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Roy JC, Hédouin R, Desmidt T, Dam S, Mirea-Grivel I, Weyl L, Bannier E, Barantin L, Drapier D, Batail JM, David R, Coloigner J, Robert GH. Quantifying Apathy in Late-Life Depression: Unraveling Neurobehavioral Links Through Daily Activity Patterns and Brain Connectivity Analysis. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:639-649. [PMID: 38615911 DOI: 10.1016/j.bpsc.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/04/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Better understanding apathy in late-life depression would help improve prediction of poor prognosis of diseases such as dementia. Actimetry provides an objective and ecological measure of apathy from patients' daily motor activity. We aimed to determine whether patterns of motor activity were associated with apathy and brain connectivity in networks that underlie goal-directed behaviors. METHODS Resting-state functional magnetic resonance imaging and diffusion magnetic resonance imaging were collected from 38 nondemented participants with late-life depression. Apathy was evaluated using the diagnostic criteria for apathy, Apathy Evaluation Scale, and Apathy Motivation Index. Functional principal components (fPCs) of motor activity were derived from actimetry recordings taken for 72 hours. Associations between fPCs and apathy were estimated by linear regression. Subnetworks whose connectivity was significantly associated with fPCs were identified via threshold-free network-based statistics. The relationship between apathy and microstructure metrics was estimated along fibers by diffusion tensor imaging and a multicompartment model called neurite orientation dispersion and density imaging via tractometry. RESULTS We found 2 fPCs associated with apathy: mean diurnal activity, negatively associated with Apathy Evaluation Scale scores, and an early chronotype, negatively associated with Apathy Motivation Index scores. Mean diurnal activity was associated with increased connectivity in the default mode, cingulo-opercular, and frontoparietal networks, while chronotype was associated with a more heterogeneous connectivity pattern in the same networks. We did not find significant associations between microstructural metrics and fPCs. CONCLUSIONS Our findings suggest that mean diurnal activity and chronotype could provide indirect ambulatory measures of apathy in late-life depression, associated with modified functional connectivity of brain networks that underlie goal-directed behaviors.
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Affiliation(s)
- Jean-Charles Roy
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France.
| | - Renaud Hédouin
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Thomas Desmidt
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France; Centre d'Investigation Clinique 1415, CHU de Tours, INSERM, Tours, France
| | - Sébastien Dam
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Iris Mirea-Grivel
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France
| | - Louise Weyl
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France
| | - Elise Bannier
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France; CHU de Rennes, Service de Radiologie, Rennes, France
| | - Laurent Barantin
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France
| | - Dominique Drapier
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Faculté de Médecine, Rennes Université, Rennes, France
| | - Jean-Marie Batail
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Faculté de Médecine, Rennes Université, Rennes, France
| | - Renaud David
- CHU de Nice, Université Côte d'Azur, Nice, France
| | - Julie Coloigner
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Gabriel H Robert
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France; Faculté de Médecine, Rennes Université, Rennes, France
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Relations of hippocampal subfields atrophy patterns with memory and biochemical changes in end stage renal disease. Sci Rep 2023; 13:2982. [PMID: 36804419 PMCID: PMC9941083 DOI: 10.1038/s41598-023-29083-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
End-stage renal disease (ESRD) results in hippocampal volume reduction, but the hippocampal subfields atrophy patterns cannot be identified. We explored the volumes and asymmetry of the hippocampal subfields and their relationships with memory function and biochemical changes. Hippocampal global and subfields volumes were derived from 33 ESRD patients and 46 healthy controls (HCs) from structural MRI. We compared the volume and asymmetric index of each subfield, with receiver operating characteristic curve analysis to evaluate the differentiation between ESRD and HCs. The relations of hippocampal subfield volumes with memory performance and biochemical data were investigated in ESRD group. ESRD patients had smaller hippocampal subfield volumes, mainly in the left CA1 body, left fimbria, right molecular layer head, right molecular layer body and right HATA. The right molecular layer body exhibited the highest accuracy for differentiating ESRD from HCs, with a sensitivity of 80.43% and specificity of 72.73%. Worse learning process (r = 0.414, p = 0.032), immediate recall (r = 0.396, p = 0.041) and delayed recall (r = 0.482, p = 0.011) was associated with left fimbria atrophy. The left fimbria volume was positively correlated with Hb (r = 0.388, p = 0.05); the left CA1 body volume was negatively correlated with Urea (r = - 0.469, p = 0.016). ESRD patients showed global and hippocampal subfields atrophy. Left fimbria atrophy was related to memory function. Anemia and Urea level may be associated with the atrophy of left fimbria and CA1 body, respectively.
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Alterations in regional homogeneity and functional connectivity associated with cognitive impairment in patients with hypertension: a resting-state functional magnetic resonance imaging study. Hypertens Res 2023; 46:1311-1325. [PMID: 36690806 DOI: 10.1038/s41440-023-01168-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/09/2022] [Accepted: 12/22/2022] [Indexed: 01/24/2023]
Abstract
Our study aims to investigate the alterations and diagnostic efficiency of regional homogeneity (ReHo) and functional connectivity (FC) in hypertension patients with cognitive impairment. A total of 62 hypertension patients with cognitive impairment (HTN-CI), 59 hypertension patients with normal cognition (HTN-NC), and 58 healthy controls (HCs) with rs-fMRI data were enrolled in this study. Univariate analysis (based on whole-brain ReHo and seed-based FC maps) was performed to observe brain regions with significant differences among the three groups. Multiple voxel pattern analysis (MVPA) was applied to evaluate the diagnostic accuracy in classifying HTN-CI from HTN-NC and HCs. Compared with the HCs and HTN-NC, HTN-CI exhibited decreased ReHo in the right caudate, left postcentral gyrus, posterior cingulate gyrus, insula, while increased ReHo in the left superior occipital gyrus and superior parietal gyrus. HTN-CI showed increased FC between seed regions (left posterior cingulate gyrus, insula, postcentral gyrus) with many specific brain regions. MVPA analysis (based on whole-brain ReHo and seed-based FC maps) displayed high classification ability in distinguishing HTN-CI from HTN-NC and HCs. The ReHo values (right caudate) and the FC values (left postcentral gyrus seed to left posterior cingulate gyrus) were positively correlated with the MoCA scores in HTN-CI. HTN-CI was associated with decreased ReHo and increased FC mainly in the left posterior cingulate gyrus, postcentral gyrus, insula compared to HTN-NC and HC. Besides, MVPA analysis yields excellent diagnostic accuracy in classifying HTN-CI from HTN-NC and HCs. The findings may contribute to unveiling the underlying neuropathological mechanism of HTN-CI.
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Wan C, Zong RY, Chen XS. The new mechanism of cognitive decline induced by hypertension: High homocysteine-mediated aberrant DNA methylation. Front Cardiovasc Med 2022; 9:928701. [PMID: 36352848 PMCID: PMC9637555 DOI: 10.3389/fcvm.2022.928701] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/30/2022] [Indexed: 11/23/2022] Open
Abstract
The prevalence and severity of hypertension-induced cognitive impairment increase with the prolonging of hypertension. The mechanisms of cognitive impairment induced by hypertension primarily include cerebral blood flow perfusion imbalance, white and gray matter injury with blood–brain barrier disruption, neuroinflammation and amyloid-beta deposition, genetic polymorphisms and variants, and instability of blood pressure. High homocysteine (HHcy) is an independent risk factor for hypertension that also increases the risk of developing early cognitive impairment. Homocysteine (Hcy) levels increase in patients with cognitive impairment induced by hypertension. This review summarizes a new mechanism whereby HHcy-mediated aberrant DNA methylation and exacerbate hypertension. It involves changes in Hcy-dependent DNA methylation products, such as methionine adenosyltransferase, DNA methyltransferases, S-adenosylmethionine, S-adenosylhomocysteine, and methylenetetrahydrofolate reductase (MTHFR). The mechanism also involves DNA methylation changes in the genes of hypertension patients, such as brain-derived neurotrophic factor, apolipoprotein E4, and estrogen receptor alpha, which contribute to learning, memory, and attention deficits. Studies have shown that methionine (Met) induces hypertension in mice. Moreover, DNA hypermethylation leads to cognitive behavioral changes alongside oligodendroglial and/or myelin deficits in Met-induced mice. Taken together, these studies demonstrate that DNA methylation regulates cognitive dysfunction in patients with hypertension. A better understanding of the function and mechanism underlying the effect of Hcy-dependent DNA methylation on hypertension-induced cognitive impairment will be valuable for early diagnosis, interventions, and prevention of further cognitive defects induced by hypertension.
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Affiliation(s)
- Chong Wan
- Department of Military Medical Geography, Army Medical Training Base, Army Medical University (Third Military Medical University), Chongqing, China
- College of Basic Medicine, Army Medical University, Chongqing, China
| | - Rui-Yi Zong
- Department of Military Medical Geography, Army Medical Training Base, Army Medical University (Third Military Medical University), Chongqing, China
- NCO School, Army Medical University, Shijiazhuang, China
| | - Xing-Shu Chen
- Department of Military Medical Geography, Army Medical Training Base, Army Medical University (Third Military Medical University), Chongqing, China
- *Correspondence: Xing-Shu Chen,
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Lee KP, Chang AYW, Sung PS. Association between Blood Pressure, Blood Pressure Variability, and Post-Stroke Cognitive Impairment. Biomedicines 2021; 9:773. [PMID: 34356837 PMCID: PMC8301473 DOI: 10.3390/biomedicines9070773] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/23/2021] [Accepted: 06/29/2021] [Indexed: 12/18/2022] Open
Abstract
After stroke, dynamic changes take place from necrotic-apoptotic continuum, inflammatory response to poststroke neurogenesis, and remodeling of the network. These changes and baseline brain pathology such as small vessel disease (SVD) and amyloid burden may be associated with the occurrence of early or late poststroke cognitive impairment (PSCI) or dementia (PSD), which affect not only stroke victims but also their families and even society. We reviewed the current concepts and understanding of the pathophysiology for PSCI/PSD and identified useful tools for the diagnosis and the prediction of PSCI in serological, CSF, and image characteristics. Then, we untangled their relationships with blood pressure (BP) and blood pressure variability (BPV), important but often overlooked risk factors for PSCI/PSD. Finally, we provided evidence for the modifying effects of BP and BPV on PSCI as well as pharmacological and non-pharmacological interventions and life style modification for PSCI/PSD prevention and treatment.
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Affiliation(s)
- Kang-Po Lee
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
- Department of Neurology, E-DA Hospital, Kaohsiung 824, Taiwan
| | - Alice Y. W. Chang
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
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