roger T Staff
- Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK
| | - Nafeesa Nazlee
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Lilian Sutton Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Tina Habota
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Lilian Sutton Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Chris J McNeil
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Lilian Sutton Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Dorota Chapko
- School of Public Health, Imperial College London, London, UK
| | | | - Caroline H D Fall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Giriraj R Chandak
- Genomic Research on Complex Diseases, CSIR - Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Shailesh Pene
- Department of Imaging and Interventional Radiology, Narayana Multispecialty Hospital, Mysore, India
| | - Murali Krishna
- Foundation for Research and Advocacy in Mental Health, Mysore, India
| | - Andrew M McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Heather C Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Kalyanaraman Kumaran
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | | | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Lilian Sutton Building, Foresterhill, Aberdeen, AB25 2ZD, UK
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Realising the potential of functional imaging to reveal brain changes after anaesthesia and surgery. Br J Anaesth 2022; 128:897-900. [PMID: 35341583 DOI: 10.1016/j.bja.2022.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/23/2022] [Accepted: 02/16/2022] [Indexed: 11/22/2022] Open
Abstract
We highlight the ability of functional brain imaging to detect changes in human brain function, even when changes are not seen in cognitive testing. These imaging changes are plausible as they correlate with known activity changes in carriers of APOE4, a genetic variant associated with increased risk for Alzheimer's disease. However, to realise the potential of functional imaging for perioperative neurocognitive disorders, collaborations similar to the Alzheimer's Disease Neuroimaging Initiative (ADNI) with open data sharing will be required. For the practicing anaesthesiologist, we believe that postoperative cognitive issues are important topics to discuss during the informed consent process.
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10
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Cognitive Test Scores and Progressive Cognitive Decline in the Aberdeen 1921 and 1936 Birth Cohorts. Brain Sci 2022; 12:brainsci12030318. [PMID: 35326274 PMCID: PMC8946766 DOI: 10.3390/brainsci12030318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/30/2022] [Accepted: 02/07/2022] [Indexed: 02/01/2023] Open
Abstract
The Aberdeen birth cohorts of 1921 and 1936 (ABC21 and ABC36) were subjected to IQ tests in 1932 or 1947 when they were aged about 11y. They were recruited between 1997–2001 among cognitively healthy community residents and comprehensively phenotyped in a long-term study of brain aging and health up to 2017. Here, we report associations between baseline cognitive test scores and long-term cognitive outcomes. On recruitment, significant sex differences within and between the ABC21 and ABC36 cohorts supported advantages in verbal ability and learning among the ABC36 women that were not significant in ABC21. Comorbid physical disorders were self-reported in both ABC21 and ABC36 but did not contribute to differences in terms of performance in cognitive tests. When used alone without other criteria, cognitive tests scores which fell below the −1.5 SD criterion for tests of progressive matrices, namely verbal learning, digit symbol and block design, did not support the concept that Mild Cognitive Impairment (MCI) is a stable class of acquired loss of function with significant links to the later emergence of a clinical dementia syndrome. This is consistent with many previous reports. Furthermore, because childhood IQ-type data were available, we showed that a lower cognitive performance at about 64 or 78 y than that predicted by IQ at 11 ± 0.5 y did not improve the prediction of progress to MCI or greater cognitive loss. We used binary logistic regression to explore how MCI might contribute to the prediction of later progress to a clinical dementia syndrome. In a fully adjusted model using ABC21 data, we found that non-amnestic MCI, along with factors such as female sex and depressive symptoms, contributed to the prediction of later dementia. A comparable model using ABC36 data did not do so. We propose that (1) MCI criteria restricted to cognitive test scores do not improve the temporal stability of MCI classifications; (2) pathways towards dementia may differ according to age at dementia onset and (3) the concept of MCI may require measures (not captured here) that underly self-reported subjective age-related cognitive decline.
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11
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Brett BL, Walton S, Meier T, Nencka AS, Powell JR, Giovanello KS, Guskiewicz KK, McCrea M. Head impact exposure, grey matter volume, and moderating effects of estimated IQ and educational attainment in former athletes at midlife. J Neurotrauma 2022; 39:497-507. [PMID: 35044240 PMCID: PMC8978573 DOI: 10.1089/neu.2021.0449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Repetitive head impact (RHI) exposure has been associated with differences in brain structure among younger active athletes, most often within the hippocampus. Studies of former athletes at early-midlife are limited. We investigated the association between RHI exposure and grey matter structure, as well as moderating factors, among former athletes in early-midlife. Former collegiate football players (N=55; age=37.9+1.5 years) completed magnetic resonance imaging to quantify grey matter morphometry and extensive structured interviews of RHI history (Head Impact Exposure Estimate). Linear regression models tested the association between RHI exposure and GM structures of interest. Interactions were tested for moderators: two estimates of IQ (single word reading and picture vocabulary) and education history. Greater RHI exposure was associated with smaller hippocampal volume, β=-.36, p=.004. Conversely, RHI exposure was not significantly associated with other GM outcomes ps>.05. Education history significantly moderated the association between RHI exposure and hippocampal volume, β=.69, p=.047. Among those with a bachelor's degree, greater RHI exposure was significantly associated with smaller hippocampal volumes, β=-.58, p<.001. For those with graduate/professional degrees, the association between RHI and hippocampal volume was not significant, β=-.33, p=.134. Consistent with studies involving younger, active athletes, smaller hippocampal volumes were selectively associated with greater RHI exposure among former collegiate football players at midlife. This relationship was moderated by higher levels of education. Future longitudinal studies are needed to investigate the course of possible changes that can occur between early-midlife to older ages, as well as the continued protective effect of education and other potential influential factors.
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Affiliation(s)
- Benjamin L Brett
- Medical College of Wisconsin, 5506, Neurosurgery and Neurology, 8701 W Watertown Plank Rd, Milwaukee, Wisconsin, United States, 53226;
| | - Samuel Walton
- University of North Carolina at Chapel Hill College of Arts and Sciences, 169101, Department of Exercise and Sport Science, Chapel Hill, North Carolina, United States;
| | - Timothy Meier
- Medical College of Wisconsin, Neurosurgery, 8701 Watertown Plank Road, Milwaukee, Wisconsin, United States, 53226;
| | - Andrew S Nencka
- Medical College of Wisconsin, Biophysics, Milwaukee, Wisconsin, United States;
| | - Jacob R Powell
- University of North Carolina at Chapel Hill College of Arts and Sciences, 169101, Department of Exercise and Sport Science, Chapel Hill, North Carolina, United States;
| | - Kelly S Giovanello
- University of North Carolina at Chapel Hill, Psychology, Chapel Hill, North Carolina, United States;
| | - Kevin K Guskiewicz
- University of North Carolina, Exercise and Sport Science, CB#8700, Chapel Hill, North Carolina, United States, 27599-8700;
| | - Michael McCrea
- Medical College of Wisconsin, Neurosurgery, Hub for Collaborative Medicine, 8701 Watertown Plank Road, Milwaukee, Wisconsin, United States, 53226;
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12
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Dissanayake AS, Tan YB, Bowie CR, Butters MA, Flint AJ, Gallagher D, Golas AC, Herrmann N, Ismail Z, Kennedy JL, Kumar S, Lanctot KL, Mah L, Mulsant BH, Pollock BG, Rajji TK, Tau M, Maraj A, Churchill NW, Tsuang D, Schweizer TA, Munoz DG, Fischer CE. Sex Modifies the Associations of APOEɛ4 with Neuropsychiatric Symptom Burden in Both At-Risk and Clinical Cohorts of Alzheimer's Disease. J Alzheimers Dis 2022; 90:1571-1588. [PMID: 36314203 DOI: 10.3233/jad-220586] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recent work suggests that APOEɛ4/4 females with Alzheimer's disease (AD) are more susceptible to developing neuropsychiatric symptoms (NPS). OBJECTIVE To examine the interaction of sex and APOEɛ4 status on NPS burden using two independent cohorts: 1) patients at risk for AD with mild cognitive impairment and/or major depressive disorder (n = 252) and 2) patients with probable AD (n = 7,261). METHODS Regression models examined the interactive effects of sex and APOEɛ4 on the number of NPS experienced and NPS Severity. APOEɛ3/4 and APOEɛ4/4 were pooled in the at-risk cohort due to the sample size. RESULTS In the at-risk cohort, there was a significant sex*APOEɛ4 interaction (p = 0.007) such that the association of APOEɛ4 with NPS was greater in females than in males (incident rate ratio (IRR) = 2.0). APOEɛ4/4 females had the most NPS (mean = 1.9) and the highest severity scores (mean = 3.5) of any subgroup. In the clinical cohort, APOEɛ4/4 females had significantly more NPS (IRR = 1.1, p = 0.001, mean = 3.1) and higher severity scores (b = 0.31, p = 0.015, mean = 3.7) than APOEɛ3/3 females (meanNPS = 2.9, meanSeverity = 3.3). No association was found in males. CONCLUSION Our study suggests that sex modifies the association of APOEɛ4 on NPS burden. APOEɛ4/4 females may be particularly susceptible to increased NPS burden among individuals with AD and among individuals at risk for AD. Further investigation into the mechanisms behind these associations are needed.
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Affiliation(s)
- Andrew S Dissanayake
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Yu Bin Tan
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Christopher R Bowie
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Queen's University, Kingston, ON, Canada
| | - Meryl A Butters
- University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Alastair J Flint
- Centre for Mental Health, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Damien Gallagher
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Angela C Golas
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Zahinoor Ismail
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - James L Kennedy
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Krista L Lanctot
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Linda Mah
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Health Science Centre, Toronto, ON, Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bruce G Pollock
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Michael Tau
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Anika Maraj
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Nathan W Churchill
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Debby Tsuang
- GRECC, VA Puget Sound and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Tom A Schweizer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
| | - David G Munoz
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
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13
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Vuksanović V, Staff RT, Morson S, Ahearn T, Bracoud L, Murray AD, Bentham P, Kipps CM, Harrington CR, Wischik CM. Degeneration of basal and limbic networks is a core feature of behavioural variant frontotemporal dementia. Brain Commun 2021; 3:fcab241. [PMID: 34939031 PMCID: PMC8688778 DOI: 10.1093/braincomms/fcab241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/13/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
The behavioural variant of frontotemporal dementia is a clinical syndrome characterized by changes in behaviour, cognition and functional ability. Although atrophy in frontal and temporal regions would appear to be a defining feature, neuroimaging studies have identified volumetric differences distributed across large parts of the cortex, giving rise to a classification into distinct neuroanatomical subtypes. Here, we extended these neuroimaging studies to examine how distributed patterns of cortical atrophy map onto brain network hubs. We used baseline structural magnetic resonance imaging data collected from 213 behavioural variant of frontotemporal dementia patients meeting consensus diagnostic criteria and having definite evidence of frontal and/or temporal lobe atrophy from a global clinical trial conducted in 70 sites in Canada, United States of America, Australia, Asia and Europe. These were compared with data from 244 healthy elderly subjects from a well-characterized cohort study. We have used statistical methods of hierarchical agglomerative clustering of 68 regional cortical and subcortical volumes (34 in each hemisphere) to determine the reproducibility of previously described neuroanatomical subtypes in a global study. We have also attempted to link the structural findings to clinical features defined systematically using well-validated clinical scales (Addenbrooke’s Cognitive Examination Revised, the Mini-Mental Status Examination, the Frontotemporal Dementia Rating Scale and the Functional Assessment Questionnaire) and subscales derived from them. Whilst we can confirm that the subtypes are robust, they have limited value in explaining the clinical heterogeneity of the syndrome. We have found that a common pattern of degeneration affecting a small number of subcortical, limbic and frontal nodes within highly connected networks (most previously identified as rich club members or functional binding nodes) is shared by all the anatomical subtypes. Degeneration in these core regions is correlated with cognitive and functional impairment, but less so with behavioural impairment. These findings suggest that degeneration in highly connected basal, limbic and frontal networks is a core feature of the behavioural variant of frontotemporal dementia phenotype irrespective of neuroanatomical and clinical heterogeneity, and may underly the impairment of integration in cognition, function and behaviour responsible for the loss of insight that characterizes the syndrome.
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Affiliation(s)
- Vesna Vuksanović
- Swansea University Medical School, Health Data Research UK, Swansea University, Swansea SA2 8PP, UK.,School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK.,TauRx Therapeutics, Aberdeen AB24 5RP, UK
| | - Roger T Staff
- Medical Physics, NHS Grampian, Aberdeen AB25 2ZD, UK
| | - Suzannah Morson
- TauRx Therapeutics, Aberdeen AB24 5RP, UK.,School of Psychology, University of Aberdeen, Aberdeen AB24 3FX, UK
| | - Trevor Ahearn
- Medical Physics, NHS Grampian, Aberdeen AB25 2ZD, UK
| | | | - Alison D Murray
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | | | - Christopher M Kipps
- University Hospital Southampton and University of Southampton, Southampton SO16 6YD, UK
| | - Charles R Harrington
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK.,TauRx Therapeutics, Aberdeen AB24 5RP, UK
| | - Claude M Wischik
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK.,TauRx Therapeutics, Aberdeen AB24 5RP, UK
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14
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Chaikittisilpa S, Orprayoon N, Santibenchakul S, Hemrungrojn S, Phutrakool P, Kengsakul M, Jaisamrarn U. Prevalence of mild cognitive impairment in surgical menopause: subtypes and associated factors. Climacteric 2021; 24:394-400. [PMID: 33688775 DOI: 10.1080/13697137.2021.1889499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The aim of this study was to determine the prevalence and associated factors of mild cognitive impairment (MCI) and subtypes, amnestic MCI (aMCI) and non-amnestic MCI (naMCI), in women with surgical menopause. METHODS We obtained the database containing information for 200 women with surgical menopause from our previous study. The Montreal Cognitive Assessment - total score, the Montreal Cognitive Assessment - memory index score (MoCA-MIS) and their age, years since menopause, education, medical and surgical history, hormone therapy use, exercise, sleep duration, alcohol use, smoking and family history of dementia were obtained. All participants without the MoCA-MIS were excluded. RESULT The average age of the 164 participants was 56.3 ± 6.9 years. The prevalence of MCI, aMCI and naMCI was 43.3%, 9.8% and 33.5%, respectively. The duration of education reduced MCI for 93% (95% confidence interval 0.03-0.20) of the women. In late postmenopause, hormone therapy >10 years showed 47% lower prevalence of MCI (age-adjusted odds ratio = 0.53, 95% confidence interval 0.22-1.28). Finally, length of education was the only independent factor associated with MCI and its subtypes. CONCLUSION We found a high prevalence of MCI and the non-amnestic subtype in women with surgical menopause. Further study is needed to clarify the long-term effects of surgical menopause on cognitive function.
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Affiliation(s)
- S Chaikittisilpa
- Menopause Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - N Orprayoon
- Menopause Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - S Santibenchakul
- Family Planning and Reproductive Health Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - S Hemrungrojn
- Cognitive Fitness Research Group, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - P Phutrakool
- Chula Data Management Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - M Kengsakul
- Department of Obstetrics and Gynecology, Faculty of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Bangkok, Thailand
| | - U Jaisamrarn
- Menopause Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Family Planning and Reproductive Health Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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15
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Caffrey A, McNulty H, Rollins M, Prasad G, Gaur P, Talcott JB, Witton C, Cassidy T, Marshall B, Dornan J, Moore AJ, Ward M, Strain JJ, Molloy AM, McLaughlin M, Lees-Murdock DJ, Walsh CP, Pentieva K. Effects of maternal folic acid supplementation during the second and third trimesters of pregnancy on neurocognitive development in the child: an 11-year follow-up from a randomised controlled trial. BMC Med 2021; 19:73. [PMID: 33750355 PMCID: PMC7945668 DOI: 10.1186/s12916-021-01914-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/14/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Maternal folic acid (FA) supplementation before and in early pregnancy prevents neural tube defects (NTD), but it is uncertain whether continuing FA after the first trimester has benefits on offspring health. We aimed to evaluate the effect of FA supplementation throughout pregnancy on cognitive performance and brain function in the child. METHODS Follow-up investigation of 11-year-old children, residing in Northern Ireland, whose mothers had participated in a randomised trial of Folic Acid Supplementation in the Second and Third Trimesters (FASSTT) in pregnancy and received 400 μg/day FA or placebo from the 14th gestational week. Cognitive performance (Full Scale Intelligence Quotient, Verbal Comprehension, Working Memory, Perceptual Reasoning, and Processing Speed) was assessed using the Wechsler Intelligence Scale for Children. Neuronal function was assessed using magnetoencephalographic (MEG) brain imaging. RESULTS Of 119 mother-child pairs in the FASSTT trial, 68 children were assessed for neurocognitive performance at 11-year follow-up (Dec 2017 to Nov 2018). Children of mothers randomised to FA compared with placebo scored significantly higher in two Processing Speed tests, i.e. symbol search (mean difference 2.9 points, 95% CI 0.3 to 5.5, p = 0.03) and cancellation (11.3 points, 2.5 to 20.1, p = 0.04), whereas the positive effect on Verbal Comprehension was significant in girls only (6.5 points, 1.2 to 11.8, p = 0.03). MEG assessment of neuronal responses to a language task showed increased power at the Beta (13-30 Hz, p = 0.01) and High Gamma (49-70 Hz, p = 0.04) bands in children from FA-supplemented mothers, suggesting more efficient semantic processing of language. CONCLUSIONS Continued FA supplementation in pregnancy beyond the early period currently recommended to prevent NTD can benefit neurocognitive development of the child. MEG provides a non-invasive tool in paediatric research to objectively assess functional brain activity in response to nutrition and other interventions. TRIAL REGISTRATION ISRCTN ISRCTN19917787 . Registered on 15 May 2013.
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Affiliation(s)
- Aoife Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Mark Rollins
- Northern Health and Social Care Trust, Causeway Hospital, Coleraine, Northern Ireland, UK
| | - Girijesh Prasad
- Intelligent Systems Research Centre, Ulster University, Derry~Londonderry, Northern Ireland, UK
| | - Pramod Gaur
- Intelligent Systems Research Centre, Ulster University, Derry~Londonderry, Northern Ireland, UK.,Department of Computer Science, BITS Pilani, Dubai campus, Dubai, United Arab Emirates
| | - Joel B Talcott
- Institute of Health and Neurodevelopment, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Caroline Witton
- Institute of Health and Neurodevelopment, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Tony Cassidy
- Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, UK
| | - Barry Marshall
- Northern Health and Social Care Trust, Causeway Hospital, Coleraine, Northern Ireland, UK
| | - James Dornan
- Royal-Jubilee Maternity Service, Belfast, Northern Ireland, UK
| | - Adrian J Moore
- School of Environmental Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Anne M Molloy
- School of Medicine, Trinity College, Dublin, Ireland
| | - Marian McLaughlin
- Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, UK
| | - Diane J Lees-Murdock
- Genomics Medicine Research Group, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Colum P Walsh
- Genomics Medicine Research Group, School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Kristina Pentieva
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK.
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16
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Occupation-related effects on motor cortex thickness among older, cognitive healthy individuals. Brain Struct Funct 2021; 226:1023-1030. [PMID: 33555422 PMCID: PMC8036179 DOI: 10.1007/s00429-021-02223-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/19/2021] [Indexed: 02/07/2023]
Abstract
Both, decline of sensorimotor functions and cortical thickness are known processes in healthy aging. Physical activity has been suggested to enhance the execution of daily routine activities and to extend the time of functional independence in advanced age. We hypothesized that cortical thickness of motor areas in retired individuals could be related to physical demands of the profession carried out during working life. Depending on their former occupations, 69 cognitively healthy individuals (range 70–85 years) were divided into higher and lower physically complex occupations (HPCO n = 27 and LPCO n = 42) according to the international standard classification of occupations (ISCO-08). Participants underwent a high-resolution 3T T1-weighted MRI scan. Surface-based analysis revealed higher cortical thickness in the left precentral (P = 0.001) and postcentral gyrus (P < 0.001) and right postcentral gyrus (P = 0.001) for the HPCO relative to the LPCO group (corrected for multiple comparisons, sex, age and leisure activities in the past 20 years). Physical leisure activities associated with exertion were positively correlated with cortical thickness in the left pre- and postcentral gyrus (P = 0.037) of the LPCO group. Time since retirement was negatively associated with cortical thickness in the left postcentral gyrus (P = 0.004) of the HPCO group. Executing a higher physically complex occupation before retirement was related to relative higher cortical thickness in the primary motor and somatosensory cortex in later life, supporting the hypothesis that physical activity contributes to neural reserve in these regions. However, these benefits appear to vanish when physical activity is reduced due to retirement.
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17
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Chen W, Lin H, Lyu M, Wang VJ, Li X, Bao S, Sun G, Xia J, Wang P. The potential role of leukoaraiosis in remodeling the brain network to buffer cognitive decline: a Leukoaraiosis And Disability study from Alzheimer's Disease Neuroimaging Initiative. Quant Imaging Med Surg 2021; 11:183-203. [PMID: 33392021 DOI: 10.21037/qims-20-580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background Leukoaraiosis (LA) is a phenomenon of the brain that is often observed in elderly people. However, little is known about the role of LA in cognitive impairment in neurodegeneration and disease. This cross-sectional, retrospective Leukoaraiosis And Disability (LADIS) study aimed to characterize the relationship between brain white matter connectivity properties with LA ratings in patients with Alzheimer's disease (AD) as compared with age-matched cognitively normal controls. Methods Patients with AD (n=76) and elderly individuals with normal cognitive (NC) function (n=82) were classified into 3 groups, LA1, LA2, and LA3, according to the rating of their white matter changes (WMCs). Diffusion tensor imaging (DTI) data were analyzed by quantifying and comparing the white matter connectivity properties and gray matter (GM) volume of brain regions of interest (ROIs). Results The rich-club network properties in the AD LA1 and LA2 groups showed significant patterns of disrupted peripheral regions and reduced connectivity compared to those in the NC LA1 and LA2 groups, respectively. However, the rich-club network properties in the AD LA3 group showed similar patterns of disrupted peripheral regions and reduced connectivity compared to those in the NC LA3 group, despite there being significant hippocampal and amygdala atrophic differences between AD patients and NC elders. Compared to the NC LA1 group, the characteristic path length of white matter fiber connectivity in the NC LA3 group was significantly increased, and the brain's global efficiency, clustering coefficient, and network connectivity strength were significantly reduced (P<0.05, respectively). However, no significant differences (P>0.05) were observed in characteristic path length, reduced global efficiency, or the clustering coefficient between the NC LA3 and AD LA1 groups, or between the NC LA3 and AD LA2 groups. Conclusions Our findings offer some insights into a potential role of LA in cognitive impairment that may predict the development of disability in older adults. The occurrence of LA, an intermediate degenerative change, during neurodegeneration and disease may potentially lead to the remodeling of the brain network through brain plasticity. LA, therefore, representing a possible compensatory mechanism to buffer cognitive decline.
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Affiliation(s)
- Wei Chen
- Department of Radiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Radiology, Pingshan District People's Hospital, Pingshan General Hospital of Southern Medical University, Shenzhen, China
| | - Hai Lin
- Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Minrui Lyu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Victoria J Wang
- Department of Nephrology, Tufts Medical Center, Boston, MA, USA
| | - Xiang Li
- Guangdong Provincial Key Laboratory of Brain Connectome and Behaviour, the Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences; Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Shixing Bao
- Department of Radiology, Osaka University, Osaka, Japan
| | - Guoping Sun
- Department of Radiology, Pingshan District People's Hospital, Pingshan General Hospital of Southern Medical University, Shenzhen, China
| | - Jun Xia
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Peijun Wang
- Department of Radiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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18
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Reserva cognitiva e os diferentes perfis de ganho cognitivo em idosos. PSICO 2020. [DOI: 10.15448/1980-8623.2020.4.33842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
O objetivo desse estudo foi verificar diferentes perfis de ganho cognitivo em idosos para a reserva cognitiva. Trata-se de uma scoping review, utilizando-se PubMed, Medline, Web of Science, Science Direct, Lilacs, SciELO, PsycInfo, PsycNet e AgeLine como base de dados; restringiu-se a busca entre o ano de 2008 e 2018. Identificou-se 2295 estudos e 51 foram elegíveis para a revisão. Dentre os 51 estudos selecionados, encontrou-se 9 perfis diferentes para manutenção cognitiva, sendo que 5 estudos não especificaram o perfil. Conclusão: Os perfis encontrados representaram relevância para a teoria de reserva cognitiva e forneceram esclarecimentos de como fatores individuais e de vida diária podem fazer o cérebro mais resiliente no envelhecimento e na velhice; no entanto, esses fatores individuais e o modo como eles contribuem para o desenvolvimento da reserva cognitiva e da manutenção da cognição ainda permanecem obscuras na literatura
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Cognitive Reserve Proxies Do Not Differentially Account for Cognitive Performance in Patients with Focal Frontal and Non-Frontal Lesions. J Int Neuropsychol Soc 2020; 26:739-748. [PMID: 32312348 DOI: 10.1017/s1355617720000326] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Cognitive reserve (CR) suggests that premorbid efficacy, aptitude, and flexibility of cognitive processing can aid the brain's ability to cope with change or damage. Our previous work has shown that age and literacy attainment predict the cognitive performance of frontal patients on frontal-executive tests. However, it remains unknown whether CR also predicts the cognitive performance of non-frontal patients. METHOD We investigated the independent effect of a CR proxy, National Adult Reading Test (NART) IQ, as well as age and lesion group (frontal vs. non-frontal) on measures of executive function, intelligence, processing speed, and naming in 166 patients with focal, unilateral frontal lesions; 91 patients with focal, unilateral non-frontal lesions; and 136 healthy controls. RESULTS Fitting multiple linear regression models for each cognitive measure revealed that NART IQ predicted executive, intelligence, and naming performance. Age also significantly predicted performance on the executive and processing speed tests. Finally, belonging to the frontal group predicted executive and naming performance, while membership of the non-frontal group predicted intelligence. CONCLUSIONS These findings suggest that age, lesion group, and literacy attainment play independent roles in predicting cognitive performance following stroke or brain tumour. However, the relationship between CR and focal brain damage does not differ in the context of frontal and non-frontal lesions.
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20
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Marseglia A, Darin‐Mattsson A, Kalpouzos G, Grande G, Fratiglioni L, Dekhtyar S, Xu W. Can active life mitigate the impact of diabetes on dementia and brain aging? Alzheimers Dement 2020; 16:1534-1543. [DOI: 10.1002/alz.12142] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/10/2020] [Indexed: 01/02/2023]
Affiliation(s)
- Anna Marseglia
- Department of Neurobiology Aging Research Center Care Sciences and Society Karolinska Institutet and Stockholm University Stockholm Sweden
| | - Alexander Darin‐Mattsson
- Department of Neurobiology Aging Research Center Care Sciences and Society Karolinska Institutet and Stockholm University Stockholm Sweden
| | - Grégoria Kalpouzos
- Department of Neurobiology Aging Research Center Care Sciences and Society Karolinska Institutet and Stockholm University Stockholm Sweden
| | - Giulia Grande
- Department of Neurobiology Aging Research Center Care Sciences and Society Karolinska Institutet and Stockholm University Stockholm Sweden
| | - Laura Fratiglioni
- Department of Neurobiology Aging Research Center Care Sciences and Society Karolinska Institutet and Stockholm University Stockholm Sweden
- Stockholm Gerontology Research Center Stockholm Sweden
| | - Serhiy Dekhtyar
- Department of Neurobiology Aging Research Center Care Sciences and Society Karolinska Institutet and Stockholm University Stockholm Sweden
| | - Weili Xu
- Department of Neurobiology Aging Research Center Care Sciences and Society Karolinska Institutet and Stockholm University Stockholm Sweden
- Department of Epidemiology and Biostatistics School of Public Health Tianjin Medical University Tianjin China
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21
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Ma LJ, Wu TM, Feng IJ, Hsu CC, Su SB, Wang JJ, Huang CC. Comparison of the risk for dementia between physicians and the general population: a nationwide population-based cohort study. Aging Clin Exp Res 2020; 32:1111-1119. [PMID: 31428999 DOI: 10.1007/s40520-019-01278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/17/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Physicians have better medical knowledge, which may decrease the risk of dementia; however, this issue remains unclear. This study was performed to clarify it. METHODS We conducted a nationwide population-based study that recruited 29,388 physicians, 50,000 participants from the general population, and 30,446 other healthcare professionals (HCPs; excluding physicians) for this study. The prevalence of dementia was compared among the three groups and physician subgroups by tracing their medical histories from 2006 to 2012. RESULTS Physicians had a lower prevalence of dementia than the general population after adjusting for age, sex, head trauma, hypothyroidism, hypertension, diabetes mellitus, stroke, vascular disease, atrial fibrillation, hypercholesterolemia, depression, and alcoholism [adjusted odds ratio (AOR) 0.56; 95% confidence interval (CI) 0.47-0.67]. Other HCPs also had a lower prevalence for dementia than the general population (AOR 0.46; 95% CI 0.36-0.60). Compared with other HCPs, physicians had no difference in the prevalence for dementia (AOR 0.98 95% CI 0.71-1.36). Physicians who were older, specialized in pediatrics and worked at local hospitals and clinics had a higher prevalence for dementia than their counterparts did. CONCLUSIONS Physicians had a lower prevalence for dementia than the general population. The prevalence for dementia in specific subgroups of physicians was higher, which needs to be clarified by further studies.
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Affiliation(s)
- Li-Jung Ma
- Health Promotion Center, Chi-Mei Medical Center, Tainan, Liouying, Taiwan
| | - Tse-Min Wu
- Department of Emergency Medicine, Chi-Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan, 710, Taiwan
| | - I-Jung Feng
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
| | - Chien-Chin Hsu
- Department of Emergency Medicine, Chi-Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan, 710, Taiwan
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi-Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan, 710, Taiwan.
- Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
- Department of Medical Research, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
| | - Jhi-Joung Wang
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
- Allied AI Biomed Center, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Chien-Cheng Huang
- Department of Emergency Medicine, Chi-Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan, 710, Taiwan.
- Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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22
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McNulty H, Rollins M, Cassidy T, Caffrey A, Marshall B, Dornan J, McLaughlin M, McNulty BA, Ward M, Strain JJ, Molloy AM, Lees-Murdock DJ, Walsh CP, Pentieva K. Effect of continued folic acid supplementation beyond the first trimester of pregnancy on cognitive performance in the child: a follow-up study from a randomized controlled trial (FASSTT Offspring Trial). BMC Med 2019; 17:196. [PMID: 31672132 PMCID: PMC6823954 DOI: 10.1186/s12916-019-1432-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/23/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Periconceptional folic acid prevents neural tube defects (NTDs), but it is uncertain whether there are benefits for offspring neurodevelopment arising from continued maternal folic acid supplementation beyond the first trimester. We investigated the effect of folic acid supplementation during trimesters 2 and 3 of pregnancy on cognitive performance in the child. METHODS We followed up the children of mothers who had participated in a randomized controlled trial in 2006/2007 of Folic Acid Supplementation during the Second and Third Trimesters (FASSTT) and received 400 μg/d folic acid or placebo from the 14th gestational week until the end of pregnancy. Cognitive performance of children at 7 years was evaluated using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and at 3 years using the Bayley's Scale of Infant and Toddler Development (BSITD-III). RESULTS From a total of 119 potential mother-child pairs, 70 children completed the assessment at age 7 years, and 39 at age 3 years. At 7 years, the children of folic acid treated mothers scored significantly higher than the placebo group in word reasoning: mean 13.3 (95% CI 12.4-14.2) versus 11.9 (95% CI 11.0-12.8); p = 0.027; at 3 years, they scored significantly higher in cognition: 10.3 (95% CI 9.3-11.3) versus 9.5 (95% CI 8.8-10.2); p = 0.040. At both time points, greater proportions of children from folic acid treated mothers compared with placebo had cognitive scores above the median values of 10 (girls and boys) for the BSITD-III, and 24.5 (girls) and 21.5 (boys) for the WPPSI-III tests. When compared with a nationally representative sample of British children at 7 years, WPPSI-III test scores were higher in children from folic acid treated mothers for verbal IQ (p < 0.001), performance IQ (p = 0.035), general language (p = 0.002), and full scale IQ (p = 0.001), whereas comparison of the placebo group with British children showed smaller differences in scores for verbal IQ (p = 0.034) and full scale IQ (p = 0.017) and no differences for performance IQ or general language. CONCLUSIONS Continued folic acid supplementation in pregnancy beyond the early period recommended to prevent NTD may have beneficial effects on child cognitive development. Further randomized trials in pregnancy with follow-up in childhood are warranted. TRIAL REGISTRATION ISRCTN ISRCTN19917787 . Registered 15 May 2013.
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Affiliation(s)
- Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Mark Rollins
- Northern Health and Social Care Trust, Causeway Hospital, Northern Ireland, UK
| | - Tony Cassidy
- Psychology Research Institute, Ulster University, Northern Ireland, UK
| | - Aoife Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Barry Marshall
- Northern Health and Social Care Trust, Causeway Hospital, Northern Ireland, UK
| | - James Dornan
- Royal-Jubilee Maternity Service, Belfast, Northern Ireland, UK
| | - Marian McLaughlin
- Psychology Research Institute, Ulster University, Northern Ireland, UK
| | - Breige A McNulty
- Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Diane J Lees-Murdock
- Genomic Medicine Group, School of Biomedical Sciences, Ulster University, Northern Ireland, UK
| | - Colum P Walsh
- Genomic Medicine Group, School of Biomedical Sciences, Ulster University, Northern Ireland, UK
| | - Kristina Pentieva
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK.
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Ter Telgte A, van Leijsen EMC, Wiegertjes K, Klijn CJM, Tuladhar AM, de Leeuw FE. Cerebral small vessel disease: from a focal to a global perspective. Nat Rev Neurol 2019; 14:387-398. [PMID: 29802354 DOI: 10.1038/s41582-018-0014-y] [Citation(s) in RCA: 299] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Cerebral small vessel disease (SVD) is commonly observed on neuroimaging among elderly individuals and is recognized as a major vascular contributor to dementia, cognitive decline, gait impairment, mood disturbance and stroke. However, clinical symptoms are often highly inconsistent in nature and severity among patients with similar degrees of SVD on brain imaging. Here, we provide a new framework based on new advances in structural and functional neuroimaging that aims to explain the remarkable clinical variation in SVD. First, we discuss the heterogeneous pathology present in SVD lesions despite an identical appearance on imaging and the perilesional and remote effects of these lesions. We review effects of SVD on structural and functional connectivity in the brain, and we discuss how network disruption by SVD can lead to clinical deficits. We address reserve and compensatory mechanisms in SVD and discuss the part played by other age-related pathologies. Finally, we conclude that SVD should be considered a global rather than a focal disease, as the classically recognized focal lesions affect remote brain structures and structural and functional network connections. The large variability in clinical symptoms among patients with SVD can probably be understood by taking into account the heterogeneity of SVD lesions, the effects of SVD beyond the focal lesions, the contribution of neurodegenerative pathologies other than SVD, and the interaction with reserve mechanisms and compensatory mechanisms.
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Affiliation(s)
- Annemieke Ter Telgte
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Esther M C van Leijsen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Kim Wiegertjes
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Catharina J M Klijn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Anil M Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.
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24
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Serra L, Gelfo F, Petrosini L, Di Domenico C, Bozzali M, Caltagirone C. Rethinking the Reserve with a Translational Approach: Novel Ideas on the Construct and the Interventions. J Alzheimers Dis 2019; 65:1065-1078. [PMID: 30149458 DOI: 10.3233/jad-180609] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The concept of brain, cognitive, and neural reserves has been introduced to account for the apparent discrepancies between neurological damage and clinical manifestations. However, these ideas are yet theoretical suggestions that are not completely assimilated in the clinical routine. The mechanisms of the reserves have been extensively studied in neurodegenerative pathologies, in particular in Alzheimer's disease. Both human and animal studies addressed this topic by following two parallel pathways. The specific aim of the present review is to attempt to combine the suggestions derived from the two different research fields to deepen the knowledge about reserves. In fact, the achievement of a comprehensive theoretical framework on reserve mechanisms is an essential step to propose well-timed interventions tailored to the clinical characteristics of patients. The present review highlights the importance of addressing three main aspects: the definition of reserve proxy measures, the interaction between reserve level and therapeutic interventions, and the specific time-window of reserve efficacy.
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Affiliation(s)
- Laura Serra
- Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Francesca Gelfo
- Department of Clinical and Behavioural Neurology, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Laura Petrosini
- Laboratory of Experimental Neurophysiology and Behaviour, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, University Sapienza of Rome, Rome, Italy
| | | | - Marco Bozzali
- Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy.,Clinical Imaging Science Center, Brighton and Sussex Medical School, Brighton, UK
| | - Carlo Caltagirone
- Department of Clinical and Behavioural Neurology, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Systemic Medicine, University of Rome Tor Vergata, Rome, Italy
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25
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Oghagbon EK, Giménez-Llort L. Short height and poor education increase the risk of dementia in Nigerian type 2 diabetic women. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2019; 11:493-499. [PMID: 31334329 PMCID: PMC6624244 DOI: 10.1016/j.dadm.2019.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction There is urgent need to investigate type 2 diabetes and dementia crosstalk in sub-Saharan African countries with special attention to women who have higher vulnerability. Nigeria which has the highest number of diabetics on the African continent is a good location for the investigation. Methods Biophysical parameters, occupation, education, burden of diabetes mellitus, cardiovascular health, and cognition were evaluated in 102 type 2 diabetics and 99 controls. Results Short physical stature and lower level of education were hallmarks of diabetes in females. Two dementia scales (Mini–Mental State Examination and six-item Cognitive Impairment Test) showed cognitive impairment status, with the six-item Cognitive Impairment Test scale being more specific and sensitive. Both scales showed correlations with age, education, weight, height, and disease onset, whereas fasten blood glucose was negatively correlated with height and their blood pressure was normal. Discussion Height, an easy-to-measure parameter in Nigeria, may reveal increased risk of dementia in poorly educated female Nigerian diabetics, thus helping to improve preventive and therapeutic interventions.
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Affiliation(s)
- Efosa Kenneth Oghagbon
- Faculty of Basic & Allied Medical Sciences, Department of Chemical Pathology, College of Health Sciences, Benue State University, Makurdi, Nigeria
- Department of Chemical Pathology, Benue State University Teaching Hospital, Makurdi, Nigeria
| | - Lydia Giménez-Llort
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
- Corresponding author. Tel: +34-5812378; Fax: +34-935811435.
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26
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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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27
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Affiliation(s)
- N. N. Koberskaya
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - G. R. Tabeeva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
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28
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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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29
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Hahn C, Lee CU. A Brief Review of Paradigm Shifts in Prevention of Alzheimer's Disease: From Cognitive Reserve to Precision Medicine. Front Psychiatry 2019; 10:786. [PMID: 31736804 PMCID: PMC6837073 DOI: 10.3389/fpsyt.2019.00786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 10/02/2019] [Indexed: 12/13/2022] Open
Abstract
Alzheimer's disease (AD) and related dementias can be an enormous economic burden for taxpayers, patients, their families, medical systems, and society as a whole. Since disease-modifying treatments have failed, several studies have instead focused on a paradigm shift for preventing and treating AD. A higher cognitive reserve (e.g., greater education, occupational attainment, or more leisure activities) is associated with protection against disease-related cognitive decline. Precision medicine aims to optimize the effectiveness of disease prevention and treatment by considering specific biological components of individuals. We suggest that research into cognitive reserve and precision medicine could be a key to overcoming the limitations of traditional approaches to the prevention and treatment of AD.
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Affiliation(s)
- Changtae Hahn
- Department of Psychiatry, Deajeon Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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30
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Resende EDPF, Rosen HJ, Chiang K, Staffaroni AM, Allen I, Grinberg LT, Carmona KC, Guimarães HC, Carvalho VA, Barbosa MT, de Souza LC, Caramelli P. Primary School Education May Be Sufficient to Moderate a Memory-Hippocampal Relationship. Front Aging Neurosci 2018; 10:381. [PMID: 30515091 PMCID: PMC6255790 DOI: 10.3389/fnagi.2018.00381] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/31/2018] [Indexed: 01/30/2023] Open
Abstract
According to the cognitive reserve theory, intellectual stimuli acquired during life can prevent against developing cognitive impairment. The underlying cognitive reserve mechanisms were underexplored in low-educated individuals. Because episodic memory impairment due to hippocampal dysfunction is a key feature of Alzheimer's dementia (AD), we sought to look at a possible cognitive reserve mechanism by determining whether few years of education moderated the relationship between the hippocampal volumes and the episodic-memory scores. The sample was composed by 183 older adults, 40.1% male, with the median age of 78[76,82] years and the median years of education of 4[2,10] who had undergone an episodic-memory test and a 3-Tesla MRI scan to access the hippocampal volumes. Overall, 112 were cognitively healthy, 26 had cognitive impairment-no dementia (CIND) and 45 had dementia. We used multiple linear regression to assess whether the interaction between years of education and each hippocampal volume significantly predicted the episodic-memory scores' variance, controlling for cognitive diagnosis and nuisance variables. The interaction term with the left hippocampus (ß = 0.2, p = 0.043, CI = 1.0, 1.4), but not with the right (ß = 0.1, p = 0.218, CI = 0.9, 1.2) significantly predicted the variation on memory scores. The mechanism by which the left hippocampus seems to play a more important role on memory processing in more educated individuals needs to be further investigated and might be associated with a better use of mnemonic strategies or higher hippocampal connectivity. Because the sample's median years of education was four, which corresponds to primary school, we may infer that this level might be sufficient to contribute for building cognitive reserve.
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Affiliation(s)
- Elisa de Paula França Resende
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Kevin Chiang
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Adam M Staffaroni
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Isabel Allen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Lea T Grinberg
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Karoline Carvalho Carmona
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Henrique Cerqueira Guimarães
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Viviane Amaral Carvalho
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maira Tonidandel Barbosa
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leonardo Cruz de Souza
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Caramelli
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Vuksanović V, Staff RT, Ahearn T, Murray AD, Wischik CM. Cortical Thickness and Surface Area Networks in Healthy Aging, Alzheimer's Disease and Behavioral Variant Fronto-Temporal Dementia. Int J Neural Syst 2018; 29:1850055. [PMID: 30638083 DOI: 10.1142/s0129065718500557] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Models of the human brain as a complex network of inter-connected sub-units are important in helping to understand the structural basis of the clinical features of neurodegenerative disorders. The aim of this study was to characterize in a systematic manner the differences in the structural correlation networks in cortical thickness (CT) and surface area (SA) in Alzheimer's disease (AD) and behavioral variant Fronto-Temporal Dementia (bvFTD). We have used the baseline magnetic resonance imaging (MRI) data available from a large population of patients from three clinical trials in mild to moderate AD and mild bvFTD and compared this to a well-characterized healthy aging cohort. The study population comprised 202 healthy elderly subjects, 213 with bvFTD and 213 with AD. We report that both CT and SA network architecture can be described in terms of highly correlated networks whose positive and inverse links map onto the intrinsic modular organization of the four cortical lobes. The topology of the disturbance in structural network is different in the two disease conditions, and both are different from normal aging. The changes from normal are global in character and are not restricted to fronto-temporal and temporo-parietal lobes, respectively, in bvFTD and AD, and indicate an increase in both global correlational strength and in particular nonhomologous inter-lobar connectivity defined by inverse correlations. These inverse correlations appear to be adaptive in character, reflecting coordinated increases in CT and SA that may compensate for corresponding impairment in functionally linked nodes. The effects were more pronounced in the cortical thickness atrophy network in bvFTD and in the surface area network in AD. Although lobar modularity is preserved in the context of neurodegenerative disease, the hub-like organization of networks differs both from normal and between the two forms of dementia. This implies that hubs may be secondary features of the connectivity adaptation to neurodegeneration and may not be an intrinsic property of the brain. However, analysis of the topological differences in hub-like organization CT and SA networks, and their underlying positive and negative correlations, may provide a basis for assisting in the differential diagnosis of bvFTD and AD.
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Affiliation(s)
- Vesna Vuksanović
- 1Aberdeen Biomedical Imaging Center, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Roger T Staff
- 2Imaging Physics, National Health Service Grampian, Aberdeen, AB25 2ZD, UK
| | - Trevor Ahearn
- 2Imaging Physics, National Health Service Grampian, Aberdeen, AB25 2ZD, UK
| | - Alison D Murray
- 1Aberdeen Biomedical Imaging Center, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Claude M Wischik
- 3TauRx, Therapeutics, Aberdeen, AB24 5RP, UK.,4School of Medicine and Dentistry, University of Aberdeen, Aberdeen, AB25 2ZD, UK
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Kaup AR, Xia F, Launer LJ, Sidney S, Nasrallah I, Erus G, Allen N, Yaffe K. Occupational cognitive complexity in earlier adulthood is associated with brain structure and cognitive health in midlife: The CARDIA study. Neuropsychology 2018; 32:895-905. [PMID: 29985017 PMCID: PMC6234051 DOI: 10.1037/neu0000474] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE In line with cognitive reserve theory, higher occupational cognitive complexity is associated with reduced cognitive decline in older adulthood. How and when occupational cognitive complexity first exerts protective effects during the life span remains unclear. We investigated associations between occupational cognitive complexity during early to midadulthood and brain structure and cognition in midlife. METHOD Participants were 669 adults from the Coronary Artery Risk Development in Young Adults study (aged 18-30 years at baseline, 52% female, 38% Black). We calculated scores reflecting occupational cognitive complexity using Census Occupation Codes (years 10 and 15) and Occupational Information Network (O*NET) data. At year 25, participants had structural brain magnetic resonance imaging, diffusion tensor imaging, and cognitive testing (Rey Auditory Verbal Learning Test, Digit Symbol Substitution Test, Stroop). In adjusted mixed models, we examined associations between occupational cognitive complexity during early to midadulthood and midlife brain structure, specifically gray matter volume and white matter fractional anisotropy, and cognition in midlife (all outcomes converted to z-scores). RESULTS Higher occupational cognitive complexity was associated with greater white matter fractional anisotropy (estimate = 0.10, p = .01) but not gray matter volume. Higher occupational cognitive complexity was associated with better Digit Symbol Substitution Test (estimate = 0.13, p < .001) and Stroop (estimate = 0.09, p = .01) performance but not Rey Auditory Verbal Learning Test performance. CONCLUSIONS Occupational cognitive complexity earlier in adulthood is associated with better white matter integrity, processing speed, and executive function in midlife. These associations may capture how occupational cognitive complexity contributes to cognitive reserve. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Allison R. Kaup
- Research Service, San Francisco VA Health Care System and Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Feng Xia
- Northern California Institute for Research and Education, San Francisco, CA, USA
| | | | - Stephen Sidney
- Kaiser Permanente Division of Research, Oakland, CA, USA
| | - Ilya Nasrallah
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Guray Erus
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Norrina Allen
- Department of Preventive Medicine-Epidemiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California San Francisco and San Francisco VA Healthcare System, San Francisco, CA, USA
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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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Chapko D, McCormack R, Black C, Staff R, Murray A. Life-course determinants of cognitive reserve (CR) in cognitive aging and dementia - a systematic literature review. Aging Ment Health 2018; 22:915-926. [PMID: 28703027 DOI: 10.1080/13607863.2017.1348471] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The concept of cognitive reserve (CR) is defined as a moderator, which allows an individual to preserve cognition despite underlying brain pathology. There is no consensus of what potentially modifiable CR determinants are of greatest importance. The aim of this review was to identify life-course factors which protect older individuals from expressing cognitive decline despite the presence of brain pathology. METHOD A systematic review search was performed in MEDLINE (1946-06/09/13), EMBASE (1947-06/09/13), and PsycheInfo (1967-06/09/13). We included studies examining CR in the context of the four commonest subtypes of dementia, mild cognitive impairment or healthy aging. Studies which combined measurement of underlying dementia-related neuropathology, cognitive function, and factors providing CR in a single model were accepted. We performed a qualitative synthesis of the results. RESULTS Thirty-four studies out of 9229 screened records met our inclusion criteria and were therefore quality assessed and data extracted. Variation in CR definition made comparison across studies difficult. One hundred and forty-four out of 156 models examined education and occupation: overall, 58% of eligible models classified education and 60% occupation as a CR determinant, with 12% and 44% of those, respectively, being of high quality. Within healthy population suitable to inform preventative interventions, there was consistent evidence for education having a protective effect on general cognition in the face of multiple brain burden measures, while occupation presented inconclusive results within cognitive groups. CONCLUSIONS Further research on modifiable determinants of CR beyond education/occupation including early-life factors and consensus on CR definition are warranted.
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Affiliation(s)
- Dorota Chapko
- a Aberdeen Biomedical Imaging Centre , University of Aberdeen , Aberdeen , UK
| | - Roisin McCormack
- a Aberdeen Biomedical Imaging Centre , University of Aberdeen , Aberdeen , UK
| | - Corri Black
- b Farr Institute @ Scotland, Institute of Applied Health Sciences , University of Aberdeen , Aberdeen , UK
| | - Roger Staff
- c Aberdeen Royal Infirmary , NHS Grampian , Aberdeen , UK
| | - Alison Murray
- a Aberdeen Biomedical Imaging Centre , University of Aberdeen , Aberdeen , UK
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Wilcock GK, Gauthier S, Frisoni GB, Jia J, Hardlund JH, Moebius HJ, Bentham P, Kook KA, Schelter BO, Wischik DJ, Davis CS, Staff RT, Vuksanovic V, Ahearn T, Bracoud L, Shamsi K, Marek K, Seibyl J, Riedel G, Storey JMD, Harrington CR, Wischik CM. Potential of Low Dose Leuco-Methylthioninium Bis(Hydromethanesulphonate) (LMTM) Monotherapy for Treatment of Mild Alzheimer's Disease: Cohort Analysis as Modified Primary Outcome in a Phase III Clinical Trial. J Alzheimers Dis 2018; 61:435-457. [PMID: 29154277 PMCID: PMC5734125 DOI: 10.3233/jad-170560] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: LMTM is being developed as a treatment for AD based on inhibition of tau aggregation. Objectives: To examine the efficacy of LMTM as monotherapy in non-randomized cohort analyses as modified primary outcomes in an 18-month Phase III trial in mild AD. Methods: Mild AD patients (n = 800) were randomly assigned to 100 mg twice a day or 4 mg twice a day. Prior to unblinding, the Statistical Analysis Plan was revised to compare the 100 mg twice a day as monotherapy subgroup (n = 79) versus 4 mg twice a day as randomized (n = 396), and 4 mg twice a day as monotherapy (n = 76) versus 4 mg twice a day as add-on therapy (n = 297), with strong control of family-wise type I error. Results: The revised analyses were statistically significant at the required threshold of p < 0.025 in both comparisons for change in ADAS-cog, ADCS-ADL, MRI atrophy, and glucose uptake. The brain atrophy rate was initially typical of mild AD in both add-on and monotherapy groups, but after 9 months of treatment, the rate in monotherapy patients declined significantly to that reported for normal elderly controls. Differences in severity or diagnosis at baseline between monotherapy and add-on patients did not account for significant differences in favor of monotherapy. Conclusions: The results are consistent with earlier studies in supporting the hypothesis that LMTM might be effective as monotherapy and that 4 mg twice a day may serve as well as higher doses. A further suitably randomized trial is required to test this hypothesis.
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Affiliation(s)
- Gordon K Wilcock
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Serge Gauthier
- McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, and Douglas Mental Health University Institute, Montreal, QC, Canada
| | | | - Jianping Jia
- Beijing Institute for Brain Disorders Alzheimer's Disease Centre, Beijing, China
| | | | | | - Peter Bentham
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | | | - Bjoern O Schelter
- Institute for Complex Systems and Mathematical Biology, University of Aberdeen, Aberdeen, UK
| | | | | | - Roger T Staff
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Vesna Vuksanovic
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Trevor Ahearn
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | | | | | | | | | - Gernot Riedel
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - John M D Storey
- TauRx Therapeutics, Aberdeen, UK.,Department of Chemistry, University of Aberdeen, Aberdeen, UK
| | - Charles R Harrington
- TauRx Therapeutics, Aberdeen, UK.,School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Claude M Wischik
- TauRx Therapeutics, Aberdeen, UK.,School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Wada M, Noda Y, Shinagawa S, Chung JK, Sawada K, Ogyu K, Tarumi R, Tsugawa S, Miyazaki T, Yamagata B, Graff-Guerrero A, Mimura M, Nakajima S. Effect of Education on Alzheimer’s Disease-Related Neuroimaging Biomarkers in Healthy Controls, and Participants with Mild Cognitive Impairment and Alzheimer’s Disease: A Cross-Sectional Study. J Alzheimers Dis 2018; 63:861-869. [DOI: 10.3233/jad-171168] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Masataka Wada
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yoshihiro Noda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Jun Ku Chung
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Kyosuke Sawada
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kamiyu Ogyu
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Ryosuke Tarumi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Sakiko Tsugawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takahiro Miyazaki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Bun Yamagata
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Ariel Graff-Guerrero
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Hinrichs KH, Hayek A, Kalmbach D, Gabel N, Bieliauskas LA. Cognitive reserve and executive function: Effect on judgment of health and safety. ACTA ACUST UNITED AC 2018; 53:863-872. [PMID: 28273320 DOI: 10.1682/jrrd.2015.04.0073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/31/2016] [Indexed: 11/05/2022]
Abstract
Individuals with the same neurological conditions do not necessarily manifest the same behavioral presentation, which suggests differences in resilience and vulnerability among individuals, a concept known as cognitive reserve. This study sought to explore the relationship among cognitive reserve, executive functioning, and health and safety judgment among a sample of older adult inpatients in an extended medical care unit at a Veterans Health Administration hospital. We hypothesized that cognitive reserve, as determined by an estimate of premorbid intellectual ability, would act as a protective factor against poor judgment in older adults with executive dysfunction. Participants included 200 Veterans who completed a comprehensive neuropsychological assessment, including measures of health and safety judgment, executive functioning, global cognitive functioning, and premorbid intellectual ability. After controlling for global cognitive functioning, executive functioning abilities did not have an effect on judgment abilities among those with high estimated intellectual ability. However, executive functioning had a significant effect on judgment abilities among those with low estimated intellectual ability. Our results suggest that intact executive functioning is critical for making appropriate health and safety decisions for patients with lower measured intellectual abilities and provide further support for the cognitive reserve model. Clinical implications are also discussed.
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Affiliation(s)
| | | | | | - Nicolette Gabel
- Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
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38
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Sun MK. Potential Therapeutics for Vascular Cognitive Impairment and Dementia. Curr Neuropharmacol 2018; 16:1036-1044. [PMID: 29046153 PMCID: PMC6120112 DOI: 10.2174/1570159x15666171016164734] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 05/24/2017] [Accepted: 05/26/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND As the human lifespan increases, the number of people affected by agerelated dementia is growing at an epidemic pace. Vascular pathology dramatically affects cognitive profiles, resulting in dementia and cognitive impairment. While vascular dementia itself constitutes a medical challenge, hypo-perfusion/vascular risk factors enhance amyloid toxicity and other memory- damaging factors and hasten Alzheimer's disease (AD) and other memory disorders' progression, as well as negatively affect treatment outcome. METHODS Research and online content related to vascular cognitive impairment and dementia is reviewed, specifically focusing on the potential treatment of the disorder. RESULTS Few therapeutic options are currently available to improve the prognosis of patients with vascular dementia and cognitive impairment, mixed AD dementia with vascular pathology, or other memory disorders. Emerging evidence, however, indicates that, like AD and other memory disorders, synaptic impairment underlies much of the memory impairment in the cognitive decline of vascular cognitive impairment and vascular dementia. CONCLUSION Effective rescues of the memory functions might be achieved through synaptic and memory therapeutics, targeting distinct molecular signaling pathways that support the formation of new synapses and maintaining their connections. Potential therapeutic agents include: 1) memory therapeutic agents that rescue synaptic and memory functions after the brain insults; 2) antipathologic therapeutics and an effective management of vascular risk factors; and 3) preventative therapeutic agents that achieve memory therapy through functional enhancement. These therapeutic agents are also likely to benefit patients with AD and/or other types of memory disorders.
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Affiliation(s)
- Miao-Kun Sun
- Blanchette Rockefeller Neurosciences Institute, 8 Medical Center Drive, Morgantown, West Virginia26505, USA
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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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40
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Schreiner SJ, Kirchner T, Narkhede A, Wyss M, Van Bergen JMG, Steininger SC, Gietl A, Leh SE, Treyer V, Buck A, Pruessmann KP, Nitsch RM, Hock C, Henning A, Brickman AM, Unschuld PG. Brain amyloid burden and cerebrovascular disease are synergistically associated with neurometabolism in cognitively unimpaired older adults. Neurobiol Aging 2017; 63:152-161. [PMID: 29310864 DOI: 10.1016/j.neurobiolaging.2017.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/16/2017] [Accepted: 12/04/2017] [Indexed: 01/08/2023]
Abstract
Alzheimer's disease (AD) is the most common cause of cognitive dysfunction in older adults. The pathological hallmarks of AD such as beta amyloid (Aβ) aggregation and neurometabolic change, as indicated by altered myo-inositol (mI) and N-acetylaspartate (NAA) levels, typically precede the onset of cognitive dysfunction by years. Furthermore, cerebrovascular disease occurs early in AD, but the interplay between vascular and neurometabolic brain change is largely unknown. Thirty cognitively normal older adults (age = 70 ± 5.6 years, Mini-Mental State Examination = 29.2 ± 1) received 11-C-Pittsburgh Compound B positron emission tomography for estimating Aβ-plaque density, 7 Tesla fluid-attenuated inversion recovery magnetic resonance imaging for quantifying white matter hyperintensity volume as a marker of small vessel cerebrovascular disease and high-resolution magnetic resonance spectroscopic imaging at 7 Tesla, based on free induction decay acquisition localized by outer volume suppression to investigate tissue-specific neurometabolism in the posterior cingulate and precuneus. Aβ (β = 0.45, p = 0.018) and white matter hyperintensities (β = 0.40, p = 0.046) were independently and interactively (β = -0.49, p = 0.026) associated with a higher ratio of mI over NAA (mI/NAA) in the posterior cingulate and precuneus gray matter but not in the white matter. Our data suggest that cerebrovascular disease and Aβ burden are synergistically associated with AD-related gray matter neurometabolism in older adults.
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Affiliation(s)
- Simon J Schreiner
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas Kirchner
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Atul Narkhede
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, NY
| | - Michael Wyss
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Jiri M G Van Bergen
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Stephanie C Steininger
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Anton Gietl
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Sandra E Leh
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Valerie Treyer
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Alfred Buck
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Klaas P Pruessmann
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Roger M Nitsch
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph Hock
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Anke Henning
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; Max Planck Institute for Biological Cybernetics, Tubingen, Germany
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, NY.
| | - Paul G Unschuld
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
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Polyakova TA, Arablinsky AV. [Neuroimaging and molecular biomarkers of dementia]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:16-22. [PMID: 28980608 DOI: 10.17116/jnevro20171176216-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Development of laboratory diagnosis and neuroimaging revealed a number of biomarkers for in vivo diagnosis of the most common forms of dementia (Alzheimer's disease, Lewy body dementia and vascular dementia). Currently, the highest diagnostic sensitivity and specificity of molecular biomarkers in the cerebrospinal fluid are detected for Alzheimer's disease. At the same time, the changes according to the magnetic resonance imaging are more prognostically significant for future cognitive decline than cerebrospinal fluid biomarkers. Cerebral microbleeds are an available adjuvant diagnostic marker, which increases the diagnostic value of leukoaraiosis that suggests the development of cerebral amyloid angiopathy or hypertensive microangiopathy, especially in cases of mixed pathology and severe cognitive deficits.
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Affiliation(s)
- T A Polyakova
- Russian Medical Academy for Continued Professional Education, Moscow, Russia
| | - A V Arablinsky
- Sechenov First Moscow Medical University, Moscow, Russia
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42
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Wen MC, Chan LL, Tan LC, Tan EK. Mild cognitive impairment in Parkinson's disease: a distinct clinical entity? Transl Neurodegener 2017; 6:24. [PMID: 28919975 PMCID: PMC5596909 DOI: 10.1186/s40035-017-0094-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/30/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mild cognitive impairment in Parkinson's disease (PD-MCI) is a common clinical condition. Understanding its pathology and clinical features is important for early intervention before the onset of dementia. In the past, variable definitions and differences in neuropsychological batteries generated divergent results of the affected cognitive patterns. MAIN BODY The introduction of PD-MCI criteria by the Movement Disorders Society (MDS) Task Force provides a more uniform system for defining and measuring PD-MCI and may improve the validity of future research. PD-MCI is likely to be heterogeneous since it can coexist with Alzheimer's disease and/ or Lewy body pathologies in PD. Pathogeneses of neuropsychiatric disturbances, such as depression, anxiety and apathy, are associated with PD with or without MCI. In addition, cognitive reserve formed by patients' unique life experiences may influence the outward cognitive performance despite the presence of the aforementioned pathogeneses and hence alter the diagnosis of MCI. CONCLUSION The overlap of cognitive impairment across different neurodegenerative diseases suggests that PD-MCI is likely to result from a mixture of complex pathophysiologies, rather than being a distinct pathologic entity. Differentiating MCI from other organic symptoms in PD would facilitate novel therapeutic strategies.
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Affiliation(s)
- Ming-Ching Wen
- Department of Research, National Neuroscience Institute, Singapore, Singapore
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore
| | - Ling Ling Chan
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore
| | - Louis C.S. Tan
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Eng King Tan
- Department of Research, National Neuroscience Institute, Singapore, Singapore
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Murray AD. Commentary on: Association of imaging abnormalities of the subcallosal septal area with Alzheimer's disease and mild cognitive impairment. Clin Radiol 2017; 72:923-924. [PMID: 28757072 DOI: 10.1016/j.crad.2017.06.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 06/15/2017] [Accepted: 06/20/2017] [Indexed: 11/30/2022]
Affiliation(s)
- A D Murray
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Lilian Sutton Building, Foresterhill, Aberdeen AB252ZD, UK.
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Baker LM, Laidlaw DH, Cabeen R, Akbudak E, Conturo TE, Correia S, Tate DF, Heaps-Woodruff JM, Brier MR, Bolzenius J, Salminen LE, Lane EM, McMichael AR, Paul RH. Cognitive reserve moderates the relationship between neuropsychological performance and white matter fiber bundle length in healthy older adults. Brain Imaging Behav 2017; 11:632-639. [PMID: 26961092 PMCID: PMC7083104 DOI: 10.1007/s11682-016-9540-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Recent work using novel neuroimaging methods has revealed shorter white matter fiber bundle length (FBL) in older compared to younger adults. Shorter FBL also corresponds to poorer performance on cognitive measures sensitive to advanced age. However, it is unclear if individual factors such as cognitive reserve (CR) effectively moderate the relationship between FBL and cognitive performance. This study examined CR as a potential moderator of cognitive performance and brain integrity as defined by FBL. Sixty-three healthy adults underwent neuropsychological evaluation and 3T brain magnetic resonance imaging. Cognitive performance was measured using the Repeatable Battery of Assessment of Neuropsychological Status (RBANS). FBL was quantified from tractography tracings of white matter fiber bundles, derived from the diffusion tensor imaging. CR was determined by estimated premorbid IQ. Analyses revealed that lower scores on the RBANS were associated with shorter whole brain FBL (p = 0.04) and lower CR (p = 0.01) CR moderated the relationship between whole brain FBL and RBANS score (p < 0.01). Tract-specific analyses revealed that CR also moderated the association between FBL in the hippocampal segment of the cingulum and RBANS performance (p = 0.03). These results demonstrate that lower cognitive performance on the RBANS is more common with low CR and short FBL. On the contrary, when individuals have high CR, the relationship between FBL and cognitive performance is attenuated. Overall, CR protects older adults against lower cognitive performance despite age-associated reductions in FBL.
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Affiliation(s)
- Laurie M Baker
- Department of Psychological Sciences, University of Missouri - Saint Louis, One University Boulevard, Stadler Hall 327, Saint Louis, MO, 63121, USA.
| | - David H Laidlaw
- Computer Science Department, Brown University, Providence, RI, 02912, USA
| | - Ryan Cabeen
- Computer Science Department, Brown University, Providence, RI, 02912, USA
| | - Erbil Akbudak
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Thomas E Conturo
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Stephen Correia
- Division of Biology and Medicine, Brown Medical School, Providence, RI, 02912, USA
| | - David F Tate
- Missouri Institute of Mental Health, St. Louis, MO, 63134, USA
| | | | - Matthew R Brier
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Jacob Bolzenius
- Missouri Institute of Mental Health, St. Louis, MO, 63134, USA
| | - Lauren E Salminen
- Department of Psychological Sciences, University of Missouri - Saint Louis, One University Boulevard, Stadler Hall 327, Saint Louis, MO, 63121, USA
| | - Elizabeth M Lane
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Amanda R McMichael
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Robert H Paul
- Department of Psychological Sciences, University of Missouri - Saint Louis, One University Boulevard, Stadler Hall 327, Saint Louis, MO, 63121, USA
- Missouri Institute of Mental Health, St. Louis, MO, 63134, USA
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45
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Hylin MJ, Kerr AL, Holden R. Understanding the Mechanisms of Recovery and/or Compensation following Injury. Neural Plast 2017; 2017:7125057. [PMID: 28512585 PMCID: PMC5415868 DOI: 10.1155/2017/7125057] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/24/2017] [Accepted: 03/26/2017] [Indexed: 11/30/2022] Open
Abstract
Injury due to stroke and traumatic brain injury result in significant long-term effects upon behavioral functioning. One central question to rehabilitation research is whether the nature of behavioral improvement observed is due to recovery or the development of compensatory mechanisms. The nature of functional improvement can be viewed from the perspective of behavioral changes or changes in neuroanatomical plasticity that follows. Research suggests that these changes correspond to each other in a bidirectional manner. Mechanisms surrounding phenomena like neural plasticity may offer an opportunity to explain how variables such as experience can impact improvement and influence the definition of recovery. What is more, the intensity of the rehabilitative experiences may influence the ability to recover function and support functional improvement of behavior. All of this impacts how researchers, clinicians, and medical professionals utilize rehabilitation.
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Affiliation(s)
- Michael J. Hylin
- Neurotrauma and Rehabilitation Laboratory, Department of Psychology, Southern Illinois University, Carbondale, IL, USA
| | - Abigail L. Kerr
- Department of Psychology, Illinois Wesleyan University, Bloomington, IL, USA
| | - Ryan Holden
- Neurotrauma and Rehabilitation Laboratory, Department of Psychology, Southern Illinois University, Carbondale, IL, USA
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46
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Medaglia JD, Pasqualetti F, Hamilton RH, Thompson-Schill SL, Bassett DS. Brain and cognitive reserve: Translation via network control theory. Neurosci Biobehav Rev 2017; 75:53-64. [PMID: 28104411 PMCID: PMC5359115 DOI: 10.1016/j.neubiorev.2017.01.016] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 01/01/2023]
Abstract
Traditional approaches to understanding the brain's resilience to neuropathology have identified neurophysiological variables, often described as brain or cognitive "reserve," associated with better outcomes. However, mechanisms of function and resilience in large-scale brain networks remain poorly understood. Dynamic network theory may provide a basis for substantive advances in understanding functional resilience in the human brain. In this perspective, we describe recent theoretical approaches from network control theory as a framework for investigating network level mechanisms underlying cognitive function and the dynamics of neuroplasticity in the human brain. We describe the theoretical opportunities offered by the application of network control theory at the level of the human connectome to understand cognitive resilience and inform translational intervention.
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Affiliation(s)
- John Dominic Medaglia
- Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Fabio Pasqualetti
- Department of Mechanical Engineering, University of California-Riverside, Riverside, CA 92521, United States
| | - Roy H Hamilton
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | | | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, PA 19104, United States; Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, PA 19104, United States.
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Abstract
OBJECTIVE Low socioeconomic position (SEP) has been linked to an increased risk of dementia and cognitive decline. However, little is known about the association between SEP and morphologic brain changes in older age. This study examines the relationships between indicators of life-course SEP with both hippocampal volume (HcV) and HcV loss in a population-based cohort of 1328 older adults aged 65 to 80 years. METHODS Multivariable linear regression models were used to estimate the associations of SEP with baseline HcV and the annual rate of HcV atrophy according to three life-course conceptual models: the sensitive/critical periods model (which explored SEP in specific periods: in childhood [using parental education], early adulthood [based on participants' education], and midlife [based on participants' socioprofessional group]); the accumulation-of-risk model (life-course cumulative SEP), and the social mobility model (life-course SEP trajectories). RESULTS Participants with lower midlife SEP had smaller HcV (-0.08 cm; 95% confidence interval, -0.15 to -0.01) and 0.17% (95% confidence interval, 0.04%-0.30%) faster hippocampal atrophy than participants with higher midlife SEP. Childhood and early adulthood SEPs were not related to hippocampal measures. The accumulation-of-risk and the social mobility models revealed that the accumulation of socioeconomic disadvantage and declining socioeconomic trajectories were related to faster hippocampal atrophy. CONCLUSIONS In this cohort of older adults, lower socioprofessional attainment in midlife and disadvantageous life-course socioeconomic position were associated with faster hippocampal atrophy, a cerebral change linked to cognitive disorders. Results support the hypothesized links between socioenvironmental exposures related to stress and/or cognitive enrichment and brain/cognitive reserve capacities.
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48
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Cognitive reserve and cognitive performance of patients with focal frontal lesions. Neuropsychologia 2016; 96:19-28. [PMID: 28041947 PMCID: PMC5317176 DOI: 10.1016/j.neuropsychologia.2016.12.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 12/22/2016] [Accepted: 12/28/2016] [Indexed: 12/21/2022]
Abstract
The Cognitive reserve (CR) hypothesis was put forward to account for the variability in cognitive performance of patients with similar degrees of brain pathology. Compensatory neural activity within the frontal lobes has often been associated with CR. For the first time we investigated the independent effects of two CR proxies, education and NART IQ, on measures of executive function, fluid intelligence, speed of information processing, verbal short term memory (vSTM), naming, and perception in a sample of 86 patients with focal, unilateral frontal lesions and 142 healthy controls. We fitted multiple linear regression models for each of the cognitive measures and found that only NART IQ predicted executive and naming performance. Neither education nor NART IQ predicted performance on fluid intelligence, processing speed, vSTM or perceptual abilities. Education and NART IQ did not modify the effect of lesion severity on cognitive impairment. We also found that age significantly predicted performance on executive tests and the majority of our other cognitive measures, except vSTM and GNT. Age was the only predictor for fluid intelligence. This latter finding suggests that age plays a role in executive performance over and above the contribution of CR proxies in patients with focal frontal lesions. Overall, our results suggest that the CR proxies do not appear to modify the relationship between cognitive impairment and frontal lesions. Effect of cognitive reserve (CR) proxies in focal unilateral lesions. NART IQ accounts for a larger proportion of variance in executive and naming skills. Age predicts performance on executive, fluid intelligence, speed and perception tests. Education and NART IQ did not modify the effect of lesion severity on cognitive impairment.
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49
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Scott JE, Mathias JL, Kneebone AC, Krishnan J. Postoperative cognitive dysfunction and its relationship to cognitive reserve in elderly total joint replacement patients. J Clin Exp Neuropsychol 2016; 39:459-472. [DOI: 10.1080/13803395.2016.1233940] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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50
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Duan D, Li C, Shen L, Cui C, Shu T, Zheng J. Regional Gray Matter Atrophy Coexistent with Occipital Periventricular White Matter Hyper Intensities. Front Aging Neurosci 2016; 8:214. [PMID: 27656141 PMCID: PMC5013128 DOI: 10.3389/fnagi.2016.00214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 08/24/2016] [Indexed: 01/03/2023] Open
Abstract
White matter hyperintensities (WMHs) and brain atrophy often coexist in the elderly. Additionally, WMH is often observed as occipital periventricular hyperintensities (OPVHs) with low-grade periventricular (PV) white matter (WM) lesions and is usually confined within an anatomical structure. However, the effects of OPVHs on gray matter (GM) atrophy remain largely unknown. In this study, we investigated GM atrophy in OPVHs patients and explored the relationship between such atrophy and clinical risk factors. T1-weighted and T2-weighted Magnetic resonance imaging (MRI) were acquired, and voxel-based morphometry (VBM) analysis was applied. The clinical (demographic and cardiovascular) risk factors of the OPVHs patients and healthy controls were then compared. Lastly, scatter plots and correlation analysis were applied to explore the relationship between the MRI results and clinical risk factors in the OPVHs patients. OPVHs patients had significantly reduced GM in the right supramarginal gyrus, right angular gyrus, right middle temporal gyrus, right anterior cingulum and left insula compared to healthy controls. Additionally, OPVHs patients had GM atrophy in the left precentral gyrus and left insula cortex, and such atrophy is associated with a reduction in low-density lipoprotein cholesterol (LDL-C) and apolipoprotein-B (Apo-B).
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Affiliation(s)
- Dazhi Duan
- Department of Neurology, Xinqiao Hospital, Third Military Medical University Chongqing, China
| | - Congyang Li
- Department of Neurology, Chengdu Military General Hospital Chengdu, China
| | - Lin Shen
- Department of Neurology, Xinqiao Hospital, Third Military Medical University Chongqing, China
| | - Chun Cui
- Department of Radiology, Xinqiao Hospital, Third Military Medical University Chongqing, China
| | - Tongsheng Shu
- Department of Radiology, Xinqiao Hospital, Third Military Medical University Chongqing, China
| | - Jian Zheng
- Department of Neurology, Xinqiao Hospital, Third Military Medical University Chongqing, China
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