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Wakita H, Takahashi Y, Masuzugawa S, Miyasaka H, Sonoda S, Shindo A, Tomimoto H. Alterations in driving ability and their relationship with morphometric magnetic resonance imaging indicators in patients with amnestic mild cognitive impairment and Alzheimer's disease. Psychogeriatrics 2024. [PMID: 38692585 DOI: 10.1111/psyg.13128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 03/31/2024] [Accepted: 04/12/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Drivers with dementia are at a higher risk of motor vehicle accidents. The characteristics of driving behaviour of patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) have not been fully elucidated. We investigated driving ability and its relationship with cognitive function and magnetic resonance imaging (MRI) morphometry indicators. METHODS The driving abilities of 19 patients with AD and 11 with amnestic MCI (aMCI) were evaluated using a driving simulator. The association between each driving ability parameter and the Mini-Mental State Examination (MMSE) score or voxel-based specific regional analysis system for AD (VSRAD) was assessed. RESULTS Patients with AD made a significantly higher number of operational errors than those with aMCI in attention allocation in the complex task test (P = 0.0008). The number of operational errors in attention allocation in the complex task test significantly and negatively correlated with MMSE scores in all participants (r = -0.4354, P = 0.0162). The decision time in the selective reaction test significantly and positively correlated with the severity and extent of medial temporal structural atrophy (r = 0.4807, P = 0.0372; r = 0.4862, P = 0.0348; respectively). CONCLUSION An increase in the operational errors for attention allocation in the complex task test could be a potential indicator of progression from aMCI to AD. Atrophy of the medial temporal structures could be a potential predictor of impaired judgement in driving performance in aMCI and AD. A driving simulator could be useful for evaluating the driving abilities of individuals with aMCI and AD.
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Affiliation(s)
- Hideaki Wakita
- Department of Internal Medicine, Nanakuri Memorial Hospital, Fujita Health University, Tsu, Japan
- Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Yu Takahashi
- Department of Internal Medicine, Nanakuri Memorial Hospital, Fujita Health University, Tsu, Japan
- Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan
| | | | - Hiroyuki Miyasaka
- Department of Rehabilitation, Fujita Health University Nanakuri Memorial Hospital, Tsu, Japan
| | - Shigeru Sonoda
- Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan
| | - Akihiro Shindo
- Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan
- Saiseikai Meiwa Hospital, Meiwa, Japan
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2
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Song J. Amygdala activity and amygdala-hippocampus connectivity: Metabolic diseases, dementia, and neuropsychiatric issues. Biomed Pharmacother 2023; 162:114647. [PMID: 37011482 DOI: 10.1016/j.biopha.2023.114647] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/04/2023] Open
Abstract
With rapid aging of the population worldwide, the number of people with dementia is dramatically increasing. Some studies have emphasized that metabolic syndrome, which includes obesity and diabetes, leads to increased risks of dementia and cognitive decline. Factors such as insulin resistance, hyperglycemia, high blood pressure, dyslipidemia, and central obesity in metabolic syndrome are associated with synaptic failure, neuroinflammation, and imbalanced neurotransmitter levels, leading to the progression of dementia. Due to the positive correlation between diabetes and dementia, some studies have called it "type 3 diabetes". Recently, the number of patients with cognitive decline due to metabolic imbalances has considerably increased. In addition, recent studies have reported that neuropsychiatric issues such as anxiety, depressive behavior, and impaired attention are common factors in patients with metabolic disease and those with dementia. In the central nervous system (CNS), the amygdala is a central region that regulates emotional memory, mood disorders, anxiety, attention, and cognitive function. The connectivity of the amygdala with other brain regions, such as the hippocampus, and the activity of the amygdala contribute to diverse neuropathological and neuropsychiatric issues. Thus, this review summarizes the significant consequences of the critical roles of amygdala connectivity in both metabolic syndromes and dementia. Further studies on amygdala function in metabolic imbalance-related dementia are needed to treat neuropsychiatric problems in patients with this type of dementia.
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Affiliation(s)
- Juhyun Song
- Department of Anatomy, Chonnam National University Medical School, Hwasun 58128, Jeollanam-do, Republic of Korea.
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3
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Krasniuk S, Crizzle AM, Toxopeus R, Mychael D, Prince N. Clinical Tests Predicting On-Road Performance in Older Drivers with Cognitive Impairment. Can J Occup Ther 2023; 90:44-54. [PMID: 35950229 PMCID: PMC9923206 DOI: 10.1177/00084174221117708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. The Trail Making Test Part B (Trails B) and Useful Field of View® (UFOV) can predict on-road outcomes in drivers with cognitive impairment (CI); however, studies have not included drivers referred for comprehensive driving evaluations (CDEs), who typically have more severe CI. Purpose. We determined the predictive ability of Trails B and UFOV on pass/fail on-road outcomes in drivers with CI (Montreal Cognitive Assessment <26) referred for CDEs. Method. Retrospective data collection from two driving assessments centers (N = 100, mean age = 76.2 ± 8.8 years). Findings. The Trails B (area under the curve [AUC] = .70) and UFOV subtests 2 (AUC = .73) and 3 (AUC = .76) predicted pass/fail outcomes. A cut-point ≥467 ms on UFOV subtest 3 better-predicted pass/fail outcomes with 78.9% sensitivity and 73.5% specificity. In comparison, a cut-point ≥3.58 min on Trails B had lower sensitivity (73.7%) and specificity (61.8%). Implications. The UFOV subtest 3 may be more useful than the Trails B for predicting pass/fail outcomes in drivers with more severe CI referred for CDEs.
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Affiliation(s)
| | - Alexander M. Crizzle
- Alexander Crizzle, School of Public Health,
University of Saskatchewan, Saskatoon, SK, Canada.
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4
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Krasniuk S, Mychael D, Crizzle AM. Driving Errors Predicting Pass/Fail On-Road Assessment Outcomes Among Cognitively Impaired Older Drivers. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:144-153. [PMID: 35337241 PMCID: PMC9729977 DOI: 10.1177/15394492221076494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Older drivers with cognitive impairment (CI)/dementia make significantly more driving errors than healthy controls; however, whether driving errors are predictive of pass/fail outcomes in older drivers with CI/dementia are unclear. This study determined the driving errors that predicted failing an on-road assessment in drivers with CI. We retrospectively collected comprehensive driving evaluation data of 80 participants (76.1 ± 9.3 years) from an Ontario driving assessment center. Adjustment to stimuli (area under the curve [AUC] = 0.88), lane maintenance (AUC = 0.84), and speed regulation errors (AUC = 0.85) strongly predicted pass/fail outcomes. Worse performance on the Trails B (time) and Useful Field of View® (Subtest 2, Subtest 3, and risk index) were significantly correlated with adjustment to stimuli (p < .05), lane maintenance (p < .05), and speed regulation errors (p < .05). Adjustment to stimuli, lane maintenance, and speed regulation errors may be critical indicators of failing an on-road assessment in older drivers with CI. Prioritizing these errors may help identify at-risk drivers.
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Affiliation(s)
| | | | - Alexander M. Crizzle
- University of Saskatchewan, Saskatoon, Canada,Alexander M. Crizzle, Associate Professor and Director of the Driving Research & Simulation Laboratory, School of Public Health, University of Saskatchewan, 104 Clinic Road, Saskatoon, Saskatchewan, Canada S7N 2Z4.
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5
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Stanitsa E, Economou A, Beratis I, Kontaxopoulou D, Fragkiadaki S, Papastefanopoulou V, Pavlou D, Papantoniou P, Kroupis C, Papatriantafyllou J, Stefanis L, Yannis G, Papageorgiou SG. Effect of Apolipoprotein E4 on the Driving Behavior of Patients with Amnestic Mild Cognitive Impairment or Mild Alzheimer's Disease Dementia. J Alzheimers Dis 2021; 84:1005-1014. [PMID: 34602476 DOI: 10.3233/jad-210622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The driving behavior of patients with mild Alzheimer's disease dementia (ADD) and patients with mild cognitive impairment (MCI) is frequently characterized by errors. A genetic factor affecting cognition is apolipoprotein E4 (APOE4), with carriers of APOE4 showing greater episodic memory impairment than non-carriers. However, differences in the driving performance of the two groups have not been investigated. OBJECTIVE To compare driving performance in APOE4 carriers and matched non-carriers. METHODS Fourteen APOE4 carriers and 14 non-carriers with amnestic MCI or mild ADD underwent detailed medical and neuropsychological assessment and participated in a driving simulation experiment, involving driving in moderate and high traffic volume in a rural environment. Driving measures were speed, lateral position, headway distance and their SDs, and reaction time. APOE was genotyped through plasma samples. RESULTS Mixed two-way ANOVAs examining traffic volume and APOE4 status showed a significant effect of traffic volume on all driving variables, but a significant effect of APOE4 on speed variability only. APOE4 carriers were less variable in their speed than non-carriers; this remained significant after a Bonferroni correction. To further examine variability in the driving performance, coefficients of variation (COV) were computed. Larger headway distance COV and smaller lateral position COV were observed in high compared to moderate traffic. APOE4 carriers had smaller speed COV compared to non-carriers. CONCLUSION The lower speed variability of APOE4 carriers in the absence of neuropsychological test differences indicates reduced speed adaptations, possibly as a compensatory strategy. Simulated driving may be a sensitive method for detecting performance differences in the absence of cognitive differences.
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Affiliation(s)
- Evangelia Stanitsa
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Alexandra Economou
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece
| | - Ion Beratis
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Stella Fragkiadaki
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Vicky Papastefanopoulou
- Department of Clinical Biochemistry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimosthenis Pavlou
- Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens, Athens, Greece
| | - Panagiotis Papantoniou
- Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens, Athens, Greece
| | - Christos Kroupis
- Department of Clinical Biochemistry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - John Papatriantafyllou
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aiginiteio University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Yannis
- Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens, Athens, Greece
| | - Sokratis G Papageorgiou
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
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Herrmann FR, Rodriguez C, Haller S, Garibotto V, Montandon ML, Giannakopoulos P. Gray Matter Densities in Limbic Areas and APOE4 Independently Predict Cognitive Decline in Normal Brain Aging. Front Aging Neurosci 2019; 11:157. [PMID: 31316372 PMCID: PMC6609870 DOI: 10.3389/fnagi.2019.00157] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/11/2019] [Indexed: 11/25/2022] Open
Abstract
Cross-sectional magnetic resonance imaging (MRI) studies reported significant associations between gray matter (GM) density changes in various limbic and neocortical areas and worst cognitive performances in elderly controls. Longitudinal studies in this field remain scarce and led to conflicting data. We report a clinico-radiological investigation of 380 cognitively preserved individuals who undergo neuropsychological assessment at baseline and after 18 months. All cases were assessed using a continuous cognitive score taking into account the global evolution of neuropsychological performances. The vast majority of Mini Mental State Examination (MMSE) 29 and 30 cases showed equal or worst performance at follow-up due to a ceiling effect. GM densities, white matter hyperintensities and arterial spin labeling (ASL) values were assessed in the hippocampus, amygdala, mesial temporal and parietal cortex at inclusion using 3 Tesla MRI Scans. Florbetapir positron emission tomography (PET) amyloid was available in a representative subsample of 64 cases. Regional amyloid uptake ratios (SUVr), mean cortical SUVr values (mcSUVr) and corresponding z-scores were calculated. Linear regression models were built to explore the association between the continuous cognitive score and imaging variables. The presence of an APOE-ε4 allele was negatively related to the continuous cognitive score. Among the areas studied, significant associations were found between GM densities in the hippocampus and amygdala but not mesial temporal and parietal areas and continuous cognitive score. Neither ASL values, Fazekas score nor mean and regional PET amyloid load was related to the cognitive score. In multivariate models, the presence of APOE-ε4 allele and GM densities in the hippocampus and amygdala were independently associated with worst cognitive evolution at follow-up. Our data support the idea that early GM damage in the hippocampus and amygdala occur long before the emergence of the very first signs of cognitive failure in brain aging.
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Affiliation(s)
- François R Herrmann
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Cristelle Rodriguez
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Sven Haller
- CIRD Centre d'Imagerie Rive Droite, Geneva, Switzerland.,Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Valentina Garibotto
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Louise Montandon
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Medical Direction, Geneva University Hospitals, Geneva, Switzerland
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7
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Beratis IN, Andronas N, Kontaxopoulou D, Fragkiadaki S, Pavlou D, Papatriantafyllou J, Economou A, Yannis G, Papageorgiou SG. Driving in mild cognitive impairment: The role of depressive symptoms. TRAFFIC INJURY PREVENTION 2017; 18:470-476. [PMID: 27936937 DOI: 10.1080/15389588.2016.1265648] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 11/22/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Previous studies indicate a negative association between depression and driving fitness in the general population. Our goal was to cover a gap in the literature and to explore the link between depressive symptoms and driving behavior in individuals with mild cognitive impairment (MCI) through the use of a driving simulator experiment. METHODS Twenty-four individuals with MCI (mean age = 67.42, SD = 7.13) and 23 cognitively healthy individuals (mean age = 65.13, SD = 7.21) were introduced in the study. A valid driving license and regular car use served as main inclusion criteria. Data collection included a neurological/neuropsychological assessment and a driving simulator evaluation. Depressive symptomatology was assessed with the Patient Health Questionnaire (PHQ-9). RESULTS Significant interaction effects indicating a greater negative impact of depressive symptoms in drivers with MCI than in cognitively healthy drivers were observed in the case of various driving indexes, namely, average speed, accident risk, side bar hits, headway distance, headway distance variation, and lateral position variation. The associations between depressive symptoms and driving behavior remained significant after controlling for daytime sleepiness and cognition. CONCLUSIONS Depressive symptoms could be a factor explaining why certain patients with MCI present altered driving skills. Therefore, interventions for treating the depressive symptoms of individuals with MCI could prove to be beneficial regarding their driving performance.
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Affiliation(s)
- Ion N Beratis
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
| | - Nikos Andronas
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
| | - Dionysia Kontaxopoulou
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
| | - Stella Fragkiadaki
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
| | - Dimosthenis Pavlou
- b Department of Transportation Planning and Engineering , School of Civil Engineering, National Technical University of Athens , Zografou , Athens , Greece
| | - John Papatriantafyllou
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
| | - Alexandra Economou
- c Department of Psychology , National and Kapodistrian University of Athens , Panepistimiopolis, Ilissia, Athens , Greece
| | - George Yannis
- b Department of Transportation Planning and Engineering , School of Civil Engineering, National Technical University of Athens , Zografou , Athens , Greece
| | - Sokratis G Papageorgiou
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
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8
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Beratis IN, Pavlou D, Papadimitriou E, Andronas N, Kontaxopoulou D, Fragkiadaki S, Yannis G, Papageorgiou SG. Mild Cognitive Impairment and driving: Does in-vehicle distraction affect driving performance? ACCIDENT; ANALYSIS AND PREVENTION 2017; 103:148-155. [PMID: 28441517 DOI: 10.1016/j.aap.2017.03.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 03/10/2017] [Accepted: 03/21/2017] [Indexed: 05/27/2023]
Abstract
OBJECTIVES In-vehicle distraction is considered to be an important cause of road accidents. Drivers with Mild Cognitive Impairment (MCI), because of their attenuated cognitive resources, may be vulnerable to the effects of distraction; however, previous relevant research is lacking. The main objective of the current study was to explore the effect of in-vehicle distraction on the driving performance of MCI patients, by assessing their reaction time at unexpected incidents and accident probability. METHODS Thirteen patients with MCI (age: 64.5±7.2) and 12 cognitively intact individuals (age: 60.0±7.7), all active drivers were introduced in the study. The driving simulator experiment included three distraction conditions: (a) undistracted driving, (b) conversing with passenger and (c) conversing through a hand-held mobile phone. RESULTS The mixed ANOVA models revealed a greater effect of distraction on MCI patients. Specifically, the use of mobile phone induced a more pronounced impact on reaction time and accident probability in the group of patients, as compared to healthy controls. On the other hand, in the driving condition "conversing with passenger" the interaction effects regarding reaction time and accident probability were not significant. Notably, the aforementioned findings concerning the MCI patients in the case of the mobile phone were observed despite the effort of the drivers to apply a compensatory strategy by reducing significantly their speed in this driving condition. CONCLUSION Overall, the current findings indicate, for the first time, that a common driving practice, such as the use of mobile phone, may have a detrimental impact on the driving performance of individuals with MCI.
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Affiliation(s)
- Ion N Beratis
- Cognitive Disorders/Dementia Unit, 2nd Department of Neurology, University of Athens, "Attikon" University Hospital, 1 Rimini Str., 12462 Haidari, Athens, Greece
| | - Dimosthenis Pavlou
- National Technical University of Athens, Department of Transportation Planning and Engineering, 5 Heroon Polytechniou Str., GR-15773 Athens, Greece
| | - Eleonora Papadimitriou
- National Technical University of Athens, Department of Transportation Planning and Engineering, 5 Heroon Polytechniou Str., GR-15773 Athens, Greece
| | - Nikolaos Andronas
- Cognitive Disorders/Dementia Unit, 2nd Department of Neurology, University of Athens, "Attikon" University Hospital, 1 Rimini Str., 12462 Haidari, Athens, Greece
| | - Dionysia Kontaxopoulou
- Cognitive Disorders/Dementia Unit, 2nd Department of Neurology, University of Athens, "Attikon" University Hospital, 1 Rimini Str., 12462 Haidari, Athens, Greece
| | - Stella Fragkiadaki
- Cognitive Disorders/Dementia Unit, 2nd Department of Neurology, University of Athens, "Attikon" University Hospital, 1 Rimini Str., 12462 Haidari, Athens, Greece
| | - George Yannis
- National Technical University of Athens, Department of Transportation Planning and Engineering, 5 Heroon Polytechniou Str., GR-15773 Athens, Greece
| | - Sokratis G Papageorgiou
- Cognitive Disorders/Dementia Unit, 2nd Department of Neurology, University of Athens, "Attikon" University Hospital, 1 Rimini Str., 12462 Haidari, Athens, Greece.
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9
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Zanchi D, Giannakopoulos P, Borgwardt S, Rodriguez C, Haller S. Hippocampal and Amygdala Gray Matter Loss in Elderly Controls with Subtle Cognitive Decline. Front Aging Neurosci 2017; 9:50. [PMID: 28326035 PMCID: PMC5340094 DOI: 10.3389/fnagi.2017.00050] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 02/20/2017] [Indexed: 11/13/2022] Open
Abstract
In contrast to the idea that hippocampal and amygdala volume loss occur in late phases of neurodegeneration, recent contributions point to the relevance of preexisting structural deficits that are associated with aging and are independent of amyloid deposition in preclinical Alzheimer disease cases. The present work explores GM hippocampal and amygdala volumes in elderly controls displaying the first signs of cognitive decline. 455 subjects (263 females), including 374 controls (228 females) and 81 middle cognitive impairment subjects (35 females), underwent two neuropsychological evaluations (baseline and 18 months follow-up) and a MRI-T1 examination (only baseline). Clinical assessment included Mini-Mental State Examination (MMSE), Clinical Dementia Rating scale, Hospitalized Anxiety and Depression scale, the Consortium to Establish a Registry for Alzheimer’s Disease neuropsychological battery and RI-48 Cued Recall Test (RI-48) for episodic memory. Based on their cognitive performance, we defined the controls as stable controls (sCON) and deteriorating controls (dCONs). Analyses included volumetric assessment, shape analyses and linear regressions between GM volume loss and differences in clinical scores between baseline and follow-up. Significant GM volume decrease in hippocampus bilaterally and right amygdala was found in dCON compared to sCON (p < 0.05). Lower right amygdala volumes were measured in mild cognitive impairment (MCI) compared to sCON (p < 0.05). Shape analyses revealed that atrophy was more pronounced at the superior- posterior lateral side of the hippocampus and amygdala. Significant correlations were found between GM volume of left hippocampus and the delta of MMSE and RI-48 scores in dCON and MCI groups separately. Decreased hippocampal and right amygdala volumes precede the first signs of cognitive decline in healthy elderly controls at the pre-MCI state. Left hippocampus volume may also predict short-term changes of overall cognition in these vulnerable cases.
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Affiliation(s)
- Davide Zanchi
- Department of Psychiatry, University of BaselBasel, Switzerland; Department of Neuropsychiatry, University Psychiatry ClinicBasel, Switzerland
| | | | - Stefan Borgwardt
- Department of Psychiatry, University of Basel Basel, Switzerland
| | - Cristelle Rodriguez
- Department of Psychiatry, Faculty of Medicine, University of Geneva Geneva, Switzerland
| | - Sven Haller
- Affidea Carouge Radiologic Diagnostic Center, GenevaSwitzerland; Department of Surgical Sciences, Radiology, Uppsala University, UppsalaSweden; Department of Neuroradiology, University Hospital FreiburgFreiburg, Germany; Department of Neuroradiology, Faculty of Medicine of the University of GenevaGeneva, Switzerland
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10
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Teasdale N, Simoneau M, Hudon L, Moszkowicz T, Laurendeau D, Germain Robitaille M, Bherer L, Duchesne S, Hudon C. Drivers with Amnestic Mild Cognitive Impairment Can Benefit from a Multiple-Session Driving Simulator Automated Training Program. J Am Geriatr Soc 2016; 64:e16-8. [PMID: 27564992 DOI: 10.1111/jgs.14219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Normand Teasdale
- Department of Kinesiology, Université Laval, Québec City, Québec, Canada.,Centre de recherche, du CHU de Québec, Québec City, Québec, Canada
| | - Martin Simoneau
- Department of Kinesiology, Université Laval, Québec City, Québec, Canada.,Centre de recherche, du CHU de Québec, Québec City, Québec, Canada
| | - Lisa Hudon
- Department of Kinesiology, Université Laval, Québec City, Québec, Canada.,Centre de recherche, du CHU de Québec, Québec City, Québec, Canada
| | - Thierry Moszkowicz
- Computer Vision and Systems Laboratory, Department of Electrical Engineering and Computer Engineering, Université Laval, Québec City, Québec, Canada
| | - Denis Laurendeau
- Computer Vision and Systems Laboratory, Department of Electrical Engineering and Computer Engineering, Université Laval, Québec City, Québec, Canada
| | - Mathieu Germain Robitaille
- Department of Kinesiology, Université Laval, Québec City, Québec, Canada.,Centre de recherche, du CHU de Québec, Québec City, Québec, Canada
| | - Louis Bherer
- Centre de recherche de, l'Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada.,Department of Psychology, PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - Simon Duchesne
- Department of Radiology, Faculté de Médecine, Université Laval, Québec City, Québec, Canada.,Centre de recherche de, l'Institut universitaire en santé mentale de Québec, Québec City, Québec, Canada
| | - Carol Hudon
- Centre de recherche de, l'Institut universitaire en santé mentale de Québec, Québec City, Québec, Canada.,École de Psychologie, Université Laval, Québec City, Québec, Canada
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11
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Gerstenecker A, Martin R, Marson DC, Bashir K, Triebel KL. Introducing demographic corrections for the 10/36 Spatial Recall Test. Int J Geriatr Psychiatry 2016; 31:406-11. [PMID: 26270773 PMCID: PMC4752917 DOI: 10.1002/gps.4346] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 06/09/2015] [Accepted: 07/21/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The 10/36 Spatial Recall Test is a measure of visuospatial memory and has been recommended for inclusion when administering a brief cognitive assessment to patients with multiple sclerosis by multiple groups. However, a notable limitation of the measure includes a lack of normative data with demographic corrections. Thus, the primary objective of the current study was to examine demographic influences on the 10/36 Spatial Recall Test and to introduce demographically corrected normative data for the instrument. METHODS Data were collected from 116 participants over the age of 50 years. All study participants were free of any neurologic disease or disorder and classified as cognitively intact by a consensus conference team that was comprised of neurologists and neuropsychologists. All study participants were administered a neuropsychological evaluation that included the 10/36 Spatial Recall Test Version A at the baseline visit. RESULTS 10/36 Spatial Recall Test scores were affected by age, education, and race. Gender effects were not observed. Given these effects, regression equations were used to correct for the effects of demographic variables. The z-scores obtained from these corrections were not significantly influenced by demographical variables. CONCLUSION The demographic corrections introduced in this paper offer the possibility to enhance the clinical utility of the 10/36 Spatial Recall Test.
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Affiliation(s)
- Adam Gerstenecker
- Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, USA
| | - Roy Martin
- Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, USA
| | - Daniel C. Marson
- Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, USA
| | - Khurram Bashir
- Department of Neurology, Division of Neuroimmunology and Multiple Sclerosis, University of Alabama at Birmingham, USA
| | - Kristen L. Triebel
- Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, USA
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Chen J, Zhang Z, Li S. Can multi-modal neuroimaging evidence from hippocampus provide biomarkers for the progression of amnestic mild cognitive impairment? Neurosci Bull 2015; 31:128-40. [PMID: 25595368 DOI: 10.1007/s12264-014-1490-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 11/06/2014] [Indexed: 02/01/2023] Open
Abstract
Impaired structure and function of the hippocampus is a valuable predictor of progression from amnestic mild cognitive impairment (aMCI) to Alzheimer's disease (AD). As a part of the medial temporal lobe memory system, the hippocampus is one of the brain regions affected earliest by AD neuropathology, and shows progressive degeneration as aMCI progresses to AD. Currently, no validated biomarkers can precisely predict the conversion from aMCI to AD. Therefore, there is a great need of sensitive tools for the early detection of AD progression. In this review, we summarize the specific structural and functional changes in the hippocampus from recent aMCI studies using neurophysiological and neuroimaging data. We suggest that a combination of advanced multi-modal neuroimaging measures in discovering biomarkers will provide more precise and sensitive measures of hippocampal changes than using only one of them. These will potentially affect early diagnosis and disease-modifying treatments. We propose a new sequential and progressive framework in which the impairment spreads from the integrity of fibers to volume and then to function in hippocampal subregions. Meanwhile, this is likely to be accompanied by progressive impairment of behavioral and neuropsychological performance in the progression of aMCI to AD.
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Affiliation(s)
- Jiu Chen
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, 210009, China
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13
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Nakano K, Park K, Zheng R, Fang F, Ohori M, Nakamura H, Kumagai Y, Okada H, Teramura K, Nakayama S, Irimajiri A, Taoka H, Okada S. Leukoaraiosis significantly worsens driving performance of ordinary older drivers. PLoS One 2014; 9:e108333. [PMID: 25295736 PMCID: PMC4189976 DOI: 10.1371/journal.pone.0108333] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 08/26/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Leukoaraiosis is defined as extracellular space caused mainly by atherosclerotic or demyelinated changes in the brain tissue and is commonly found in the brains of healthy older people. A significant association between leukoaraiosis and traffic crashes was reported in our previous study; however, the reason for this is still unclear. METHOD This paper presents a comprehensive evaluation of driving performance in ordinary older drivers with leukoaraiosis. First, the degree of leukoaraiosis was examined in 33 participants, who underwent an actual-vehicle driving examination on a standard driving course, and a driver skill rating was also collected while the driver carried out a paced auditory serial addition test, which is a calculating task given verbally. At the same time, a steering entropy method was used to estimate steering operation performance. RESULTS The experimental results indicated that a normal older driver with leukoaraiosis was readily affected by external disturbances and made more operation errors and steered less smoothly than one without leukoaraiosis during driving; at the same time, their steering skill significantly deteriorated. CONCLUSIONS Leukoaraiosis worsens the driving performance of older drivers because of their increased vulnerability to distraction.
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Affiliation(s)
- Kimihiko Nakano
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| | - Kaechang Park
- Traffic Medicine Laboratory, Research Organization for Regional Alliances, Kochi University of Technology, Kami-shi, Kochi, Japan
- The Brain Checkup Center, Kochi Kenshin Clinic, Kochi-shi, Kochi, Japan
| | - Rencheng Zheng
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Fang Fang
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Masanori Ohori
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Hiroki Nakamura
- Faculty of Engineering, Kanagawa University, Yokohama, Japan
| | - Yasuhiho Kumagai
- Regional ITS Research Laboratory, Research Organization for Regional Alliances, Kochi University of Technology, Kami-shi, Kochi, Japan
| | - Hiroshi Okada
- Driver's License Center, Kochi Prefectural Police Department, Ino-cho, Kochi, Japan
| | - Kazuhiko Teramura
- Driver's License Center, Kochi Prefectural Police Department, Ino-cho, Kochi, Japan
| | - Satoshi Nakayama
- Driver's License Center, Kochi Prefectural Police Department, Ino-cho, Kochi, Japan
| | - Akinori Irimajiri
- Driver's License Center, Kochi Prefectural Police Department, Ino-cho, Kochi, Japan
| | - Hiroshi Taoka
- Driver's License Center, Kochi Prefectural Police Department, Ino-cho, Kochi, Japan
| | - Satoshi Okada
- Driver's License Center, Kochi Prefectural Police Department, Ino-cho, Kochi, Japan
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