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Kameyama H, Tagai K, Takasaki E, Kashibayashi T, Takahashi R, Kanemoto H, Ishii K, Ikeda M, Shigeta M, Shinagawa S, Kazui H. Examining Frontal Lobe Asymmetry and Its Potential Role in Aggressive Behaviors in Early Alzheimer's Disease. J Alzheimers Dis 2024; 98:539-547. [PMID: 38393911 DOI: 10.3233/jad-231306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Background Neuropsychiatric symptoms (NPS) in patients with dementia lead to caregiver burdens and worsen the patient's prognosis. Although many neuroimaging studies have been conducted, the etiology of NPS remains complex. We hypothesize that brain structural asymmetry could play a role in the appearance of NPS. Objective This study explores the relationship between NPS and brain asymmetry in patients with Alzheimer's disease (AD). Methods Demographic and MRI data for 121 mild AD cases were extracted from a multicenter Japanese database. Brain asymmetry was assessed by comparing the volumes of gray matter in the left and right brain regions. NPS was evaluated using the Neuropsychiatric Inventory (NPI). Subsequently, a comprehensive assessment of the correlation between brain asymmetry and NPS was conducted. Results Among each NPS, aggressive NPS showed a significant correlation with asymmetry in the frontal lobe, indicative of right-side atrophy (r = 0.235, p = 0.009). This correlation remained statistically significant even after adjustments for multiple comparisons (p < 0.01). Post-hoc analysis further confirmed this association (p < 0.05). In contrast, no significant correlations were found for other NPS subtypes, including affective and apathetic symptoms. Conclusions The study suggests frontal lobe asymmetry, particularly relative atrophy in the right hemisphere, may be linked to aggressive behaviors in early AD. These findings shed light on the neurobiological underpinnings of NPS, contributing to the development of potential interventions.
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Affiliation(s)
- Hiroshi Kameyama
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenji Tagai
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Emi Takasaki
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Tetsuo Kashibayashi
- Dementia-Related Disease Medical Center, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Hyogo, Japan
| | - Ryuichi Takahashi
- Dementia-Related Disease Medical Center, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Hyogo, Japan
| | - Hideki Kanemoto
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazunari Ishii
- Department of Radiology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masatoshi Shigeta
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Hiroaki Kazui
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
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Tremblay C, Serrano GE, Intorcia AJ, Mariner MR, Sue LI, Arce RA, Atri A, Adler CH, Belden CM, Shill HA, Driver-Dunckley E, Mehta SH, Beach TG. Olfactory Bulb Amyloid-β Correlates With Brain Thal Amyloid Phase and Severity of Cognitive Impairment. J Neuropathol Exp Neurol 2022; 81:643-649. [PMID: 35751438 PMCID: PMC9297096 DOI: 10.1093/jnen/nlac042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Alzheimer disease (AD) neuropathological hallmarks amyloid β (Aβ) and tau neurofibrillary (NF) pathology have been reported in the olfactory bulb (OB) in aging and in different neurodegenerative diseases, which coincides with frequently reported olfactory dysfunction in these conditions. To better understand when the OB is affected in relation to the hierarchical progression of Aβ throughout the brain and whether OB pathology might be an indicator of AD severity, we assessed the presence of OB Aβ and tau NF pathology in an autopsy cohort of 158 non demented control and 173 AD dementia cases. OB Aβ was found in less than 5% of cases in lower Thal phases 0 and 1, in 20% of cases in phase 2, in 60% of cases in phase 3 and in more than 80% of cases in higher Thal phases 4 and 5. OB Aβ and tau pathology significantly predicted a Thal phase greater than 3, a Braak NF stage greater than 4, and an MMSE score lower than 24. While OB tau pathology is almost universal in the elderly and therefore is not a good predictor of AD severity, OB Aβ pathology coincides with clinically-manifest AD and might prove to be a useful biomarker of the extent of brain spread of both amyloid and tau pathology.
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Affiliation(s)
- Cécilia Tremblay
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Geidy E Serrano
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Anthony J Intorcia
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Monica R Mariner
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Lucia I Sue
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Richard A Arce
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Alireza Atri
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA.,Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Christine M Belden
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Holly A Shill
- Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Erika Driver-Dunckley
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Shyamal H Mehta
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Thomas G Beach
- Department of Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
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