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Witt ST, Brown A, Gravelsins L, Engström M, Classon E, Lykke N, Åvall-Lundqvist E, Theodorsson E, Ernerudh J, Kjölhede P, Einstein G. Gray matter volume in women with the BRCA mutation with and without ovarian removal: evidence for increased risk of late-life Alzheimer's disease or dementia. Menopause 2024; 31:608-616. [PMID: 38688467 DOI: 10.1097/gme.0000000000002361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Ovarian removal prior to spontaneous/natural menopause (SM) is associated with increased risk of late life dementias including Alzheimer's disease. This increased risk may be related to the sudden and early loss of endogenous estradiol. Women with breast cancer gene mutations (BRCAm) are counseled to undergo oophorectomy prior to SM to significantly reduce their risk of developing breast, ovarian, and cervical cancers. There is limited evidence of the neurological effects of ovarian removal prior to the age of SM showing women without the BRCAm had cortical thinning in medial temporal lobe structures. A second study in women with BRCAm and bilateral salpingo-oophorectomy (BSO) noted changes in cognition. METHODS The present, cross-sectional study examined whole-brain differences in gray matter (GM) volume using high-resolution, quantitative magnetic resonance imaging in women with BRCAm and intact ovaries (BRCA-preBSO [study cohort with BRCA mutation prior to oophorectomy]; n = 9) and after surgery with (BSO + estradiol-based therapy [ERT]; n = 10) and without (BSO; n = 10) postsurgical estradiol hormone therapy compared with age-matched women (age-matched controls; n = 10) with their ovaries. RESULTS The BRCA-preBSO and BSO groups showed significantly lower GM volume in the left medial temporal and frontal lobe structures. BSO + ERT exhibited few areas of lower GM volume compared with age-matched controls. Novel to this study, we also observed that all three BRCAm groups exhibited significantly higher GM volume compared with age-matched controls, suggesting continued plasticity. CONCLUSIONS The present study provides evidence, through lower GM volume, to support both the possibility that the BRCAm, alone, and early life BSO may play a role in increasing the risk for late-life dementia. At least for BRCAm with BSO, postsurgical ERT seems to ameliorate GM losses.
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Affiliation(s)
| | - Alana Brown
- Psychology, University of Toronto, Toronto, ON, Canada
| | | | | | - Elisabet Classon
- Department of Acute Internal Medicine and Geriatrics, and Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden
| | - Nina Lykke
- Thematic Studies, Linköping University, Sweden
| | - Elisabeth Åvall-Lundqvist
- Department of Oncology in Linköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Elvar Theodorsson
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Jan Ernerudh
- Department of Clinical Immunology and Transfusion Medicine, and Department of Biomedical and Clinical Sciences, Linköping University, Sweden
| | - Preben Kjölhede
- Department of Obstetrics and Gynecology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Schmill LP, Bohle K, Röhrdanz N, Schiffelholz T, Balueva K, Wulff P. Regional and interhemispheric differences of neuronal representations in dentate gyrus and CA3 inferred from expression of zif268. Sci Rep 2023; 13:18443. [PMID: 37891194 PMCID: PMC10611715 DOI: 10.1038/s41598-023-45304-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
The hippocampal formation is one of the best studied brain regions for spatial and mnemonic representations. These representations have been reported to differ in their properties for individual hippocampal subregions. One approach that allows the detection of neuronal representations is immediate early gene imaging, which relies on the visualization of genomic responses of activated neuronal populations, so called engrams. This method permits the within-animal comparison of neuronal representations across different subregions. In this work, we have used compartmental analysis of temporal activity by fluorescence in-situ hybridisation (catFISH) of the immediate early gene zif268/erg1 to compare neuronal representations between subdivisions of the dentate gyrus and CA3 upon exploration of different contexts. Our findings give an account of subregion-specific ensemble sizes. We confirm previous results regarding disambiguation abilities in dentate gyrus and CA3 but in addition report novel findings: Although ensemble sizes in the lower blade of the dentate gyrus are significantly smaller than in the upper blade both blades are responsive to environmental change. Beyond this, we show significant differences in the representation of familiar and novel environments along the longitudinal axis of dorsal CA3 and most interestingly between CA3 regions of both hemispheres.
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Affiliation(s)
- Lars-Patrick Schmill
- Institute of Physiology, Christian-Albrechts-University Kiel, Kiel, Germany
- Clinic for Radiology and Neuroradiology, UKSH, Kiel, Germany
| | - Katharina Bohle
- Institute of Physiology, Christian-Albrechts-University Kiel, Kiel, Germany
- Clinic for Orthopaedic and Trauma and Reconstructive Surgery, Klinikum Frankfurt Höchst GmbH, Frankfurt am Main, Germany
| | - Niels Röhrdanz
- Institute of Physiology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Thomas Schiffelholz
- Center of Integrative Psychiatry, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Kira Balueva
- Institute of Physiology, Christian-Albrechts-University Kiel, Kiel, Germany.
| | - Peer Wulff
- Institute of Physiology, Christian-Albrechts-University Kiel, Kiel, Germany.
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Aghakhanyan G, Galgani A, Vergallo A, Lombardo F, Martini N, Baldacci F, Tognoni G, Leo A, Guidoccio F, Siciliano G, Fornai F, Pavese N, Volterrani D, Giorgi FS. Brain metabolic correlates of Locus Coeruleus degeneration in Alzheimer's disease: a multimodal neuroimaging study. Neurobiol Aging 2023; 122:12-21. [PMID: 36463849 DOI: 10.1016/j.neurobiolaging.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
Abstract
Locus Coeruleus (LC) degeneration occurs early in Alzheimer's disease (AD) and this could affect several brain regions innervated by LC noradrenergic axon terminals, as these bear neuroprotective effects and modulate neurovascular coupling/neuronal activity. We used LC-sensitive Magnetic Resonance imaging (MRI) sequences enabling LC integrity quantification, and [18F]Fluorodeoxyglucose (FDG) PET, to investigate the association of LC-MRI changes with brain glucose metabolism in cognitively impaired patients (30 amnesticMCI and 13 demented ones). Fifteen cognitively intact age-matched controls (HCs) were submitted only to LC-MRI for comparison with patients. Voxel-wise regression analyses of [18F]FDG images were conducted using the LC-MRI parameters signal intensity (LCCR) and LC-belonging voxels (LCVOX). Both LCCR and LCVOX were significantly lower in patients compared to HCs, and were directly associated with [18F]FDG uptake in fronto-parietal cortical areas, mainly involving the left hemisphere (p < 0.001, kE > 100). These results suggest a possible association between LC degeneration and cortical hypometabolism in degenerative cognitive impairment with a prevalent left-hemispheric vulnerability, and that LC degeneration might be linked to large-scale functional network alteration in AD pathology.
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Affiliation(s)
- Gayane Aghakhanyan
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Alessandro Galgani
- Neurology Unit - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Andrea Vergallo
- Department of Radiology, Fondazione Monasterio/CNR, Pisa, Italy
| | | | | | - Filippo Baldacci
- Neurology Unit - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Neurology Unit - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Leo
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Federica Guidoccio
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Francesco Fornai
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Nicola Pavese
- Clinical Aging Research Unit, Newcastle University, Newcastle upon Tyne, UK; Institute of Clinical Medicine, PET Centre, Aarhus University, Aarhus, Denmark
| | - Duccio Volterrani
- Nuclear Medicine Unit - Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Filippo S Giorgi
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
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Qiu T, Zeng Q, Zhang Y, Luo X, Xu X, Li X, Shen Z, Li K, Wang C, Huang P, Zhang M, Dai S, Xie F. Altered functional connectivity pattern of hippocampal subfields in individuals with objectively-defined subtle cognitive decline and its association with cognition and cerebrospinal fluid biomarkers. Eur J Neurosci 2022; 56:6227-6238. [PMID: 36342704 PMCID: PMC10100315 DOI: 10.1111/ejn.15860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 10/17/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Abstract
Recent studies have shown that in the preclinical phase of Alzheimer's disease (AD), subtle cognitive changes can be detected using sensitive neuropsychological measures, and have proposed the concept of objectively-defined subtle cognitive decline (Obj-SCD). We aimed to assess the functional alteration of hippocampal subfields in individuals with Obj-SCD and its association with cognition and pathological biomarkers. Forty-two participants with cognitively normal (CN), 29 with Obj-SCD, and 55 with mild cognitive impairment (MCI) were retrospectively collected from the ADNI database. Neuropsychological performance, functional MRI, and cerebrospinal fluid (CSF) data were obtained. We calculated the seed-based functional connectivity (FC) of hippocampal subfields (cornu ammonis1 [CA1], CA2/3/dentate gyrus [DG], and subiculum) with whole-brain voxels. Additionally, we analyzed the correlation between FC values of significantly altered regions and neuropsychological performance and CSF biomarkers. The Obj-SCD group showed lower FC between left CA1-CA2/3/DG and right thalamus and higher FC between right subiculum and right superior parietal gyrus (SPG) compared with the CN and MCI groups. In the Obj-SCD group, FC values between left CA2/3/DG and right thalamus were positively associated with Auditory Verbal Learning Test (AVLT) recognition (r = 0.395, p = 0.046) and CSF Aβ1-42 levels (r = 0.466, p = 0.019), and FC values between left CA1 and right thalamus were positively correlated with CSF Aβ1-42 levels (r = 0.530, p = 0.006). Taken together, dysfunction in CA1-CA2/3/DG subregions suggests subtle cognitive impairment and AD-specific pathological changes in individuals with Obj-SCD. Additionally, increased subiculum connectivity may indicate early functional compensation for subtle cognitive changes.
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Affiliation(s)
- Tiantian Qiu
- Department of RadiologyLinyi People's HospitalLinyiChina
| | - Qingze Zeng
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Yusong Zhang
- Department of RadiologyLinyi People's HospitalLinyiChina
| | - Xiao Luo
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Xiaopei Xu
- Department of RadiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Xiaodong Li
- Department of RadiologyLinyi People's HospitalLinyiChina
| | - Zhujing Shen
- 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
| | - Chao Wang
- 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
| | - Shouping Dai
- Department of RadiologyLinyi People's HospitalLinyiChina
| | - Fei Xie
- Department of Equipment and Medical EngineeringLinyi People's HospitalLinyiChina
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Warren A. Preserved Consciousness in Alzheimer's Disease and Other Dementias: Caregiver Awareness and Communication Strategies. Front Psychol 2021; 12:790025. [PMID: 34950092 PMCID: PMC8688803 DOI: 10.3389/fpsyg.2021.790025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022] Open
Abstract
Alzheimer's disease is an insidious onset neurodegenerative syndrome without effective treatment or cure. It is rapidly becoming a global health crisis that is overwhelming healthcare, society, and individuals. The clinical nature of neurocognitive decline creates significant challenges in bidirectional communication between caregivers and persons with Alzheimer's disease (AD) that can negatively impact quality-of-life. This paper sought to understand how and to what extent would awareness training about the levels of consciousness in AD influence the quality-of-life interactions in the caregiver-patient dyad. A literature review of multiple databases was conducted utilizing a transdisciplinary approach. The sum of findings indicates a positive relationship between enhanced caregiver awareness and training, positive interactions, and improved QOL measures among patients and caregivers. A multidirectional relationship was found among healthcare policies, training and education resources, caregivers, and persons with AD. Specifically, the current lack of policy and inadequate training and educational resources has various detrimental effects on patients and caregivers, while improvements in training and education of caregivers yields positive outcomes in communication and QOL. Furthermore, evidence of preserved consciousness in persons with AD was demonstrated from multiple disciplines, including neurobiological, psychological, and biopsychosocial models. The literature further revealed several methods to access the preserved consciousness in persons with AD and related dementias, including sensory, emotional, and cognitive stimulations. The evidence from the literature suggests a reframed approach to our understanding and treatment of persons with AD is not only warranted, but crucial to address the needs of those affected by AD.
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Affiliation(s)
- Alison Warren
- The Department of Clinical Research and Leadership, The George Washington University, Washington, DC, United States
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