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Kang JE, Graham-Engeland JE, Martire LM, Almeida DM, Sliwinski MJ. Short-Term Coupling Associations Between State Loneliness and Cognitive Performance in Daily Life Among Older Adults. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae134. [PMID: 39105303 PMCID: PMC11402366 DOI: 10.1093/geronb/gbae134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Indexed: 08/07/2024] Open
Abstract
OBJECTIVES Despite extensive efforts to study individual differences in loneliness and neurocognitive health, little is known about how within-person changes in state loneliness relate to cognitive performance. This study addressed this gap by examining the association between within-person variation in state loneliness and cognitive performance assessed objectively in daily life. METHODS Participants were 313 community-dwelling older adults (70-90 years) who reported momentary feelings of loneliness and completed smartphone-based cognitive tests 5 times daily for 14 consecutive days. Mobile cognitive tests assess visual associative memory, processing speed, and spatial memory. RESULTS At the day level, average state loneliness levels were negatively related to cognitive performance on the same day and subsequent day. Consistent with the day-level analysis, momentary assessments of increased loneliness were consistently linked to worse cognitive performance on concurrent assessments. However, moments characterized by lower cognitive performance predicted higher levels of loneliness 3-4 hr later (next occasion), but not vice versa. DISCUSSION The findings suggest a prospective association between loneliness and cognitive performance, with higher daily loneliness negatively associated with cognitive performance on the same day and predicting worse performance the following day. Notably, within a single day, lower cognitive performance at a given moment predicted elevated loneliness later in the day. This highlights a complex, reciprocal relationship-loneliness predicting and being predicted by cognitive performance depending on timescale.
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Affiliation(s)
- Jee Eun Kang
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jennifer E Graham-Engeland
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, USA
- Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Lynn M Martire
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, USA
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - David M Almeida
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, USA
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Martin J Sliwinski
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, USA
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
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Morrissey S, Gillings R, Hornberger M. Feasibility and reliability of online vs in-person cognitive testing in healthy older people. PLoS One 2024; 19:e0309006. [PMID: 39163365 PMCID: PMC11335153 DOI: 10.1371/journal.pone.0309006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/04/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Early evidence in using online cognitive assessments show that they could offer a feasible and resource-efficient alternative to in-person clinical assessments in evaluating cognitive performance, yet there is currently little understanding about how these assessments relate to traditional, in-person cognitive tests. OBJECTIVES In this preliminary study, we assess the feasibility and reliability of NeurOn, a novel online cognitive assessment tool. NeurOn measures various cognitive domains including processing speed, executive functioning, spatial working memory, episodic memory, attentional control, visuospatial functioning, and spatial orientation. DESIGN Thirty-two participants (mean age: 70.19) completed two testing sessions, unsupervised online and in-person, one-week apart. Participants were randomised in the order of testing appointments. For both sessions, participants completed questionnaires prior to a cognitive assessment. Test-retest reliability and concurrent validity of the online cognitive battery was assessed using intraclass correlation coefficients (ICCs) and correlational analysis, respectively. This was conducted by comparing performance in repeated tasks across testing sessions as well as with traditional, in-person cognitive tests. RESULTS Global cognition in the NeurOn battery moderately validated against MoCA performance, and the battery demonstrated moderate test-retest reliability. Concurrent validity was found only between the online and paper versions of the Trail Making Test -A, as well as global cognitive performance between online and in-person testing sessions. CONCLUSIONS The NeurOn cognitive battery provides a promising tool for measuring cognitive performance online both longitudinally and across short retesting intervals within healthy older adults. When considering cost-effectiveness, flexible administration, and improved accessibility for wider populations, online cognitive assessments show promise for future screening of neurodegenerative diseases.
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Affiliation(s)
- Sol Morrissey
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Rachel Gillings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Michael Hornberger
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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Li Y, Chen G, Wang G, Zhou Z, An S, Dai S, Jin Y, Zhang C, Zhang M, Yu F. Dominating Alzheimer's disease diagnosis with deep learning on sMRI and DTI-MD. Front Neurol 2024; 15:1444795. [PMID: 39211812 PMCID: PMC11358067 DOI: 10.3389/fneur.2024.1444795] [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] [Received: 06/06/2024] [Accepted: 07/25/2024] [Indexed: 09/04/2024] Open
Abstract
Background Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disorder that has become one of the major health concerns for the elderly. Computer-aided AD diagnosis can assist doctors in quickly and accurately determining patients' severity and affected regions. Methods In this paper, we propose a method called MADNet for computer-aided AD diagnosis using multimodal datasets. The method selects ResNet-10 as the backbone network, with dual-branch parallel extraction of discriminative features for AD classification. It incorporates long-range dependencies modeling using attention scores in the decision-making layer and fuses the features based on their importance across modalities. To validate the effectiveness of our proposed multimodal classification method, we construct a multimodal dataset based on the publicly available ADNI dataset and a collected XWNI dataset, which includes examples of AD, Mild Cognitive Impairment (MCI), and Cognitively Normal (CN). Results On this dataset, we conduct binary classification experiments of AD vs. CN and MCI vs. CN, and demonstrate that our proposed method outperforms other traditional single-modal deep learning models. Furthermore, this conclusion also confirms the necessity of using multimodal sMRI and DTI data for computer-aided AD diagnosis, as these two modalities complement and convey information to each other. We visualize the feature maps extracted by MADNet using Grad-CAM, generating heatmaps that guide doctors' attention to important regions in patients' sMRI, which play a crucial role in the development of AD, establishing trust between human experts and machine learning models. Conclusion We propose a simple yet effective multimodal deep convolutional neural network model MADNet that outperforms traditional deep learning methods that use a single-modality dataset for AD diagnosis.
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Affiliation(s)
- Yuxia Li
- Department of Neurology, Tangshan Central Hospital, Hebei, China
| | - Guanqun Chen
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guoxin Wang
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Zhiyi Zhou
- JD Health International Inc., Beijing, China
| | - Shan An
- JD Health International Inc., Beijing, China
| | - Shipeng Dai
- College of Science, Northeastern University, Shenyang, China
| | - Yuxin Jin
- JD Health International Inc., Beijing, China
| | - Chao Zhang
- JD Health International Inc., Beijing, China
| | - Mingkai Zhang
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Feng Yu
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
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Raposo Pereira F, George N, Dalla Barba G, Dubois B, La Corte V. The memory binding test can anticipate Alzheimer's disease diagnosis at an early preclinical stage: a longitudinal study in the INSIGHTpreAD cohort. Front Aging Neurosci 2024; 16:1414419. [PMID: 39175810 PMCID: PMC11340525 DOI: 10.3389/fnagi.2024.1414419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/12/2024] [Indexed: 08/24/2024] Open
Abstract
Introduction Anticipating the diagnosis of Alzheimer's disease (AD) at an early asymptomatic at-risk stage, where therapeutics can more effectively delay conscious cognitive decline, is currently among the biggest challenges in the field. Herein, we aimed to compare the capacity of the Memory Binding Test (MBT) with the official diagnostic tool, the Free and Cued Selective Reminding Test (FCSRT), to anticipate AD diagnosis at an early preclinical stage based on the associative memory component of MBT (binding), suggested as more sensitive to the emergence of subtle episodic memory (EM) deficits (AD hallmark). Methods We assessed the tests performance longitudinally (over 5 years) in 263 cognitively-normal elderly individuals at risk of AD (>6 months of subjective memory complaints) using linear mixed-effect models controlled for age, sex, and education. We stratified participants in 2 models: amyloid-β (Aβ)/neurodegeneration (N) model, assessing Aβ burden and neurodegeneration effect [3 groups: controls (Aβ-/N-); stable/N- (Aβ+); stable/N+ (Aβ+)]; and the stable/progressors model, assessing progression to prodromal-AD effect [2 groups: stable (Aβ+); progressors (Aβ+)], based on 15 subjects who progressed to AD during follow-up (excluded once diagnosed). Results Aβ burden was associated with significantly less MBT-intrusions, while Aβ burden and neurodegeneration together, with the most. Progression status had a strong negative effect on both tests performance. When compared with the FCSRT, the MBT seems to anticipate diagnosis based on a worst performance in a higher number of scores (including binding) in at least a year. Discussion Anticipation of diagnosis to an asymptomatic at-risk stage, while participants remain cognitively-normal according to FCSRT cut-offs and unaware of objective EM deficits, has the potential to delay the onset of AD-linked cognitive decline by applying promising therapeutics before decline becomes too advanced.
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Affiliation(s)
- Filipa Raposo Pereira
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, U 1127, CNRS, UMR 7225, APHP, Hôpital de la Pitié-Salpêtrière, Paris, France
- Department of Neurology, Institute of Memory and Alzheimer’s Disease (IM2A), Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
| | - Nathalie George
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, U 1127, CNRS, UMR 7225, APHP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | | | - Bruno Dubois
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, U 1127, CNRS, UMR 7225, APHP, Hôpital de la Pitié-Salpêtrière, Paris, France
- Department of Neurology, Institute of Memory and Alzheimer’s Disease (IM2A), Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
- Centre of Excellence of Neurodegenerative Disease (CoEN), ICM, CIC Neurosciences, APHP, Department of Neurology, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Valentina La Corte
- Department of Neurology, Institute of Memory and Alzheimer’s Disease (IM2A), Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), Institut de Psychologie, Université Paris Cité, Boulogne Billancourt, France
- Institut Universitaire de France, Paris, France
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Dubbelman MA, Hendriksen HMA, Harrison JE, Vijverberg EGB, Prins ND, Kroeze LA, Ottenhoff L, Van Leeuwenstijn MMSSA, Verberk IMW, Teunissen CE, van de Giessen EM, Van Harten AC, Van Der Flier WM, Sikkes SAM. Cognitive and Functional Change Over Time in Cognitively Healthy Individuals According to Alzheimer Disease Biomarker-Defined Subgroups. Neurology 2024; 102:e207978. [PMID: 38165338 PMCID: PMC10962908 DOI: 10.1212/wnl.0000000000207978] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/04/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES It is unclear to what extent cognitive outcome measures are sensitive to capture decline in Alzheimer disease (AD) prevention trials. We aimed to analyze the sensitivity to changes over time of a range of neuropsychological tests in several cognitively unimpaired, biomarker-defined patient groups. METHODS Cognitively unimpaired individuals from the Amsterdam Dementia Cohort and the SCIENCe project with available AD biomarkers, obtained from CSF, PET scans, and plasma at baseline, were followed over time (4.5 ± 3.1 years, range 0.6-18.9 years). Based on common inclusion criteria for clinical trials, we defined groups (amyloid, phosphorylated tau [p-tau], APOE ε4). Linear mixed models, adjusted for age, sex, and education, were used to estimate change over time in neuropsychological tests, a functional outcome, and 2 cognitive composite measures. Standardized regression coefficients of time in years (βtime) were reported as outcome of interest. We analyzed change over time with full follow-up, as well as with follow-up limited to 1.5 and 3 years. RESULTS We included 387 individuals (aged 61.7 ± 8.6 years; 44% female) in the following (partly overlapping) biomarker groups: APOE ε4 carriers (n = 212), amyloid-positive individuals (n = 109), amyloid-positive APOE ε4 carriers (n = 66), CSF p-tau-positive individuals (n = 127), plasma p-tau-positive individuals (n = 71), and amyloid and CSF p-tau-positive individuals (n = 50), or in a control group (normal biomarkers; n = 65). An executive functioning task showed most decline in all biomarker groups (βtime range -0.30 to -0.71), followed by delayed word list recognition (βtime range -0.18 to -0.50). Functional decline (βtime range -0.17 to -0.63) was observed in all, except the CSF and plasma tau-positive groups. Both composites showed comparable amounts of change (βtime range -0.12 to -0.62) in all groups, except plasma p-tau-positive individuals. When limiting original follow-up duration, many effects disappeared or even flipped direction. DISCUSSION In conclusion, functional, composite, and neuropsychological outcome measures across all cognitive domains detect changes over time in various biomarker-defined groups, with changes being most evident among individuals with more AD pathology. AD prevention trials should use sufficiently long follow-up duration and/or more sensitive outcome measures to optimally capture subtle cognitive changes over time.
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Affiliation(s)
- Mark A Dubbelman
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Heleen M A Hendriksen
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - John E Harrison
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Everard G B Vijverberg
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Niels D Prins
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Lior A Kroeze
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Lois Ottenhoff
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Mardou M S S A Van Leeuwenstijn
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Inge M W Verberk
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Elsmarieke M van de Giessen
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Argonde C Van Harten
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Wiesje M Van Der Flier
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Sietske A M Sikkes
- From the Alzheimer Center Amsterdam, Neurology (M.A.D., H.M.A.H., J.E.H., E.G.B.V., L.A.K., L.O., M.M.S.S.A.V.L., I.M.W.V., C.E.T., A.C.V.H., W.M.V.D.F., S.A.M.S.), and Departments of Radiology & Nuclear Medicine (E.M.v.d.G.), Epidemiology & Data Science (W.M.V.D.F.), and Neurochemistry Laboratory, Department of Laboratory Medicine (I.M.W.V., C.E.T.), Amsterdam UMC, Vrije Universiteit Amsterdam; Neurodegeneration, Amsterdam Neuroscience; Brain Research Center (N.D.P., L.O.); and Department of Clinical, Neuro and Developmental Psychology (S.A.M.S.), Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
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De Anda‐Duran I, Sunderaraman P, Searls E, Moukaled S, Jin X, Popp Z, Karjadi C, Hwang PH, Ding H, Devine S, Shih LC, Low S, Lin H, Kolachalama VB, Bazzano L, Libon DJ, Au R. Comparing Cognitive Tests and Smartphone-Based Assessment in 2 US Community-Based Cohorts. J Am Heart Assoc 2024; 13:e032733. [PMID: 38226519 PMCID: PMC10926794 DOI: 10.1161/jaha.123.032733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/04/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Smartphone-based cognitive assessments have emerged as promising tools, bridging gaps in accessibility and reducing bias in Alzheimer disease and related dementia research. However, their congruence with traditional neuropsychological tests and usefulness in diverse cohorts remain underexplored. METHODS AND RESULTS A total of 406 FHS (Framingham Heart Study) and 59 BHS (Bogalusa Heart Study) participants with traditional neuropsychological tests and digital assessments using the Defense Automated Neurocognitive Assessment (DANA) smartphone protocol were included. Regression models investigated associations between DANA task digital measures and a neuropsychological global cognitive Z score (Global Cognitive Score [GCS]), and neuropsychological domain-specific Z scores. FHS participants' mean age was 57 (SD, 9.75) years, and 44% (179) were men. BHS participants' mean age was 49 (4.4) years, and 28% (16) were men. Participants in both cohorts with the lowest neuropsychological performance (lowest quartile, GCS1) demonstrated lower DANA digital scores. In the FHS, GCS1 participants had slower average response times and decreased cognitive efficiency scores in all DANA tasks (P<0.05). In BHS, participants in GCS1 had slower average response times and decreased cognitive efficiency scores for DANA Code Substitution and Go/No-Go tasks, although this was not statistically significant. In both cohorts, GCS was significantly associated with DANA tasks, such that higher GCS correlated with faster average response times (P<0.05) and increased cognitive efficiency (all P<0.05) in the DANA Code Substitution task. CONCLUSIONS Our findings demonstrate that smartphone-based cognitive assessments exhibit concurrent validity with a composite measure of traditional neuropsychological tests. This supports the potential of using smartphone-based assessments in cognitive screening across diverse populations and the scalability of digital assessments to community-dwelling individuals.
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Affiliation(s)
- Ileana De Anda‐Duran
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| | - Preeti Sunderaraman
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston University Alzheimer’s Disease Research CenterBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Edward Searls
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Shirine Moukaled
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| | - Xuanyi Jin
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| | - Zachary Popp
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Cody Karjadi
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Phillip H. Hwang
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
| | - Huitong Ding
- Framingham Heart StudyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Sherral Devine
- Framingham Heart StudyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Ludy C. Shih
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Spencer Low
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
| | - Honghuang Lin
- University of Massachusetts Chan Medical SchoolWorcesterMAUSA
| | - Vijaya B. Kolachalama
- Department of MedicineBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Department of Computer ScienceBoston UniversityBostonMAUSA
| | - Lydia Bazzano
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| | - David J. Libon
- Department of PsychologyRowan UniversityMullica HillNJUSA
- New Jersey Institute of Successful AgingRowan University School of Osteopathic MedicineStratfordNJUSA
| | - Rhoda Au
- Framingham Heart StudyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Boston University Alzheimer’s Disease Research CenterBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMAUSA
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Giuffrè GM, Quaranta D, Citro S, Morganti TG, Martellacci N, Vita MG, Rossini PM, Calabresi P, Marra C. Associations Between Free and Cued Selective Reminding Test and Cerebrospinal Fluid Biomarkers in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2024; 100:713-723. [PMID: 38905044 DOI: 10.3233/jad-240150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
Background The Free and Cued Selective Reminding Test (FCSRT), assessing verbal episodic memory with controlled learning and semantic cueing, has been recommended for detecting the genuine encoding and storage deficits characterizing AD-related memory disorders. Objective The present study aims at investigating the ability of FCSRT in predicting cerebrospinal fluid (CSF) evidence of amyloid-β positivity in subjects with amnestic mild cognitive impairment (aMCI) and exploring its associations with amyloidopathy, tauopathy and neurodegeneration biomarkers. Methods 120 aMCI subjects underwent comprehensive neurological and neuropsychological examinations, including the FCSRT assessment, and CSF collection; CSF Aβ42/40 ratio, p-tau181, and total-tau quantification were conducted by an automated CLEIA method on Lumipulse G1200. Based on the Aβ42/40 ratio value, subjects were classified as either A+ or A-. Results All FCSRT subitem scores were significantly lower in A+ group and significantly predicted the amyloid-β status, with Immediate Total Recall (ITR) being the best predictor. No significant correlations were found between FCSRT and CSF biomarkers in the A- aMCI group, while in the A+ aMCI group, all FCSRT subitem scores were negatively correlated with CSF p-tau181 and total-tau, but not with the Aβ42/40 ratio. Conclusions FCSRT confirms its validity as a tool for the diagnosis of AD, being able to predict the presence of amyloid-β deposition with high specificity. The associations between FCSRT subitem scores and CSF p-tau-181 and total-tau levels in aMCI due to AD could further encourage the clinical use of this simple and cost-effective test in the evaluation of individuals with aMCI.
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Affiliation(s)
- Guido Maria Giuffrè
- Neurology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Memory Clinic Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy
| | - Davide Quaranta
- Neurology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Memory Clinic Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy
| | - Salvatore Citro
- Neurology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy
| | - Tommaso Giuseppe Morganti
- Neurology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy
| | - Noemi Martellacci
- Memory Clinic Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Maria Gabriella Vita
- Neurology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Maria Rossini
- Department of Neuroscience and Neurorehabilitation, Brain Connectivity Laboratory, IRCCS San Raffaele Roma, Rome, Italy
| | - Paolo Calabresi
- Neurology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy
| | - Camillo Marra
- Memory Clinic Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy
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8
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Rapos Pereira F, George N, Dalla Barba G, Dubois B, La Corte V. The Memory Binding Test Detects Early Subtle Episodic Memory Decline in Preclinical Alzheimer's Disease: A Longitudinal Study. J Alzheimers Dis 2024; 98:465-479. [PMID: 38393903 DOI: 10.3233/jad-230921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Background The asymptomatic at-risk phase might be the optimal time-window to establish clinically meaningful endpoints in Alzheimer's disease (AD). Objective We investigated whether, compared with the Free and Cued Selective Reminding Test (FCSRT), the Memory Binding Test (MBT) can anticipate the diagnosis of emergent subtle episodic memory (EM) deficits to an at-risk phase. Methods Five-year longitudinal FCSRT and MBT scores from 45 individuals matched for age, education, and gender, were divided into 3 groups of 15 subjects: Aβ-/controls, Aβ+/stable, and Aβ+/progressors (preclinical-AD). The MBT adds an associative memory component (binding), particularly sensitive to subtle EM decline. Results In the MBT, EM decline started in the Aβ+/progressors (preclinical-AD) up to 4 years prior to diagnosis in delayed free recall (FR), followed by decline in binding-associated scores 1 year later. Conversely, in the FCSRT, EM-decline began later, up to 3 years prior to diagnosis, in the same group on both immediate and delayed versions of FR, while on total recall (TR) and intrusions decline started only 1 year prior to diagnosis. Conclusions The MBT seems more sensitive than the FCSRT for early EM-decline detection, regarding the year of diagnosis and the number of scores showing AD-linked EM deficits (associated with the AD-characteristic amnesic hippocampal syndrome). Considering the MBT as a detection tool of early subtle EM-decline in an asymptomatic at-risk phase, and the FCSRT as a classification tool of stages of EM-decline from a preclinical phase, these tests ought to potentially become complementary diagnostic tools that can foster therapies to delay cognitive decline. Clinical trial registration title: Electrophysiological markers of the progression to clinical Alzheimer disease in asymptomatic at-risk individuals: a longitudinal event-related potential study of episodic memory in the INSIGHT pre-AD cohort (acronym: ePARAD).
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Affiliation(s)
- Filipa Rapos Pereira
- Institut du Cerveau - Paris Brain Institute - ICM, INSERM, U 1127, CNRS, UMR 7225' APHP, CENIR, Centre MEG-EEG, Sorbonne Université, Hôpital de la Pitié-Salpêtrière, Paris, France
- Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Nathalie George
- Institut du Cerveau - Paris Brain Institute - ICM, INSERM, U 1127, CNRS, UMR 7225' APHP, CENIR, Centre MEG-EEG, Sorbonne Université, Hôpital de la Pitié-Salpêtrière, Paris, France
| | | | - Bruno Dubois
- Institut du Cerveau - Paris Brain Institute - ICM, INSERM, U 1127, CNRS, UMR 7225' APHP, CENIR, Centre MEG-EEG, Sorbonne Université, Hôpital de la Pitié-Salpêtrière, Paris, France
- Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
- Department of Neurology, Centre of Excellence of Neurodegenerative Disease (CoEN), ICM, CIC Neurosciences, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Valentina La Corte
- Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
- Laboratoire Mémoire Cerveau et Cognition (UR 7536), Institut de Psychologie, Université Paris Cité, Boulogne-Billancourt, France
- Institut Universitaire de France, Paris, France
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9
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Cheng GR, Liu D, Huang LY, Han GB, Hu FF, Wu ZX, He XM, Huang YW, Yu YF, Xu L, Li JQ, Chen YS, Wei Z, Wu Q, Mei YF, Chen XX, Ou YM, Zhang JJ, Yang ML, Lian PF, Tan W, Xie XY, Zeng Y. Prevalence and risk factors for subjective cognitive decline and the correlation with objective cognition among community-dwelling older adults in China: Results from the Hubei memory and aging cohort study. Alzheimers Dement 2023; 19:5074-5085. [PMID: 37186161 DOI: 10.1002/alz.13047] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/18/2023] [Accepted: 02/23/2023] [Indexed: 05/17/2023]
Abstract
INTRODUCTION The prevalence and risk factors for subjective cognitive decline (SCD) and its correlation with objective cognition decline (OCD) among community-dwelling older adults is inconsistent. METHODS Older adults underwent neuropsychological and clinical evaluations to reach a consensus on diagnoses. RESULTS This study included 7486 adults without mild cognitive impairment and dementia (mean age: 71.35 years [standard deviation = 5.40]). The sex-, age-, and residence-adjusted SCD prevalence was 58.33% overall (95% confidence interval: 58.29% to 58.37%), with higher rates of 61.25% and 59.87% in rural and female subgroups, respectively. SCD global and OCD language, SCD memory and OCD global, SCD and OCD memory, and SCD and OCD language were negatively correlated in fully adjusted models. Seven health and lifestyle factors were associated with an increased risk for SCD. DISCUSSION SCD affected 58.33% of older adults and may indicate concurrent OCD, which should prompt the initiation of preventative intervention for dementia. HIGHLIGHTS SCD affects 58.33% of older adults in China. SCD may indicate concurrent objective cognitive decline. Difficulty finding words and memory impairments may indicate a risk for AD. The presence of SCD may prompt preventative treatment initiation of MCI or dementia. Social network factors may be initial targets for the early prevention of SCD.
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Affiliation(s)
- Gui-Rong Cheng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Dan Liu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Lin-Ya Huang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Gang-Bin Han
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Fei-Fei Hu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | | | - Xiao-Ming He
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Wei Huang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Ya-Fu Yu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Lang Xu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Jin-Quan Li
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Shan Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Zhen Wei
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Qiong Wu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Fei Mei
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Xing-Xing Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yang-Ming Ou
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Jing-Jing Zhang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Meng-Liu Yang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Peng-Fei Lian
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Wei Tan
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Xin-Yan Xie
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yan Zeng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
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10
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Huang L, Mei Z, Ye J, Guo Q. AMES: An Automated Self-Administered Scale to Detect Incipient Cognitive Decline in Primary Care Settings. Assessment 2023; 30:2247-2257. [PMID: 36633098 DOI: 10.1177/10731911221144774] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Early identification and intervention of cognitive decline could be effective to prevent progression to dementia. We developed a self-delivered cognitive screening tool, Automated Memory and Executive Screening (AMES), to assess cognitive domains including memory, language, and executive function. 189 participants with diagnoses of mild cognitive impairment (MCI, n = 43), subjective cognitive decline (SCD, n = 29), objectively-defined subtle cognitive decline (obj-SCD, n = 18), and normal controls (NC, n = 99) completed the study. AMES had good convergent validity with conventional scales, and was good to discriminate patients with MCI (area under the curve [AUC] = 0.88; sensitivity = 86%; specificity = 80%) and obj-SCD (AUC = 0.78; sensitivity = 89%; specificity = 63%) from NC. These findings support that AMES is an easy to administer and effective instrument to screen for early cognitive impairment in community-based settings.
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Affiliation(s)
- Lin Huang
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zihan Mei
- NeuroWeave, Co., Ltd., Shanghai, China
| | | | - Qihao Guo
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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11
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Curiel Cid RE, Zheng DD, Kitaigorodsky M, Adjouadi M, Crocco EA, Georgiou M, Gonzalez-Jimenez C, Ortega A, Goryawala M, Nagornaya N, Pattany P, Sfakianaki E, Visser U, Loewenstein DA. A Novel Computerized Cognitive Test for the Detection of Mild Cognitive Impairment and Its Association with Neurodegeneration in Alzheimer's Disease Prone Brain Regions. ADVANCES IN ALZHEIMER'S DISEASE 2023; 12:38-54. [PMID: 38873169 PMCID: PMC11170665 DOI: 10.4236/aad.2023.123004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
During the prodromal stage of Alzheimer's disease (AD), neurodegenerative changes can be identified by measuring volumetric loss in AD-prone brain regions on MRI. Cognitive assessments that are sensitive enough to measure the early brain-behavior manifestations of AD and that correlate with biomarkers of neurodegeneration are needed to identify and monitor individuals at risk for dementia. Weak sensitivity to early cognitive change has been a major limitation of traditional cognitive assessments. In this study, we focused on expanding our previous work by determining whether a digitized cognitive stress test, the Loewenstein-Acevedo Scales for Semantic Interference and Learning, Brief Computerized Version (LASSI-BC) could differentiate between Cognitively Unimpaired (CU) and amnestic Mild Cognitive Impairment (aMCI) groups. A second focus was to correlate LASSI-BC performance to volumetric reductions in AD-prone brain regions. Data was gathered from 111 older adults who were comprehensively evaluated and administered the LASSI-BC. Eighty-seven of these participants (51 CU; 36 aMCI) underwent MR imaging. The volumes of 12 AD-prone brain regions were related to LASSI-BC and other memory tests correcting for False Discovery Rate (FDR). Results indicated that, even after adjusting for initial learning ability, the failure to recover from proactive semantic interference (frPSI) on the LASSI-BC differentiated between CU and aMCI groups. An optimal combination of frPSI and initial learning strength on the LASSI-BC yielded an area under the ROC curve of 0.876 (76.1% sensitivity, 82.7% specificity). Further, frPSI on the LASSI-BC was associated with volumetric reductions in the hippocampus, amygdala, inferior temporal lobes, precuneus, and posterior cingulate.
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Affiliation(s)
- Rosie E. Curiel Cid
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - D. Diane Zheng
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Marcela Kitaigorodsky
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Malek Adjouadi
- Center for Advanced Technology and Education, Department of Electrical and Computer Engineering, College of Engineering and Computing, Florida International University, Miami, Florida, USA
| | - Elizabeth A. Crocco
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Mike Georgiou
- Department of Radiology and Nuclear Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Christian Gonzalez-Jimenez
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Alexandra Ortega
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Mohammed Goryawala
- Department of Radiology and Nuclear Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Natalya Nagornaya
- Department of Radiology and Nuclear Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Pradip Pattany
- Department of Radiology and Nuclear Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Efrosyni Sfakianaki
- Department of Radiology and Nuclear Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Ubbo Visser
- Department of Computer Science, University of Miami, Miami, Florida, USA
| | - David A. Loewenstein
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
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12
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Rentz DM, Klinger HM, Samaroo A, Fitzpatrick C, Schneider OR, Amagai S, Peipert JD. Face Name Associative Memory Exam and biomarker status in the ARMADA study: Advancing reliable measurement in Alzheimer's disease and cognitive aging. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12473. [PMID: 37693224 PMCID: PMC10483494 DOI: 10.1002/dad2.12473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/30/2023] [Accepted: 07/31/2023] [Indexed: 09/12/2023]
Abstract
The Face Name Associative Memory Exam (FNAME) was introduced into the NIH Toolbox as part of the ARMADA study and establishes normative data for diverse participants, ages 64 to 85+, and proposes cutoff scores between biomarker positive versus negative (+/-) groups. The FNAME was administered to 257 participants across the clinical spectrum with 122 having amyloid biomarkers. Linear regression explored the association between demographics and FNAME and between amyloid (+/-) groups. Receiver operating characteristic curves (ROC) identified performance thresholds that best discriminated between biomarker (+/-) individuals. Lower FNAME scores occurred in males, older ages, Black/African Americans, Hispanics, and biomarker-positive participants. ROC analyses demonstrated acceptable accuracy (0.73 to 0.77) but only when combined with clinical status. The diagnostic discrimination of amyloid positivity was acceptable but not excellent, suggesting the FNAME may be a better screening indicator of clinical status rather than amyloid deposition in cognitively normal individuals. Normative data are provided.
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Affiliation(s)
- Dorene M. Rentz
- Departments of NeurologyMassachusetts General HospitalBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Hannah M. Klinger
- Departments of NeurologyMassachusetts General HospitalBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | | | - Colleen Fitzpatrick
- Departments of NeurologyMassachusetts General HospitalBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | | | - Saki Amagai
- Northwestern University Feinberg School of MedicineChicagoIllinoisUSA
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13
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Markova H, Fendrych Mazancova A, Jester DJ, Cechova K, Matuskova V, Nikolai T, Nedelska Z, Uller M, Andel R, Laczó J, Hort J, Vyhnalek M. Memory Binding Test and Its Associations With Hippocampal Volume Across the Cognitive Continuum Preceding Dementia. Assessment 2023; 30:856-872. [PMID: 35023365 DOI: 10.1177/10731911211069676] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Innovative memory paradigms have been introduced to capture subtle memory changes in early Alzheimer's disease (AD). We aimed to examine the associations between different indexes of the challenging Memory Binding Test (MBT) and hippocampal volume (HV) in a sample of individuals with subjective cognitive decline (SCD; n = 50), amnestic mild cognitive impairment (aMCI) due to AD (n = 31), and cognitively normal (CN) older adults (n = 29) recruited from the Czech Brain Aging Study, in contrast to traditional verbal memory tests. Both MBT free and cued recall scores in immediate and delayed recall conditions were associated with lower HV in both SCD and aMCI due to AD, whereas in traditional verbal memory tests only delayed recall scores were associated with lower HV. In SCD, the associations with lower HV in the immediate recall covered specific cued recall indexes only. In conclusion, the MBT is a promising test for detecting subtle hippocampal-associated memory decline during the predementia continuum.
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Affiliation(s)
- Hana Markova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- Department of Clinical Psychology, Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Adela Fendrych Mazancova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- Department of Clinical Psychology, Motol University Hospital, Prague, Czech Republic
- Department of Neurology and Centre of Clinical Neuroscience, Neuropsychology Laboratory, Charles University, First Faculty of Medicine and General University Hospital in Prague, Czech Republic
| | - Dylan J Jester
- School of Aging Studies, University of South Florida, Tampa, FL, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA
| | - Katerina Cechova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Veronika Matuskova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Tomas Nikolai
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- Department of Clinical Psychology, Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
- Department of Neurology and Centre of Clinical Neuroscience, Neuropsychology Laboratory, Charles University, First Faculty of Medicine and General University Hospital in Prague, Czech Republic
| | - Zuzana Nedelska
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Miroslav Uller
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Ross Andel
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Jan Laczó
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Jakub Hort
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Martin Vyhnalek
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
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14
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Varela V, Evdokimidis I, Potagas C. Binding objects to their spatiotemporal context: Age gradient and neuropsychological correlates of What-Where-When task performance. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:214-226. [PMID: 34053387 DOI: 10.1080/23279095.2021.1924719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A number of recent studies have shown that the ability to accurately recall bound object and spatiotemporal aspects of an experienced event develops gradually in children and is greatly impaired in the elderly, reflecting developmental discontinuities in the integrity of the underlying medial temporal lobe network. Using a novel What-Where-When (WWW) visuospatial reconstruction task, the experiential memory performance of a group of healthy older adults (aged 60-80) was compared to that of a group of younger adults (aged 20-40). Both groups were equated on their general cognitive ability, their executive functioning, and on the presence of depression, anxiety, and stress symptomatology. As hypothesized, the performance of the older adults in the binding task was significantly lower, with younger participants recalling three times the amount of bound object and spatiotemporal triads than their older counterparts. Psychomotor speed was found to be lower in older adults and was the only neuropsychological index to significantly affect success on the WWW binding task. Based on this and other relevant studies, the selective associative memory impairment obtained using a non-verbal What-Where-When paradigm emerges as a marker for the detection of early pre-clinical signs of experiential memory pathology.
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Affiliation(s)
- Vasiliki Varela
- Eginition Hospital, Department of Neurology, School of Medicine, University of Athens, Athens, Greece
| | - Ioannis Evdokimidis
- Eginition Hospital, Department of Neurology, School of Medicine, University of Athens, Athens, Greece
| | - Constantin Potagas
- Eginition Hospital, Department of Neurology, School of Medicine, University of Athens, Athens, Greece
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15
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Jutten RJ, Papp KV, Hendrix S, Ellison N, Langbaum JB, Donohue MC, Hassenstab J, Maruff P, Rentz DM, Harrison J, Cummings J, Scheltens P, Sikkes SAM. Why a clinical trial is as good as its outcome measure: A framework for the selection and use of cognitive outcome measures for clinical trials of Alzheimer's disease. Alzheimers Dement 2023; 19:708-720. [PMID: 36086926 PMCID: PMC9931632 DOI: 10.1002/alz.12773] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/29/2022] [Accepted: 07/22/2022] [Indexed: 11/11/2022]
Abstract
A crucial aspect of any clinical trial is using the right outcome measure to assess treatment efficacy. Compared to the rapidly evolved understanding and measurement of pathophysiology in preclinical and early symptomatic stages of Alzheimer's disease (AD), relatively less progress has been made in the evolution of clinical outcome assessments (COAs) for those stages. The current paper aims to provide a benchmark for the design and evaluation of COAs for use in early AD trials. We discuss lessons learned on capturing cognitive changes in predementia stages of AD, including challenges when validating novel COAs for those early stages and necessary evidence for their implementation in clinical trials. Moving forward, we propose a multi-step framework to advance the use of more effective COAs to assess clinically meaningful changes in early AD, which will hopefully contribute to the much-needed consensus around more appropriate outcome measures to assess clinical efficacy of putative treatments. HIGHLIGHTS: We discuss lessons learned on capturing cognitive changes in predementia stages of AD. We propose a framework for the design and evaluation of performance based cognitive tests for use in early AD trials. We provide recommendations to facilitate the implementation of more effective cognitive outcome measures in AD trials.
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Affiliation(s)
- Roos J. Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kathryn V. Papp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Michael C. Donohue
- Alzheimer’s Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego, California, USA
| | - Jason Hassenstab
- Knight Alzheimer Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Paul Maruff
- Cogstate Ltd., Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - John Harrison
- Metis Cognition Ltd., Kilmington, UK
- Department of Psychiatry, Psychology & Neuroscience, King’s College London, UK
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada, USA
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
| | - Sietske A. M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Movement and Behavioral Sciences, VU University, Amsterdam, The Netherlands
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16
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Jónsdóttir MK, Harrison J, Hannesdóttir KI. The ambivalence toward neuropsychology in dementia research, diagnosis, and drug development: Myths and misconceptions. Alzheimers Dement 2023; 19:2175-2181. [PMID: 36638069 DOI: 10.1002/alz.12909] [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: 09/11/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 01/14/2023]
Abstract
Clinical assessment remains the gold standard for diagnosing dementia, monitoring progression, and conducting clinical research. Biomarkers hold promise for targeted therapeutic approaches, selection of participants in clinical trials, and direct physiological efficacy readouts. However, the anchoring of biomarker research to clinical symptomatology is often based on short and insensitive cognitive screening. This gives the impression that cognitive symptoms occur relatively late and that their progression in the early stages of the disease is slow. A thorough cognitive assessment is a powerful tool and has a key role in the accurate and early diagnosis of dementia. It is very different from the cognitive testing usually seen in biomarker research and drug development. Yet the distinction between these approaches is unclear to many. This paper highlights the misconceptions around cognitive research in dementia and suggests a way forward to facilitate biomarker and drug development through the improved utility of cognitive assessment tools.
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Affiliation(s)
- María K Jónsdóttir
- Reykjavík University, Reykjavík, Iceland.,Landspitali - The National University Hospital of Iceland (Memory Clinic), Reykjavík, Iceland
| | - John Harrison
- Metis Cognition Ltd., Kilmington Common Wiltshire, UK.,Alzheimercentrum, Amsterdam, the Netherlands.,Institute of Psychiatry, Psychology & Neuroscience, KCL, London, UK
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17
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Sinha N, Fausto BA, Mander B, Gluck MA. High-Quality Sleep Mitigates ABCA7-Related Generalization Deficits in Healthy Older African Americans. J Alzheimers Dis 2023; 94:281-290. [PMID: 37212111 PMCID: PMC10357211 DOI: 10.3233/jad-230043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Both sleep deficiencies and Alzheimer's disease (AD) disproportionately affect older African Americans. Genetic susceptibility to AD further compounds risk for cognitive decline in this population. Aside from APOE ɛ4, ABCA7 rs115550680 is the strongest genetic locus associated with late-onset AD in African Americans. While sleep and ABCA7 rs115550680 independently influence late-life cognitive outcomes, we know too little about the interplay between these two factors on cognitive function. OBJECTIVE We investigated the interaction between sleep and ABCA7 rs115550680 on hippocampal-dependent cognitive function in older African Americans. METHODS One-hundred fourteen cognitively healthy older African Americans were genotyped for ABCA7 risk (n = 57 carriers of risk "G" allele; n = 57 non-carriers), responded to lifestyle questionnaires, and completed a cognitive battery. Sleep was assessed via a self-reported rating of sleep quality (poor, average, good). Covariates included age and years of education. RESULTS Using ANCOVA, we found that carriers of the risk genotype who reported poor or average sleep quality demonstrated significantly poorer generalization of prior learning-a cognitive marker of AD-compared to their non-risk counterparts. Conversely, there was no genotype-related difference in generalization performance in individuals who reported good sleep quality. CONCLUSION These results indicate that sleep quality may be neuroprotective against genetic risk for AD. Future studies employing more rigorous methodology should investigate the mechanistic role of sleep neurophysiology in the pathogenesis and progression of AD associated with ABCA7. There is also need for the continued development of non-invasive sleep interventions tailored to racial groups with specific AD genetic risk profiles.
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Affiliation(s)
- Neha Sinha
- Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University – Newark, Newark, NJ, USA
| | - Bernadette A. Fausto
- Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University – Newark, Newark, NJ, USA
| | - Bryce Mander
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA, USA
| | - Mark A. Gluck
- Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University – Newark, Newark, NJ, USA
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18
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Huang L, Li Y, Wu J, Chen N, Xia H, Guo Q. Shanghai Cognitive Screening: A Mobile Cognitive Assessment Tool Using Voice Recognition to Detect Mild Cognitive Impairment and Dementia in the Community. J Alzheimers Dis 2023; 95:227-236. [PMID: 37482999 DOI: 10.3233/jad-230277] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
BACKGROUND A rapid digital instrument is needed to facilitate community-based screening of mild cognitive impairment (MCI) and Alzheimer's disease (AD) in China. OBJECTIVE We developed a voice recognition-based cognitive assessment (Shanghai Cognitive Screening, SCS) on mobile devices and evaluated its diagnostic performance. METHODS Participants (N = 251) including healthy controls (N = 98), subjective cognitive decline (SCD, N = 42), MCI (N = 80), and mild AD (N = 31) were recruited from the memory clinic at Shanghai Sixth People's Hospital. The SCS is fully self-administered, takes about six minutes and measures the function of visual memory, language, and executive function. Participants were instructed to complete SCS tests, gold-standard neuropsychological tests and standardized structural 3T brain MRI. RESULTS The Cronbach's alpha was 0.910 of the overall scale, indicating high internal consistency. The SCS total score had an AUC of 0.921 to detect AD (sensitivity = 0.903, specificity = 0.945, positive predictive value = 0.700, negative predictive value = 0.986, likelihood ratio = 16.42, number needed for screening utility = 0.639), and an AUC of 0.838 to detect MCI (sensitivity = 0.793, specificity = 0.671, positive predictive value = 0.657, negative predictive value = 0.803, likelihood ratio = 2.41, number needed for screening utility = 0.944). The subtests demonstrated moderate to high correlations with the gold-standard tests from their respective cognitive domains. The SCS total score and its memory scores all correlated positively with relative volumes of the whole hippocampus and almost all subregions, after controlling for age, sex, and education. CONCLUSION The SCS has good diagnostic accuracy for detecting MCI and AD dementia and has the potential to facilitate large-scale screening in the general community.
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Affiliation(s)
- Lin Huang
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yatian Li
- Center for Brain Science, Shanghai BestCovered Limited, Shanghai, China
| | - Jingnan Wu
- Center for Brain Science, Shanghai BestCovered Limited, Shanghai, China
| | - Nan Chen
- Center for Brain Science, Shanghai BestCovered Limited, Shanghai, China
| | - Huanhuan Xia
- Center for Brain Science, Shanghai BestCovered Limited, Shanghai, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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19
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Öhman F, Berron D, Papp KV, Kern S, Skoog J, Hadarsson Bodin T, Zettergren A, Skoog I, Schöll M. Unsupervised mobile app-based cognitive testing in a population-based study of older adults born 1944. Front Digit Health 2022; 4:933265. [PMID: 36426215 PMCID: PMC9679642 DOI: 10.3389/fdgth.2022.933265] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 10/18/2022] [Indexed: 01/04/2024] Open
Abstract
Background Mobile app-based tools have the potential to yield rapid, cost-effective, and sensitive measures for detecting dementia-related cognitive impairment in clinical and research settings. At the same time, there is a substantial need to validate these tools in real-life settings. The primary aim of this study was thus to evaluate the feasibility, validity, and reliability of mobile app-based tasks for assessing cognitive function in a population-based sample of older adults. Method A total of 172 non-demented (Clinical Dementia Rating 0 and 0.5) older participants (aged 76-77) completed two mobile app-based memory tasks-the Mnemonic Discrimination Task for Objects and Scenes (MDT-OS) and the long-term (24 h) delayed Object-In-Room Recall Task (ORR-LDR). To determine the validity of the tasks for measuring relevant cognitive functions in this population, we assessed relationships with conventional cognitive tests. In addition, psychometric properties, including test-retest reliability, and the participants' self-rated experience with mobile app-based cognitive tasks were assessed. Result MDT-OS and ORR-LDR were weakly-to-moderately correlated with the Preclinical Alzheimer's Cognitive Composite (PACC5) (r = 0.3-0.44, p < .001) and with several other measures of episodic memory, processing speed, and executive function. Test-retest reliability was poor-to-moderate for one single session but improved to moderate-to-good when using the average of two sessions. We observed no significant floor or ceiling effects nor effects of education or gender on task performance. Contextual factors such as distractions and screen size did not significantly affect task performance. Most participants deemed the tasks interesting, but many rated them as highly challenging. While several participants reported distractions during tasks, most could concentrate well. However, there were difficulties in completing delayed recall tasks on time in this unsupervised and remote setting. Conclusion Our study proves the feasibility of mobile app-based cognitive assessments in a community sample of older adults, demonstrating its validity in relation to conventional cognitive measures and its reliability for repeated measurements over time. To further strengthen study adherence, future studies should implement additional measures to improve task completion on time.
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Affiliation(s)
- Fredrik Öhman
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - David Berron
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Kathryn V. Papp
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Silke Kern
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Timothy Hadarsson Bodin
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michael Schöll
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, United Kingdom
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20
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Cattaneo G, Pachón-García C, Roca A, Alviarez-Schulze V, Opisso E, García-Molina A, Bartrés-Faz D, Pascual-Leone A, Tormos-Muñoz JM, Solana-Sánchez J. "Guttmann Cognitest" ®, preliminary validation of a digital solution to test cognitive performance. Front Aging Neurosci 2022; 14:987891. [PMID: 36408102 PMCID: PMC9669647 DOI: 10.3389/fnagi.2022.987891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/10/2022] [Indexed: 02/19/2024] Open
Abstract
Thanks to technological advances, the administration of cognitive assessments via digital solutions continues to increase, both in research and clinical practice. "Guttmann Cognitest"°ledR is a digital solution for cognitive assessment which includes seven computerized tasks designed to assess main cognitive functions requiring approximately 20 min to be completed. The purpose of the present study was to validate it against standard and more extensive in-person neuropsychological assessments in the context of the Barcelona Brain Health Initiative (BBHI) cohort study. We studied 274 participants of the BBHI (126 women, mean age = 56.14, age range 44-69), who underwent an extensive in-person assessment, including a classical paper-and-pencil neuropsychological assessment and a cognitive assessment via the "Guttmann Cognitest"°ledR. Principal component analysis indicated that "Guttmann Cognitest"°ledR measures four main cognitive domains and convergent validity analysis demonstrated that cognitive performance was associated with gold standard paper and pencil tests. Results also showed an expected negative correlation with age, a relation with educational level as well as a gender effect. Regression-based norming equations for the sample tested are also reported. Performing a cognitive assessment with this digital solution is feasible and potentially useful to gather information about cognitive functioning in large samples and experimental settings.
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Affiliation(s)
- Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Catherine Pachón-García
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Alba Roca
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Vanessa Alviarez-Schulze
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Departamento de Ciencias del Comportamiento, Escuela de Psicología, Universidad Metropolitana, Caracas, Venezuela
| | - Eloy Opisso
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Alberto García-Molina
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - David Bartrés-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, United States
- Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States
- Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - Josep M. Tormos-Muñoz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Javier Solana-Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
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21
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Parra MA, Calia C, Pattan V, Della Sala S. Memory markers in the continuum of the Alzheimer's clinical syndrome. Alzheimers Res Ther 2022; 14:142. [PMID: 36180965 PMCID: PMC9526252 DOI: 10.1186/s13195-022-01082-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/14/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The individual and complementary value of the Visual Short-Term Memory Binding Test (VSTMBT) and the Free and Cued Selective Reminding Test (FCSRT) as markers to trace the AD continuum was investigated. It was hypothesised that the VSTMBT would be an early indicator while the FCSRT would inform on imminent progression. METHODS Healthy older adults (n=70) and patients with mild cognitive impairment (MCI) (n=80) were recruited and followed up between 2012 and 2017. Participants with at least two assessment points entered the study. Using baseline and follow-up assessments four groups were defined: Older adults who were healthy (HOA), with very mild cognitive but not functional impairment (eMCI), and with MCI who did and did not convert to dementia (MCI converters and non-converters). RESULTS Only the VSTMBT predicted group membership in the very early stages (HOA vs eMCI). As the disease progressed, the FCSRT became a strong predictor excluding the VSTMB from the models. Their complementary value was high during the mid-prodromal stages and decreased in stages closer to dementia. DISCUSSION The study supports the notion that neuropsychological assessment for AD needs to abandon the notion of one-size-fits-all. A memory toolkit for AD needs to consider tools that are early indicators and tools that suggest imminent progression. The VSTMBT and the FSCRT are such tools.
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Affiliation(s)
- Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Graham Hills Building, 40 George Street, Glasgow, G1 1QE, UK.
| | - Clara Calia
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Vivek Pattan
- NHS Forth Valley, Stirling Community Hospital, Stirling, UK
| | - Sergio Della Sala
- Human Cognitive Neuroscience, Psychology Department, University of Edinburgh, Edinburgh, UK
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22
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Spinelli G, Bakardjian H, Schwartz D, Potier MC, Habert MO, Levy M, Dubois B, George N. Theta Band-Power Shapes Amyloid-Driven Longitudinal EEG Changes in Elderly Subjective Memory Complainers At-Risk for Alzheimer's Disease. J Alzheimers Dis 2022; 90:69-84. [PMID: 36057818 DOI: 10.3233/jad-220204] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) includes progressive symptoms spread along a continuum of preclinical and clinical stages. Although numerous studies uncovered the neuro-cognitive changes of AD, very little is known on the natural history of brain lesions and modifications of brain networks in elderly cognitively-healthy memory complainers at risk of AD for carrying pathophysiological biomarkers (amyloidopathy and tauopathy). OBJECTIVE We analyzed resting-state electroencephalography (EEG) of 318 cognitively-healthy subjective memory complainers from the INSIGHT-preAD cohort at the time of their first visit (M0) and two-years later (M24). METHODS Using 18F-florbetapir PET-scanner, subjects were stratified between amyloid negative (A-; n = 230) and positive (A+; n = 88) groups. Differences between A+ and A-were estimated at source-level in each band-power of the EEG spectrum. RESULTS At M0, we found an increase of theta power in the mid-frontal cortex in A+ compared to A-. No significant association was found between mid-frontal theta and the individuals' cognitive performance. At M24, theta power increased in A+ relative to A-individuals in the posterior cingulate cortex and the pre-cuneus. Alpha band revealed a peculiar decremental trend in posterior brain regions in the A+ relative to the A-group only at M24. Theta power increase over the mid-frontal and mid-posterior cortices suggests an hypoactivation of the default-mode network in the A+ individuals and a non-linear longitudinal progression at M24. CONCLUSION We provide the first source-level longitudinal evidence on the impact of brain amyloidosis on the EEG dynamics of a large-scale, monocentric cohort of elderly individuals at-risk for AD.
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Affiliation(s)
- Giuseppe Spinelli
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Centre MEG-EEG, CENIR, Paris, France.,AP-HP, Hôpital de la Pitié-Salpêtrière, Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Paris, France
| | - Hovagim Bakardjian
- AP-HP, Hôpital de la Pitié-Salpêtrière, Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Paris, France
| | | | - Marie-Claude Potier
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Centre MEG-EEG, CENIR, Paris, France
| | - Marie-Odile Habert
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France.,AP-HP, Hôpital de la Pitié-Salpêtrière, Médecine Nucléaire, Paris, France.,Centre d'Acquisition et Traitement des Images (CATI), http://www.cati-neuroimaging.com
| | - Marcel Levy
- AP-HP, Hôpital de la Pitié-Salpêtrière, Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Paris, France
| | - Bruno Dubois
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Centre MEG-EEG, CENIR, Paris, France.,AP-HP, Hôpital de la Pitié-Salpêtrière, Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Paris, France
| | - Nathalie George
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Centre MEG-EEG, CENIR, Paris, France
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23
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Shared pathophysiology: Understanding stroke and Alzheimer’s disease. Clin Neurol Neurosurg 2022; 218:107306. [PMID: 35636382 DOI: 10.1016/j.clineuro.2022.107306] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 12/17/2022]
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24
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Vyhnalek M, Jester DJ, Andel R, Markova H, Nikolai T, Laczó J, Matuskova V, Cechova K, Sheardova K, Hort J. Contribution of Memory Tests to Early Identification of Conversion from Amnestic Mild Cognitive Impairment to Dementia. J Alzheimers Dis 2022; 88:1397-1409. [PMID: 35786650 PMCID: PMC9484087 DOI: 10.3233/jad-215364] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Memory tests using controlled encoding and cued recall paradigm (CECR) have been shown to identify prodromal Alzheimer’s disease (AD), but information about the effectiveness of CECR compared to other memory tests in predicting clinical progression is missing. Objective: The aim was to examine the predictive ability of a memory test based on the CECR paradigm in comparison to other memory/non-memory tests for conversion to dementia in patients with amnestic mild cognitive impairment (aMCI). Methods: 270 aMCI patients from the clinical-based Czech Brain Aging Study underwent a comprehensive neuropsychological assessment including the Enhanced Cued Recall test (ECR), a memory test with CECR, two verbal memory tests without controlled encoding: the Auditory Verbal Learning Test (AVLT) and Logical memory test (LM), a visuospatial memory test: the Rey-Osterrieth Complex Figure test, and cognitive testing based on the Uniform Data Set battery. The patients were followed prospectively. Conversion to dementia as a function of cognitive performance was examined using Cox proportional hazard models. Results: 144 (53%) patients converted to dementia. Most converters (89%) developed dementia due to AD or mixed (AD and vascular) dementia. Comparing the four memory tests, the delayed recall scores on AVLT and LM best predicted conversion to dementia. Adjusted hazard ratios (HR) of immediate recall scores on ECR, AVLT, and LM were similar to the HR of categorical verbal fluency. Conclusion: Using the CECR memory paradigm in assessment of aMCI patients has no superiority over verbal and non-verbal memory tests without cued recall in predicting conversion to dementia.
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Affiliation(s)
- Martin Vyhnalek
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Dylan J Jester
- School of Aging Studies, University of South Florida, Tampa, FL, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA
| | - Ross Andel
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.,School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Hana Markova
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Tomas Nikolai
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Jan Laczó
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Veronika Matuskova
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Katerina Cechova
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Katerina Sheardova
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Jakub Hort
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
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25
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Chen YC, Ton That V, Ugonna C, Liu Y, Nadel L, Chou YH. Diffusion MRI-guided theta burst stimulation enhances memory and functional connectivity along the inferior longitudinal fasciculus in mild cognitive impairment. Proc Natl Acad Sci U S A 2022; 119:e2113778119. [PMID: 35594397 PMCID: PMC9173759 DOI: 10.1073/pnas.2113778119] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 04/16/2022] [Indexed: 11/18/2022] Open
Abstract
Mild cognitive impairment (MCI) during aging is often a harbinger of Alzheimer’s disease, and, therefore, early intervention to preserve cognitive abilities before the MCI symptoms become medically refractory is particularly critical. Functional MRI–guided transcranial magnetic stimulation is a promising approach for modulating hippocampal functional connectivity and enhancing memory in healthy adults. Here, we extend these previous findings to individuals with MCI and leverage theta burst stimulation (TBS) and white matter tractography derived from diffusion-weighted MRI to target the hippocampus. Our preliminary findings suggested that TBS could be used to improve associative memory performance and increase resting-state functional connectivity of the hippocampus and other brain regions, including the occipital fusiform, frontal orbital cortex, putamen, posterior parahippocampal gyrus, and temporal pole, along the inferior longitudinal fasciculus in MCI. Although the sample size is small, these results shed light on how TBS propagates from the superficial cortex around the parietal lobe to the hippocampus.
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Affiliation(s)
- Yu-Chin Chen
- Department of Psychology, University of Arizona, Tucson, AZ 85721
| | - Viet Ton That
- Department of Psychology, University of Arizona, Tucson, AZ 85721
| | - Chidi Ugonna
- Department of Psychology, University of Arizona, Tucson, AZ 85721
| | - Yilin Liu
- Department of Psychology, University of Arizona, Tucson, AZ 85721
| | - Lynn Nadel
- Department of Psychology, University of Arizona, Tucson, AZ 85721
- Program in Cognitive Science, University of Arizona, Tucson, AZ 85721
| | - Ying-hui Chou
- Department of Psychology, University of Arizona, Tucson, AZ 85721
- Program in Cognitive Science, University of Arizona, Tucson, AZ 85721
- Evelyn F McKnight Brain Institute, Tucson, AZ 85721
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26
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Fausto BA, Gluck MA. Low body mass and high-quality sleep maximize the ability of aerobic fitness to promote improved cognitive function in older African Americans. ETHNICITY & HEALTH 2022; 27:909-928. [PMID: 32931310 PMCID: PMC7956916 DOI: 10.1080/13557858.2020.1821176] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
ABSTRACTObjectives: Because African Americans are at elevated risk for cognitive decline and Alzheimer's disease, it is important to understand which health and lifestyle factors are most important for reducing this risk. Obesity and poor sleep quality are common in lower-income, urban African Americans and have been linked to cognitive decline in older age. Fortunately, increasing aerobic fitness via regular exercise can improve cognitive function. This study sought to (1) examine the cross-sectional relationship between aerobic fitness and cognitive function in older African Americans, and (2) determine whether body mass index and sleep quality moderated the relationship between aerobic fitness and cognition.Design: 402 older African Americans, ages 60-90 (84% female, mean education level = 14 years) completed neuropsychological testing, computerized behavioral tasks, physical performance measures, and health and lifestyle questionnaires. Hierarchical linear regressions were performed to determine associations between aerobic fitness and cognition and whether body mass index and sleep quality moderate the fitness-cognition relationship while controlling for age, sex, education, depressive symptoms, and literacy.Results: Higher aerobic fitness levels were significantly associated with better executive function. The relationships between fitness and hippocampal-dependent cognitive functions (learning and memory, generalization) were attenuated in those who are obese (body mass index ≥ 30 kg/m2) or rated their sleep quality as poor, ps < .05.Conclusion: Our results suggest that while exercise and associated improvements in aerobic fitness are key for improved cognition, these benefits are maximized in those who maintain low body weight and get sufficient, high quality sleep. Exercise programs for older African Americans will be most effective if they are integrated with education programs that emphasize healthy eating, weight control, and sleep hygiene and conceptualize individuals as part of their broader social and environmental context.
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Affiliation(s)
- Bernadette A. Fausto
- Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University–Newark, NJ, United States
- Corresponding author: Bernadette A. Fausto, PhD, Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University–Newark, 197 University Ave., Suite 209, Newark, NJ 07102, United States, Phone: (973) 353-3673,
| | - Mark A. Gluck
- Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University–Newark, NJ, United States
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27
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Pettigrew C, Soldan A, Brichko R, Zhu Y, Wang MC, Kutten K, Bilgel M, Mori S, Miller MI, Albert M. Computerized paired associate learning performance and imaging biomarkers in older adults without dementia. Brain Imaging Behav 2022; 16:921-929. [PMID: 34686968 PMCID: PMC9012682 DOI: 10.1007/s11682-021-00583-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 01/21/2023]
Abstract
This cross-sectional study examined whether performance on the computerized Paired Associate Learning (PAL) task from the Cambridge Neuropsychological Test Automated Battery is associated with amyloid positivity as measured by Positron Emission Tomography, regional volume composites as measured by Magnetic Resonance Imaging, and cognitive impairment. Participants from the BIOCARD Study (N = 73, including 62 cognitively normal and 11 with mild cognitive impairment; M age = 70 years) completed the PAL task, a comprehensive clinical and neuropsychological assessment, and neuroimaging as part of their annual study visit. In linear regressions covarying age, sex, years of education and diagnosis, higher PAL error scores were associated with amyloid positivity but not with medial temporal or cortical volume composites. By comparison, standard neuropsychological measures of episodic memory and global cognition were unrelated to amyloid positivity, but better performance on the verbal episodic memory measures was associated with larger cortical volume composites. Participants with mild cognitive impairment demonstrated worse cognitive performance on all of the cognitive measures, including the PAL task. These findings suggest that this computerized visual paired associate learning task may be more sensitive to amyloid positivity than standard neuropsychological tests, and may therefore be a promising tool for detecting amyloid positivity in non-demented participants.
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Affiliation(s)
- Corinne Pettigrew
- Department of Neurology, Division of Cognitive Neuroscience, Johns Hopkins University School of Medicine, 1620 McElderry Street, Reed Hall West - 1, Baltimore, MD, 21205, USA.
| | - Anja Soldan
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Rostislav Brichko
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Yuxin Zhu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21287, USA
| | - Mei-Cheng Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21287, USA
| | - Kwame Kutten
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute On Aging, Baltimore, MD, 21224, USA
| | - Susumu Mori
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Michael I Miller
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Marilyn Albert
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
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28
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Nunes AS, Kozhemiako N, Stephen CD, Schmahmann JD, Khan S, Gupta AS. Automatic Classification and Severity Estimation of Ataxia From Finger Tapping Videos. Front Neurol 2022; 12:795258. [PMID: 35295715 PMCID: PMC8919801 DOI: 10.3389/fneur.2021.795258] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
Digital assessments enable objective measurements of ataxia severity and provide informative features that expand upon the information obtained during a clinical examination. In this study, we demonstrate the feasibility of using finger tapping videos to distinguish participants with Ataxia (N = 169) from participants with parkinsonism (N = 78) and from controls (N = 58), and predict their upper extremity and overall disease severity. Features were extracted from the time series representing the distance between the index and thumb and its derivatives. Classification models in ataxia archived areas under the receiver-operating curve of around 0.91, and regression models estimating disease severity obtained correlation coefficients around r = 0.64. Classification and prediction model coefficients were examined and they not only were in accordance, but were in line with clinical observations of ataxia phenotypes where rate and rhythm are altered during upper extremity motor movement.
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Affiliation(s)
- Adonay S. Nunes
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Nataliia Kozhemiako
- Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Christopher D. Stephen
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States,Ataxia Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States,Movement Disorders Unit, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Jeremy D. Schmahmann
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States,Ataxia Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Sheraz Khan
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States,Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Anoopum S. Gupta
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States,Ataxia Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States,Movement Disorders Unit, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States,*Correspondence: Anoopum S. Gupta
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29
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Abstract
Internet-connected devices, including personal computers, smartphones, smartwatches, and voice assistants, have evolved into powerful multisensor technologies that billions of people interact with daily to connect with friends and colleagues, access and share information, purchase goods, play games, and navigate their environment. Digital phenotyping taps into the data streams captured by these devices to characterize and understand health and disease. The purpose of this article is to summarize opportunities for digital phenotyping in neurology, review studies using everyday technologies to obtain motor and cognitive information, and provide a perspective on how neurologists can embrace and accelerate progress in this emerging field.
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Affiliation(s)
- Anoopum S. Gupta
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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30
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Sahoo S, Grover S. Technology-based Neurocognitive Assessment of the Elderly: a Mini Review: Оценка нейрокогнитивных функций на основе компьютерных технологий у пожилых людей: краткий обзор. CONSORTIUM PSYCHIATRICUM 2022; 3:37-44. [PMID: 39045356 PMCID: PMC11262097 DOI: 10.17816/cp155] [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: 02/11/2022] [Accepted: 02/28/2022] [Indexed: 11/08/2022] Open
Abstract
Neurocognitive disorders in the elderly are on the rise all over the world. Neuropsychological assessment is vital to monitoring the progress of cognitive deficits. Over the years, there has been significant development in neuropsychological assessment to predict the development and progression of MCI and dementia. One such area of recent advancement in the field of neuropsychology is technology-based assessment. There are several types of technology-based assessments available based on the type of usage, site of the assessment, type of administration, type of device used for assessment, etc. Virtual reality-based assessments and digital assessments of neurocognitions for early identification of subtle cognitive deficits in patients with mild cognitive impairment (MCI) and major neurocognitive disorders (MND) represent two newly developed technologies. A few studies have demonstrated their efficacy; however, there remain several limitations and drawbacks to their usage within the elderly population. In this review, we have briefly discussed technology-based neuropsychological assessment, along with their usage and limitations.
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31
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Fukuda T, Kanatome A, Takashima A, Tajima O, Umeda S, Ano Y. Effect of Whey-Derived Lactopeptide β-Lactolin on Memory in Healthy Adults: An Integrated Analysis of Data from Randomized Controlled Trials. J Nutr Health Aging 2022; 26:127-132. [PMID: 35166303 DOI: 10.1007/s12603-022-1733-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
Abstract
CONTEXT Epidemiological studies have shown that consumption of dairy products reduces the risk of dementia and cognitive decline in older individuals. Tryptophan-tyrosine-related β-lactopeptides and their representative β-lactolin of glycine-threonine-tryptophan-tyrosine tetra-peptide have been identified as agents in dairy products, which improve cognitive function as well as memory function via the activation of the dopaminergic system in a mouse model of amnesia. Previous clinical trials have shown that supplementation with β-lactolin improves memory retrieval in healthy older adults. Specifically, β-lactolin improved the scores in some neuropsychological tests. However, the effects of β-lactolin on memory function have not been clarified. OBJECTIVES The aim of this study was to evaluate the effect of β-lactolin on memory function using statistical methods. DATA SOURCES We searched the Web of Science, Cochrane Library, and JDream III until November 2021 to identify relevant randomized controlled trials for integrated analysis. DATA SYNTHESIS Three randomized controlled trials evaluating the effect of β-lactolin on memory in healthy adults were selected for the integrated analysis. The results showed that the score of cued recall among the neuropsychological tests in the β-lactolin group was significantly higher than that in the placebo group (g=0.33; 95% CI: 0.10, 0.55). In addition, the total memory score was higher but this difference was not significant (g=0.17; 95% CI: -0.09, 0.43). CONCLUSIONS Taken together, these results suggest that supplementation with β-lactolin improves cued recall in healthy older adults.
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Affiliation(s)
- T Fukuda
- Takafumi Fukuda, KIRIN Central Research Institute, Kirin Holdings Company, Limited, 26-1, Muraoka-Higashi 2-chome. Fujisawa, Kanagawa 251-8555, Japan, , Tel: +81-80-1930-9968
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32
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Validation and Normative Data of the Spanish Version of the Face Name Associative Memory Exam (S-FNAME). J Int Neuropsychol Soc 2022; 28:74-84. [PMID: 33749568 DOI: 10.1017/s1355617721000084] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The relevance of the episodic memory in the prediction of brain aging is well known. The Face Name Associative Memory Exam (FNAME) is a valued associative memory measure related to Alzheimer's disease (AD) biomarkers, such as amyloid-β deposition preclinical AD individuals. Previous validation of the Spanish version of the FNAME test (S-FNAME) provided normative data and psychometric characteristics. The study was limited to subjects attending a memory clinic and included a reduced sample with gender inequality distribution. The purpose of this study was to assess S-FNAME psychometric properties and provide normative data in a larger independent sample of cognitively healthy individuals. METHOD S-FNAME was administered to 511 cognitively healthy volunteers (242 women, aged 41-65 years) participating in the Barcelona Brain Health Initiative cohort study. RESULTS Factor analysis supported construct validity revealing two underlying components: face-name and face-occupation and explaining 95.34% of the total variance, with satisfactory goodness of fit. Correlations between S-FNAME and Rey Auditory-Verbal Learning Test were statistically significant and confirmed its convergent validity. We also found weak correlations with non-memory tests supporting divergent validity. Women showed better scores, and S-FNAME was positively correlated with education and negatively with age. Finally, we generated normative data. CONCLUSIONS The S-FNAME test exhibits good psychometric properties, consistent with previous findings, resulting in a valid and reliable tool to assess episodic memory in cognitively healthy middle-aged adults. It is a promising test for the early detection of subtle memory dysfunction associated with abnormal brain aging.
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33
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Kokje E, Gerwien J, von Stutterheim C. Macro-event recognition in healthy ageing, Alzheimer's disease, and mild cognitive impairment. J Neuropsychol 2021; 16:306-323. [PMID: 34970842 DOI: 10.1111/jnp.12271] [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: 07/15/2021] [Revised: 12/08/2021] [Indexed: 11/27/2022]
Abstract
Event perception and cognition is integral to our everyday experience and functional ability. A commonly reported complaint in Alzheimer's disease (AD) is the inability to follow narratives - be it textual, conversational, video, or pictures. This phenomenon has received little systematic research so far. In the current study, we developed a novel paradigm to examine macro-event recognition in individuals with AD in the early stage and its preceding stage of mild cognitive impairment (MCI) in comparison with cognitively healthy older adults, using pictures depicting events. In Experiment 1, we examined participants' ability to integrate pictorially depicted sub-events into macro-events. The pictures were presented in a scrambled order, and participants were expected to arrange them in the temporally and causally appropriate sequence, as dictated by the macro-event schema. Additionally, we investigated the effect of cueing the appropriate event schema by providing a word cue (verb). In Experiment 2, macro-event recognition was examined again using a cognitively less taxing paradigm, where pictures depicting sub-events were presented in correct order, but staggered, and recognition speed was measured. We observed significant deficits in the AD and MCI groups' performance compared with the cognitively healthy older adults, across both experiments, suggesting event perception and cognition is impaired early in the course of AD. There was no effect of cueing on the performance of any of the groups. The theoretical and clinical implications of these findings are discussed.
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Affiliation(s)
- Eesha Kokje
- Network Aging Research, Heidelberg University, Germany
| | - Johannes Gerwien
- Institut für Deutsch als Fremdsprachenphilologie, Heidelberg University, Germany
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34
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Decreased Resting-State Functional Complexity in Elderly with Subjective Cognitive Decline. ENTROPY 2021; 23:e23121591. [PMID: 34945897 PMCID: PMC8700613 DOI: 10.3390/e23121591] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022]
Abstract
Individuals with subjective cognitive decline (SCD) are at high risk of developing preclinical or clinical state of Alzheimer’s disease (AD). Resting state functional magnetic resonance imaging, which can indirectly reflect neuron activities by measuring the blood-oxygen-level-dependent (BOLD) signals, is promising in the early detection of SCD. This study aimed to explore whether the nonlinear complexity of BOLD signals can describe the subtle differences between SCD and normal aging, and uncover the underlying neuropsychological implications of these differences. In particular, we introduce amplitude-aware permutation entropy (AAPE) as the novel measure of brain entropy to characterize the complexity in BOLD signals in each brain region of the Brainnetome atlas. Our results demonstrate that AAPE can reflect the subtle differences between both groups, and the SCD group presented significantly decreased complexities in subregions of the superior temporal gyrus, the inferior parietal lobule, the postcentral gyrus, and the insular gyrus. Moreover, the results further reveal that lower complexity in SCD may correspond to poorer cognitive performance or even subtle cognitive impairment. Our findings demonstrated the effectiveness and sensitiveness of the novel brain entropy measured by AAPE, which may serve as the potential neuroimaging marker for exploring the subtle changes in SCD.
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35
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Autobiographical Memory Fluency Reductions in Cognitively Unimpaired Middle-Aged and Older Adults at Increased Risk for Alzheimer's Disease Dementia. J Int Neuropsychol Soc 2021; 27:905-915. [PMID: 33509324 PMCID: PMC8319219 DOI: 10.1017/s1355617720001319] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Recent research has revealed that cognitively unimpaired older adults who are at higher risk for developing Alzheimer's disease (AD) dementia often exhibit subtle cognitive alterations in their neuropsychological profiles. Emerging evidence suggests that autobiographical memory, which is memory for personal events and knowledge, may be sensitive to early AD-related cognitive alterations. In the present study, we investigated whether the rapid generation of autobiographical memory category exemplars, a retrieval process that taxes the neural network that is vulnerable to early AD, is compromised in cognitively unimpaired middle-aged and older carriers of the e4 allele of the apolipoprotein E gene (APOE4), which increases risk for AD dementia. METHODS In addition to standard neuropsychological tests, we administered a fluency task that requires generating exemplars for two types of autobiographical memory, namely episodic memories and personal semantics, to a group of cognitively unimpaired middle-aged and older adults (n = 45) enriched with APOE4 carriers (n = 20). RESULTS While no APOE4 deficits were found on standard neuropsychological tests, episodic and personal semantic exemplar generation was reduced in the APOE4 group. DISCUSSION Autobiographical memory aberrations associated with a higher risk for AD are evident in fluency and affect both episodic memory and personal semantics.
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36
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Tsoy E, Sideman AB, Piña Escudero SD, Pintado-Caipa M, Kanjanapong S, Al-Rousan T, Mbakile-Mahlanza L, de Oliveira MO, De la Cruz Puebla M, Zygouris S, Mohamed AA, Ibrahim H, Goode CA, Miller BL, Valcour V, Possin KL. Global Perspectives on Brief Cognitive Assessments for Dementia Diagnosis. J Alzheimers Dis 2021; 82:1001-1013. [PMID: 34120897 DOI: 10.3233/jad-201403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Timely diagnosis of dementia is a global healthcare priority, particularly in low to middle income countries where rapid increases in older adult populations are expected. OBJECTIVE To investigate global perspectives on the role of brief cognitive assessments (BCAs) in dementia diagnosis, strengths and limitations of existing measures, and future directions and needs. METHODS This is a qualitative study of 18 dementia experts from different areas of the world. Participants were selected using purposeful sampling based on the following criteria: 1) practicing in countries with projected growth of older adult population of over 100%by 2050; 2) expertise in dementia diagnosis and treatment; 3) involvement in clinical practice and training; and 4) recognition as a national dementia expert based on leadership positions within healthcare system, research, and/or policy work. Participants were individually interviewed in their language of choice over secure videoconference sessions. Interviews were analyzed by a multidisciplinary team using theme identification approach. RESULTS Four domains with subthemes emerged illustrating participants' perspectives: 1) strengths of BCAs; 2) limitations of BCAs; 3) needs related to the use of BCAs; and 4) characteristics of an ideal BCA. While most experts agreed that BCAs were important and useful for dementia diagnosis, the themes emphasized the need for development and validation of novel measures that are sensitive, psychometrically sound, and culturally appropriate. CONCLUSION BCAs are important for guiding diagnosis and care for dementia patients. Findings provide a roadmap for novel BCA development to assist in diagnostic decision making for clinicians serving a rapidly growing and diverse dementia population.
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Affiliation(s)
- Elena Tsoy
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Alissa Bernstein Sideman
- Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, CA, USA.,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA.,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Stefanie D Piña Escudero
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Maritza Pintado-Caipa
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Suchanan Kanjanapong
- Division of Geriatrics, Department of Preventive Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tala Al-Rousan
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Lingani Mbakile-Mahlanza
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Maira Okada de Oliveira
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Myriam De la Cruz Puebla
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Stelios Zygouris
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Aya Ashour Mohamed
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Hany Ibrahim
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Collette A Goode
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA.,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Victor Valcour
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA.,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
| | - Katherine L Possin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA.,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.,Trinity College Dublin, Ireland
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Öhman F, Hassenstab J, Berron D, Schöll M, Papp KV. Current advances in digital cognitive assessment for preclinical Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12217. [PMID: 34295959 PMCID: PMC8290833 DOI: 10.1002/dad2.12217] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/30/2021] [Accepted: 06/04/2021] [Indexed: 12/24/2022]
Abstract
There is a pressing need to capture and track subtle cognitive change at the preclinical stage of Alzheimer's disease (AD) rapidly, cost-effectively, and with high sensitivity. Concurrently, the landscape of digital cognitive assessment is rapidly evolving as technology advances, older adult tech-adoption increases, and external events (i.e., COVID-19) necessitate remote digital assessment. Here, we provide a snapshot review of the current state of digital cognitive assessment for preclinical AD including different device platforms/assessment approaches, levels of validation, and implementation challenges. We focus on articles, grants, and recent conference proceedings specifically querying the relationship between digital cognitive assessments and established biomarkers for preclinical AD (e.g., amyloid beta and tau) in clinically normal (CN) individuals. Several digital assessments were identified across platforms (e.g., digital pens, smartphones). Digital assessments varied by intended setting (e.g., remote vs. in-clinic), level of supervision (e.g., self vs. supervised), and device origin (personal vs. study-provided). At least 11 publications characterize digital cognitive assessment against AD biomarkers among CN. First available data demonstrate promising validity of this approach against both conventional assessment methods (moderate to large effect sizes) and relevant biomarkers (predominantly weak to moderate effect sizes). We discuss levels of validation and issues relating to usability, data quality, data protection, and attrition. While still in its infancy, digital cognitive assessment, especially when administered remotely, will undoubtedly play a major future role in screening for and tracking preclinical AD.
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Affiliation(s)
- Fredrik Öhman
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Wallenberg Centre for Molecular and Translational MedicineUniversity of GothenburgGothenburgSweden
| | - Jason Hassenstab
- Department of NeurologyWashington University in St. LouisSt. LouisMissouriUSA
- Department of Psychological & Brain SciencesWashington University in St. LouisSt. LouisMissouriUSA
| | - David Berron
- German Center for Neurodegenerative Diseases (DZNE)MagdeburgGermany
- Clinical Memory Research Unit, Department of Clinical Sciences MalmöLund UniversityLundSweden
| | - Michael Schöll
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Wallenberg Centre for Molecular and Translational MedicineUniversity of GothenburgGothenburgSweden
- Dementia Research Centre, Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Kathryn V. Papp
- Center for Alzheimer Research and TreatmentDepartment of Neurology, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of Neurology, Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
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Narbutas J, Chylinski D, Van Egroo M, Bahri MA, Koshmanova E, Besson G, Muto V, Schmidt C, Luxen A, Balteau E, Phillips C, Maquet P, Salmon E, Vandewalle G, Bastin C, Collette F. Positive Effect of Cognitive Reserve on Episodic Memory, Executive and Attentional Functions Taking Into Account Amyloid-Beta, Tau, and Apolipoprotein E Status. Front Aging Neurosci 2021; 13:666181. [PMID: 34122044 PMCID: PMC8194490 DOI: 10.3389/fnagi.2021.666181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/20/2021] [Indexed: 01/01/2023] Open
Abstract
Studies exploring the simultaneous influence of several physiological and environmental factors on domain-specific cognition in late middle-age remain scarce. Therefore, our objective was to determine the respective contribution of modifiable risk/protective factors (cognitive reserve and allostatic load) on specific cognitive domains (episodic memory, executive functions, and attention), taking into account non-modifiable factors [sex, age, and genetic risk for Alzheimer's disease (AD)] and AD-related biomarker amount (amyloid-beta and tau/neuroinflammation) in a healthy late-middle-aged population. One hundred and one healthy participants (59.4 ± 5 years; 68 women) were evaluated for episodic memory, executive and attentional functioning via neuropsychological test battery. Cognitive reserve was determined by the National Adult Reading Test. The allostatic load consisted of measures of lipid metabolism and sympathetic nervous system functioning. The amyloid-beta level was assessed using positron emission tomography in all participants, whereas tau/neuroinflammation positron emission tomography scans and apolipoprotein E genotype were available for 58 participants. Higher cognitive reserve was the main correlate of better cognitive performance across all domains. Moreover, age was negatively associated with attentional functioning, whereas sex was a significant predictor for episodic memory, with women having better performance than men. Finally, our results did not show clear significant associations between performance over any cognitive domain and apolipoprotein E genotype and AD biomarkers. This suggests that domain-specific cognition in late healthy midlife is mainly determined by a combination of modifiable (cognitive reserve) and non-modifiable factors (sex and age) rather than by AD biomarkers and genetic risk for AD.
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Affiliation(s)
- Justinas Narbutas
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Daphne Chylinski
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
| | - Maxime Van Egroo
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
| | - Mohamed Ali Bahri
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
| | - Ekaterina Koshmanova
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
| | - Gabriel Besson
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
| | - Vincenzo Muto
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
| | - Christina Schmidt
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - André Luxen
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
| | - Evelyne Balteau
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
| | - Christophe Phillips
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
| | - Pierre Maquet
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
- Department of Neurology, CHU de Liège, Liège, Belgium
| | - Eric Salmon
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
- Department of Neurology, CHU de Liège, Liège, Belgium
| | - Gilles Vandewalle
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
| | - Christine Bastin
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Fabienne Collette
- GIGA Institute, Cyclotron Research Centre In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
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Kitaigorodsky M, Crocco E, Curiel‐Cid RE, Leal G, Zheng D, Eustache MK, Greig‐Custo MT, Barker W, Duara R, Loewenstein DA. The relationship of semantic intrusions to different etiological subtypes of MCI and cognitively healthy older adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12192. [PMID: 34084887 PMCID: PMC8144934 DOI: 10.1002/dad2.12192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION There is increasing evidence that susceptibility to proactive semantic interference (PSI) and the failure to recover from PSI (frPSI) as evidenced by intrusion errors may be early cognitive markers of both preclinical and prodromal Alzheimer's disease (AD). METHODS One hundred forty-five participants were administered extensive clinical and neuropsychological evaluations including the Loewenstein-Acevedo Scales for Semantic Interference and Learning (LASSI-L), a sensitive cognitive stress test measuring PSI and frPSI. Participants also underwent structural magnetic resonance imaging (MRI) and amyloid positron emission tomography/computed tomography (PET/CT) imaging. RESULTS PSI and frPSI errors were much more prevalent in the mild cognitive impairment (MCI)-AD (amyloid positive) group than the other diagnostic groups. The number of intrusion errors observed across the other MCI groups without amyloid pathology and those with normal cognition were comparable. DISCUSSION Semantic intrusion errors on the LASSI-L occur much less frequently in persons who have different types of non-AD-related MCI and may be used as an early cognitive marker of prodromal AD.
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Affiliation(s)
- Marcela Kitaigorodsky
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral SciencesUniversity of Miami Miller School of MedicineMiamiUSA
| | - Elizabeth Crocco
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral SciencesUniversity of Miami Miller School of MedicineMiamiUSA
| | - Rosie E. Curiel‐Cid
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral SciencesUniversity of Miami Miller School of MedicineMiamiUSA
- 1Florida Alzheimer's Disease Research CenterGainesvilleFloridaUSA
| | - Giselle Leal
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral SciencesUniversity of Miami Miller School of MedicineMiamiUSA
| | - Diane Zheng
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral SciencesUniversity of Miami Miller School of MedicineMiamiUSA
| | - Melissa K. Eustache
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral SciencesUniversity of Miami Miller School of MedicineMiamiUSA
| | - Maria T. Greig‐Custo
- 1Florida Alzheimer's Disease Research CenterGainesvilleFloridaUSA
- Wien Center for Alzheimer's Disease and Memory DisordersMount Sinai, Medical CenterNew YorkUSA
| | - William Barker
- 1Florida Alzheimer's Disease Research CenterGainesvilleFloridaUSA
- Wien Center for Alzheimer's Disease and Memory DisordersMount Sinai, Medical CenterNew YorkUSA
| | - Ranjan Duara
- 1Florida Alzheimer's Disease Research CenterGainesvilleFloridaUSA
- Wien Center for Alzheimer's Disease and Memory DisordersMount Sinai, Medical CenterNew YorkUSA
| | - David A. Loewenstein
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral SciencesUniversity of Miami Miller School of MedicineMiamiUSA
- 1Florida Alzheimer's Disease Research CenterGainesvilleFloridaUSA
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Katabathula S, Wang Q, Xu R. Predict Alzheimer's disease using hippocampus MRI data: a lightweight 3D deep convolutional network model with visual and global shape representations. Alzheimers Res Ther 2021; 13:104. [PMID: 34030743 PMCID: PMC8147046 DOI: 10.1186/s13195-021-00837-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/27/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is a progressive and irreversible brain disorder. Hippocampus is one of the involved regions and its atrophy is a widely used biomarker for AD diagnosis. We have recently developed DenseCNN, a lightweight 3D deep convolutional network model, for AD classification based on hippocampus magnetic resonance imaging (MRI) segments. In addition to the visual features of the hippocampus segments, the global shape representations of the hippocampus are also important for AD diagnosis. In this study, we propose DenseCNN2, a deep convolutional network model for AD classification by incorporating global shape representations along with hippocampus segmentations. METHODS The data was obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and was T1-weighted structural MRI from initial screening or baseline, including ADNI 1,2/GO and 3. DenseCNN2 was trained and evaluated with 326 AD subjects and 607 CN hippocampus MRI using 5-fold cross-validation strategy. DenseCNN2 was compared with other state-of-the-art machine learning approaches for the task of AD classification. RESULTS We showed that DenseCNN2 with combined visual and global shape features performed better than deep learning models with visual or global shape features alone. DenseCNN2 achieved an average accuracy of 0.925, sensitivity of 0.882, specificity of 0.949, and area under curve (AUC) of 0.978, which are better than or comparable to the state-of-the-art methods in AD classification. Data visualization analysis through 2D embedding of UMAP confirmed that global shape features improved class discrimination between AD and normal. CONCLUSION DenseCNN2, a lightweight 3D deep convolutional network model based on combined hippocampus segmentations and global shape features, achieved high performance and has potential as an efficient diagnostic tool for AD classification.
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Affiliation(s)
- Sreevani Katabathula
- Center for Artificial Intelligence in Drug Discovery, School of Medicine, Case Western Reserve University, 2103 Cornell Rd, Cleveland, OH, 44106, USA
| | - Qinyong Wang
- Center for Artificial Intelligence in Drug Discovery, School of Medicine, Case Western Reserve University, 2103 Cornell Rd, Cleveland, OH, 44106, USA
| | - Rong Xu
- Center for Artificial Intelligence in Drug Discovery, School of Medicine, Case Western Reserve University, 2103 Cornell Rd, Cleveland, OH, 44106, USA.
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Cecchini MA, Yassuda MS, Squarzoni P, Coutinho AM, de Paula Faria D, Duran FLDS, Costa NAD, Porto FHDG, Nitrini R, Forlenza OV, Brucki SMD, Buchpiguel CA, Parra MA, Busatto GF. Deficits in short-term memory binding are detectable in individuals with brain amyloid deposition in the absence of overt neurodegeneration in the Alzheimer's disease continuum. Brain Cogn 2021; 152:105749. [PMID: 34022637 DOI: 10.1016/j.bandc.2021.105749] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/24/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
The short-term memory binding (STMB) test involves the ability to hold in memory the integration between surface features, such as shapes and colours. The STMB test has been used to detect Alzheimer's disease (AD) at different stages, from preclinical to dementia, showing promising results. The objective of the present study was to verify whether the STMB test could differentiate patients with distinct biomarker profiles in the AD continuum. The sample comprised 18 cognitively unimpaired (CU) participants, 30 mild cognitive impairment (MCI) and 23 AD patients. All participants underwent positron emission tomography (PET) with Pittsburgh compound-B labelled with carbon-11 ([11C]PIB) assessing amyloid beta (Aβ) aggregation (A) and 18fluorine-fluorodeoxyglucose ([18F]FDG)-PET assessing neurodegeneration (N) (A-N- [n = 35]); A+N- [n = 11]; A+ N+ [n = 19]). Participants who were negative and positive for amyloid deposition were compared in the absence (A-N- vs. A+N-) of neurodegeneration. When compared with the RAVLT and SKT memory tests, the STMB was the only cognitive task that differentiated these groups, predicting the group outcome in logistic regression analyses. The STMB test showed to be sensitive to the signs of AD pathology and may represent a cognitive marker within the AD continuum.
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Affiliation(s)
- Mario Amore Cecchini
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Mônica Sanches Yassuda
- Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil; Gerontology, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil.
| | - Paula Squarzoni
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Artur Martins Coutinho
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil; Laboratory of Nuclear Medicine (LIM43), Centro de Medicina Nuclear, Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Daniele de Paula Faria
- Laboratory of Neuroscience (LIM 27), Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil; Núcleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), University of São Paulo, São Paulo, Brazil
| | - Fábio Luiz de Souza Duran
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Naomi Antunes da Costa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fábio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ricardo Nitrini
- Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Orestes Vicente Forlenza
- Laboratory of Neuroscience (LIM 27), Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine (LIM43), Centro de Medicina Nuclear, Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Geraldo F Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil; Núcleo de Apoio a Pesquisa em Neurociência Aplicada (NAPNA), University of São Paulo, São Paulo, Brazil
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Rodrigo-Herrero S, Luque-Tirado A, Méndez-Barrio C, García-Solís D, Bernal Sánchez-Arjona M, Oropesa-Ruiz JM, Maillet D, Franco-Macías E. TMA-93 Validation by Alzheimer's Disease Biomarkers: A Comparison with the Free and Cued Selective Reminding Test on a Biobank Sample. J Alzheimers Dis 2021; 82:401-410. [PMID: 34024831 DOI: 10.3233/jad-210115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Memory Associative Test TMA-93 examines visual relational binding, characteristically affected in early-AD stages. OBJECTIVE We aim to validate the TMA-93 by biomarkers determination and compare its diagnostic characteristics with the Free and Cued Selective Reminding Test (FCSRT). METHODS Retrospective analysis of a Biobank database. Patients' records initially consulted for memory complaints, scored MMSE≥22, had TMA-93 and FCSRT tested, and AD biomarker determination (Amyloid-PET or CSF), either positive or negative, were selected. As cutoffs, we considered the 10-percentile for TMA-93 (P10/TMA-93), and "total free recall" (TFR) 21/22, total recall (TR) 43/44, and Cued Index < 0.77 for FCSRT from previous Spanish validation and normative studies. Diagnostic utilities were calculated using ROC curves and compared by the DeLong method. We studied if one test improved the other test's prediction, following a forward stepwise logistic regression model. RESULTS We selected 105 records: 64 "positive" and 41 "negative" biomarkers. TMA-93 total score diagnostic utility (AUC = 0.72; 95%CI:0.62-0.82) was higher than those of the FCSRT: TFR (AUC = 0.70; 95%CI: 0.60-0.80), TR (AUC = 0.63; 95%CI:0.53-0.74), and Cued Index (AUC = 0.62; 95%CI:0.52-0.73). The P10/TMA-93 cutoff showed 86%sensitivity, similar to that of the most sensitive FCSRT cutoff (TFR21/22, 89%) and 29%specificity, lower than that of the most specific FCSRT cutoff (Cued Index < 0.77, 57%). 32.8%of the positive-biomarker group scored above CI/0.77 but below p10TMA-93. The addition of TMA-93 total score to FCSRT variables improved significantly the biomarkers results' prediction. CONCLUSION TMA-93 demonstrated "reasonable" diagnostic utility, similar to FCSRT, for discriminating AD biomarker groups. TMA-93 total score improved the AD biomarker result prediction when added to FCSRT variables.
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Affiliation(s)
| | | | | | - David García-Solís
- Nuclear Medicine Unit, Virgen del Rocio University Hospital, Seville, Spain
| | | | | | - Didier Maillet
- Neurology Service, Saint-Louis Hospital (AP-HP), Paris, France
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Identifying Sensitive Measures of Cognitive Decline at Different Clinical Stages of Alzheimer's Disease. J Int Neuropsychol Soc 2021; 27:426-438. [PMID: 33046162 PMCID: PMC8041916 DOI: 10.1017/s1355617720000934] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Alzheimer's disease (AD) studies are increasingly targeting earlier (pre)clinical populations, in which the expected degree of observable cognitive decline over a certain time interval is reduced as compared to the dementia stage. Consequently, endpoints to capture early cognitive changes require refinement. We aimed to determine the sensitivity to decline of widely applied neuropsychological tests at different clinical stages of AD as outlined in the National Institute on Aging - Alzheimer's Association (NIA-AA) research framework. METHOD Amyloid-positive individuals (as determined by positron emission tomography or cerebrospinal fluid) with longitudinal neuropsychological assessments available were included from four well-defined study cohorts and subsequently classified among the NIA-AA stages. For each stage, we investigated the sensitivity to decline of 17 individual neuropsychological tests using linear mixed models. RESULTS 1103 participants (age = 70.54 ± 8.7, 47% female) were included: n = 120 Stage 1, n = 206 Stage 2, n = 467 Stage 3 and n = 309 Stage 4. Neuropsychological tests were differentially sensitive to decline across stages. For example, Category Fluency captured significant 1-year decline as early as Stage 1 (β = -.58, p < .001). Word List Delayed Recall (β = -.22, p < .05) and Trail Making Test (β = 6.2, p < .05) became sensitive to 1-year decline in Stage 2, whereas the Mini-Mental State Examination did not capture 1-year decline until Stage 3 (β = -1.13, p < .001) and 4 (β = -2.23, p < .001). CONCLUSIONS We demonstrated that commonly used neuropsychological tests differ in their ability to capture decline depending on clinical stage within the AD continuum (preclinical to dementia). This implies that stage-specific cognitive endpoints are needed to accurately assess disease progression and increase the chance of successful treatment evaluation in AD.
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Gellersen HM, Coughlan G, Hornberger M, Simons JS. Memory precision of object-location binding is unimpaired in APOE ε4-carriers with spatial navigation deficits. Brain Commun 2021; 3:fcab087. [PMID: 33987536 PMCID: PMC8108563 DOI: 10.1093/braincomms/fcab087] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/09/2021] [Accepted: 03/29/2021] [Indexed: 12/19/2022] Open
Abstract
Research suggests that tests of memory fidelity, feature binding and spatial navigation are promising for early detection of subtle behavioural changes related to Alzheimer's disease. In the absence of longitudinal data, one way of testing the early detection potential of cognitive tasks is through the comparison of individuals at different genetic risk for Alzheimer's dementia. Most studies have done so using samples aged 70 years or older. Here, we tested whether memory fidelity of long-term object-location binding may be a sensitive marker even among cognitively healthy individuals in their mid-60s by comparing participants at low and higher risk based on presence of the ε4-allele of the apolipoprotein gene (n = 26 ε3ε3, n = 20 ε3ε4 carriers). We used a continuous report paradigm in a visual memory task that required participants to recreate the spatial position of objects in a scene. We employed mixture modelling to estimate the two distinct memory processes that underpin the trial-by-trial variation in localization errors: retrieval success which indexes the proportion of trials where participants recalled any information about an object's position and the precision with which participants retrieved this information. Prior work has shown that these memory paradigms that separate retrieval success from precision are capable of detecting subtle differences in mnemonic fidelity even when retrieval success could not. Nonetheless, Bayesian analyses found good evidence that ε3ε4 carriers did not remember fewer object locations [F(1, 42) = 0.450, P = 0.506, BF01 = 3.02], nor was their precision for the spatial position of objects reduced compared to ε3ε3 carriers [F(1, 42) = 0.12, P = 0.726, BF01 = 3.19]. Because the participants in the sample presented here were a subset of a study on apolipoprotein ε4-carrier status and spatial navigation in the Sea Hero Quest game [Coughlan et al., 2019. PNAS, 116(9)], we obtained these data to contrast genetic effects on the two tasks within the same sample (n = 33). Despite the smaller sample size, wayfinding deficits among ε3ε4 carriers could be replicated [F(1, 33) = 5.60, P = 0.024, BF10 = 3.44]. Object-location memory metrics and spatial navigation scores were not correlated (all r < 0.25, P > 0.1, 0 < BF10 < 3). These findings show spared object-location binding in the presence of a detrimental apolipoprotein ε4 effect on spatial navigation. This suggests that the sensitivity of memory fidelity and binding tasks may not extend to individuals with one ε4-allele in their early to mid-60s. The results provide further support to prior proposals that spatial navigation may be a sensitive marker for the earliest cognitive changes in Alzheimer's disease, even before episodic memory.
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Affiliation(s)
- Helena M Gellersen
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
| | - Gillian Coughlan
- Rotman Research Institute, Baycrest Hospital, Toronto, ON M6A 1W1, Canada
| | | | - Jon S Simons
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
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Kozlova I, Parra MA, Titova N, Gantman M, Sala SD. Alzheimer's Disease and Parkinson Dementia Distinguished by Cognitive Marker. Arch Clin Neuropsychol 2021; 36:307-315. [PMID: 32101280 DOI: 10.1093/arclin/acz082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Temporary memory binding (TMB) has been shown to be specifically affected by Alzheimer's disease (AD) when it is assessed via free recall and titrating the task demands to equate baseline performance across patients. METHODS Patients with Parkinson's disease (PD) were subdivided into patients with and without cognitive impairment and compared with AD and amnestic mild cognitive impairment (aMCI) patients on their performance on the TMB. RESULTS The results show that only patients with AD dementia present with impaired TMB performance. Receiver operating characteristic curve analyses showed that TMB holds high sensitivity and specificity for aMCI and AD relative to PD groups and healthy controls. CONCLUSION The TMB is sensitive to the neurodegenerative mechanisms leading to AD dementia but not to those underpinning PD dementia. As such, TMB task can aid the differential diagnosis of these common forms of dementia.
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Affiliation(s)
- Irina Kozlova
- Human Cognitive Neuroscience, Psychology Department, University of Edinburgh, UK
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK
- Alzheimer's Scotland Dementia Research Centre, Edinburgh University, UK
- Autonomous University of the Caribbean, Barranquilla, Colombia
| | - Nataliya Titova
- Neurology and Neurosurgery Department, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Maria Gantman
- Department of Alzheimer's Diseases and Related Disorders, Mental Health Research Centre, Moscow, Russia
| | - Sergio Della Sala
- Human Cognitive Neuroscience, Psychology Department, University of Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK
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Can discourse processing performance serve as an early marker of Alzheimer’s disease and mild cognitive impairment? A systematic review of text comprehension. Eur J Ageing 2021; 19:3-18. [PMID: 35241996 PMCID: PMC8881530 DOI: 10.1007/s10433-021-00619-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
A number of linguistic and cognitive deficits have been reported during the course of Alzheimer’s disease (AD) and its preceding stage of mild cognitive impairment (MCI), with some deficits appearing years before onset of clinical symptoms. It continues to be a critical task to identify tools that may serve as an early marker of pathology that are also reliably able to distinguish AD from normal ageing. Given the limited success of classic psychometric cognitive testing, a novel approach in assessment is warranted. A potentially sensitive assessment paradigm is discourse processing. The aim of this review was to synthesize original research studies investigating comprehension of discourse in AD and MCI, and to evaluate the potential of this paradigm as a promising avenue for further research. A literature search targeting studies with AD or MCI groups over 60 years of age was conducted in PubMed, Web of Science, and PsycINFO databases. Eight articles with good quality were included in the review. Six measures of discourse comprehension—naming latency, summary, lesson, main idea, proportion of inferential clauses, true/false questions—were identified. All eight studies reported significant deficits in discourse comprehension in AD and MCI groups on five of the six measures, when compared to cognitively healthy older adults. Mixed results were observed for associations with commonly used cognitive measures. Given the consistent findings for discourse comprehension measures across all studies, we strongly recommend further research on its early predictive potential, and discuss different avenues for research.
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Gellersen HM, Trelle AN, Henson RN, Simons JS. Executive function and high ambiguity perceptual discrimination contribute to individual differences in mnemonic discrimination in older adults. Cognition 2021; 209:104556. [PMID: 33450438 PMCID: PMC8223497 DOI: 10.1016/j.cognition.2020.104556] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 12/03/2022]
Abstract
Mnemonic discrimination deficits, or impaired ability to discriminate between similar events in memory, is a hallmark of cognitive aging, characterised by a stark age-related increase in false recognition. While individual differences in mnemonic discrimination have gained attention due to potential relevance for early detection of Alzheimer's disease, our understanding of the component processes that contribute to variability in task performance across older adults remains limited. The present investigation explores the roles of representational quality, indexed by perceptual discrimination of objects and scenes with overlapping features, and strategic retrieval ability, indexed by standardised tests of executive function, to mnemonic discrimination in a large cohort of older adults (N=124). We took an individual differences approach and characterised the contributions of these factors to performance under Forced Choice (FC) and Yes/No (YN) recognition memory formats, which place different demands on strategic retrieval. Performance in both test formats declined with age. Accounting for age, individual differences in FC memory performance were best explained by perceptual discrimination score, whereas YN memory performance was best explained by executive functions. A linear mixed model and dominance analyses confirmed the relatively greater importance of perceptual discrimination over executive functioning for FC performance, while the opposite was true for YN. These findings highlight parallels between perceptual and mnemonic discrimination in aging, the importance of considering demands on executive functions in the context of mnemonic discrimination, and the relevance of test format for modulating the impact of these factors on performance in older adults.
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Affiliation(s)
| | - Alexandra N Trelle
- Department of Psychology, University of Cambridge, Cambridge, UK; Department of Psychology, Stanford University, Palo Alto, USA
| | - Richard N Henson
- MRC Cognition and Brain Sciences Unit, and Department of Psychiatry, University of Cambridge, UK
| | - Jon S Simons
- Department of Psychology, University of Cambridge, Cambridge, UK.
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Rentz DM, Papp KV, Mayblyum DV, Sanchez JS, Klein H, Souillard-Mandar W, Sperling RA, Johnson KA. Association of Digital Clock Drawing With PET Amyloid and Tau Pathology in Normal Older Adults. Neurology 2021; 96:e1844-e1854. [PMID: 33589537 DOI: 10.1212/wnl.0000000000011697] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 12/30/2020] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To determine whether a digital clock-drawing test, DCTclock, improves upon standard cognitive assessments for discriminating diagnostic groups and for detecting biomarker evidence of amyloid and tau pathology in clinically normal older adults (CN). METHODS Participants from the Harvard Aging Brain Study and the PET laboratory at Massachusetts General Hospital were recruited to undergo the DCTclock, standard neuropsychological assessments including the Preclinical Alzheimer Cognitive Composite (PACC), and amyloid/tau PET imaging. Receiver operating curve analyses were used to assess diagnostic and biomarker discriminability. Logistic regression and partial correlations were used to assess DCTclock performance in relation to PACC and PET biomarkers. RESULTS A total of 300 participants were studied. Among the 264 CN participants, 143 had amyloid and tau PET imaging (Clinical Dementia Rating [CDR] 0, Mini-Mental State Examination [MMSE] 28.9 ± 1.2). An additional 36 participants with a diagnosis of mild cognitive impairment or early Alzheimer dementia (CDR 0.5, MMSE 25.2 ± 3.9) were added to assess diagnostic discriminability. DCTclock showed excellent discrimination between diagnostic groups (area under the receiver operating characteristic curve 0.86). Among CN participants with biomarkers, the DCTclock summary score and spatial reasoning subscores were associated with greater amyloid and tau burden and showed better discrimination (Cohen d = 0.76) between Aβ± groups than the PACC (d = 0.30). CONCLUSION DCTclock discriminates between diagnostic groups and improves upon traditional cognitive tests for detecting biomarkers of amyloid and tau pathology in CN older adults. The validation of such digitized measures has the potential of providing an efficient tool for detecting early cognitive changes along the AD trajectory. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that DCTclock results were associated with amyloid and tau burden in CN older adults.
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Affiliation(s)
- Dorene M Rentz
- From the Department of Neurology (D.M.R., K.V.P., D.V.M., J.S.S., H.K., R.A.S., K.A.J.) and Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (K.A.J.), Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment, Department of Neurology (D.M.R., K.V.P., R.A.S., K.A.J.), Brigham and Women's Hospital, Harvard Medical School, Boston; Digital Cognition Technologies (W.S.-M.); and Linus Health Inc (W.S.-M.), Waltham, MA.
| | - Kathryn V Papp
- From the Department of Neurology (D.M.R., K.V.P., D.V.M., J.S.S., H.K., R.A.S., K.A.J.) and Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (K.A.J.), Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment, Department of Neurology (D.M.R., K.V.P., R.A.S., K.A.J.), Brigham and Women's Hospital, Harvard Medical School, Boston; Digital Cognition Technologies (W.S.-M.); and Linus Health Inc (W.S.-M.), Waltham, MA
| | - Danielle V Mayblyum
- From the Department of Neurology (D.M.R., K.V.P., D.V.M., J.S.S., H.K., R.A.S., K.A.J.) and Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (K.A.J.), Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment, Department of Neurology (D.M.R., K.V.P., R.A.S., K.A.J.), Brigham and Women's Hospital, Harvard Medical School, Boston; Digital Cognition Technologies (W.S.-M.); and Linus Health Inc (W.S.-M.), Waltham, MA
| | - Justin S Sanchez
- From the Department of Neurology (D.M.R., K.V.P., D.V.M., J.S.S., H.K., R.A.S., K.A.J.) and Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (K.A.J.), Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment, Department of Neurology (D.M.R., K.V.P., R.A.S., K.A.J.), Brigham and Women's Hospital, Harvard Medical School, Boston; Digital Cognition Technologies (W.S.-M.); and Linus Health Inc (W.S.-M.), Waltham, MA
| | - Hannah Klein
- From the Department of Neurology (D.M.R., K.V.P., D.V.M., J.S.S., H.K., R.A.S., K.A.J.) and Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (K.A.J.), Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment, Department of Neurology (D.M.R., K.V.P., R.A.S., K.A.J.), Brigham and Women's Hospital, Harvard Medical School, Boston; Digital Cognition Technologies (W.S.-M.); and Linus Health Inc (W.S.-M.), Waltham, MA
| | - William Souillard-Mandar
- From the Department of Neurology (D.M.R., K.V.P., D.V.M., J.S.S., H.K., R.A.S., K.A.J.) and Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (K.A.J.), Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment, Department of Neurology (D.M.R., K.V.P., R.A.S., K.A.J.), Brigham and Women's Hospital, Harvard Medical School, Boston; Digital Cognition Technologies (W.S.-M.); and Linus Health Inc (W.S.-M.), Waltham, MA
| | - Reisa A Sperling
- From the Department of Neurology (D.M.R., K.V.P., D.V.M., J.S.S., H.K., R.A.S., K.A.J.) and Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (K.A.J.), Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment, Department of Neurology (D.M.R., K.V.P., R.A.S., K.A.J.), Brigham and Women's Hospital, Harvard Medical School, Boston; Digital Cognition Technologies (W.S.-M.); and Linus Health Inc (W.S.-M.), Waltham, MA
| | - Keith A Johnson
- From the Department of Neurology (D.M.R., K.V.P., D.V.M., J.S.S., H.K., R.A.S., K.A.J.) and Division of Nuclear Medicine and Molecular Imaging, Department of Radiology (K.A.J.), Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment, Department of Neurology (D.M.R., K.V.P., R.A.S., K.A.J.), Brigham and Women's Hospital, Harvard Medical School, Boston; Digital Cognition Technologies (W.S.-M.); and Linus Health Inc (W.S.-M.), Waltham, MA
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Tsoy E, Strom A, Iaccarino L, Erlhoff SJ, Goode CA, Rodriguez AM, Rabinovici GD, Miller BL, Kramer JH, Rankin KP, La Joie R, Possin KL. Detecting Alzheimer's disease biomarkers with a brief tablet-based cognitive battery: sensitivity to Aβ and tau PET. ALZHEIMERS RESEARCH & THERAPY 2021; 13:36. [PMID: 33557905 PMCID: PMC7871372 DOI: 10.1186/s13195-021-00776-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/25/2021] [Indexed: 11/29/2022]
Abstract
Background β-amyloid (Aβ) and tau positron emission tomography (PET) detect the pathological changes that define Alzheimer’s disease (AD) in living people. Cognitive measures sensitive to Aβ and tau burden may help streamline identification of cases for confirmatory AD biomarker testing. Methods We examined the association of Brain Health Assessment (BHA) tablet-based cognitive measures with dichotomized Aβ -PET status using logistic regression models in individuals with mild cognitive impairment (MCI) or dementia (N = 140; 43 Aβ-, 97 Aβ+). We also investigated the relationship between the BHA tests and regional patterns of tau-PET signal using voxel-wise regression analyses in a subsample of 60 Aβ+ individuals with MCI or dementia. Results Favorites (associative memory), Match (executive functions and speed), and Everyday Cognition Scale scores were significantly associated with Aβ positivity (area under the curve [AUC] = 0.75 [95% CI 0.66–0.85]). We found significant associations with tau-PET signal in mesial temporal regions for Favorites, frontoparietal regions for Match, and occipitoparietal regions for Line Orientation (visuospatial skills) in a subsample of individuals with MCI and dementia. Conclusion The BHA measures are significantly associated with both Aβ and regional tau in vivo imaging markers and could be used for the identification of patients with suspected AD pathology in clinical practice. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00776-w.
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Affiliation(s)
- Elena Tsoy
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Amelia Strom
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Leonardo Iaccarino
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Sabrina J Erlhoff
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Collette A Goode
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Anne-Marie Rodriguez
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA.,Department of Radiology and Biomedical Imaging, University of California San Francisco, 1500 Owens Street, 2nd Fl, San Francisco, CA, 94158, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA.,Global Brain Health Institute, University of California San Francisco, 675 Nelson Rising Lane, San Francisco, CA, 94158, USA
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA.,Global Brain Health Institute, University of California San Francisco, 675 Nelson Rising Lane, San Francisco, CA, 94158, USA
| | - Katherine P Rankin
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Renaud La Joie
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Katherine L Possin
- Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA. .,Global Brain Health Institute, University of California San Francisco, 675 Nelson Rising Lane, San Francisco, CA, 94158, USA.
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50
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Trelle AN, Carr VA, Wilson EN, Swarovski MS, Hunt MP, Toueg TN, Tran TT, Channappa D, Corso NK, Thieu MK, Jayakumar M, Nadiadwala A, Guo W, Tanner NJ, Bernstein JD, Litovsky CP, Guerin SA, Khazenzon AM, Harrison MB, Rutt BK, Deutsch GK, Chin FT, Davidzon GA, Hall JN, Sha SJ, Fredericks CA, Andreasson KI, Kerchner GA, Wagner AD, Mormino EC. Association of CSF Biomarkers With Hippocampal-Dependent Memory in Preclinical Alzheimer Disease. Neurology 2021; 96:e1470-e1481. [PMID: 33408146 DOI: 10.1212/wnl.0000000000011477] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/02/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To determine whether memory tasks with demonstrated sensitivity to hippocampal function can detect variance related to preclinical Alzheimer disease (AD) biomarkers, we examined associations between performance in 3 memory tasks and CSF β-amyloid (Aβ)42/Aβ40 and phosopho-tau181 (p-tau181) in cognitively unimpaired older adults (CU). METHODS CU enrolled in the Stanford Aging and Memory Study (n = 153; age 68.78 ± 5.81 years; 94 female) completed a lumbar puncture and memory assessments. CSF Aβ42, Aβ40, and p-tau181 were measured with the automated Lumipulse G system in a single-batch analysis. Episodic memory was assayed using a standardized delayed recall composite, paired associate (word-picture) cued recall, and a mnemonic discrimination task that involves discrimination between studied "target" objects, novel "foil" objects, and perceptually similar "lure" objects. Analyses examined cross-sectional relationships among memory performance, age, and CSF measures, controlling for sex and education. RESULTS Age and lower Aβ42/Aβ40 were independently associated with elevated p-tau181. Age, Aβ42/Aβ40, and p-tau181 were each associated with (1) poorer associative memory and (2) diminished improvement in mnemonic discrimination performance across levels of decreased task difficulty (i.e., target-lure similarity). P-tau mediated the effect of Aβ42/Aβ40 on memory. Relationships between CSF proteins and delayed recall were similar but nonsignificant. CSF Aβ42 was not significantly associated with p-tau181 or memory. CONCLUSIONS Tests designed to tax hippocampal function are sensitive to subtle individual differences in memory among CU and correlate with early AD-associated biomarker changes in CSF. These tests may offer utility for identifying CU with preclinical AD pathology.
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Affiliation(s)
- Alexandra N Trelle
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA.
| | - Valerie A Carr
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Edward N Wilson
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Michelle S Swarovski
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Madison P Hunt
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Tyler N Toueg
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Tammy T Tran
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Divya Channappa
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Nicole K Corso
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Monica K Thieu
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Manasi Jayakumar
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Ayesha Nadiadwala
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Wanjia Guo
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Natalie J Tanner
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Jeffrey D Bernstein
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Celia P Litovsky
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Scott A Guerin
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Anna M Khazenzon
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Marc B Harrison
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Brian K Rutt
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Gayle K Deutsch
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Frederick T Chin
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Guido A Davidzon
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Jacob N Hall
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Sharon J Sha
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Carolyn A Fredericks
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Katrin I Andreasson
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Geoffrey A Kerchner
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Anthony D Wagner
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
| | - Elizabeth C Mormino
- From the Department of Psychology (A.N.T., V.A.C., M.P.H., T.T.T., M.K.T., M.J., W.G., N.J.T., J.D.B., C.P.L., S.A.G., A.M.K., M.B.H., A.D.W.), Stanford University; and Department of Neurology and Neurological Sciences (E.N.W., M.S.S., T.N.T., D.C., N.K.C., A.N., G.K.D., J.N.H., S.J.S., C.A.F., K.I.A., G.A.K., E.C.M.) and Division of Nuclear Medicine & Molecular Imaging Division, Department of Radiology (B.K.R., F.T.C., G.A.D.), Stanford Medical School, CA
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