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Zhukovsky P, Tio ES, Coughlan G, Bennett DA, Wang Y, Hohman TJ, Pizzagalli DA, Mulsant BH, Voineskos AN, Felsky D. Genetic influences on brain and cognitive health and their interactions with cardiovascular conditions and depression. Nat Commun 2024; 15:5207. [PMID: 38890310 PMCID: PMC11189393 DOI: 10.1038/s41467-024-49430-7] [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: 05/08/2023] [Accepted: 06/04/2024] [Indexed: 06/20/2024] Open
Abstract
Approximately 40% of dementia cases could be prevented or delayed by modifiable risk factors related to lifestyle and environment. These risk factors, such as depression and vascular disease, do not affect all individuals in the same way, likely due to inter-individual differences in genetics. However, the precise nature of how genetic risk profiles interact with modifiable risk factors to affect brain health is poorly understood. Here we combine multiple data resources, including genotyping and postmortem gene expression, to map the genetic landscape of brain structure and identify 367 loci associated with cortical thickness and 13 loci associated with white matter hyperintensities (P < 5×10-8), with several loci also showing a significant association with cognitive function. We show that among 220 unique genetic loci associated with cortical thickness in our genome-wide association studies (GWAS), 95 also showed evidence of interaction with depression or cardiovascular conditions. Polygenic risk scores based on our GWAS of inferior frontal thickness also interacted with hypertension in predicting executive function in the Canadian Longitudinal Study on Aging. These findings advance our understanding of the genetic underpinning of brain structure and show that genetic risk for brain and cognitive health is in part moderated by treatable mid-life factors.
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Grants
- P30 AG072975 NIA NIH HHS
- U01 AG046152 NIA NIH HHS
- U01 AG061356 NIA NIH HHS
- R01 AG017917 NIA NIH HHS
- P30 AG010161 NIA NIH HHS
- R01 AG059716 NIA NIH HHS
- Wellcome Trust
- R01 AG015819 NIA NIH HHS
- Gouvernement du Canada | Instituts de Recherche en Santé du Canada | CIHR Skin Research Training Centre (Skin Research Training Centre)
- D.F. is supported by the generous contributions from the Michael and Sonja Koerner Foundation and the Krembil Family Foundation. D.F. is also supported in part by the Centre for Addiction and Mental Health (CAMH) Discovery Fund and CIHR.
- PZ was funded by the Canadian Institute of Health Research Postdoctoral Fellowship.
- Over the past 3 years, D.A.P has received consulting fees from Albright Stonebridge Group, Boehringer Ingelheim, Compass Pathways, Engrail Therapeutics, Neumora Therapeutics (formerly BlackThorn Therapeutics), Neurocrine Biosciences, Neuroscience Software, Otsuka, Sunovion, and Takeda; he has received honoraria from the Psychonomic Society and American Psychological Association (for editorial work) and from Alkermes; he has received research funding from the Brain and Behavior Research Foundation, the Dana Foundation, Millennium Pharmaceuticals, Wellcome Leap MCPsych, and NIMH; he has received stock options from Compass Pathways, Engrail Therapeutics, Neumora Therapeutics, and Neuroscience Software. No funding from these entities was used to support the current work, and all views expressed are solely those of the authors.
- U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH)
- A.N.V. currently receives funding from CIHR, the NIH, the National Sciences and Engineering Research Council (NSERC), the CAMH Foundation, and the University of Toronto. E.S.T. was funded by the Ontario Graduate Scholarship.
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Affiliation(s)
- Peter Zhukovsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5T 1R8, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5T 1R8, Canada
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Earvin S Tio
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Gillian Coughlan
- Department of Neurology, Massachusetts General Hospital, Boston, MA, 02129, USA
| | - David A Bennett
- Department of Neurological Sciences, RUSH Medical College, Chicago, IL, 60612, USA
| | - Yanling Wang
- Department of Neurological Sciences, RUSH Medical College, Chicago, IL, 60612, USA
| | - Timothy J Hohman
- Vanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School and Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, 02478, USA
| | - Benoit H Mulsant
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5T 1R8, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5T 1R8, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5T 1R8, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5T 1R8, Canada.
| | - Daniel Felsky
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5T 1R8, Canada.
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5S 1A8, Canada.
- Rotman Research Institute, Baycrest Hospital, Toronto, ON, M6A 2E1, Canada.
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2
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Gutteridge DS, Segal A, McNeil JJ, Beilin L, Brodtmann A, Chowdhury EK, Egan GF, Ernst ME, Hussain SM, Reid CM, Robb CE, Ryan J, Woods RL, Keage HA, Jamadar S. The relationship between long-term blood pressure variability and cortical thickness in older adults. Neurobiol Aging 2023; 129:157-167. [PMID: 37331246 DOI: 10.1016/j.neurobiolaging.2023.05.011] [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: 01/17/2023] [Revised: 05/02/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023]
Abstract
High blood pressure variability (BPV) is a risk factor for cognitive decline and dementia, but its association with cortical thickness is not well understood. Here we use a topographical approach, to assess links between long-term BPV and cortical thickness in 478 (54% men at baseline) community dwelling older adults (70-88 years) from the ASPirin in Reducing Events in the Elderly NEURO sub-study. BPV was measured as average real variability, based on annual visits across three years. Higher diastolic BPV was significantly associated with reduced cortical thickness in multiple areas, including temporal (banks of the superior temporal sulcus), parietal (supramarginal gyrus, post-central gyrus), and posterior frontal areas (pre-central gyrus, caudal middle frontal gyrus), while controlling for mean BP. Higher diastolic BPV was associated with faster progression of cortical thinning across the three years. Diastolic BPV is an important predictor of cortical thickness, and trajectory of cortical thickness, independent of mean blood pressure. This finding suggests an important biological link in the relationship between BPV and cognitive decline in older age.
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Affiliation(s)
- D S Gutteridge
- Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), University of South Australia, Adelaide, South Australia, Australia.
| | - A Segal
- Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia
| | - J J McNeil
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - L Beilin
- School of Medicine, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - A Brodtmann
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - E K Chowdhury
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - G F Egan
- Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - M E Ernst
- Department of Family Medicine, Carver College of Medicine. The University of Iowa, Iowa City, IA, USA; Department of Pharmacy Practice and Science, College of Pharmacy, Carver College of Medicine. The University of Iowa, Iowa City, IA, USA
| | - S M Hussain
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia; Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - C M Reid
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia; School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - C E Robb
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - J Ryan
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - R L Woods
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - H A Keage
- Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), University of South Australia, Adelaide, South Australia, Australia
| | - S Jamadar
- Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
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3
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Rizvi B, Lao PJ, Chesebro AG, Dworkin JD, Amarante E, Beato JM, Gutierrez J, Zahodne LB, Schupf N, Manly JJ, Mayeux R, Brickman AM. Association of Regional White Matter Hyperintensities With Longitudinal Alzheimer-Like Pattern of Neurodegeneration in Older Adults. JAMA Netw Open 2021; 4:e2125166. [PMID: 34609497 PMCID: PMC8493439 DOI: 10.1001/jamanetworkopen.2021.25166] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
IMPORTANCE Small vessel cerebrovascular disease, visualized as white matter hyperintensities (WMH), is associated with cognitive decline and risk of clinical Alzheimer disease (AD). One way in which small vessel cerebrovascular disease could contribute to AD is through the promotion of neurodegeneration; the effect of small vessel cerebrovascular disease on neurodegeneration may differ across racial and ethnic groups. OBJECTIVE To examine whether WMH volume is associated with cortical thinning over time and subsequent memory functioning and whether the association between WMH volume and cortical thinning differs among racial and ethnic groups. DESIGN, SETTING, AND PARTICIPANTS This longitudinal community-based cohort study included older adults from northern Manhattan who were participants in the Washington Heights-Inwood Columbia Aging Project. Participants underwent two 3T magnetic resonance imaging (MRI) scans a mean of 4 years apart. Data were collected from March 2011 to January 2020. EXPOSURES Total and regional WMH volumes. MAIN OUTCOMES AND MEASURES The association of total and regional WMH volumes with cortical thinning over time was tested using general linear models in a vertexwise analysis. Cortical thinning was measured vertexwise by symmetrized percent change between 2 time points. The association of changes in cortical thickness with memory and whether this association differed by race and ethnicity was also analyzed. Delayed memory was a secondary outcome. RESULTS In 303 participants (mean [SD] age, 73.16 [5.19] years, 181 [60%] women, 96 [32%] non-Hispanic White, 113 [37%] Non-Hispanic Black, 94 [31%] Hispanic), baseline WMH volumes were associated with cortical thinning in medial temporal and frontal/parietal regions. Specifically, total WMH volume was associated with cortical thinning in the right caudal middle frontal cortex (P = .001) and paracentral cortex (P = .04), whereas parietal WMH volume was associated with atrophy in the left entorhinal cortex (P = .03) and right rostral middle frontal (P < .001), paracentral (P < .001), and pars triangularis (P = .02) cortices. Thinning of the right caudal middle frontal and left entorhinal cortices was related to lower scores on a memory test administered closest to the second MRI visit (right caudal middle frontal cortex: standardized β = 0.129; unstandardized b = 0.335; 95% CI, 0.055 to 0.616; P = .01; left entorhinal cortex: β = 0.119; b = 0.290; 95% CI, 0.018 to 0.563; P = .03). The association of total WMH with thinning in the right caudal middle frontal and right paracentral cortex was greater in non-Hispanic Black participants compared with White participants (right caudal middle frontal cortex: β = -0.222; b = -0.059; 95% CI, -0.114 to -0.004; P = .03; right paracentral cortex: β = -0.346; b = -0.155; 95% CI, -0.244 to -0.066; P = .001). The association of parietal WMH with cortical thinning of the right rostral middle frontal, right pars triangularis, and right paracentral cortices was also stronger among non-Hispanic Black participants compared with White participants (right rostral middle frontal cortex: β = -0.252; b = -0.202; 95% CI, -0.349 to -0.055; P = .007; right pars triangularis cortex: β = -0.327; b = -0.253; 95% CI, -0.393 to -0.113; P < .001; right paracentral cortex: β = -0.263; b = -0.337; 95% CI, -0.567 to -0.107; P = .004). CONCLUSIONS AND RELEVANCE In this study, small vessel cerebrovascular disease, operationalized as WMH, was associated with subsequent cortical atrophy in regions that overlap with typical AD neurodegeneration patterns, particularly among non-Hispanic Black older adults. Cerebrovascular disease may affect risk and progression of AD by promoting neurodegeneration and subsequent memory decline.
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Affiliation(s)
- Batool Rizvi
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Patrick J. Lao
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Anthony G. Chesebro
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Jordan D. Dworkin
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Erica Amarante
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Juliet M. Beato
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Jose Gutierrez
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | | | - Nicole Schupf
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Jennifer J. Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
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4
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Schoemaker D, Velilla-Jimenez L, Zuluaga Y, Baena A, Ospina C, Bocanegra Y, Alvarez S, Ochoa-Escudero M, Guzmán-Vélez E, Martinez J, Lopera F, Arboleda-Velasquez JF, Quiroz YT. Global Cardiovascular Risk Profile and Cerebrovascular Abnormalities in Presymptomatic Individuals with CADASIL or Autosomal Dominant Alzheimer's Disease. J Alzheimers Dis 2021; 82:841-853. [PMID: 34092645 DOI: 10.3233/jad-210313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiovascular risk factors increase the risk of developing dementia, including Alzheimer's disease and vascular dementia. OBJECTIVE Studying individuals with autosomal dominant mutations leading to the early onset of dementia, this study examines the effect of the global cardiovascular risk profile on early cognitive and neuroimaging features of Alzheimer's disease and vascular dementia. METHODS We studied 85 non-demented and stroke-free individuals, including 20 subjects with Presenilin1 (PSEN1) E280A mutation leading to the early onset of autosomal dominant Alzheimer's disease (ADAD), 20 subjects with NOTCH3 mutations leading to cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and to the early onset of vascular dementia, and 45 non-affected family members (non-carriers). All subjects underwent clinical and neuropsychological evaluations and an MRI. The global cardiovascular risk profile was estimated using the office-based Framingham Cardiovascular Risk Profile (FCRP) score. RESULTS In individuals with CADASIL, a higher FCRP score was associated with a reduced hippocampal volume (B = -0.06, p < 0.05) and an increased severity of cerebral microbleeds (B = 0.13, p < 0.001), lacunes (B = 0.30, p < 0.001), and perivascular space enlargement in the basal ganglia (B = 0.50, p < 0.05). There was no significant association between the FCRP score and neuroimaging measures in ADAD or non-carrier subjects. While the FCRP score was related to performance in executive function in non-carrier subjects (B = 0.06, p < 0.05), it was not significantly associated with cognitive performance in individuals with CADASIL or ADAD. CONCLUSION Our results suggest that individuals with CADASIL and other forms of vascular cognitive impairment might particularly benefit from early interventions aimed at controlling cardiovascular risks.
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Affiliation(s)
- Dorothee Schoemaker
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA, USA
| | | | - Yesica Zuluaga
- Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia
| | - Ana Baena
- Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia
| | - Carolina Ospina
- Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia
| | - Yamile Bocanegra
- Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia
| | - Sergio Alvarez
- Department of Radiology, Hospital Pablo Tobon Uribe, Medellín, Colombia
| | | | - Edmarie Guzmán-Vélez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jairo Martinez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Francisco Lopera
- Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia
| | - Joseph F Arboleda-Velasquez
- Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Yakeel T Quiroz
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Grupo de Neurociencias, Universidad de Antioquia, Medellín, Colombia.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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5
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Won J, Ranadive SM, Callow DD, Chen S, Carson Smith J. Blood pressure-related differences in brain health between young African Americans and Caucasian Americans. Physiol Rep 2021; 9:e14819. [PMID: 33769700 PMCID: PMC7995666 DOI: 10.14814/phy2.14819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background Although there are moderating effects of race on blood pressure (BP) and brain health in older adults, it is currently unknown if these race‐related differences in cardiovascular and associated brain function are also present in younger adults. The purpose of this study was to investigate the interaction between race and BP on brain health in younger African (AA) and Caucasian Americans (CA). Methods We studied 971 younger adults (29.1 ± 3.5 years; 180 AAs and 791 CAs) who volunteered to participate in the Human Connectome Project. Cognitive composite scores, brain volume, and cortical thickness using MRI were cross‐sectionally assessed. ANCOVA was used to examine interactions between race and mean arterial pressure (MAP) on cognitive test scores and brain structure. Results After controlling for age, sex, education, and BMI, there were significant Race × MAP interaction effects on cognitive composite scores and cortical thickness. Among AAs but not CAs, as MAP increased, both global cognitive performance and entorhinal cortex (ERC) thickness decreased. Conclusions MAP was an important moderator of racial differences in cognitive performance and ERC thickness. Our findings suggest that young AAs may carry a greater hypertension‐associated risk for cognitive brain health deficit. Interventions that address early signs of hypertension in AAs are needed to determine if the racial disparities in BP‐related brain health in late adulthood can be reduced.
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Affiliation(s)
- Junyeon Won
- Department of Kinesiology, University of Maryland, College Park, MD, USA
| | - Sushant M Ranadive
- Department of Kinesiology, University of Maryland, College Park, MD, USA
| | - Daniel D Callow
- Department of Kinesiology, University of Maryland, College Park, MD, USA.,Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA
| | - Shuo Chen
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J Carson Smith
- Department of Kinesiology, University of Maryland, College Park, MD, USA.,Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA
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6
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Elliott ML. MRI-based biomarkers of accelerated aging and dementia risk in midlife: how close are we? Ageing Res Rev 2020; 61:101075. [PMID: 32325150 DOI: 10.1016/j.arr.2020.101075] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/10/2020] [Accepted: 04/15/2020] [Indexed: 01/18/2023]
Abstract
The global population is aging, leading to an increasing burden of age-related neurodegenerative disease. Efforts to intervene against age-related dementias in older adults have generally proven ineffective. These failures suggest that a lifetime of brain aging may be difficult to reverse once widespread deterioration has occurred. To test interventions in younger populations, biomarkers of brain aging are needed that index subtle signs of accelerated brain deterioration that are part of the putative pathway to dementia. Here I review potential MRI-based biomarkers that could connect midlife brain aging to later life dementia. I survey the literature with three questions in mind, 1) Does the biomarker index age-related changes across the lifespan? 2) Does the biomarker index cognitive ability and cognitive decline? 3) Is the biomarker sensitive to known risk factors for dementia? I find that while there is preliminary support for some midlife MRI-based biomarkers for accelerated aging, the longitudinal research that would best answer these questions is still in its infancy and needs to be further developed. I conclude with suggestions for future research.
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Affiliation(s)
- Maxwell L Elliott
- Department of Psychology and Neuroscience, Duke University, 2020 West Main Street, Suite 030, Durham, NC, 27701, USA.
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7
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Gyanwali B, Shaik MA, Tan CS, Vrooman H, Venketasubramanian N, Chen C, Hilal S. Mixed-location cerebral microbleeds as a biomarker of neurodegeneration in a memory clinic population. Aging (Albany NY) 2019; 11:10581-10596. [PMID: 31767809 PMCID: PMC6914397 DOI: 10.18632/aging.102478] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/08/2019] [Indexed: 11/25/2022]
Abstract
Cerebral microbleeds (CMBs) in the lobar and deep locations are associated with two distinct pathologies: cerebral amyloid angiopathy and hypertensive arteriopathy. However, the role of mixed-location CMBs in neurodegeneration remains unexplored. We investigated the associations between strictly lobar, strictly deep and mixed-location CMBs with markers of neurodegeneration. This study recruited 477 patients from a memory clinic who underwent 3T MRI scans. CMBs were categorized into strictly lobar, strictly deep and mixed-location. Cortical thickness, white matter volume and subcortical structural volumes were quantified using Free-Surfer. Linear regression models were performed to assess the association between CMBs and cerebral atrophy, and the mean difference (β) and 95% confidence intervals (CIs) were reported. In the regression analyses, mixed-location CMBs were associated with smaller cortical thickness of limbic region [β= -0.01; 95% CI= -0.02, -0.00, p=0.007) as well as with smaller accumbens volume [β= -0.01; 95% CI= -0.02, -0.00, p=0.004) and presubiculum region of hippocampus [β= -0.01; 95% CI= -0.02, -0.00, p=0.002). Strictly lobar CMBs were associated with smaller total white matter volume [β= -0.03; 95% CI= -0.04, -0.01, p<0.001] and with region specific white matter volumes. The underlying mechanism requires further research and may involve shared mechanisms of vascular dysfunction and neurodegeneration.
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Affiliation(s)
- Bibek Gyanwali
- Memory Aging and Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
| | - Muhammad Amin Shaik
- Ageing Research Institute for Society and Education, Nanyang Technological University, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Henri Vrooman
- Departments of Radiology and Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Christopher Chen
- Memory Aging and Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
| | - Saima Hilal
- Memory Aging and Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Departments of Epidemiology and Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
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8
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Examining the identification of age-related atrophy between T1 and T1 + T2-FLAIR cortical thickness measurements. Sci Rep 2019; 9:11288. [PMID: 31375692 PMCID: PMC6677836 DOI: 10.1038/s41598-019-47294-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 07/10/2019] [Indexed: 11/10/2022] Open
Abstract
Cortical thickness is traditionally derived from T1-weighted MRI images. Recent studies have shown an improvement in segmentation with the combination of T1 + T2-FLAIR images. MRI data from 54 adults (mean: 71 years, 65–81 years, 48% females) that are part of an ongoing cohort study were analyzed to investigate whether T1 + T2-FLAIR cortical thickness measurements were superior to those derived from T1-weighted images in identifying age-related atrophy. T1-weighted and T2-FLAIR MRI images were processed through FreeSurfer v6.0. Data was extracted using the Desikan-Killiany (DKT) atlas. FreeSurfer’s GUI QDEC examined age-related atrophy. Nonparametric tests, effect sizes, and Pearson correlations examined differences between T1-only and T1 + T2-FLAIR cortical thickness data. These analyses demonstrated that T1 + T2-FLAIR processed images significantly improved the segmentation of gray matter (chi-square x2, p < 0.05) and demonstrated significantly thicker cortical thickness means (p < 0.05) with medium to large effect sizes. Significant regions of age-related cortical atrophy were identified within the T1 + T2-FLAIR data (FDR corrected, p < 0.05). This is in contrast to the T1-only data where no regions survived FDR correction. In summary, T1 + T2-FLAIR data were associated with significant improvement in cortical segmentation and the identification of age-related cortical atrophy. Future studies should consider employing this imaging strategy to obtain cortical thickness measurements sensitive to age-related changes.
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9
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Dickie DA, Gardner K, Wagener A, Wyss A, Arba F, Wardlaw JM, Dawson J. Cortical thickness, white matter hyperintensities, and cognition after stroke. Int J Stroke 2019; 15:46-54. [PMID: 31088224 DOI: 10.1177/1747493019851291] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND A thinner cerebral cortex is associated with higher white matter hyperintensity burden and cognitive impairment in community-dwelling and dementia cohorts. It is important to assess these associations in people with ischemic stroke because their cerebrovascular disease profiles are different to these cohorts. AIMS We aimed to determine whether cortical thickness was related to white matter hyperintensity burden and cognition after ischemic stroke. METHODS We measured cortical thickness using advanced normalization tools' "KellyKapowski" function in 244 patients with ischemic stroke or transient ischemic attack from the Virtual International Stroke Trials Archive. We measured white matter hyperintensity burden via quantitative volumes and Fazekas score. We extracted data on vascular risk factors at baseline and Mini Mental State Examination scores at one year. We assessed associations between imaging and clinical data using correlation and multiple linear regression. RESULTS Pairwise correlation showed that higher white matter hyperintensity Fazekas score was associated with a thinner cortex (rho = -0.284, P < 0.0001). White matter hyperintensities were generally distributed adjacent to and above the lateral ventricles. Voxel-wise analyses showed statistically significant negative associations between cortical thickness and white matter hyperintensities across fronto-temporal and inferior parietal cortical regions. Mean cortical thickness was positively related to Mini Mental State Examination in pair-wise correlation (r = 0.167, P = 0.0088) but there was no independent association after adjustment for age and white matter hyperintensities (beta = 0.016, P = 0.7874). CONCLUSIONS Cortical thickness was not an independent predictor of cognition after ischemic stroke. Further work is required to understand how white matter hyperintensities are associated with a thinner cortex in temporal regions but less so in more superior regions where white matter hyperintensities are generally found in people with stroke.
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Affiliation(s)
- David Alexander Dickie
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, UK
| | - Kirstyn Gardner
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, UK
| | - Annika Wagener
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, UK.,Interdisciplinary Center for Neurosciences, Heidelberg University, Heidelberg, Germany
| | - Annick Wyss
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, UK.,Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Francesco Arba
- Stroke Unit, Careggi University Hospital, Florence, Italy
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, Royal Infirmary of Edinburgh, The University of Edinburgh, Edinburgh, UK
| | - Jesse Dawson
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, UK
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10
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Jung NY, Cho H, Kim YJ, Kim HJ, Lee JM, Park S, Kim ST, Kim EJ, Kim JS, Moon SH, Lee JH, Ewers M, Na DL, Seo SW. The impact of education on cortical thickness in amyloid-negative subcortical vascular dementia: cognitive reserve hypothesis. ALZHEIMERS RESEARCH & THERAPY 2018; 10:103. [PMID: 30261914 PMCID: PMC6161352 DOI: 10.1186/s13195-018-0432-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/17/2018] [Indexed: 01/22/2023]
Abstract
Background The protective effect of education has been well established in Alzheimer’s disease, whereas its role in patients with isolated cerebrovascular diseases remains unclear. We examined the correlation of education with cortical thickness and cerebral small vessel disease markers in patients with pure subcortical vascular mild cognitive impairment (svMCI) and patients with pure subcortical vascular dementia (SVaD). Methods We analyzed 45 patients with svMCI and 47 patients with SVaD with negative results on Pittsburgh compound B positron emission tomographic imaging who underwent structural brain magnetic resonance imaging. The main outcome was cortical thickness measured using surface-based morphometric analysis. We also assessed the volumes of white matter hyperintensities (WMH) and numbers of lacunes as other outcomes. To investigate the correlation of education with cortical thickness, WMH volume, and number of lacunes, multiple linear regression analyses were performed after controlling for covariates, including Mini Mental State Examination, in the svMCI and SVaD groups. Results In the SVaD group, higher education was correlated with more severe cortical thinning in the bilateral dorsolateral frontal, left medial frontal, and parahippocampal areas, whereas there was no correlation of education with cortical thickness in the svMCI group. There was no correlation between education and cerebral small vessel disease, including WMH and lacunes, in both patients with svMCI and patients with SVaD. Conclusions Our findings suggest that the compensatory effects of education on cortical thinning apply to patients with SVaD, which might be explained by the cognitive reserve hypothesis.
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Affiliation(s)
- Na-Yeon Jung
- Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea.,Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Jong Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Seongbeom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Busan, Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung Hwan Moon
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. .,Neuroscience Center, Samsung Medical Center, Seoul, Korea.
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11
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Kwak S, Kim H, Chey J, Youm Y. Feeling How Old I Am: Subjective Age Is Associated With Estimated Brain Age. Front Aging Neurosci 2018; 10:168. [PMID: 29930506 PMCID: PMC5999722 DOI: 10.3389/fnagi.2018.00168] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/18/2018] [Indexed: 11/13/2022] Open
Abstract
While the aging process is a universal phenomenon, people perceive and experience one's aging considerably differently. Subjective age (SA), referring to how individuals experience themselves as younger or older than their actual age, has been highlighted as an important predictor of late-life health outcomes. However, it is unclear whether and how SA is associated with the neurobiological process of aging. In this study, 68 healthy older adults underwent a SA survey and magnetic resonance imaging (MRI) scans. T1-weighted brain images of open-access datasets were utilized to construct a model for age prediction. We utilized both voxel-based morphometry (VBM) and age-prediction modeling techniques to explore whether the three groups of SA (i.e., feels younger, same, or older than actual age) differed in their regional gray matter (GM) volumes, and predicted brain age. The results showed that elderly individuals who perceived themselves as younger than their real age showed not only larger GM volume in the inferior frontal gyrus and the superior temporal gyrus, but also younger predicted brain age. Our findings suggest that subjective experience of aging is closely related to the process of brain aging and underscores the neurobiological mechanisms of SA as an important marker of late-life neurocognitive health.
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Affiliation(s)
- Seyul Kwak
- Department of Psychology, Seoul National University, Seoul, South Korea
| | - Hairin Kim
- Department of Psychology, Seoul National University, Seoul, South Korea
| | - Jeanyung Chey
- Department of Psychology, Seoul National University, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, South Korea
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12
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Altered cerebral hemodyamics and cortical thinning in asymptomatic carotid artery stenosis. PLoS One 2017; 12:e0189727. [PMID: 29240808 PMCID: PMC5730122 DOI: 10.1371/journal.pone.0189727] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 11/30/2017] [Indexed: 11/19/2022] Open
Abstract
Cortical thinning is a potentially important biomarker, but the pathophysiology in cerebrovascular disease is unknown. We investigated the association between regional cortical blood flow and regional cortical thickness in patients with asymptomatic unilateral high-grade internal carotid artery disease without stroke. Twenty-nine patients underwent high resolution anatomical and single-delay, pseudocontinuous arterial spin labeling magnetic resonance imaging with partial volume correction to assess gray matter baseline flow. Cortical thickness was estimated using Freesurfer software, followed by co-registration onto each patient's cerebral blood flow image space. Paired t-tests assessed regional cerebral blood flow in motor cortex (supplied by the carotid artery) and visual cortex (indirectly supplied by the carotid) on the occluded and unoccluded side. Pearson correlations were calculated between cortical thickness and regional cerebral blood flow, along with age, hypertension, diabetes and white matter hyperintensity volume. Multiple regression and generalized estimating equation were used to predict cortical thickness bilaterally and in each hemisphere separately. Cortical blood flow correlated with thickness in motor cortex bilaterally (p = 0.0002), and in the occluded and unoccluded sides individually; age (p = 0.002) was also a predictor of cortical thickness in the motor cortex. None of the variables predicted cortical thickness in visual cortex. Blood flow was significantly lower on the occluded versus unoccluded side in the motor cortex (p<0.0001) and in the visual cortex (p = 0.018). On average, cortex was thinner on the side of occlusion in motor but not in visual cortex. The association between cortical blood flow and cortical thickness in carotid arterial territory with greater thinning on the side of the carotid occlusion suggests that altered cerebral hemodynamics is a factor in cortical thinning.
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13
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Chang CY, Lin CC, Tsai CF, Yang WC, Wang SJ, Lin FH, Fuh JL. Cognitive impairment and hippocampal atrophy in chronic kidney disease. Acta Neurol Scand 2017; 136:477-485. [PMID: 28261781 DOI: 10.1111/ane.12753] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cognition impairment is well known in patients with chronic kidney disease (CKD). The relationship between brain structure and cognitive performance in CKD patients is still under investigation. The study aimed to quantitatively assess the relationship between brain structure and cognitive performance in patients with CKD. METHODS We recruited 39 patients with CKD and 39 age- and sex-matched control participants from a tertiary medical center. All participants underwent 3-T MRI scan neuropsychological assessments, and renal function tests. FreeSurfer software was used for imaging processing and analysis, including measurement of cortical thickness and gray matter (GM) and white matter volumes. RESULTS Compared with control subjects (73.1±7.5 years old), patients with CKD (76.4±8.4 years old) had significantly lower scores on the Mini-Mental State Examination, and forward digit span test (P<.01). Patients with CKD had smaller cerebral GM volume, hippocampus, and decreased cortical thickness (P<.01) relative to the control group. Estimated glomerular filtration rate (eGFR) was correlated with cognitive performance, cortical thickness, GM volume, and hippocampal volume (P<.001). Linear regression analysis revealed that eGFR and GM volume were independently negatively associated with cognitive performance (P<.001), while eGFR and age were negatively associated with cortical thinning and GM volume after controlling for confounding factors. CONCLUSIONS This study demonstrated that impaired kidney function is associated not only with poor cognitive performance, but also with small cerebral GM volume and reduced cortical thickness.
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Affiliation(s)
- C.-Y. Chang
- Institute of Biomedical Engineering; National Taiwan University; Taipei Taiwan
- Department of Neurology; Min-Sheng General Hospital; Taoyuan Taiwan
| | - C.-C. Lin
- Division of Nephrology; Department of Medicine; Neurological Institute; Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine; National Yang-Ming University Schools of Medicine; Taipei Taiwan
| | - C.-F. Tsai
- Faculty of Medicine; National Yang-Ming University Schools of Medicine; Taipei Taiwan
- Department of Psychiatry; Neurological Institute; Taipei Veterans General Hospital; Taipei Taiwan
| | - W.-C. Yang
- Division of Nephrology; Department of Medicine; Neurological Institute; Taipei Veterans General Hospital; Taipei Taiwan
- Faculty of Medicine; National Yang-Ming University Schools of Medicine; Taipei Taiwan
| | - S.-J. Wang
- Faculty of Medicine; National Yang-Ming University Schools of Medicine; Taipei Taiwan
- Department of Neurology; Neurological Institute; Taipei Veterans General Hospital; Taipei Taiwan
| | - F.-H. Lin
- Institute of Biomedical Engineering; National Taiwan University; Taipei Taiwan
| | - J.-L. Fuh
- Faculty of Medicine; National Yang-Ming University Schools of Medicine; Taipei Taiwan
- Department of Neurology; Neurological Institute; Taipei Veterans General Hospital; Taipei Taiwan
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14
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Cerebral changes and cognitive impairment after an ischemic heart disease: a multimodal MRI study. Brain Imaging Behav 2017; 10:893-900. [PMID: 26589710 DOI: 10.1007/s11682-015-9483-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Three to 6 months after an acute coronary syndrome (ACS), cognitive impairment is observed in more than 30 % of the patients, mainly in executive functioning. The aim of this study was to investigate, using multimodal MRI, cerebral anatomo-functional substratum of executive dysfunction. Thirty-three patients were recruited 4 ± 1 months after a first ACS. Executive functions were evaluated with the Trail-Making-Test-B (TMTB) at baseline (ie 4 ± 1 months after ACS) and 6 months later (ie 10 ± 1 months after ACS). Using both time-points, we identified 3 groups of patients according to normative data based on age, gender and education level: 15 'cognitively normal' patients without impairment at each follow-up, 10 'transient impaired' patients with an impairment only at baseline and 8 'impairing' patients with an impairment only at follow-up. We explored, in the whole-brain, the structural integrity using Voxel-Based Morphometry and Tract-Based Spatial Statistics and the resting-state functional connectivity using Network-Based Statistics. No structural difference was observed between impaired and cognitively normal patients. At the functional level, compared to the 'cognitively normal' group, the 'transient impaired' patients presented an increased functional connectivity in a network centered on middle-orbito-frontal regions, whereas the 'impairing' patients presented only a non-significant decrease of functional connectivity. Executive dysfunction in ACS patients is associated to functional but no structural characteristics, particularly to an increased functional connectivity in cognitive networks in transient impaired patients. Further studies with larger sample size are needed to confirm these results and to determine if these patients could be at higher risk for developing permanent cognitive disorders.
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15
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Alves GS, de Carvalho LDA, Sudo FK, Briand L, Laks J, Engelhardt E. A panel of clinical and neuropathological features of cerebrovascular disease through the novel neuroimaging methods. Dement Neuropsychol 2017; 11:343-355. [PMID: 29354214 PMCID: PMC5769992 DOI: 10.1590/1980-57642016dn11-040003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED The last decade has witnessed substantial progress in acquiring diagnostic biomarkers for the diagnostic workup of cerebrovascular disease (CVD). Advanced neuroimaging methods not only provide a strategic contribution for the differential diagnosis of vascular dementia (VaD) and vascular cognitive impairment (VCI), but also help elucidate the pathophysiological mechanisms ultimately leading to small vessel disease (SVD) throughout its course. OBJECTIVE In this review, the novel imaging methods, both structural and metabolic, were summarized and their impact on the diagnostic workup of age-related CVD was analysed. Methods: An electronic search between January 2010 and 2017 was carried out on PubMed/MEDLINE, Institute for Scientific Information Web of Knowledge and EMBASE. RESULTS The use of full functional multimodality in simultaneous Magnetic Resonance (MR)/Positron emission tomography (PET) may potentially improve the clinical characterization of VCI-VaD; for structural imaging, MRI at 3.0 T enables higher-resolution scanning with greater imaging matrices, thinner slices and more detail on the anatomical structure of vascular lesions. CONCLUSION Although the importance of most of these techniques in the clinical setting has yet to be recognized, there is great expectancy in achieving earlier and more refined therapeutic interventions for the effective management of VCI-VaD.
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Affiliation(s)
| | | | - Felipe Kenji Sudo
- Departamento de Psicologia, Pontifícia Universidade Católica do Rio de Janeiro, RJ, Brazil
- Instituto D'Or de Ensino e Pesquisa, Rio de Janeiro, RJ, Brazil
| | - Lucas Briand
- Departamento de Medicina Interna, Universidade Federal do Ceará, CE, Brazil
| | - Jerson Laks
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, RJ, Brazil
- Programa de Pós-Graduação em Biomedicina Translacional (BIOTRANS), Unigranrio, Duque de Caxias, RJ, Brazil
| | - Eliasz Engelhardt
- Setor de Neurologia Cognitiva e do Comportamento, Instituto de Neurologia Deolindo Couto (INDC-CDA/IPUB), Rio de Janeiro, RJ, Brazil
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16
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Schwarz NF, Nordstrom LK, Pagen LHG, Palombo DJ, Salat DH, Milberg WP, McGlinchey RE, Leritz EC. Differential associations of metabolic risk factors on cortical thickness in metabolic syndrome. NEUROIMAGE-CLINICAL 2017; 17:98-108. [PMID: 29062686 PMCID: PMC5641920 DOI: 10.1016/j.nicl.2017.09.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/31/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
Objective Metabolic syndrome (MetS) refers to a cluster of risk factors for cardiovascular disease, including obesity, hypertension, dyslipidemia, and hyperglycemia. While sizable prior literature has examined associations between individual risk factors and quantitative measures of cortical thickness (CT), only very limited research has investigated such measures in MetS. Furthermore, the relative contributions of these risk factors to MetS-related effects on brain morphology have not yet been studied. The primary goal of this investigation was to examine how MetS may affect CT. A secondary goal was to explore the relative contributions of individual risk factors to regional alterations in CT, with the potential to identify risk factor combinations that may underlie structural changes. Methods Eighteen participants with MetS (mean age = 59.78 years) were age-matched with 18 healthy control participants (mean age = 60.50 years). CT measures were generated from T1-weighted images and groups were contrasted using whole-brain general linear modeling. A follow-up multivariate partial least squares correlation (PLS) analysis, including the full study sample with complete risk factor measurements (N = 53), was employed to examine which risk factors account for variance in group structural differences. Results Participants with MetS demonstrated significantly reduced CT in left hemisphere inferior parietal, rostral middle frontal, and lateral occipital clusters and in a right hemisphere precentral cluster. The PLS analysis revealed that waist circumference, high-density lipoprotein cholesterol (HDL-C), triglycerides, and glucose were significant contributors to reduced CT in these clusters. In contrast, diastolic blood pressure showed a significantly positive association with CT while systolic blood pressure did not emerge as a significant contributor. Age was not associated with CT. Conclusion These results indicate that MetS can be associated with regionally specific reductions in CT. Importantly, a novel link between a risk factor profile comprising indices of obesity, hyperglycemia, dyslipidemia and diastolic BP and localized alterations in CT emerged. While the pathophysiological mechanisms underlying these associations remain incompletely understood, these findings may be relevant for future investigations of MetS and might have implications for treatment approaches that focus on specific risk factor profiles with the aim to reduce negative consequences on the structural integrity of the brain. Cortical thickness is reduced bilaterally in metabolic syndrome. Five out of six risk factor components contribute to altered cortical thickness. Particular risk factor combination may be an important target for intervention.
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Affiliation(s)
- Nicolette F Schwarz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Leslie K Nordstrom
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Linda H G Pagen
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Daniela J Palombo
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA
| | - David H Salat
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; The Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA
| | - William P Milberg
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Regina E McGlinchey
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Elizabeth C Leritz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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17
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Divergent Influences of Cardiovascular Disease Risk Factor Domains on Cognition and Gray and White Matter Morphology. Psychosom Med 2017; 79:541-548. [PMID: 28498826 PMCID: PMC5453811 DOI: 10.1097/psy.0000000000000448] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Hypertension, diabetes, dyslipidemia, and obesity are associated with preclinical alterations in cognition and brain structure; however, this often comes from studies of comprehensive risk scores or single isolated factors. We examined associations of empirically derived cardiovascular disease risk factor domains with cognition and brain structure. METHODS A total of 124 adults (age, 59.8 [13.1] years; 41% African American; 50% women) underwent neuropsychological and cardiovascular assessments and structural magnetic resonance imaging. Principal component analysis of nine cardiovascular disease risk factors resulted in a four-component solution representing 1, cholesterol; 2, glucose dysregulation; 3, metabolic dysregulation; and 4, blood pressure. Separate linear regression models for learning, memory, executive functioning, and attention/information processing were performed, with all components entered at once, adjusting for age, sex, and education. MRI analyses included whole-brain cortical thickness and tract-based fractional anisotropy adjusted for age and sex. RESULTS Higher blood pressure was associated with poorer learning (B = -0.19; p = .019), memory (B = -0.22; p = .005), and executive functioning performance (B = -0.14; p = .031), and lower cortical thickness within the right lateral occipital lobe. Elevated glucose dysregulation was associated with poorer attention/information processing performance (B = -0.21; p = .006) and lower fractional anisotropy in the right inferior and bilateral superior longitudinal fasciculi. Cholesterol was associated with higher cortical thickness within left caudal middle frontal cortex. Metabolic dysfunction was positively associated with right superior parietal lobe, left inferior parietal lobe, and left precuneus cortical thickness. CONCLUSIONS Cardiovascular domains were associated with distinct cognitive, gray, and white matter alterations and distinct age groups. Future longitudinal studies may assist in identifying vulnerability profiles that may be most important for individuals with multiple cardiovascular disease risk factors.
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18
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Sanfratello L, Lundy SL, Qualls C, Knoefel JE, Adair JC, Caprihan A, Stephen JM, Aine CJ. Brain structure and verbal function across adulthood while controlling for cerebrovascular risks. Hum Brain Mapp 2017; 38:3472-3490. [PMID: 28390167 DOI: 10.1002/hbm.23602] [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: 01/22/2016] [Revised: 03/01/2017] [Accepted: 03/26/2017] [Indexed: 11/08/2022] Open
Abstract
The development and decline of brain structure and function throughout adulthood is a complex issue, with cognitive aging trajectories influenced by a host of factors including cerebrovascular risk. Neuroimaging studies of age-related cognitive decline typically reveal a linear decrease in gray matter (GM) volume/density in frontal regions across adulthood. However, white matter (WM) tracts mature later than GM, particularly in regions necessary for executive functions and memory. Therefore, it was predicted that a middle-aged group (MC: 35-45 years) would perform best on a verbal working memory task and reveal greater regional WM integrity, compared with both young (YC: 18-25 years) and elder groups (EC: 60+ years). Diffusion tensor imaging (DTI) and magnetoencephalography (MEG) were obtained from 80 healthy participants. Objective measures of cerebrovascular risk and cognition were also obtained. As predicted, MC revealed best verbal working memory accuracy overall indicating some maturation of brain function between YC and MC. However, contrary to the prediction fractional anisotropy values (FA), a measure of WM integrity, were not greater in MC (i.e., there were no significant differences in FA between YC and MC but both groups showed greater FA than EC). An overall multivariate model for MEG ROIs showed greater peak amplitudes for MC and YC, compared with EC. Subclinical cerebrovascular risk factors (systolic blood pressure and blood glucose) were negatively associated with FA in frontal callosal, limbic, and thalamic radiation regions which correlated with executive dysfunction and slower processing speed, suggesting their contribution to age-related cognitive decline. Hum Brain Mapp 38:3472-3490, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- L Sanfratello
- The Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, New Mexico, 87106.,Department of Radiology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, 87131
| | - S L Lundy
- Center for Neuropsychological Services, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, 87131
| | - C Qualls
- Clinical and Translational Science Center (Biostatistics),University of New Mexico Health Sciences Center, Albuquerque, New Mexico, 87131
| | - J E Knoefel
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, 87131.,Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, 87131
| | - J C Adair
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, 87131.,New Mexico VA Health Care System, Albuquerque, New Mexico, 87108
| | - A Caprihan
- The Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, New Mexico, 87106
| | - J M Stephen
- The Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, New Mexico, 87106
| | - C J Aine
- The Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, New Mexico, 87106.,Department of Radiology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, 87131
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19
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Price CC, Garvan C, Hizel LP, Lopez MG, Billings FT. Delayed Recall and Working Memory MMSE Domains Predict Delirium following Cardiac Surgery. J Alzheimers Dis 2017; 59:1027-1035. [PMID: 28697572 PMCID: PMC5544543 DOI: 10.3233/jad-170380] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Reduced preoperative cognition is a risk factor for postoperative delirium. The significance for type of preoperative cognitive deficit, however, has yet to be explored and could provide important insights into mechanisms and prediction of delirium. OBJECTIVE Our goal was to determine if certain cognitive domains from the general cognitive screener, the Mini-Mental State Exam (MMSE), predict delirium after cardiac surgery. METHODS Patients completed a preoperative MMSE prior to undergoing elective cardiac surgery. Following surgery, delirium was assessed throughout ICU stay using the Confusion Assessment Method for ICU delirium and the Richmond Agitation and Sedation Scale. RESULTS Cardiac surgery patients who developed delirium (n = 137) had lower total MMSE scores than patients who did not develop delirium (n = 457). In particular, orientation to place, working memory, delayed recall, and language domain scores were lower. Of these, only the working memory and delayed recall domains predicted delirium in a regression model adjusting for history of chronic obstructive pulmonary disease, age, sex, and duration of cardiopulmonary bypass. For each word not recalled on the three-word delayed recall assessment, the odds of delirium increased by 50%. For each item missed on the working memory index, the odds of delirium increased by 36%. Of the patients who developed delirium, 47% had a primary impairment in memory, 21% in working memory, and 33% in both domains. The area under the receiver operating characteristics curve using only the working memory and delayed recall domains was 0.75, compared to 0.76 for total MMSE score. CONCLUSION Delirium risk is greater for individuals with reduced MMSE scores on the delayed recall and working memory domains. Research should address why patients with memory and executive vulnerabilities are more prone to postoperative delirium than those with other cognitive limitations.
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Affiliation(s)
- Catherine C Price
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Anesthesiology, University of Florida, Gainesville, FL, USA
| | - Cynthia Garvan
- Anesthesiology, University of Florida, Gainesville, FL, USA
| | - Loren P Hizel
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Marcos G Lopez
- Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
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20
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Classifying anatomical subtypes of subjective memory impairment. Neurobiol Aging 2016; 48:53-60. [DOI: 10.1016/j.neurobiolaging.2016.08.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/18/2016] [Accepted: 08/10/2016] [Indexed: 11/22/2022]
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21
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Solis-Gaspar C, Vazquez-Roque RA, De Jesús Gómez-Villalobos M, Flores G. Cerebrolysin improves memory and ameliorates neuronal atrophy in spontaneously hypertensive, aged rats. Synapse 2016; 70:378-89. [DOI: 10.1002/syn.21912] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/05/2016] [Accepted: 05/06/2016] [Indexed: 01/26/2023]
Affiliation(s)
- Carlos Solis-Gaspar
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla; 14 Sur 6301, CP 72570, Puebla México
| | - Ruben A. Vazquez-Roque
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla; 14 Sur 6301, CP 72570, Puebla México
| | | | - Gonzalo Flores
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla; 14 Sur 6301, CP 72570, Puebla México
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22
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Lambert C, Sam Narean J, Benjamin P, Zeestraten E, Barrick TR, Markus HS. Characterising the grey matter correlates of leukoaraiosis in cerebral small vessel disease. Neuroimage Clin 2015; 9:194-205. [PMID: 26448913 PMCID: PMC4564392 DOI: 10.1016/j.nicl.2015.07.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 06/30/2015] [Accepted: 07/03/2015] [Indexed: 01/05/2023]
Abstract
Cerebral small vessel disease (SVD) is a heterogeneous group of pathological disorders that affect the small vessels of the brain and are an important cause of cognitive impairment. The ischaemic consequences of this disease can be detected using MRI, and include white matter hyperintensities (WMH), lacunar infarcts and microhaemorrhages. The relationship between SVD disease severity, as defined by WMH volume, in sporadic age-related SVD and cortical thickness has not been well defined. However, regional cortical thickness change would be expected due to associated phenomena such as underlying ischaemic white matter damage, and the observation that widespread cortical thinning is observed in the related genetic condition CADASIL (Righart et al., 2013). Using MRI data, we have developed a semi-automated processing pipeline for the anatomical analysis of individuals with cerebral small vessel disease and applied it cross-sectionally to 121 subjects diagnosed with this condition. Using a novel combined automated white matter lesion segmentation algorithm and lesion repair step, highly accurate warping to a group average template was achieved. The volume of white matter affected by WMH was calculated, and used as a covariate of interest in a voxel-based morphometry and voxel-based cortical thickness analysis. Additionally, Gaussian Process Regression (GPR) was used to assess if the severity of SVD, measured by WMH volume, could be predicted from the morphometry and cortical thickness measures. We found significant (Family Wise Error corrected p < 0.05) volumetric decline with increasing lesion load predominately in the parietal lobes, anterior insula and caudate nuclei bilaterally. Widespread significant cortical thinning was found bilaterally in the dorsolateral prefrontal, parietal and posterio-superior temporal cortices. These represent distinctive patterns of cortical thinning and volumetric reduction compared to ageing effects in the same cohort, which exhibited greater changes in the occipital and sensorimotor cortices. Using GPR, the absolute WMH volume could be significantly estimated from the grey matter density and cortical thickness maps (Pearson's coefficients 0.80 and 0.75 respectively). We demonstrate that SVD severity is associated with regional cortical thinning. Furthermore a quantitative measure of SVD severity (WMH volume) can be predicted from grey matter measures, supporting an association between white and grey matter damage. The pattern of cortical thinning and volumetric decline is distinctive for SVD severity compared to ageing. These results, taken together, suggest that there is a phenotypic pattern of atrophy associated with SVD severity.
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Affiliation(s)
- Christian Lambert
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
| | - Janakan Sam Narean
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
| | - Philip Benjamin
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
| | - Eva Zeestraten
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
| | - Thomas R. Barrick
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
| | - Hugh S. Markus
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, United Kingdom
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23
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Moon Y, Moon WJ, Han SH. Pathomechanisms of atrophy in insular cortex in Alzheimer's disease. Am J Alzheimers Dis Other Demen 2015; 30:497-502. [PMID: 25596207 PMCID: PMC10852619 DOI: 10.1177/1533317514566113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
The insular cortex is associated with neuropsychiatric symptoms, changes in cardiovascular and autonomic control, and mortality in Alzheimer's dementia. However, the insular cortex does not provide information on the contribution of the other cortices to cognitive decline. We hypothesized that the factors that affect to atrophy in insular cortex are different from other cortical regions. A total of 42 patients with probable Alzheimer's dementia were included in the analyses. The manual drawing of regions of interest was used to detect insular cortex located in the deep gray matter and to avoid coatrophy. Covariates, which could affect to the atrophy of the cerebral cortex, were selected based on previous studies. Any of the demographic factors, vascular risk factors, and the severity scales of dementia was not associated with any insular volume ratio. We suggest that the pathomechanisms of atrophy in insular cortex are different from those of other cortex regions in Alzheimer's disease.
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Affiliation(s)
- Yeonsil Moon
- Department of Neurology, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Won-Jin Moon
- Department of Radiology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Seol-Heui Han
- Department of Neurology, Konkuk University Medical Center, Seoul, Republic of Korea Center for Geriatric Neuroscience Research, Institute of Biomedical Science, Konkuk Medical Science Research Center, Seoul, Republic of Korea
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Noh Y, Seo SW, Jeon S, Lee JM, Kim JH, Kim GH, Cho H, Yoon CW, Kim HJ, Ye BS, Kim ST, Choe YS, Lee KH, Kim JS, Ewers M, Weiner MW, Lee JH, Werring DJ, Kang DR, Kim CS, Na DL. White matter hyperintensities are associated with amyloid burden in APOE4 non-carriers. J Alzheimers Dis 2015; 40:877-86. [PMID: 24577457 DOI: 10.3233/jad-130461] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Previous preclinical studies have suggested a close relationship between cerebrovascular disease (CVD) and Alzheimer's disease. However, a direct correlation between CVD and amyloid burden has not yet been shown in humans. If there is a relationship between CVD and amyloid burden, it is possible that the apolipoprotein E4 (APOE4) genotype may have an effect on this relationship because APOE4 is a risk factor for the development of AD. We therefore evaluated the effects of APOE4 on the relationship between white matter hyperintensities (WMH), a marker of CVD, and amyloid burden, measured by 11C-Pittsburgh compound B (PiB) PET. We recruited 53 patients with subcortical vascular cognitive impairments, who had both WMH on MRI and amyloid deposition assessed by PiB PET. Twenty-two of these patients were APOE4 carriers (41.5%). In the APOE4 non-carriers, a significant positive correlation was shown between the volume of WMH and PiB retention (β = 7.0 × 10-3, p = 0.034) while no significant correlation was found in APOE4 carriers (β = -9.0 × 10-3, p = 0.085). Statistical parametric mapping analyses in APOE4 non-carriers showed that WMH were associated with PiB retention in the bilateral medial occipitotemporal gyrus, cuneus, and superior cerebellum. Our results suggested that WMH are correlated with amyloid burden especially in the posterior brain regions in APOE4 non-carriers. However, this correlation was not observed in APOE4 carriers, perhaps because in these subjects the influence of APOE4 overrides the effect of CVD.
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Affiliation(s)
- Young Noh
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seun Jeon
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Jong Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Jung-Hyun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Geon Ha Kim
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hanna Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Cindy W Yoon
- Department of Neurology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byoung Seok Ye
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yearn Seong Choe
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Han Lee
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Ludwig-Maximilians-University, Munich, Germany
| | - Michael W Weiner
- University of California, San Francisco, San Francisco, CA, USA Center for Imaging of Neurodegenerative Diseases, Department of Veterans Affairs Medical Center, SanFrancisco, CA, USA
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - David J Werring
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London, UK
| | - Dae Ryong Kang
- Clinical Trials Center, Yonsei University Health System, Seoul, Korea
| | - Chang Soo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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25
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Yoon CW, Kang M, Shin HY, Jeon S, Yang JJ, Kim ST, Noh Y, Kim GH, Kim HJ, Kim YJ, Kim JH, Cho H, Ye BS, Lee JM, Choi SH, Im K, Moon HS, Na DL, Seo SW. Higher C-peptide levels are associated with regional cortical thinning in 1093 cognitively normal subjects. Eur J Neurol 2014; 21:1318-23, e80-1. [DOI: 10.1111/ene.12485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 05/05/2014] [Indexed: 11/28/2022]
Affiliation(s)
- C. W. Yoon
- Department of Neurology; Inha University School of Medicine; Incheon South Korea
| | - M. Kang
- Center for Health Promotion; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - H. Y. Shin
- Center for Health Promotion; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - S. Jeon
- Department of Biomedical Engineering; Hanyang University; Seoul South Korea
| | - J.-J. Yang
- Department of Biomedical Engineering; Hanyang University; Seoul South Korea
| | - S. T. Kim
- Department of Radiology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - Y. Noh
- Department of Neurology; Gachon University Gil Medical Center; Incheon South Korea
| | - G. H. Kim
- Department of Neurology; Ewha Womans University Mokdong Hospital; Ewha Womans University School of Medicine; Seoul South Korea
| | - H. J. Kim
- Department of Neurology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - Y. J. Kim
- Department of Neurology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - J.-H. Kim
- Department of Neurology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - H. Cho
- Department of Neurology; Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul South Korea
| | - B. S. Ye
- Department of Neurology; Yonsei University College of Medicine; Seoul South Korea
| | - J. M. Lee
- Department of Biomedical Engineering; Hanyang University; Seoul South Korea
| | - S. H. Choi
- Department of Neurology; Inha University School of Medicine; Incheon South Korea
| | - K. Im
- Division of Newborn Medicine; Boston Children's Hospital; Harvard Medical School; Boston MA USA
| | - H.-S. Moon
- Department of Neurology; Kangbuk Samsung Hospital; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - D. L. Na
- Department of Neurology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - S. W. Seo
- Department of Neurology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
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26
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Villeneuve S, Reed BR, Madison CM, Wirth M, Marchant NL, Kriger S, Mack WJ, Sanossian N, DeCarli C, Chui HC, Weiner MW, Jagust WJ. Vascular risk and Aβ interact to reduce cortical thickness in AD vulnerable brain regions. Neurology 2014; 83:40-7. [PMID: 24907234 DOI: 10.1212/wnl.0000000000000550] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The objective of this study was to define whether vascular risk factors interact with β-amyloid (Aβ) in producing changes in brain structure that could underlie the increased risk of Alzheimer disease (AD). METHODS Sixty-six cognitively normal and mildly impaired older individuals with a wide range of vascular risk factors were included in this study. The presence of Aβ was assessed using [(11)C]Pittsburgh compound B-PET imaging, and cortical thickness was measured using 3-tesla MRI. Vascular risk was measured with the Framingham Coronary Risk Profile Index. RESULTS Individuals with high levels of vascular risk factors have thinner frontotemporal cortex independent of Aβ. These frontotemporal regions are also affected in individuals with Aβ deposition, but the latter show additional thinning in parietal cortices. Aβ and vascular risk were found to interact in posterior (especially in parietal) brain regions, where Aβ has its greatest effect. In this way, the negative effect of Aβ in posterior regions is increased by the presence of vascular risk. CONCLUSION Aβ and vascular risk interact to enhance cortical thinning in posterior brain regions that are particularly vulnerable to AD. These findings give insight concerning the mechanisms whereby vascular risk increases the likelihood of developing AD and supports the therapeutic intervention of controlling vascular risk for the prevention of AD.
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Affiliation(s)
- Sylvia Villeneuve
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles.
| | - Bruce R Reed
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
| | - Cindee M Madison
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
| | - Miranka Wirth
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
| | - Natalie L Marchant
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
| | - Stephen Kriger
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
| | - Wendy J Mack
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
| | - Nerses Sanossian
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
| | - Charles DeCarli
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
| | - Helena C Chui
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
| | - Michael W Weiner
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
| | - William J Jagust
- From the Helen Wills Neuroscience Institute (S.V., C.M.M., M.W., W.J.J.), University of California Berkeley; Department of Neurology (B.R.R., C.D.), University of California Davis; Department of Old Age Psychiatry (N.L.M.), Institute of Psychiatry, King's College London, UK; Center for Imaging of Neurodegenerative Diseases (S.K., M.W.W.), University of California San Francisco; and Departments of Preventive Medicine (W.J.M.) and Neurology (N.S., H.C.C.), University of Southern California, Los Angeles
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27
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Tchistiakova E, Anderson ND, Greenwood CE, MacIntosh BJ. Combined effects of type 2 diabetes and hypertension associated with cortical thinning and impaired cerebrovascular reactivity relative to hypertension alone in older adults. NEUROIMAGE-CLINICAL 2014; 5:36-41. [PMID: 24967157 PMCID: PMC4066185 DOI: 10.1016/j.nicl.2014.05.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 05/17/2014] [Accepted: 05/30/2014] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Type 2 diabetes mellitus is characterized by metabolic dysregulation in the form of hyperglycemia and insulin resistance and can have a profound impact on brain structure and vasculature. The primary aim of this study was to identify brain regions where the combined effects of type 2 diabetes and hypertension on brain health exceed those of hypertension alone. A secondary objective was to test whether vascular impairment and structural brain measures in this population are associated with cognitive function. RESEARCH DESIGN AND METHODS We enrolled 18 diabetic participants with hypertension (HTN + T2DM, 7 women, 71.8 ± 5.6 years) and 22 participants with hypertension only (HTN, 12 women, 73.4 ± 6.2 years). Cerebrovascular reactivity (CVR) was assessed using blood oxygenation level dependent (BOLD) MRI during successive breath holds. Gray matter structure was evaluated using cortical thickness (CThk) measures estimated from T1-weighted images. Analyses of cognitive and blood data were also performed. RESULTS Compared to HTN, HTN + T2DM had decreased CVR and CThk in a spatially overlapping region of the right occipital lobe (P < 0.025); CVR group differences were more expansive and included bilateral occipito-parietal areas (P < 0.025). Whereas CVR showed no significant associations with measures of cognitive function (P > 0.05), CThk in the right lingual gyrus ROI and regions resulting from a vertex-wise analysis (including posterior cingulate, precuneus, superior and middle frontal, and middle and inferior temporal regions (P < 0.025) were associated with executive function. CONCLUSIONS Individuals with T2DM and HTN showed decreased CVR and CThk compared to age-matched HTN controls. This study identifies brain regions that are impacted by the combined effects of comorbid T2DM and HTN conditions, with new evidence that the corresponding cortical thinning may contribute to cognitive decline.
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Key Words
- 3DMPRAGE, three-dimensional magnetization-prepared rapid gradient-echo
- BH, breath hold
- BOLD, blood oxygenation level dependent imaging
- CThk, cortical thickness
- CVR, cerebrovascular reactivity
- Cerebrovascular reactivity
- Cortical thickness
- Diabetes
- FLAIR, fluid attenuation inversion recovery
- FLEX, fuzzy lesion extractor
- HBA1C, hemoglobin A1C
- HTN, hypertension
- Hypertension
- T2DM, type 2 diabetes mellitus
- TICS, Telephone Interview for Cognitive Status
- WMH, white matter hyperintensities
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Affiliation(s)
- Ekaterina Tchistiakova
- Department of Medical Biophysics, University of Toronto, 610 University Ave., Toronto, ON M5G 2M9, Canada ; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada ; Brain Sciences Research Program, Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada
| | - Nicole D Anderson
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON M5S 1A8, Canada ; Rotman Research Institute, Baycrest, 3560 Bathurst Street, Toronto, ON M6A 2E1, Canada ; Department of Medicine (Psychiatry), University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Carol E Greenwood
- Rotman Research Institute, Baycrest, 3560 Bathurst Street, Toronto, ON M6A 2E1, Canada ; Department of Nutritional Sciences, University of Toronto, FitzGerald Building, 150 College Street, Toronto, ON M5S 3E2, Canada
| | - Bradley J MacIntosh
- Department of Medical Biophysics, University of Toronto, 610 University Ave., Toronto, ON M5G 2M9, Canada ; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada ; Brain Sciences Research Program, Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada
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Foley JM, Salat DH, Stricker NH, Zink TA, Grande LJ, McGlinchey RE, Milberg WP, Leritz EC. Interactive effects of apolipoprotein E4 and diabetes risk on later myelinating white matter regions in neurologically healthy older aged adults. Am J Alzheimers Dis Other Demen 2014; 29:222-35. [PMID: 24381137 PMCID: PMC4356251 DOI: 10.1177/1533317513517045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Possession of the apolipoprotein E4 (APOE4) allele and diabetes risk are independently related to reduced white matter (WM) integrity that may contribute to the development of Alzheimer's disease (AD). The purpose of this study is to examine the interactive effects of APOE4 and diabetes risk on later myelinating WM regions among healthy elderly individuals at risk of AD. A sample of 107 healthy elderly (80 APOE4-/27 APOE4+) individuals underwent structural magnetic resonance imaging/diffusion tensor imaging (DTI). Data were prepared using Tract-Based Spatial Statistics, and a priori regions of interest (ROIs) were extracted from T1-based WM parcellations. Regions of interest included later myelinating frontal/temporal/parietal WM regions and control regions measured by fractional anisotropy (FA). There were no APOE group differences in DTI for any ROI. Within the APOE4 group, we found negative relationships between hemoglobin A1c/fasting glucose and APOE4 on FA for all later myelinating WM regions but not for early/middle myelinating control regions. Results also showed APOE4/diabetes risk interactions for WM underlying supramarginal, superior temporal, precuneus, superior parietal, and superior frontal regions. Results suggest interactive effects of APOE4 and diabetes risk on later myelinating WM regions, which supports preclinical detection of AD among this particularly susceptible subgroup.
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Affiliation(s)
- Jessica M. Foley
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - David H. Salat
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Nikki H. Stricker
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Tyler A. Zink
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Laura J. Grande
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Regina E. McGlinchey
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - William P. Milberg
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Elizabeth C. Leritz
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
- Division of Aging, Brigham & Women’s Hospital, Boston, MA, USA
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29
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The pattern of brain gray matter impairments in patients with subcortical vascular dementia. J Neurol Sci 2014; 341:110-8. [PMID: 24798224 DOI: 10.1016/j.jns.2014.04.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 04/01/2014] [Accepted: 04/14/2014] [Indexed: 11/23/2022]
Abstract
Though subcortical ischemic vascular dementia (SIVD) is known to initially affect subcortical regions, numerous brain imaging studies have also documented the widespread cortical alternations. Here we collected brain structural magnetic resonance imaging data from 34 SIVD patients and 35 healthy controls. Voxel-based morphometry (VBM), cortical thickness (and surface area) analysis and deep gray matter volume measurements were performed. VBM analysis showed gray matter volume reduction in lateral and medial temporal lobes, as well as orbitofrontal cortex in SIVD patients. The surface-based analyses revealed more subtle structural differences in the perisylvian area, medial temporal lobe, anterior and posterior cingulate, as well as prefrontal areas. Furthermore, analyses of deep gray matter demonstrated significant atrophy of the hippocampus, amygdala, nucleus accumbens and other nuclei. Finally, we found that thinning in the hippocampus and anterior cingulate cortex, as well as the volume decline in thalamus, caudate nucleus and amygdala was correlated with the cognitive impairment in patients. In conclusion, our study showed the structural abnormalities of the hippocampus and its associated outflow areas, as well as cortices implicated in cholinergic circuits in SIVD. These findings may bring new insights into the dysfunction of brain gray matter in SIVD.
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30
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Alosco ML, Gunstad J, Xu X, Clark US, Labbe DR, Riskin-Jones HH, Terrero G, Schwarz NF, Walsh EG, Poppas A, Cohen RA, Sweet LH. The impact of hypertension on cerebral perfusion and cortical thickness in older adults. ACTA ACUST UNITED AC 2014; 8:561-70. [PMID: 25151318 DOI: 10.1016/j.jash.2014.04.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 03/23/2014] [Accepted: 04/07/2014] [Indexed: 12/25/2022]
Abstract
Hypertension may increase risk for dementia possibly because of its association with decreased cortical thickness. Disturbed cerebral autoregulation is one plausible mechanism by which hypertension impacts the cerebral structure, but the associations among hypertension, brain perfusion, and cortical thickness are poorly understood. The current sample consisted of 58 older adults with varying levels of vascular disease. Diagnostic history of hypertension and antihypertensive medication status was ascertained through self-report, and when available, confirmed by medical record review. All participants underwent arterial spin labeling and T1-weighted magnetic resonance imaging to quantify total and regional cortical perfusion and thickness. Analysis of covariance adjusting for medical variables showed that participants with hypertension exhibited reduced temporal and occipital brain perfusion and total and regional cortical thickness relative to those without hypertension. The effects of hypertension on total brain perfusion remained unchanged even after adjustment for age, although no such pattern emerged for cortical thickness. Decreased total brain perfusion predicted reduced thickness of the total brain and of the frontal, temporal, and parietal lobe cortices. Antihypertensive treatment was not associated with total cerebral perfusion or cortical thickness. This study provides initial evidence for the adverse effects of a diagnostic history of hypertension on brain hypoperfusion and reduced cortical thickness. Longitudinal studies are needed to investigate the role of hypertension and its interaction with other contributing factors (e.g., age) in the manifestation of cerebral hypoperfusion and reduced cortical thickness.
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Affiliation(s)
| | - John Gunstad
- Department of Psychology, Kent State University, Kent, OH, USA
| | - Xiaomeng Xu
- Department of Psychology, Idaho State University, Pocatello, ID, USA
| | - Uraina S Clark
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Donald R Labbe
- Alpert Medical School of Brown University, the Department of Psychiatry and Human Behavior, Providence, RI, USA
| | - Hannah H Riskin-Jones
- Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Gretel Terrero
- Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Edward G Walsh
- Brown University, Departments of Neuroscience and Diagnostic Imaging., Providence, RI, USA
| | - Athena Poppas
- Alpert Medical School of Brown University, Department of Medicine, Providence, RI, USA
| | - Ronald A Cohen
- Cognitive Aging and Memory Program, Clinical Translational Research Program, Institute on Aging, University of Florida, Gainesville, FL, USA
| | - Lawrence H Sweet
- Alpert Medical School of Brown University, the Department of Psychiatry and Human Behavior, Providence, RI, USA; Department of Psychology, University of Georgia, Athens, GA, USA
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31
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Valkanova V, Ebmeier KP. Neuroimaging in dementia. Maturitas 2014; 79:202-8. [PMID: 24685291 DOI: 10.1016/j.maturitas.2014.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 02/25/2014] [Accepted: 02/28/2014] [Indexed: 10/25/2022]
Abstract
Over the last few years, advances in neuroimaging have generated biomarkers, which increase diagnostic certainty, provide valuable information about prognosis, and suggest a particular pathology underlying the clinical dementia syndrome. We aim to review the evidence for use of already established imaging modalities, along with selected techniques that have a great potential to guide clinical decisions in the future. We discuss structural, functional and molecular imaging, focusing on the most common dementias: Alzheimer's disease, fronto-temporal dementia, dementia with Lewy bodies and vascular dementia. Finally, we stress the importance of conducting research using representative cohorts and in a naturalistic set up, in order to build a strong evidence base for translating imaging methods for a National Health Service. If we assess a broad range of patients referred to memory clinic with a variety of imaging modalities, we will make a step towards accumulating robust evidence and ultimately closing the gap between the dramatic advances in neurosciences and meaningful clinical applications for the maximum benefit of our patients.
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Affiliation(s)
- Vyara Valkanova
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
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32
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Moon Y, Moon WJ, Kim H, Han SH. Regional Atrophy of the Insular Cortex Is Associated with Neuropsychiatric Symptoms in Alzheimer's Disease Patients. Eur Neurol 2014; 71:223-9. [DOI: 10.1159/000356343] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 10/13/2013] [Indexed: 11/19/2022]
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33
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Diallyl disulfide impairs hippocampal neurogenesis in the young adult brain. Toxicol Lett 2013; 221:31-8. [DOI: 10.1016/j.toxlet.2013.05.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/16/2013] [Accepted: 05/21/2013] [Indexed: 11/19/2022]
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34
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Krishnadas R, McLean J, Batty DG, Burns H, Deans KA, Ford I, McConnachie A, McGinty A, McLean JS, Millar K, Sattar N, Shiels PG, Velupillai YN, Packard CJ, Cavanagh J. Cardio-metabolic risk factors and cortical thickness in a neurologically healthy male population: Results from the psychological, social and biological determinants of ill health (pSoBid) study. Neuroimage Clin 2013; 2:646-57. [PMID: 24179815 PMCID: PMC3777783 DOI: 10.1016/j.nicl.2013.04.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 04/03/2013] [Accepted: 04/16/2013] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Cardio-metabolic risk factors have been associated with poor physical and mental health. Epidemiological studies have shown peripheral risk markers to be associated with poor cognitive functioning in normal healthy population and in disease. The aim of the study was to explore the relationship between cardio-metabolic risk factors and cortical thickness in a neurologically healthy middle aged population-based sample. METHODS T1-weighted MRI was used to create models of the cortex for calculation of regional cortical thickness in 40 adult males (average age = 50.96 years), selected from the pSoBid study. The relationship between cardio-vascular risk markers and cortical thickness across the whole brain, was examined using the general linear model. The relationship with various covariates of interest was explored. RESULTS Lipid fractions with greater triglyceride content (TAG, VLDL and LDL) were associated with greater cortical thickness pertaining to a number of regions in the brain. Greater C reactive protein (CRP) and intercellular adhesion molecule (ICAM-1) levels were associated with cortical thinning pertaining to perisylvian regions in the left hemisphere. Smoking status and education status were significant covariates in the model. CONCLUSIONS This exploratory study adds to a small body of existing literature increasingly showing a relationship between cardio-metabolic risk markers and regional cortical thickness involving a number of regions in the brain in a neurologically normal middle aged sample. A focused investigation of factors determining the inter-individual variations in regional cortical thickness in the adult brain could provide further clarity in our understanding of the relationship between cardio-metabolic factors and cortical structures.
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Key Words
- Apo, apolipoprotien
- BMI, body mass index
- CIMT, carotid intima-media thickness
- CRP, high sensitivity C-reactive protein
- Cardiovascular risk
- Cholesterol
- Cortical thickness
- ELISA, enzyme linked immunosorbent assay
- HDL, high-density lipoprotein
- ICAM, intercellular adhesion molecule-1
- IL-6, interleukin-6
- Inflammation
- LDL, low-density lipoprotein
- Metabolic risk
- PCA, principal component analysis
- SIMD, Scottish Index of Multiple Deprivation
- TAG, triglycerides
- pSoBid, psychological, social and biological determinants of ill health
- tPA, tissue plasminogen activator
- vWF, von Willebrand factor
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Affiliation(s)
- Rajeev Krishnadas
- Sackler Institute of Psychobiological Research, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - John McLean
- Sackler Institute of Psychobiological Research, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - David G. Batty
- Medical Research Council Social and Public Health Sciences Unit, Glasgow, Scotland, UK
- Clinical Epidemiology Group, Department of Epidemiology and Public Health, University College London, London, England, UK
| | - Harry Burns
- Scottish Government, Edinburgh, Scotland, UK
| | - Kevin A. Deans
- Department of Clinical Biochemistry, NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Glasgow, Scotland, UK
- Department of Clinical Biochemistry, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK
| | - Ian Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland, UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland, UK
| | - Agnes McGinty
- Glasgow Clinical Research Facility, Glasgow, Scotland, UK
| | | | - Keith Millar
- Sackler Institute of Psychobiological Research, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - Paul G. Shiels
- Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | | | | | - Jonathan Cavanagh
- Sackler Institute of Psychobiological Research, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
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35
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Alosco ML, Brickman AM, Spitznagel MB, Griffith EY, Narkhede A, Raz N, Cohen R, Sweet LH, Colbert LH, Josephson R, Hughes J, Rosneck J, Gunstad J. Poorer physical fitness is associated with reduced structural brain integrity in heart failure. J Neurol Sci 2013; 328:51-7. [PMID: 23528350 DOI: 10.1016/j.jns.2013.02.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Revised: 02/15/2013] [Accepted: 02/18/2013] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Physical fitness is an important correlate of structural and functional integrity of the brain in healthy adults. In heart failure (HF) patients, poor physical fitness may contribute to cognitive dysfunction and we examined the unique contribution of physical fitness to brain structural integrity among patients with HF. METHODS Sixty-nine HF patients performed the Modified Mini Mental State examination (3MS) and underwent brain magnetic resonance imaging. All participants completed the 2-minute step test (2MST), a brief measure of physical fitness. We examined the associations between cognitive performance, physical fitness, and three indices of global brain integrity: total cortical gray matter volume, total white matter volume, and whole brain cortical thickness. RESULTS Regression analyses adjusting for demographic characteristics, medical variables (e.g., left ventricular ejection fraction), and intracranial volume revealed reduced performance on the 2MST were associated with decreased gray matter volume and thinner cortex (p<.05). Follow up analyses showed that reduced gray matter volume and decreased cortical thickness were associated with poorer 3MS scores (p<.05). CONCLUSIONS Poor physical fitness is common in HF and associated with reduced structural brain integrity. Prospective studies are needed to elucidate underlying mechanisms for the influence of physical fitness on brain health in HF.
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Affiliation(s)
- Michael L Alosco
- Department of Psychology, Kent State University, Kent, OH 44242, USA.
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