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De Vita D, Sagliano L, Trojano L. Memory biases in Alzheimer's disease and mild cognitive impairment. A systematic review and metanalysis. Neurosci Biobehav Rev 2023; 152:105277. [PMID: 37286118 DOI: 10.1016/j.neubiorev.2023.105277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/17/2023] [Accepted: 06/03/2023] [Indexed: 06/09/2023]
Abstract
Several studies demonstrated that individuals are more likely to remember emotional than neutral information; this phenomenon is known as emotional enhancement of memory (EEM). Adults generally tend to remember negative information more efficiently than neutral or positive items. In contrast, healthy elders seem to show an opposite bias for positive information, but results are inconsistent, also because during aging, elaboration of emotional information could change as a consequence of cognitive impairment. In this systematic review and meta-analysis, we conducted literature search of studies investigating emotion memory biases in mild cognitive impairment (MCI) and Alzheimer's disease (AD) on PubMed, Scopus and PsycINFO databases following PRISMA guidelines. The findings showed that emotional memory biases are still present despite the presence of cognitive impairment, both in MCI and at least in early stages of AD. However, the direction of emotion memory biases is not consistent across studies. These results suggest that patients with cognitive impairment might still benefit from EEM and help to define targets of intervention for cognitive rehabilitation in pathological aging.
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Affiliation(s)
- Dalila De Vita
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, Italy.
| | - Laura Sagliano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, Italy
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2
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Isato A, Yokokawa K, Higuchi M, Suhara T, Yamada M. Resting-state functional connectivity relates to interindividual variations in positive memory. Behav Brain Res 2022; 419:113663. [PMID: 34780857 DOI: 10.1016/j.bbr.2021.113663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/29/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022]
Abstract
Individual differences in positive memory recollection are of interest in mental health, as positive memories can help protect people against stress and depression. However, it is unclear how individual differences in positive memory recollection are reflected in brain activity in the resting state. Here, we investigate the resting-state functional connectivity (FC) associated with interindividual variations in positive memory by employing cluster-level inferences based on randomization/permutation region of interest (ROI)-to-ROI analyses. We identified a cluster of FCs that was positively associated with positive memory performance, including the frontal operculum, central operculum, parietal operculum, Heschl's gyrus, and planum temporale. The current results suggest that positive memory is innervated by frontotemporal network connectivity, which may have implications for future investigations of vulnerability to stress and depression.
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Affiliation(s)
- Ayako Isato
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan; Faculty of Humanities, Saitama Gakuen University, Saitama 333-0831, Japan
| | - Keita Yokokawa
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Tetsuya Suhara
- Institute for Quantum Life Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Makiko Yamada
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan; Institute for Quantum Life Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan.
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3
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Chaudhary S, Zhornitsky S, Chao HH, van Dyck CH, Li CSR. Emotion Processing Dysfunction in Alzheimer's Disease: An Overview of Behavioral Findings, Systems Neural Correlates, and Underlying Neural Biology. Am J Alzheimers Dis Other Demen 2022; 37:15333175221082834. [PMID: 35357236 PMCID: PMC9212074 DOI: 10.1177/15333175221082834] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We described behavioral studies to highlight emotional processing deficits in Alzheimer's disease (AD). The findings suggest prominent deficit in recognizing negative emotions, pronounced effect of positive emotion on enhancing memory, and a critical role of cognitive deficits in manifesting emotional processing dysfunction in AD. We reviewed imaging studies to highlight morphometric and functional markers of hippocampal circuit dysfunction in emotional processing deficits. Despite amygdala reactivity to emotional stimuli, hippocampal dysfunction conduces to deficits in emotional memory. Finally, the reviewed studies implicating major neurotransmitter systems in anxiety and depression in AD supported altered cholinergic and noradrenergic signaling in AD emotional disorders. Overall, the studies showed altered emotions early in the course of illness and suggest the need of multimodal imaging for further investigations. Particularly, longitudinal studies with multiple behavioral paradigms translatable between preclinical and clinical models would provide data to elucidate the time course and underlying neurobiology of emotion processing dysfunction in AD.
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Affiliation(s)
- Shefali Chaudhary
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Herta H. Chao
- Department of Medicine, Yale University School of Medicine, New Haven, CT, USA,VA Connecticut Healthcare System, West Haven, CT, USA
| | - Christopher H. van Dyck
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA,Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA,Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA,Wu Tsai Institute, Yale University, New Haven, CT, USA
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4
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Paek EJ. Emotional Valence Affects Word Retrieval During Verb Fluency Tasks in Alzheimer's Dementia. Front Psychol 2021; 12:777116. [PMID: 34925179 PMCID: PMC8674734 DOI: 10.3389/fpsyg.2021.777116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/10/2021] [Indexed: 12/01/2022] Open
Abstract
Individuals with amnestic Alzheimer's disease (AD) often demonstrate preserved emotional processing skills despite the neurodegenerative disease that affects their limbic system. Emotional valence encompasses the encoding and retrieval of memory and it also affects word retrieval in healthy populations, but it remains unclear whether these effects are preserved in individuals with amnestic AD. Previous studies used a variety of encoding procedures and different retrieval methods that resulted in mixed findings. Therefore, the purpose of the current study is to investigate whether emotional enhancement of memory effects is observed in an experimental condition where the memory encoding process is not required, namely verb (action) fluency tasks. Seventeen participants who were cognitively healthy older adults (CHOA) and 15 participants with amnestic AD were asked to complete verb fluency tasks, and the relative degree of emotional valence observed in their responses was compared between the two groups. A neuropsychological test battery was administered to determine the participants' cognitive and linguistic profiles, and correlational analyses were conducted to delineate relationships between emotional valence, verbal memory, and learning abilities. The results indicated that the participants with amnestic AD produced words with higher emotional valence (i.e., more pleasant words) compared to CHOA during action fluency testing. In addition, the degree of emotional valence in the words was negatively correlated with verbal memory and learning skills, showing that those with poorer memory skills tend to retrieve words with higher emotional valence. The findings are consistent with those previous studies that stressed that individuals with AD have preserved emotional enhancement of memory effects and may benefit from them for retrieval of information, which may offer some insight into the development of novel rehabilitative strategies for this population.
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Affiliation(s)
- Eun Jin Paek
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville, TN, United States
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5
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Helbing C, Angenstein F. Frequency-dependent electrical stimulation of fimbria-fornix preferentially affects the mesolimbic dopamine system or prefrontal cortex. Brain Stimul 2020; 13:753-764. [PMID: 32289705 DOI: 10.1016/j.brs.2020.02.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/06/2020] [Accepted: 02/19/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The fimbria/fornix fiber system is an essential part of the hippocampal-VTA loop, and therefore activities that are propagated through this fiber system control the activity of the mesolimbic dopamine system. OBJECTIVES/HYPOTHESIS We hypothesized that stimulation of the fimbria/fornix with an increasing number of electrical pulses would cause increasing activity of the mesolimbic dopamine system, which coincides with concurrent changes in neuronal activities in target regions of the mesolimbic dopaminergic system. METHODS Right fimbria/fornix fibers were electrically stimulated with different pulse protocols. Stimulus-induced changes in neuronal activities were visualized with BOLD-fMRI, whereas stimulus-induced release of dopamine, as measured for the activity of the mesolimbic dopamine system, was determined in the nucleus accumbens with in vivo fast-scan cyclic voltammetry. RESULTS Dependent on the protocol, electrical fimbria/fornix stimulation caused BOLD responses in various targets of the mesolimbic dopamine system. Stimulation in the low theta frequency range (5 Hz) triggered significant BOLD responses mainly in the hippocampal formation, infralimbic cortex, and septum. Stimulation in the beta frequency range (20 Hz) caused additional activation in the medial prefrontal cortex (mPFC), nucleus accumbens, striatum, and VTA. Stimulation in the high-gamma frequency range (100 Hz) caused further activation in the hippocampus proper and mPFC. The strong activation in the mPFC during 100 Hz stimulations depended not only on the number of pulses but also on the frequency. Thus, short bursts of 5 or 20 high-frequency pulses caused stronger activation in the mPFC than continuous 5 or 20 Hz pulses. In contrast, high-frequency burst fimbria/fornix stimulation did not further activate the mesolimbic dopamine system when compared to continuous 5 or 20 Hz pulse stimulation. CONCLUSIONS There exists a frequency-dependent dissociation between BOLD responses and activation of the dopaminergic system. Low frequencies were more efficient to activate the mesolimbic dopamine system, whereas high frequencies were more efficient to trigger BOLD responses in target regions of the mesolimbic dopamine system, particularly the mPFC.
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Affiliation(s)
- Cornelia Helbing
- Functional Neuroimaging Group, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), Otto von Guericke University, Magdeburg, Germany.
| | - Frank Angenstein
- Functional Neuroimaging Group, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), Otto von Guericke University, Magdeburg, Germany; Leibniz Institute for Neurobiology (LIN), Magdeburg, Germany; Medical Faculty, Otto von Guericke University, Magdeburg, Germany.
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Ratovohery S, Baudouin A, Palisson J, Maillet D, Bailon O, Belin C, Narme P. Music as a mnemonic strategy to mitigate verbal episodic memory in Alzheimer's disease: Does musical valence matter? J Clin Exp Neuropsychol 2019; 41:1060-1073. [PMID: 31394979 DOI: 10.1080/13803395.2019.1650897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Introduction: Music is increasingly used to improve cognition in clinical settings. However, it remains unclear whether its use as a mnemonic strategy is effective in Alzheimer's disease (AD). The present study aimed at determining whether a musical mnemonic might mitigate patients' learning of new verbal information and at exploring the effect of factors such as retention delay and emotional valence of the musical excerpt used. Method: 13 patients with AD and 26 healthy comparisons (HC) with a low musical expertise were included. They learned texts about everyday life themes that were either set to familiar instrumental music, which was positively- or negatively-valenced, or spoken only. Immediate and delayed recalls (after 10 min and 24 hours) were measured. Results: Main results showed that (i) HC demonstrated better verbal episodic memory performance than participants with AD; (ii) participants with AD encoded texts paired with positively-valenced music better than texts paired with negatively-valenced music; (iii) participants with AD recalled sung texts better than spoken texts (after 10 min and 24 hours), regardless of musical valence while HC displayed better recall for texts paired with positively-valenced music. Conclusions: Musical mnemonics may help people with AD learn verbal information that relates to their daily life, regardless the musical expertise of the patients. This result gives promising clinical insights showing that music processing is robust to brain damage in AD. Possible hypotheses explaining the effectiveness of musical mnemonics in AD regardless the musical valence are discussed (e.g., different processing between musical and spoken conditions; disappearance of the positivity bias and implications with respect to the underlying socio-emotional selectivity theory).
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Affiliation(s)
- Stéphie Ratovohery
- Equipe Neuropsychologie du Vieillissement (EA 4468), Université de Paris , Boulogne-Billancourt , France
| | | | - Juliette Palisson
- Service de Neurologie, UF Mémoire et maladies neurodégénératives, CHU Avicenne, APHP , Bobigny , France
| | - Didier Maillet
- Service de Neurologie, Hôpital Saint-Louis, APHP, Université Paris Diderot , Paris , France
| | | | - Catherine Belin
- Equipe Neuropsychologie du Vieillissement (EA 4468), Université de Paris , Boulogne-Billancourt , France.,Service de Neurologie, Hôpital Saint-Louis, APHP, Université Paris Diderot , Paris , France
| | - Pauline Narme
- MC2Lab, Université de Paris , Boulogne-Billancourt , France
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[A pilot study into person-centred use of photo's in the communication with people with dementia]. Tijdschr Gerontol Geriatr 2018; 49:147-155. [PMID: 30088252 DOI: 10.1007/s12439-018-0258-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Social contact is important for the wellbeing of people. Dementia can complicate social interaction. In two randomized controlled pilot studies, it was investigated whether viewing different types of images together affects the mood and social interaction of people with moderately severe to severe Alzheimer's dementia residing in nursing homes. At the first intervention participants in the experimental group (n = 10) were shown portraits with positive facial expressions, and the participants in the control group (n = 10) were shown portraits with a neutral facial expression. During the second intervention, the experimental group (n = 10) were shown personalized photos and the control group (n = 10) non-personalized photos. There were no statistically significant differences in mood and the degree of social interaction between the groups. However, calculation of the effect sizes showed that there was a tendency for more positive behavior in viewing neutral portraits and that personalized images had a more positive impact on social interaction, negative behavior, speech and mood.
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Abstract
UNLABELLED ABSTRACTObjective:We aimed at examining the relation between stress markers (cortisol levels and state anxiety) with memory for emotional information in AD patients and in healthy elderly. DESIGN, SETTING, AND PARTICIPANTS Baseline and changes in stress markers during memory testing were assessed in a sample of 98 elderly (46 mild-to-moderate Alzheimer's disease patients and 52 controls) recruited from dementia day centers and adult day centers, respectively. MEASUREMENTS Salivary cortisol, state anxiety, and measures of immediate recall and delayed recognition using the International Affective Pictures System. RESULTS Patients' performance in memory tasks was not associated with either cortisol levels or anxiety. In controls, quadratic and linear associations were found between cortisol and immediate recall scores (total and bias, respectively). Besides, quadratic and linear associations were observed between anxiety and delayed recognition scores (total and bias, respectively). CONCLUSIONS The emotional memory of patients with Alzheimer´s disease is not related to stress markers as healthy older adults' is. Future studies that include moderating variables are needed to explain the lack of association.
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Saarela C, Joutsa J, Laine M, Parkkola R, Rinne JO, Karrasch M. Regional gray matter correlates of memory for emotion-laden words in middle-aged and older adults: A voxel-based morphometry study. PLoS One 2017; 12:e0182541. [PMID: 28771634 PMCID: PMC5542677 DOI: 10.1371/journal.pone.0182541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 07/20/2017] [Indexed: 11/19/2022] Open
Abstract
Emotional content is known to enhance memory in a content-dependent manner in healthy populations. In middle-aged and older adults, a reduced preference for negative material, or even an enhanced preference for positive material has been observed. This preference seems to be modulated by the emotional arousal that the material evokes. The neuroanatomical basis for emotional memory processes is, however, not well understood in middle-aged and older healthy people. Previous research on local gray matter correlates of emotional memory in older populations has mainly been conducted with patients suffering from various neurodegenerative diseases. To our knowledge, this is the first study to examine regional gray matter correlates of immediate free recall and recognition memory of intentionally encoded positive, negative, and emotionally neutral words using voxel-based morphometry (VBM) in a sample of 50-to-79-year-old cognitively intact normal adults. The behavioral analyses yielded a positivity bias in recognition memory, but not in immediate free recall. No associations with memory performance emerged from the region-of-interest (ROI) analyses using amygdalar and hippocampal volumes. Controlling for total intracranial volume, age, and gender, the whole-brain VBM analyses showed statistically significant associations between immediate free recall of negative words and volumes in various frontal regions, between immediate free recall of positive words and cerebellar volume, and between recognition memory of positive words and primary visual cortex volume. The findings indicate that the neural areas subserving memory for emotion-laden information encompass posterior brain areas, including the cerebellum, and that memory for emotion-laden information may be driven by cognitive control functions.
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Affiliation(s)
- Carina Saarela
- Department of Psychology, Abo Akademi University, Åbo, Finland
- Centre for Cognitive Neuroscience, University of Turku, Turku, Finland
| | - Juho Joutsa
- Turku PET Centre, Turku University Hospital, Turku, Finland
- Department of Neurology, University of Turku, Turku, Finland
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America
| | - Matti Laine
- Department of Psychology, Abo Akademi University, Åbo, Finland
- Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, University of Tampere, Tampere, Finland
- Department of Radiology, Tampere University Hospital, Tampere, Finland
| | - Juha O Rinne
- Turku PET Centre, Turku University Hospital, Turku, Finland
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
| | - Mira Karrasch
- Department of Psychology, Abo Akademi University, Åbo, Finland
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Memory for emotional images differs according to the presence of depressive symptoms in individuals at risk for dementia. Int Psychogeriatr 2017; 29:673-685. [PMID: 27974073 DOI: 10.1017/s1041610216002179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Studies of amnestic mild cognitive impairment (aMCI) and late-life depression (LLD) have examined the similarities and differences between these syndromes, but few have investigated how the cognitive profile of comorbid aMCI and subclinical depressive symptoms (aMCI/D+) may compare to that of aMCI or LLD. Memory biases for certain types of emotional information may distinguish these groups. METHODS A total of 35 aMCI, 23 aMCI/D+, 13 LLD, and 17 elderly controls (CONT) rated the valence (positive, negative, or neutral) of 30 pictures from the International Affective Picture System. Mean percent positive, negative, and neutral images recalled was compared within groups immediately and 30 minutes later. RESULTS Overall memory performance was comparable in aMCI and aMCI/D+, and both recalled fewer items than CONT and LLD. Group differences emerged when valence ratings were considered: at immediate and delayed recall, positive and negative pictures were generally better-remembered than neutral pictures by CONT, aMCI, and LLD, but valence was not associated with recall in aMCI/D+. Follow-up analyses suggested that the perceived intensity of stimuli may explain the emotional enhancement effect in CONT, aMCI, and LLD. CONCLUSIONS Results support previous research suggesting that the neuropsychological profile of aMCI/D+ is different from that of aMCI and LLD. Although depressed and non-depressed individuals with aMCI recall comparable quantities of information, the quality of the recalled information differs significantly. On theoretical grounds, this suggests the existence of distinct neurobiological or neurofunctional manifestations in both groups. Practically, these differences may guide the development of personalized emotion-focused encoding strategies in cognitive training programs.
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Yang EJ, Mahmood U, Kim H, Choi M, Choi Y, Lee JP, Chang MJ, Kim HS. Alterations in protein phosphorylation in the amygdala of the 5XFamilial Alzheimer's disease animal model. J Pharmacol Sci 2017; 133:261-267. [PMID: 28408165 DOI: 10.1016/j.jphs.2017.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/13/2017] [Accepted: 03/21/2017] [Indexed: 12/18/2022] Open
Abstract
Alzheimer's disease is the most common disease underlying dementia in humans. Two major neuropathological hallmarks of AD are neuritic plaques primarily composed of amyloid beta peptide and neurofibrillary tangles primarily composed of hyperphosphorylated tau. In addition to impaired memory function, AD patients often display neuropsychiatric symptoms and abnormal emotional states such as confusion, delusion, manic/depressive episodes and altered fear status. Brains from AD patients show atrophy of the amygdala which is involved in fear expression and emotional processing as well as hippocampal atrophy. However, which molecular changes are responsible for the altered emotional states observed in AD remains to be elucidated. Here, we observed that the fear response as assessed by evaluating fear memory via a cued fear conditioning test was impaired in 5XFamilial AD (5XFAD) mice, an animal model of AD. Compared to wild-type mice, 5XFAD mice showed changes in the phosphorylation of twelve proteins in the amygdala. Thus, our study provides twelve potential protein targets in the amygdala that may be responsible for the impairment in fear memory in AD.
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Affiliation(s)
- Eun-Jeong Yang
- Department of Pharmacology and Biomedical Sciences, College of Medicine, Seoul National University, 103 Daehakro, Jongro-gu, Seoul, Republic of Korea.
| | - Usman Mahmood
- Department of Pharmacology and Biomedical Sciences, College of Medicine, Seoul National University, 103 Daehakro, Jongro-gu, Seoul, Republic of Korea.
| | - Hyunju Kim
- Department of Pharmacology and Biomedical Sciences, College of Medicine, Seoul National University, 103 Daehakro, Jongro-gu, Seoul, Republic of Korea.
| | - Moonseok Choi
- Department of Pharmacology and Biomedical Sciences, College of Medicine, Seoul National University, 103 Daehakro, Jongro-gu, Seoul, Republic of Korea.
| | - Yunjung Choi
- Department of Pharmacology and Biomedical Sciences, College of Medicine, Seoul National University, 103 Daehakro, Jongro-gu, Seoul, Republic of Korea.
| | - Jean-Pyo Lee
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, 1430 Tulane Ave, SL99, New Orleans, LA 70112, USA.
| | - Moon-Jeong Chang
- Department of Foods and Nutrition, College of Natural Science, Kookmin University, Seoul, Republic of Korea.
| | - Hye-Sun Kim
- Department of Pharmacology and Biomedical Sciences, College of Medicine, Seoul National University, 103 Daehakro, Jongro-gu, Seoul, Republic of Korea; Seoul National University College of Medicine, Bundang Hospital, Bundang-Gu, Sungnam, Republic of Korea; Neuroscience Research Institute, College of Medicine, Seoul National University, 103 Daehakro, Jongro-gu, Seoul, Republic of Korea.
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12
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Ateş FE, Cangöz B, Özel Kızıl ET, Baskak B, Baran Z, Özgüven HD. Frontal activity during a verbal emotional working memory task in patients with Alzheimer's disease: A functional near-infrared spectroscopy study. Psychiatry Res Neuroimaging 2017; 261:29-34. [PMID: 28126617 DOI: 10.1016/j.pscychresns.2016.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 11/08/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
Emotional working memory (EWM) is suggested as a working memory (WM) type, distinguished to process emotional stimuli, and may or may not be spared in Alzheimer's disease (AD). The aim was to compare patients with AD and healthy older adults (HC) on verbal EWM performance and accompanying prefrontal cortex activity. Twenty AD patients along with 20 HC individuals are required to complete an emotional one-back task in three conditions (neutral, positive and negative word lists). Prefrontal oxyhemoglobin (oxyHb) concentrations were measured simultaneously by a 24- channel functional near infrared spectroscopy device. Correct response rates were similar in two groups in all conditions. Reaction times were comparable in the EWM positive condition but longer in the AD group in EWMneutral and negative conditions. In the HC group, emotional words had no significant effect on WM. On the other hand, positive compared to neutral words led to greater activation in the left ventral prefrontal cortex (VPFC) in AD group. When compared to HCs, activity in the VPFC was significantly higher in AD patients during the positive condition. Positive words facilitated WM performance in participants with AD. Activity in VPFC may be the functional correlate of this phenomenon.
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Affiliation(s)
- Fatma Ebru Ateş
- Hacettepe University, Department of Psychology, Turkey; School of Psychology - Keynes College, AG9, University of Kent, Canterbury, Kent CT2 7NP, United Kingdom.
| | - Banu Cangöz
- Hacettepe University, Department of Psychology, Turkey
| | - Erguvan Tuğba Özel Kızıl
- Ankara University Faculty of Medicine, Psychiatry Department, Ankara University, Brain Research and Applications Center (BAUM), Turkey
| | - Bora Baskak
- Ankara University Faculty of Medicine, Psychiatry Department, Ankara University, Brain Research and Applications Center (BAUM), Turkey
| | - Zeynel Baran
- Hacettepe University, Department of Psychology, Turkey
| | - Halise Devrimci Özgüven
- Ankara University Faculty of Medicine, Psychiatry Department, Ankara University, Brain Research and Applications Center (BAUM), Turkey
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Baran Z, Cangöz B, Ozel-Kizil ET. The Impact of Aging and Alzheimer's Disease on Emotional Enhancement of Memory. Eur Neurol 2014; 72:30-7. [DOI: 10.1159/000359924] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 12/17/2013] [Indexed: 11/19/2022]
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14
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Behavioral improvement of dementia residents in a group home with an increased number of residents after the Great East Japan Earthquake 2011. Int Psychogeriatr 2014; 26:871-2. [PMID: 24308794 DOI: 10.1017/s1041610213002305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Great East Japan Earthquake 2011 occurred on March 11 (Meguro, 2011). Group homes (GH)-A and B, run by a private company, were located in the coastal area of Kesen-numa city and damaged by the disaster. Fourteen of the 17 elderly residents living prior to the disaster in GH-A and B were evacuated to another GH-C run by the same company. The number of residents prior to the disaster in GH-C was nine, but almost tripled to 23 after the disaster, and several residents started to live together in one room. Compatibility of residents living in the same room was examined. Worsening of behavioral abnormalities caused by overcrowding was anticipated, but surprisingly behavior was improved (see Supplementary Table S1, available as supplementary material attached to the electronic version of this paper at www.journals.cambridge.org/jid_IPG).
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15
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Kalenzaga S, Piolino P, Clarys D. The emotional memory effect in Alzheimer's disease: emotional words enhance recollective experience similarly in patients and control participants. Cogn Emot 2014; 29:342-50. [PMID: 24734952 DOI: 10.1080/02699931.2014.907127] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of the present study was to investigate emotional memory enhancement (EME) in Alzheimer's disease (AD). In particular, we were interested in exploring which memory process (i.e., recollection or familiarity) could be improved by emotional information in the course of the disease. Eighteen AD patients were compared with 15 normal controls on the Remember/Know/Guess paradigm following encoding of emotional and neutral words. AD patients' recollective experience was improved for emotional compared to neutral words to the same extent as that of normal controls, whereas emotion had no effect on participants' memory performance involving familiarity processes. Our results showed that AD patients' memory can be enhanced qualitatively but not quantitatively by an emotional material. Furthermore, we found that AD patients were as able as normal controls to benefit from the emotional content of information to improve the recollection of details.
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Affiliation(s)
- Sandrine Kalenzaga
- a UMR-CNRS 7295 Research Center on Cognition and Learning , University of Poitiers , Poitiers , France
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Bruno D, Brown AD, Kapucu A, Marmar CR, Pomara N. Cognitive Reserve and Emotional Stimuli in Older Individuals: Level of Education Moderates the Age-Related Positivity Effect. Exp Aging Res 2014; 40:208-23. [DOI: 10.1080/0361073x.2014.882212] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mammarella N, Fairfield B. Emotional working memory and Alzheimer's disease. Int J Alzheimers Dis 2014; 2014:207698. [PMID: 24639911 PMCID: PMC3932272 DOI: 10.1155/2014/207698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 11/19/2013] [Accepted: 12/03/2013] [Indexed: 11/25/2022] Open
Abstract
A number of recent studies have reported that working memory does not seem to show typical age-related deficits in healthy older adults when emotional information is involved. Differently, studies about the short-term ability to encode and actively manipulate emotional information in dementia of Alzheimer's type are few and have yielded mixed results. Here, we review behavioural and neuroimaging evidence that points to a complex interaction between emotion modulation and working memory in Alzheimer's. In fact, depending on the function involved, patients may or may not show an emotional benefit in their working memory performance. In addition, this benefit is not always clearly biased (e.g., towards negative or positive information). We interpret this complex pattern of results as a consequence of the interaction between multiple factors including the severity of Alzheimer's disease, the nature of affective stimuli, and type of working memory task.
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Affiliation(s)
- Nicola Mammarella
- Department of Psychological Sciences, University of Chieti, Via dei Vestini 31, 66013 Chieti, Italy
| | - Beth Fairfield
- Department of Psychological Sciences, University of Chieti, Via dei Vestini 31, 66013 Chieti, Italy
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Parra MA, Pattan V, Wong D, Beaglehole A, Lonie J, Wan HI, Honey G, Hall J, Whalley HC, Lawrie SM. Medial temporal lobe function during emotional memory in early Alzheimer's disease, mild cognitive impairment and healthy ageing: an fMRI study. BMC Psychiatry 2013; 13:76. [PMID: 23497150 PMCID: PMC3599533 DOI: 10.1186/1471-244x-13-76] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 02/27/2013] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Relative to intentional memory encoding, which quickly declines in Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD), incidental memory for emotional stimuli appears to deteriorate more slowly. We hypothesised that tests of incidental emotional memory may inform on different aspects of cognitive decline in MCI and AD. METHODS Patients with MCI, AD and Healthy Controls (HC) were asked to attend to emotional pictures (i.e., positive and neutral) sequentially presented during an fMRI session. Attention was monitored behaviourally. A surprise post-scan recognition test was then administered. RESULTS The groups remained attentive within the scanner. The post-scan recognition pattern was in the form of (HC = MCI) > AD, with only the former group showing a clear benefit from emotional pictures. fMRI analysis of incidental encoding demonstrated clusters of activation in para-hippocampal regions and in the hippocampus in HC and MCI patients but not in AD patients. The pattern of activation observed in MCI patients tended to be greater than that found in HC. CONCLUSIONS The results suggest that incidental emotional memory might offer a suitable platform to investigate, using behavioural and fMRI measures, subtle changes in the process of developing AD. These changes seem to differ from those found using standard episodic memory tests. The underpinnings of such differences and the potential clinical use of this methodology are discussed in depth.
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Affiliation(s)
- Mario A Parra
- Scottish Dementia Clinical Research Network, Human Cognitive Neuroscience and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh EH8 9JZ, UK.
| | - Vivek Pattan
- Higher Specialty Trainee -Old Age Psychiatry, Stobhill Hospital, Glasgow, UK
| | - Dichelle Wong
- Division of Psychiatry, School of Molecular Medicine, Royal Edinburgh Hospital, Morningside, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | | | - Jane Lonie
- Division of Psychiatry, School of Molecular Medicine, Royal Edinburgh Hospital, Morningside, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Hong I Wan
- Translational Medicine, BioTherapeutics Clinical Programs, Pfizer, Inc, Cambridge, USA
| | - Garry Honey
- Translational Medicine, BioTherapeutics Clinical Programs, Pfizer, Inc, Cambridge, USA
| | - Jeremy Hall
- Division of Psychiatry, School of Molecular Medicine, Royal Edinburgh Hospital, Morningside, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Heather C Whalley
- Division of Psychiatry, School of Molecular Medicine, Royal Edinburgh Hospital, Morningside, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Stephen M Lawrie
- Division of Psychiatry, School of Molecular Medicine, Royal Edinburgh Hospital, Morningside, University of Edinburgh, Edinburgh, EH10 5HF, UK
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Klein-Koerkamp Y, Baciu M, Hot P. Preserved and impaired emotional memory in Alzheimer's disease. Front Psychol 2012; 3:331. [PMID: 23049516 PMCID: PMC3442282 DOI: 10.3389/fpsyg.2012.00331] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 08/18/2012] [Indexed: 11/13/2022] Open
Abstract
Patients with early atrophy of both limbic structures involved in memory and emotion processing in Alzheimer's disease (AD) provide a unique clinical population for investigating how emotion is able to modulate retention processes. This review focuses on the emotional enhancement effect (EEE), defined as the improvement of memory for emotional events compared with neutral ones. The assessment of the EEE for different memory systems in AD suggests that the EEE could be preserved under specific retrieval instructions. The first part of this review examines these data in light of compelling evidence that the amygdala can modulate processes of hippocampus-dependent memory. We argue that the EEE could be a useful paradigm to reduce impairment in episodic memory tasks. In the second part, we discuss theoretical consequences of the findings in favor of an EEE, according to which a compensatory mechanism in patients with AD solicits greater amygdala functioning or additional networks, even when amygdala atrophy is present. These considerations emphasize the relevance of investigating patients with AD to understand the relationship between emotion and memory processes.
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Affiliation(s)
- Yanica Klein-Koerkamp
- Laboratoire de Psychologie et Neurocognition, CNRS UMR-5105 Grenoble, France ; Université de Savoie Chambéry Cedex, France
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Emotional memory in patients with Alzheimer's disease: a report of two cases. Case Rep Psychiatry 2012; 2012:313906. [PMID: 22934217 PMCID: PMC3423798 DOI: 10.1155/2012/313906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 07/08/2012] [Indexed: 11/18/2022] Open
Abstract
Highly emotional events in daily life can be preserved in memory and such memory is generally referred to as emotional memory. Some reports have demonstrated that emotional memory is also found in patients with Alzheimer's disease (AD). However, to our knowledge, there have been no reports about how long memory retention for emotional events can continue in patients with AD. In this paper, we present two patients with AD who lost an immediate family member during followup and retained the memory over a long period despite progression of the AD.
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Sotaniemi M, Pulliainen V, Hokkanen L, Pirttilä T, Hallikainen I, Soininen H, Hänninen T. CERAD-neuropsychological battery in screening mild Alzheimer's disease. Acta Neurol Scand 2012; 125:16-23. [PMID: 21198445 DOI: 10.1111/j.1600-0404.2010.01459.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery (nb) is used as an evaluation tool for dementia. In Finland, CERAD-nb was introduced in 1999 and has been proposed to be used in primary health care. However, some of its parts need reassessment and focusing. The goal of this study was to examine the sensitivity and specificity of the subtests and their cut-off points most appropriate for identifying mild Alzheimer's disease (AD). MATERIALS AND METHODS The study population consisted of 171 patients with mild AD and 315 cognitively normal elderly. Both groups underwent CERAD-nb investigation as a part of a wider examination procedure. RESULTS The most efficient subtests to discriminate patients with mild AD from the normal elderly were Wordlist delayed recall and savings, Wordlist learning and Wordlist recognition and a new variable of Total recall. Optimal cut-off points for each subtest are suggested. The sensitivities of the verbal memory subtests varied between 0.75 and 0.94, the specificities between 0.80 and 0.93 and the areas under the receiver operating characteristics curve between 0.89 and 0.96. CONCLUSIONS The CERAD-nb is capable of differentiating cases with mild AD from normal elderly individuals particularly with its verbal memory subtests. New cut-off scores for CERAD's subtests validated in the study further enhance the differentiating power, and with these clarifications, CERAD-nb is considered appropriate to be used as a screening tool for AD even in primary health care.
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Affiliation(s)
- M Sotaniemi
- Department of Psychology, Institute of Behavioural Sciences, University of Helsinki, Finland.
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Mark RE. Understanding the individual with Alzheimer’s disease: Can socioemotional selectivity theory guide us? ACTA ACUST UNITED AC 2012. [DOI: 10.4236/aad.2012.13010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Poulin SP, Dautoff R, Morris JC, Barrett LF, Dickerson BC. Amygdala atrophy is prominent in early Alzheimer's disease and relates to symptom severity. Psychiatry Res 2011; 194:7-13. [PMID: 21920712 PMCID: PMC3185127 DOI: 10.1016/j.pscychresns.2011.06.014] [Citation(s) in RCA: 266] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 06/21/2011] [Accepted: 06/22/2011] [Indexed: 10/17/2022]
Abstract
Despite numerous studies on the role of medial temporal lobe structures in Alzheimer's disease (AD), the magnitude and clinical significance of amygdala atrophy have been relatively sparsely investigated. In this study, we used magnetic resonance imaging (MRI) to compare the level of amygdala atrophy to that of the hippocampus in very mild and mild AD subjects in two large samples (Sample 1 n=90; Sample 2 n=174). Using a series of linear regression analyses, we investigated whether amygdala atrophy is related to global cognitive functioning (Clinical Dementia Rating Sum of Boxes: CDR-SB; Mini Mental State Examination: MMSE) and neuropsychiatric status. Results indicated that amygdala atrophy was comparable to hippocampal atrophy in both samples. MMSE and CDR-SB were strongly related to amygdala atrophy, with amygdala atrophy predicting MMSE scores as well as hippocampal atrophy, but predicting CDR-SB scores less robustly. Amygdala atrophy was related to aberrant motor behavior, with potential relationships to anxiety and irritability. These results suggest that the magnitude of amygdala atrophy is comparable to that of the hippocampus in the earliest clinical stages of AD, and is related to global illness severity. There also appear to be specific relationships between the level of amygdala atrophy and neuropsychiatric symptoms that deserve further investigation.
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Affiliation(s)
- Stéphane P. Poulin
- Department Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Department Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rebecca Dautoff
- Department Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - John C. Morris
- Department of Neurology and Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Lisa Feldman Barrett
- Department Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Department Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Department of Psychology, Northeastern University, Boston, MA, USA
| | - Bradford C. Dickerson
- Department Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Department Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Department Frontotemporal Dementia Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Department Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Department Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Corresponding author: Bradford C. Dickerson, M.D., Frontotemporal Dementia Unit, Massachusetts General Hospital, 149 13th St., Suite 2691, Charlestown, MA 02129, Tel: (617) 726-5571, Fax: (617) 726-5760,
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Huijbers MJ, Bergmann HC, Olde Rikkert MGM, Kessels RPC. Memory for emotional pictures in patients with Alzheimer's dementia: comparing picture-location binding and subsequent recognition. J Aging Res 2011; 2011:409364. [PMID: 21822492 PMCID: PMC3142551 DOI: 10.4061/2011/409364] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 06/08/2011] [Accepted: 06/09/2011] [Indexed: 11/24/2022] Open
Abstract
Emotional content typically facilitates subsequent memory, known as the emotional enhancement effect. We investigated whether emotional content facilitates spatial and item memory in patients with Alzheimer's dementia (AD). Twenty-three AD patients, twenty-three healthy elderly, and twenty-three young adults performed a picture relocation task and a delayed recognition task with positive, negative, and neutral stimuli. AD patients showed a benefit in immediate spatial memory for positive pictures, while healthy young and older participants did not benefit from emotional content. No emotional enhancement effects on delayed item recognition were seen. We conclude that AD patients may have a memory bias for positive information in spatial memory. Discrepancies between our findings and earlier studies are discussed.
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Affiliation(s)
- Marloes J Huijbers
- Department of Psychiatry, Radboud University Nijmegen Medical Centre, Internal Post 966, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Cavedo E, Boccardi M, Ganzola R, Canu E, Beltramello A, Caltagirone C, Thompson PM, Frisoni GB. Local amygdala structural differences with 3T MRI in patients with Alzheimer disease. Neurology 2011; 76:727-33. [PMID: 21339500 DOI: 10.1212/wnl.0b013e31820d62d9] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Histologic studies show that the amygdala is affected by Alzheimer disease (AD) pathology, and its medial aspect is the most involved. We aimed to assess in vivo local structural differences in the amygdala of patients with AD using high-field MRI. METHODS A total of 19 patients with AD (mean age 76, SD 6 years, mean Mini-Mental State Examination score [MMSE] 13, SD 4) and 19 healthy elderly controls (age 74, SD 5, MMSE 29, SD 1) were enrolled. The radial atrophy mapping technique was used to reconstruct the 3-dimensional surface of the amygdala. Maps of surface tissue loss in patients with AD vs controls were computed and statistically tested with permutation tests thresholded at p < 0.05, to correct for multiple comparisons. A digital atlas of the amygdalar nuclei was used to infer which nuclei were involved. RESULTS Both amygdalar volumes were significantly smaller in patients with AD (right 1,508 mm³, SD 418; left 1,646, SD 419) than controls (right 2,129 mm³, SD 316; left 2,077, SD 376; p < 0.002). In the dorsomedial part, significant local tissue loss (20%-30%) was mapped in the medial and central nuclei. Ventrally, the lateral nucleus (La) and the basolateral ventral medial nucleus (BLVM) were also involved (20%-30% loss). CONCLUSIONS We found in vivo local structural differences in the amygdala of patients with AD. The nuclei involved have known connections to the hippocampus (BLVM, La) and olfactory system (medial nucleus) and with cholinergic pathways (central nucleus). This pattern is consistent with the known pathophysiology of neural systems affected by AD.
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Affiliation(s)
- E Cavedo
- LENITEM (Laboratory of Epidemiology Neuroimaging & Telemedicine), IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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