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Anshu K, Kristensen K, Godar SP, Zhou X, Hartley SL, Litovsky RY. Speech Recognition and Spatial Hearing in Young Adults With Down Syndrome: Relationships With Hearing Thresholds and Auditory Working Memory. Ear Hear 2024:00003446-990000000-00324. [PMID: 39090791 DOI: 10.1097/aud.0000000000001549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
OBJECTIVES Individuals with Down syndrome (DS) have a higher incidence of hearing loss (HL) compared with their peers without developmental disabilities. Little is known about the associations between HL and functional hearing for individuals with DS. This study investigated two aspects of auditory functions, "what" (understanding the content of sound) and "where" (localizing the source of sound), in young adults with DS. Speech reception thresholds in quiet and in the presence of interferers provided insight into speech recognition, that is, the "what" aspect of auditory maturation. Insights into "where" aspect of auditory maturation were gained from evaluating speech reception thresholds in colocated versus separated conditions (quantifying spatial release from masking) as well as right versus left discrimination and sound location identification. Auditory functions in the "where" domain develop during earlier stages of cognitive development in contrast with the later developing "what" functions. We hypothesized that young adults with DS would exhibit stronger "where" than "what" auditory functioning, albeit with the potential impact of HL. Considering the importance of auditory working memory and receptive vocabulary for speech recognition, we hypothesized that better speech recognition in young adults with DS, in quiet and with speech interferers, would be associated with better auditory working memory ability and receptive vocabulary. DESIGN Nineteen young adults with DS (aged 19 to 24 years) participated in the study and completed assessments on pure-tone audiometry, right versus left discrimination, sound location identification, and speech recognition in quiet and with speech interferers that were colocated or spatially separated. Results were compared with published data from children and adults without DS and HL, tested using similar protocols and stimuli. Digit Span tests assessed auditory working memory. Receptive vocabulary was examined using the Peabody Picture Vocabulary Test Fifth Edition. RESULTS Seven participants (37%) had HL in at least 1 ear; 4 individuals had mild HL, and 3 had moderate HL or worse. Participants with mild or no HL had ≥75% correct at 5° separation on the discrimination task and sound localization root mean square errors (mean ± SD: 8.73° ± 2.63°) within the range of adults in the comparison group. Speech reception thresholds in young adults with DS were higher than all comparison groups. However, spatial release from masking did not differ between young adults with DS and comparison groups. Better (lower) speech reception thresholds were associated with better hearing and better auditory working memory ability. Receptive vocabulary did not predict speech recognition. CONCLUSIONS In the absence of HL, young adults with DS exhibited higher accuracy during spatial hearing tasks as compared with speech recognition tasks. Thus, auditory processes associated with the "where" pathways appear to be a relative strength than those associated with "what" pathways in young adults with DS. Further, both HL and auditory working memory impairments contributed to difficulties in speech recognition in the presence of speech interferers. Future larger-sized samples are needed to replicate and extend our findings.
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Affiliation(s)
- Kumari Anshu
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kayla Kristensen
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Shelly P Godar
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Xin Zhou
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Sigan L Hartley
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Human Development & Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ruth Y Litovsky
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Larsen FK, Baksh RA, McGlinchey E, Langballe EM, Benejam B, Beresford‐Webb J, McCarron M, Coppus A, Falquero S, Fortea J, Levin J, Loosli SV, Mark R, Rebillat A, Zaman S, Strydom A. Age of Alzheimer's disease diagnosis in people with Down syndrome and associated factors: Results from the Horizon 21 European Down syndrome consortium. Alzheimers Dement 2024; 20:3270-3280. [PMID: 38506627 PMCID: PMC11095427 DOI: 10.1002/alz.13779] [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: 11/24/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION People with Down syndrome (DS) have high risk of developing Alzheimer's disease (AD). This study examined mean ages of AD diagnosis and associations with co-occurring conditions among adults with DS from five European countries. METHODS Data from 1335 people with DS from the Horizon 21 European DS Consortium were used for the analysis. RESULTS Mean ages of AD diagnosis ranged between 51.4 (SD 7.0) years (United Kingdom) and 55.6 (SD 6.8) years (France). Sleep-related and mental health problems were associated with earlier age of AD diagnosis. The higher number of co-occurring conditions the more likely the person with DS is diagnosed with AD at an earlier age. DISCUSSION Mean age of AD diagnosis in DS was relatively consistent across countries. However, co-occurring conditions varied and impacted on age of diagnosis, suggesting that improvements can be made in diagnosing and managing these conditions to delay onset of AD in DS. HIGHLIGHTS Mean age of AD diagnosis was relatively consistent between countries Sleep problems and mental health problems were associated with earlier age of AD diagnosis APOE ε4 carriers were diagnosed with AD at an earlier age compared to non-carriers Number of co-occurring conditions was associated with earlier age of AD diagnosis No differences between level of intellectual disability and mean age of AD diagnosis.
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Affiliation(s)
- Frode Kibsgaard Larsen
- The Norwegian National Centre for Ageing and HealthVestfold Hospital TrustTønsbergNorway
- Institute of Clinical MedicineFaculty of MedicineUniversity of OsloOsloNorway
| | - R. Asaad Baksh
- Institute of PsychiatryPsychology, and NeuroscienceDepartment of Forensic and Neurodevelopmental Sciences, King's College LondonLondonUK
- The London Down Syndrome (LonDownS) ConsortiumLondonUK
| | - Eimear McGlinchey
- Trinity Centre for Ageing and Intellectual DisabilityTrinity College Dublin, Lincoln GateDublinIreland
- Global Brain Health InstituteTrinity College Dublin & University of CaliforniaSan FranciscoCaliforniaUSA
| | - Ellen Melbye Langballe
- The Norwegian National Centre for Ageing and HealthVestfold Hospital TrustTønsbergNorway
- Department of Geriatric MedicineOslo University HospitalOsloNorway
| | - Bessy Benejam
- Barcelona Down Medical CenterFundació Catalana Síndrome de DownBarcelonaSpain
| | - Jessica Beresford‐Webb
- Department of PsychiatryUniversity of CambridgeThe Old SchoolsCambridgeUK
- Cambridgeshire & Peterborough NHS Foundation TrustFulbourn HospitalCambridgeUK
| | - Mary McCarron
- Trinity Centre for Ageing and Intellectual DisabilityTrinity College Dublin, Lincoln GateDublinIreland
| | - Antonia Coppus
- Department of Primary and Community CareRadboud University Medical CenterNijmegenThe Netherlands
| | | | - Juan Fortea
- Barcelona Down Medical CenterFundació Catalana Síndrome de DownBarcelonaSpain
- Sant Pau Memory UnitDepartment of NeurologyHospital of Sant Pau, Sant Pau Research InstituteBarcelonaSpain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED)Monforte de LemosMadridSpain
| | - Johannes Levin
- Department of NeurologyLudwig‐Maximilians‐Universität MünchenMunichGermany
- German Center for Neurodegenerative DiseasesMunichGermany
- Munich Cluster for Systems Neurology (SyNergy)MunichGermany
| | - Sandra V. Loosli
- Department of NeurologyLudwig‐Maximilians‐Universität MünchenMunichGermany
- Department of NeurologyUniversity Hospital ZurichZurichSwitzerland
| | - Ruth Mark
- Cognitive NeuropsychologyTilburg UniversityTilburgThe Netherlands
| | | | - Shahid Zaman
- Department of PsychiatryUniversity of CambridgeThe Old SchoolsCambridgeUK
- Cambridgeshire & Peterborough NHS Foundation TrustFulbourn HospitalCambridgeUK
| | - Andre Strydom
- Institute of PsychiatryPsychology, and NeuroscienceDepartment of Forensic and Neurodevelopmental Sciences, King's College LondonLondonUK
- The London Down Syndrome (LonDownS) ConsortiumLondonUK
- South London and the Maudsley NHS Foundation TrustLondonUK
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Schworer EK, Handen BL, Petersen M, O'Bryant S, Peven JC, Tudorascu DL, Lee L, Krinsky‐McHale SJ, Hom CL, Clare ICH, Christian BT, Schupf N, Lee JH, Head E, Mapstone M, Lott I, Ances BM, Zaman S, Brickman AM, Lai F, Rosas HD, Hartley SL. Cognitive and functional performance and plasma biomarkers of early Alzheimer's disease in Down syndrome. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12582. [PMID: 38623384 PMCID: PMC11016818 DOI: 10.1002/dad2.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION People with Down syndrome (DS) have a 75% to 90% lifetime risk of Alzheimer's disease (AD). AD pathology begins a decade or more prior to onset of clinical AD dementia in people with DS. It is not clear if plasma biomarkers of AD pathology are correlated with early cognitive and functional impairments in DS, and if these biomarkers could be used to track the early stages of AD in DS or to inform inclusion criteria for clinical AD treatment trials. METHODS This large cross-sectional cohort study investigated the associations between plasma biomarkers of amyloid beta (Aβ)42/40, total tau, and neurofilament light chain (NfL) and cognitive (episodic memory, visual-motor integration, and visuospatial abilities) and functional (adaptive behavior) impairments in 260 adults with DS without dementia (aged 25-81 years). RESULTS In general linear models lower plasma Aβ42/40 was related to lower visuospatial ability, higher total tau was related to lower episodic memory, and higher NfL was related to lower visuospatial ability and lower episodic memory. DISCUSSION Plasma biomarkers may have utility in tracking AD pathology associated with early stages of cognitive decline in adults with DS, although associations were modest. Highlights Plasma Alzheimer's disease (AD) biomarkers correlate with cognition prior to dementia in Down syndrome.Lower plasma amyloid beta 42/40 was related to lower visuospatial abilities.Higher plasma total tau and neurofilament light chain were associated with lower cognitive performance.Plasma biomarkers show potential for tracking early stages of AD symptomology.
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Affiliation(s)
| | - Benjamin L. Handen
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Melissa Petersen
- Department of Family Medicine and Institute for Translational ResearchUniversity of North Texas Health Science CenterFort WorthTexasUSA
| | - Sid O'Bryant
- Department of Family Medicine and Institute for Translational ResearchUniversity of North Texas Health Science CenterFort WorthTexasUSA
| | - Jamie C. Peven
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Dana L. Tudorascu
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Laisze Lee
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Sharon J. Krinsky‐McHale
- New York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Christy L. Hom
- Department of Psychiatry and Human BehaviorUniversity of CaliforniaIrvineCaliforniaUSA
| | | | | | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainSergievsky Centerand Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Joseph H. Lee
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainSergievsky Centerand Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Elizabeth Head
- Department of Pathology & Laboratory MedicineUniversity of CaliforniaIrvine School of MedicineIrvineCaliforniaUSA
| | - Mark Mapstone
- Department of NeurologyUniversity of CaliforniaIrvine School of MedicineIrvineCaliforniaUSA
| | - Ira Lott
- Department of NeurologyUniversity of CaliforniaIrvine School of MedicineIrvineCaliforniaUSA
| | - Beau M. Ances
- Department of NeurologyWashington University at St. LouisSt. LouisMissouriUSA
| | - Shahid Zaman
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainSergievsky Centerand Department of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Florence Lai
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - H. Diana Rosas
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Center for Neuro‐imaging of Aging and Neurodegenerative DiseasesMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Sigan L. Hartley
- Waisman CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- School of Human EcologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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Aldecoa I, Barroeta I, Carroll SL, Fortea J, Gilmore A, Ginsberg SD, Guzman SJ, Hamlett ED, Head E, Perez SE, Potter H, Molina‐Porcel L, Raha‐Chowdhury R, Wisniewski T, Yong WH, Zaman S, Ghosh S, Mufson EJ, Granholm A. Down Syndrome Biobank Consortium: A perspective. Alzheimers Dement 2024; 20:2262-2272. [PMID: 38270275 PMCID: PMC10984425 DOI: 10.1002/alz.13692] [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: 11/02/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 01/26/2024]
Abstract
Individuals with Down syndrome (DS) have a partial or complete trisomy of chromosome 21, resulting in an increased risk for early-onset Alzheimer's disease (AD)-type dementia by early midlife. Despite ongoing clinical trials to treat late-onset AD, individuals with DS are often excluded. Furthermore, timely diagnosis or management is often not available. Of the genetic causes of AD, people with DS represent the largest cohort. Currently, there is a knowledge gap regarding the underlying neurobiological mechanisms of DS-related AD (DS-AD), partly due to limited access to well-characterized brain tissue and biomaterials for research. To address this challenge, we created an international consortium of brain banks focused on collecting and disseminating brain tissue from persons with DS throughout their lifespan, named the Down Syndrome Biobank Consortium (DSBC) consisting of 11 biobanking sites located in Europe, India, and the USA. This perspective describes the DSBC harmonized protocols and tissue dissemination goals.
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Affiliation(s)
- Iban Aldecoa
- Pathology DepartmentHospital Clinic de Barcelona‐University of BarcelonaBarcelonaSpain
- Neurological Tissue Bank of the BiobankHospital Clinic de Barcelona‐FCRB/IDIBAPSBarcelonaSpain
| | - Isabel Barroeta
- Neurology DepartmentHospital de la Santa Creu i Sant Pau, NeurologyBarcelonaSpain
| | - Steven L. Carroll
- Department of Pathology & Laboratory MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Juan Fortea
- Neurology DepartmentHospital de la Santa Creu i Sant Pau, NeurologyBarcelonaSpain
| | - Anah Gilmore
- University of Colorado Denver Anschutz Medical Campus, NeurosurgeryAuroraColoradoUSA
| | - Stephen D. Ginsberg
- Center for Dementia Research, Nathan Kline InstituteOrangeburgNew YorkUSA
- Departments of PsychiatryNeuroscience & Physiology, and the NYU Neuroscience Institute, New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Samuel J. Guzman
- Department of PathologyUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Eric D. Hamlett
- Department of Pathology & Laboratory MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Elizabeth Head
- Department of Pathology and Laboratory MedicineUniversity of California Irvine, UCI School of Medicine D440 Medical Sciences IIrvineCaliforniaUSA
| | - Sylvia E. Perez
- Barrow Neurological InstituteTranslational Neurosciences and NeurologyPhoenixArizonaUSA
| | - Huntington Potter
- University of Colorado Denver Anschutz Medical Campus, NeurologyAuroraColoradoUSA
| | - Laura Molina‐Porcel
- Pathology DepartmentHospital Clinic de Barcelona‐University of BarcelonaBarcelonaSpain
- Alzheimer's Disease and Other Cognitive Disorders UnitNeurology Service, Hospital Clínic, IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Ruma Raha‐Chowdhury
- Department of PsychiatryCambridge Intellectual & Developmental Disabilities Research GroupUniversity of CambridgeCambridgeUK
| | - Thomas Wisniewski
- Center for Cognitive Neurology, Departments of Neurology, Pathology and PsychiatryNew York University Grossman School of MedicineNew YorkNew YorkUSA
| | - William H. Yong
- Department of Pathology and Laboratory MedicineUniversity of California Irvine, UCI School of Medicine D440 Medical Sciences IIrvineCaliforniaUSA
| | - Shahid Zaman
- Department of PsychiatryCambridge Intellectual & Developmental Disabilities Research GroupUniversity of CambridgeCambridgeUK
| | - Sujay Ghosh
- Department of ZoologyCytogenetics and Genomics Research UnitKolkataIndia
| | - Elliott J. Mufson
- Barrow Neurological InstituteTranslational Neurosciences and NeurologyPhoenixArizonaUSA
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DiFilippo A, Jonaitis E, Makuch R, Gambetti B, Fleming V, Ennis G, Barnhart T, Engle J, Bendlin B, Johnson S, Handen B, Krinsky-McHale S, Hartley S, Christian B. Measurement of synaptic density in Down syndrome using PET imaging: a pilot study. Sci Rep 2024; 14:4676. [PMID: 38409349 PMCID: PMC10897336 DOI: 10.1038/s41598-024-54669-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/15/2024] [Indexed: 02/28/2024] Open
Abstract
Down syndrome (DS) is the most prevalent genetic cause of intellectual disability, resulting from trisomy 21. Recently, positron emission tomography (PET) imaging has been used to image synapses in vivo. The motivation for this pilot study was to investigate whether synaptic density in low functioning adults with DS can be evaluated using the PET radiotracer [11C]UCB-J. Data were acquired from low functioning adults with DS (n = 4) and older neurotypical (NT) adults (n = 37). Motion during the scans required the use of a 10-minute acquisition window for the calculation of synaptic density using SUVR50-60,CS which was determined to be a suitable approximation for specific binding in this analysis using dynamic data from the NT group. Of the regions analyzed a large effect was observed when comparing DS and NT hippocampus and cerebral cortex synaptic density as well as hippocampus and cerebellum volumes. In this pilot study, PET imaging of [11C]UCB-J was successfully completed and synaptic density measured in low functioning DS adults. This work provides the basis for studies where synaptic density may be compared between larger groups of NT adults and adults with DS who have varying degrees of baseline cognitive status.
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Affiliation(s)
- Alexandra DiFilippo
- Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
| | - Erin Jonaitis
- Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Renee Makuch
- University of Wisconsin-Madison Waisman Center, Madison, WI, USA
| | - Brianna Gambetti
- University of Wisconsin-Madison Waisman Center, Madison, WI, USA
| | - Victoria Fleming
- University of Wisconsin-Madison Waisman Center, Madison, WI, USA
| | - Gilda Ennis
- Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Todd Barnhart
- Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Jonathan Engle
- Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Barbara Bendlin
- Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Sterling Johnson
- Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Benjamin Handen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sharon Krinsky-McHale
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
| | - Sigan Hartley
- University of Wisconsin-Madison Waisman Center, Madison, WI, USA
| | - Bradley Christian
- Madison School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- University of Wisconsin-Madison Waisman Center, Madison, WI, USA
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Desai S, Chen IY, Hom C, Doran E, Nguyen DD, Benca RM, Lott IT, Mander BA. Insomnia Symptoms Are Associated with Measures of Functional Deterioration and Dementia Status in Adults with Down Syndrome at High Risk for Alzheimer's Disease. J Alzheimers Dis 2024; 100:613-629. [PMID: 38875029 PMCID: PMC11307085 DOI: 10.3233/jad-220750] [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] [Accepted: 05/14/2024] [Indexed: 06/16/2024]
Abstract
Background While obstructive sleep apnea (OSA) and insomnia symptoms in neurotypical populations are associated with Alzheimer's disease (AD), their association with dementia in adults with Down syndrome (DS) remains less clear, even though these symptoms are prevalent and treatable in DS. Understanding their associations with AD-related dementia status, cognitive impairment, and functional deterioration may lead to interventions to slow decline or disease progression in adults with DS. Objective To characterize differences in OSA and insomnia symptom expression by dementia status, and to determine which sleep factors support dementia diagnosis. Methods Multimodal consensus conference was used to determine dementia status in 52 adults with DS (52.2 ± 6.4 years, 21 women). Cognitive impairment, adaptive behavior skills, and symptoms of OSA and insomnia were quantified using validated assessments for adults with DS and their primary informants. Results A sex by dementia status interaction demonstrated that older women with DS and dementia had more severe terminal insomnia but not OSA symptoms relative to older women with DS who were cognitively stable (CS). Greater insomnia symptom severity was associated with greater functional impairments in social and self-care domains adjusting for age, sex, premorbid intellectual impairment, and dementia status. Conclusions Insomnia symptoms are more severe in women with DS with dementia than in women with DS and no dementia, and regardless of dementia status or sex, more severe insomnia symptoms are associated with greater impairment in activities of daily living. These findings underscore the potential importance of early insomnia symptom evaluation and treatment in women with DS at risk of developing AD.
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Affiliation(s)
- Shivum Desai
- Department of Pediatrics, University of California, Irvine, CA, USA
- Ascension Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI, USA
| | - Ivy Y. Chen
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Christy Hom
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Eric Doran
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Dana D. Nguyen
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Ruth M. Benca
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
- Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Ira T. Lott
- Department of Pediatrics, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Bryce A. Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
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Videla L, Benejam B, Carmona-Iragui M, Barroeta I, Fernández S, Arranz J, Azzahchi SE, Altuna M, Padilla C, Valldeneu S, Pegueroles J, Montal V, Aranha MR, Vaqué-Alcázar L, Iulita MF, Alcolea D, Bejanin A, Videla S, Blesa R, Lleó A, Fortea J. Cross-sectional versus longitudinal cognitive assessments for the diagnosis of symptomatic Alzheimer's disease in adults with Down syndrome. Alzheimers Dement 2023; 19:3916-3925. [PMID: 37038748 DOI: 10.1002/alz.13073] [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: 01/11/2023] [Revised: 02/27/2023] [Accepted: 03/08/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Down syndrome (DS) is a genetic form of Alzheimer's disease (AD). However, clinical diagnosis is difficult, and experts emphasize the need for detecting intra-individual cognitive decline. OBJECTIVE To compare the performance of baseline and longitudinal neuropsychological assessments for the diagnosis of symptomatic AD in DS. METHODS Longitudinal cohort study of adults with DS. Individuals were classified as asymptomatic, prodromal AD, or AD dementia. We performed receiver operating characteristic curve analyses to compare baseline and longitudinal changes of CAMCOG-DS and mCRT. RESULTS We included 562 adults with DS. Baseline assessments showed good to excellent diagnostic performance for AD dementia (AUCs between 0.82 and 0.99) and prodromal AD, higher than the 1-year intra-individual cognitive decline (area under the ROC curve between 0.59 and 0.79 for AD dementia, lower for prodromal AD). Longer follow-ups increased the diagnostic performance of the intra-individual cognitive decline. DISCUSSION Baseline cognitive assessment outperforms the 1-year intra-individual cognitive decline in adults with DS.
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Affiliation(s)
- Laura Videla
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Bessy Benejam
- Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
| | - María Carmona-Iragui
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Isabel Barroeta
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Susana Fernández
- Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
| | - Javier Arranz
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sumia Elbachiri Azzahchi
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miren Altuna
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- CITA-alzheimer foundation, Donostia-San Sebsatián, Spain
| | - Concepción Padilla
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Silvia Valldeneu
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Jordi Pegueroles
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Víctor Montal
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Mateus Rozalem Aranha
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lídia Vaqué-Alcázar
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Maria Florencia Iulita
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Daniel Alcolea
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Alexandre Bejanin
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Sebastià Videla
- Clinical Research Support Unit-[HUB-IDIBELL], Clinical Pharmacology Department, Bellvitge University Hospital, University of Barcelona, Barcelona, Spain
| | - Rafael Blesa
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Alberto Lleó
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Juan Fortea
- Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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8
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Davis TJ, Salazar R, Beenders S, Boehme A, LaMarca NM, Bain JM. A Prospective, Longitudinal Study of Caregiver-Reported Adaptive Skills and Function of Individuals with HNRNPH2-related Neurodevelopmental Disorder. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2023; 8:445-456. [PMID: 39220267 PMCID: PMC11358239 DOI: 10.1007/s41252-023-00346-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 09/04/2024]
Abstract
Objectives This study presents a cohort of individuals in a natural history study with de novo pathogenic missense variants in HNRNPH2 causative of HNRNPH2-related neurodevelopmental disorder (NDD) to describe individuals' adaptive functional abilities. Methods We measured adaptive function using the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) and the Vineland Adaptive Behavior Scale (VABS-III). Results were compared using inferential statistics and regression analysis. Results Sixty-seven individuals carried known pathogenic or likely pathogenic variants in HNRNPH2. Thirty-five participants (2.89-42.04 years, 83% female) and caregivers completed PEDI-CAT assessments with 25 of these participants completing the VABS-III. Sixteen, three and two participants completed a follow-up PEDI-CAT assessment at one, two and three years respectively. Individuals had mean normative scores less than age-matched peers across all domains on both PEDI-CAT and VABS-III measures, with 91% participants < 5th percentile on both the PEDI- CAT and VABS-III. Verbal and ambulatory participants had significantly higher PEDI-CAT scores across all domains, using both raw and normative data. There was no significant change in PEDI-CAT scores over 3 years. Conclusions Overall scores, both raw and normative, are low across all individuals with HNRNPH2-related NDD using both the PEDI-CAT and VABS-III. PEDI-CAT normative scores do not likely represent the clinical variability, but raw scores may be able to capture functional variability. In a small sample, longitudinal data from the PEDI-CAT domain scores demonstrate stability in performance at 3 years.Trial Registration: ClinicalTrials.gov NCT03492060.
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Affiliation(s)
- Thomas J. Davis
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
| | - Rachel Salazar
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
- Department of Interprofessional Health Sciences and Health Administration, Seton Hall University, Nutley, NJ United States
| | - Sarah Beenders
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, PA Philadelphia, United States
| | - Amelia Boehme
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
| | - Nicole M. LaMarca
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
| | - Jennifer M. Bain
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
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9
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Mattie LJ, Loveall SJ, Channell MM, Rodgers DB. Perspectives on adaptive functioning and intellectual functioning measures for intellectual disabilities behavioral research. Front Psychol 2023; 14:1084576. [PMID: 36993885 PMCID: PMC10040585 DOI: 10.3389/fpsyg.2023.1084576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/14/2023] [Indexed: 03/14/2023] Open
Abstract
IntroductionIntellectual disability (ID) is a significant limitation in both intellectual ability and adaptive functioning, but many studies of participants with ID only include a measure of overall intellectual functioning when describing their samples. The purpose of this perspective article was to provide a starting point for future research regarding the utility of including measures of both intellectual and adaptive functioning in research focused on ID. In this article, we discuss the differences and similarities between the constructs of intellectual and adaptive functioning, how they are measured, and the benefits of using both measures to describe participant abilities. Data are presented to demonstrate that intellectual and adaptive functioning measures capture separate but related skills in a sample of individuals with ID (i.e., children with Down syndrome [DS]; the leading genetic cause of ID).MethodsThirty children with DS (7–31 months) were administered the Mullen Scales of Early Learning and their mothers were interviewed using the Vineland Adaptive Behavior Scales.ResultsAt the group level, Vineland and Mullen composite scores were relatively normally distributed and positively correlated. At the individual level, a concordance correlation coefficient indicated moderate agreement between Vineland and Mullen composite scores.DiscussionAlthough many children showed consistency between measures, others did not. Our discussion and findings, though preliminary, highlight that intellectual and adaptive functioning are separate but related skills and that there are benefits to including both measures when describing samples with ID. We discuss considerations for including adaptive functioning measures to enhance future research on individuals with ID.
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Affiliation(s)
- Laura J. Mattie
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- *Correspondence: Laura J. Mattie,
| | - Susan J. Loveall
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Marie Moore Channell
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Derek B. Rodgers
- Department of Teaching and Learning, University of Iowa, Iowa City, IA, United States
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10
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Schworer EK, Soltani A, Altaye M, Fidler DJ, Esbensen AJ. Cognitive flexibility assessment in youth with Down syndrome: Reliability, practice effects, and validity. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 133:104416. [PMID: 36603310 PMCID: PMC9852016 DOI: 10.1016/j.ridd.2022.104416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/14/2022] [Accepted: 12/30/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Cognitive flexibility refers to the ability to switch between different mental sets, tasks, or strategies and is challenging for some individuals with Down syndrome (DS). The lack of reliable and valid cognitive flexibility measures for individuals with DS is a major barrier to clinical trials and intervention studies designed to address cognitive challenges specific to DS. To avoid measurement limitations that could confound interpretations of performance in clinical trials in children with DS, it is critical to use phenotype-sensitive and psychometrically sound measures of cognitive flexibility. AIM This study aimed to evaluate the psychometric properties of three measures of cognitive flexibility including Rule-Shift, Weigl Sorting, and KiTAP Flexibility in a sample of 97 youth with DS aged 6-17 years old. METHOD Data were collected at two time points with a two-week interval. Parents also completed adaptive behavior and cognitive flexibility questionnaires. Child cognitive and language abilities were also assessed. RESULTS The Weigl Sorting met the most psychometric criteria, with adequate feasibility (≥ 80 %) and significant correlations with most of the broader developmental domains; however, the levels of test-retest reliability, practice effects, and convergent validity did not meet a priori criteria. Rule-Shift and KiTAP Flexibility measures did not have acceptable feasibility; although sensitivity and specificity analyses revealed that Rule-Shift may be appropriate for a subgroup of the participants. CONCLUSION No evaluated measures met all psychometric study criteria and, therefore, additional evaluation of cognitive flexibility measures is needed for use among individuals with DS.
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Affiliation(s)
- Emily K Schworer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; University of Wisconsin-Madison, Waisman Center, Madison, WI, USA.
| | - Amanallah Soltani
- Department of Educational Psychology, Kerman Branch, Islamic Azad University, Kerman, Iran
| | - Mekibib Altaye
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Deborah J Fidler
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Anna J Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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11
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Cañete-Massé C, Carbó-Carreté M, Peró-Cebollero M, Cui SX, Yan CG, Guàrdia-Olmos J. Abnormal degree centrality and functional connectivity in Down syndrome: A resting-state fMRI study. Int J Clin Health Psychol 2023; 23:100341. [PMID: 36262644 PMCID: PMC9551068 DOI: 10.1016/j.ijchp.2022.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/10/2022] [Indexed: 11/05/2022] Open
Abstract
Background/Objective Neuroimaging studies have shown brain abnormalities in Down syndrome (DS) but have not clarified the underlying mechanisms of dysfunction. Here, we investigated the degree centrality (DC) abnormalities found in the DS group compared with the control group, and we conducted seed-based functional connectivity (FC) with the significant clusters found in DC. Moreover, we used the significant clusters of DC and the seed-based FC to elucidate differences between brain networks in DS compared with controls. Method The sample comprised 18 persons with DS (M = 28.67, SD = 4.18) and 18 controls (M = 28.56, SD = 4.26). Both samples underwent resting-state functional magnetic resonance imaging. Results DC analysis showed increased DC in the DS in temporal and right frontal lobe, as well as in the left caudate and rectus and decreased DC in the DS in regions of the left frontal lobe. Regarding seed-based FC, DS showed increased and decreased FC. Significant differences were also found between networks using Yeo parcellations, showing both hyperconnectivity and hypoconnectivity between and within networks. Conclusions DC, seed-based FC and brain networks seem altered in DS, finding hypo- and hyperconnectivity depending on the areas. Network analysis revealed between- and within-network differences, and these abnormalities shown in DS could be related to the characteristics of the population.
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Affiliation(s)
- Cristina Cañete-Massé
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain,UB Institute of Complex Systems, Universitat de Barcelona, Barcelona, Spain,Corresponding author at: Campus de Mundet, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain.
| | - Maria Carbó-Carreté
- Serra Hunter Fellow, Department of Cognition, Development and Educational Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain,Institute of Neuroscience, Universitat de Barcelona, Barcelona, Spain
| | - Maribel Peró-Cebollero
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain,UB Institute of Complex Systems, Universitat de Barcelona, Barcelona, Spain,Institute of Neuroscience, Universitat de Barcelona, Barcelona, Spain
| | - Shi-Xian Cui
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China,International Big-Data Center for Depression Research, Chinese Academy of Sciences, Beijing, China,Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Sino-Danish College, Sino-Danish Center for Education and Research, University of Chinese Academy of Sciences, Beijing, China
| | - Chao-Gan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China,International Big-Data Center for Depression Research, Chinese Academy of Sciences, Beijing, China,Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Sino-Danish College, Sino-Danish Center for Education and Research, University of Chinese Academy of Sciences, Beijing, China
| | - Joan Guàrdia-Olmos
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain,UB Institute of Complex Systems, Universitat de Barcelona, Barcelona, Spain,Institute of Neuroscience, Universitat de Barcelona, Barcelona, Spain
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12
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Hartley SL, Fleming V, Schworer EK, Peven J, Handen BL, Krinsky-McHale S, Hom C, Lee L, Tudorascu DL, Laymon C, Minhas D, Luo W, Cohen A, Zaman S, Ances BM, Mapstone M, Head E, Lai F, Rosas HD, Klunk W, Christian B. Timing of Alzheimer's Disease by Intellectual Disability Level in Down Syndrome. J Alzheimers Dis 2023; 95:213-225. [PMID: 37482997 PMCID: PMC10578224 DOI: 10.3233/jad-230200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Trisomy 21 causes Down syndrome (DS) and is a recognized cause of early-onset Alzheimer's disease (AD). OBJECTIVE The current study sought to determine if premorbid intellectual disability level (ID) was associated with variability in age-trajectories of AD biomarkers and cognitive impairments. General linear mixed models compared the age-trajectory of the AD biomarkers PET Aβ and tau and cognitive decline across premorbid ID levels (mild, moderate, and severe/profound), in models controlling trisomy type, APOE status, biological sex, and site. METHODS Analyses involved adults with DS from the Alzheimer's Biomarkers Consortium-Down Syndrome. Participants completed measures of memory, mental status, and visuospatial ability. Premorbid ID level was based on IQ or mental age scores prior to dementia concerns. PET was acquired using [11C] PiB for Aβ, and [18F] AV-1451 for tau. RESULTS Cognitive data was available for 361 participants with a mean age of 45.22 (SD = 9.92) and PET biomarker data was available for 154 participants. There was not a significant effect of premorbid ID level by age on cognitive outcomes. There was not a significant effect of premorbid ID by age on PET Aβ or on tau PET. There was not a significant difference in age at time of study visit of those with mild cognitive impairment-DS or dementia by premorbid ID level. CONCLUSION Findings provide robust evidence of a similar time course in AD trajectory across premorbid ID levels, laying the groundwork for the inclusion of individuals with DS with a variety of IQ levels in clinical AD trials.
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Affiliation(s)
- Sigan L. Hartley
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- School of Human Ecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Victoria Fleming
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- School of Human Ecology, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Jamie Peven
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Sharon Krinsky-McHale
- Department of Psychology, New York Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
| | - Christy Hom
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Laisze Lee
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dana L. Tudorascu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Charles Laymon
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Davneet Minhas
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Weiquan Luo
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Annie Cohen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shahid Zaman
- Cambridgeshire & Peterborough NHS Foundation Trust (CPFT), Elizabeth House, Fulbourn Hospital, Cambridge, UK
- Department of Psychiatry, Cambridge Intellectual & Developmental Disabilities Research Group (CIDDRG), University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Beau M. Ances
- Department of Neurology, Washington University St. Louis, St. Louis, MO, USA
| | - Mark Mapstone
- Clinical Neurology, University of California, Irvine, Irvine, CA, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, USA
| | - Florence Lai
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - H. Diana Rosas
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Massachusetts General Hospital, Center for Neuro-imaging of Aging and Neurodegenerative Diseases, Charlestown, MA, USA
| | - William Klunk
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - the Alzheimer Biomarker Consortium-Down Syndrome
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- School of Human Ecology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, New York Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
- Cambridgeshire & Peterborough NHS Foundation Trust (CPFT), Elizabeth House, Fulbourn Hospital, Cambridge, UK
- Department of Psychiatry, Cambridge Intellectual & Developmental Disabilities Research Group (CIDDRG), University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
- Department of Neurology, Washington University St. Louis, St. Louis, MO, USA
- Clinical Neurology, University of California, Irvine, Irvine, CA, USA
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, USA
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Massachusetts General Hospital, Center for Neuro-imaging of Aging and Neurodegenerative Diseases, Charlestown, MA, USA
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13
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Fleming V, Hom CL, Clare ICH, Hurd-Thomas SL, Krinsky-McHale S, Handen B, Hartley SL. Cognitive outcome measures for tracking Alzheimer's disease in Down syndrome. INTERNATIONAL REVIEW OF RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 62:227-263. [PMID: 37396708 PMCID: PMC10312212 DOI: 10.1016/bs.irrdd.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Down syndrome (DS) is now viewed as a genetic type of Alzheimer's disease (AD), given the near-universal presence of AD pathology in middle adulthood and the elevated risk for developing clinical AD in DS. As the field of DS prepares for AD clinical intervention trials, there is a strong need to identify cognitive measures that are specific and sensitive to the transition from being cognitively stable to the prodromal (e.g., Mild Cognitive Impairment-Down syndrome) and clinical AD (e.g., Dementia) stages of the disease in DS. It is also important to determine cognitive measures that map onto biomarkers of early AD pathology during the transition from the preclinical to the prodromal stage of the disease, as this transition period is likely to be targeted and tracked in AD clinical trials. The present chapter discusses the current state of research on cognitive measures that could be used to screen/select study participants and as potential outcome measures in future AD clinical trials with adults with DS. In this chapter, we also identify key challenges that need to be overcome and questions that need to be addressed by the DS field as it prepares for AD clinical trials in the coming years.
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Affiliation(s)
- Victoria Fleming
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- School of Human Ecology, University of Wisconsin-Madison, Madison, WI, United States
| | - Christy L Hom
- Department of Psychiatry and Human Behavior, University of California, Irvine School of Medicine, Orange, CA, United States
| | - Isabel C H Clare
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | | | - Sharon Krinsky-McHale
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY, United States
| | - Benjamin Handen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sigan L Hartley
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- School of Human Ecology, University of Wisconsin-Madison, Madison, WI, United States
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14
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Barrón-Martínez JB, Salvador-Cruz J. Social abilities in young Mexicans with Down syndrome during the COVID-19 pandemic. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 69:888-895. [PMID: 37885837 PMCID: PMC10599167 DOI: 10.1080/20473869.2022.2038527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/29/2022] [Indexed: 10/28/2023]
Abstract
Background: Social abilities include interpersonal skills, interaction, and social responsibility. The nature of these abilities has not been explored in young people with Down syndrome (DS) during the social isolation of the COVID-19 pandemic. Method: The aim of this online study was to describe the social profile of a group of 30 Mexican people with DS, with a chronological age of 15-29 years, and explore the variables related to their psychosocial profiles. A sociodemographic questionnaire, mental age examination, and socialization battery were applied. Social behavior was analyzed in domains that facilitate socialization (leadership, joviality, social sensitivity, respect/self-control), in domains that disrupt socialization (aggressiveness/stubbornness, apathy/withdrawal, anxiety/shyness), and on a global scale. Results: Participants' scores in the facilitative domains were above average, and their scores in the disruptive domains were below average, as expected. Scores on the respect/self-control scale were associated with chronological age (CA), and those on the global scale with mental age (MA). Discussion: No impairments were found in the social skills of young people with DS according to the parameters of the scale. The development of the social profile with CA and MA stimulates cognition and promotes independence, autonomy, and proactivity. Parents' role in regulating children's behavior was an important factor in managing their social isolation during the COVID-19 pandemic.
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Affiliation(s)
- J. B. Barrón-Martínez
- Faculty of Higher Studies Zaragoza, National Autonomous University of Mexico, Mexico
| | - J. Salvador-Cruz
- Faculty of Higher Studies Zaragoza, National Autonomous University of Mexico, Mexico
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15
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Modenato C, Martin-Brevet S, Moreau CA, Rodriguez-Herreros B, Kumar K, Draganski B, Sønderby IE, Jacquemont S. Lessons Learned From Neuroimaging Studies of Copy Number Variants: A Systematic Review. Biol Psychiatry 2021; 90:596-610. [PMID: 34509290 DOI: 10.1016/j.biopsych.2021.05.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 01/06/2023]
Abstract
Pathogenic copy number variants (CNVs) and aneuploidies alter gene dosage and are associated with neurodevelopmental psychiatric disorders such as autism spectrum disorder and schizophrenia. Brain mechanisms mediating genetic risk for neurodevelopmental psychiatric disorders remain largely unknown, but there is a rapid increase in morphometry studies of CNVs using T1-weighted structural magnetic resonance imaging. Studies have been conducted one mutation at a time, leaving the field with a complex catalog of brain alterations linked to different genomic loci. Our aim was to provide a systematic review of neuroimaging phenotypes across CNVs associated with developmental psychiatric disorders including autism and schizophrenia. We included 76 structural magnetic resonance imaging studies on 20 CNVs at the 15q11.2, 22q11.2, 1q21.1 distal, 16p11.2 distal and proximal, 7q11.23, 15q11-q13, and 22q13.33 (SHANK3) genomic loci as well as aneuploidies of chromosomes X, Y, and 21. Moderate to large effect sizes on global and regional brain morphometry are observed across all genomic loci, which is in line with levels of symptom severity reported for these variants. This is in stark contrast with the much milder neuroimaging effects observed in idiopathic psychiatric disorders. Data also suggest that CNVs have independent effects on global versus regional measures as well as on cortical surface versus thickness. Findings highlight a broad diversity of regional morphometry patterns across genomic loci. This heterogeneity of brain patterns provides insight into the weak effects reported in magnetic resonance imaging studies of cognitive dimension and psychiatric conditions. Neuroimaging studies across many more variants will be required to understand links between gene function and brain morphometry.
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Affiliation(s)
- Claudia Modenato
- Laboratory for Research in Neuroimaging, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Sandra Martin-Brevet
- Laboratory for Research in Neuroimaging, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Clara A Moreau
- Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada; Human Genetics and Cognitive Functions, Centre National de la Recherche Scientifique UMR 3571, Department of Neuroscience, Université de Paris, Institut Pasteur, Paris, France
| | - Borja Rodriguez-Herreros
- Service des Troubles du Spectre de l'Autisme et Apparentés, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Kuldeep Kumar
- Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada; Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - Bogdan Draganski
- Laboratory for Research in Neuroimaging, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland; Neurology Department, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ida E Sønderby
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Sébastien Jacquemont
- Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada; Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada.
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16
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Shu C, Green Snyder L, Shen Y, Chung WK. Imputing cognitive impairment in SPARK, a large autism cohort. Autism Res 2021; 15:156-170. [PMID: 34636158 DOI: 10.1002/aur.2622] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/26/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022]
Abstract
Diverse large cohorts are necessary for dissecting subtypes of autism, and intellectual disability is one of the most robust endophenotypes for analysis. However, current cognitive assessment methods are not feasible at scale. We developed five commonly used machine learning models to predict cognitive impairment (FSIQ<80 and FSIQ<70) and FSIQ scores among 521 children with autism using parent-reported online surveys in SPARK, and evaluated them in an independent set (n = 1346) with a missing data rate up to 70%. We assessed accuracy, sensitivity, and specificity by comparing predicted cognitive levels against clinical IQ data. The elastic-net model has good performance (AUC = 0.876, sensitivity = 0.772, specificity = 0.803) using 129 predictive features to impute cognitive impairment (FSIQ<80). Top-ranked predictive features included parent-reported language and cognitive levels, age at autism diagnosis, and history of services. Prediction of FSIQ<70 and FSIQ scores also showed good performance. We show cognitive levels can be imputed with high accuracy for children with autism, using commonly collected parent-reported data and standardized surveys. The current model offers a method for large-scale autism studies seeking estimates of cognitive ability when standardized psychometric testing is not feasible. LAY SUMMARY: Children with autism who have more severe learning challenges or cognitive impairment have different needs that are important to consider in research studies. When children in our study were missing standardized cognitive testing scores, we were able to use machine learning with other information to correctly "guess" when they have cognitive impairment about 80% of the time. We can use this information in research in the future to develop more appropriate treatments for children with autism and cognitive impairment.
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Affiliation(s)
- Chang Shu
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.,Department of Systems Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - LeeAnne Green Snyder
- Simons Foundation Autism Research Initiative, Simons Foundation, New York, New York, USA
| | - Yufeng Shen
- Department of Systems Biology, Columbia University Irving Medical Center, New York, New York, USA.,Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
| | - Wendy K Chung
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.,Simons Foundation Autism Research Initiative, Simons Foundation, New York, New York, USA.,Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
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17
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Hom CL, Walsh D, Fernandez G, Tournay A, Touchette P, Lott IT. Cognitive assessment using the Rapid Assessment for Developmental Disabilities, Second Edition (RADD-2). JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:831-848. [PMID: 34196436 DOI: 10.1111/jir.12863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 04/12/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Individuals with developmental disabilities (DD) often have severe impairments and maladaptive behaviours that make it difficult to reliably assess their cognitive abilities. Given these challenges, the Rapid Assessment of Developmental Disabilities, Second Edition (RADD-2), was designed to measure general cognitive ability in this population. The purpose of this study is to demonstrate the battery's psychometric properties when used with individuals with DD who have challenging behavioural and psychiatric conditions and for those who have limited verbal skills. METHOD The cognitive and adaptive behaviour skills of 193 children and adults with DD and considerable medical, behavioural and/or psychiatric problems were evaluated using the first and second editions of the RADD, Kaufmann Brief Intelligence Test - 2nd Edition, and Scales of Independent Behaviour - Revised Edition. Medication side effects and challenging behaviours were assessed using the Aberrant Behaviour Checklist. RESULTS There were no floor or ceiling effects on the RADD-2. Both the nonverbal index and total scores had strong concurrent validity with other abbreviated tests of intellectual ability and good discriminant validity from measures of adaptive behaviour and medication side effects. RADD-2 scores also had strong criterion validity as they successfully differentiated between all levels of intellectual functioning. Age and sex did not differentially affect RADD-2 performance, and the co-occurrence of psychiatric conditions did not negatively affect performance. The only medical condition associated with lower RADD-2 performance was epilepsy. CONCLUSIONS The RADD-2 can quantify the differential cognitive abilities of individuals with DD, even for those with minimal communication skills, challenging behaviours or severe medication side effects that can typically complicate assessment. This brief cognitive battery can be used to measure changes due to interventions, on the one hand, and progression of neurological disease, on the other.
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Affiliation(s)
- C L Hom
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D Walsh
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - G Fernandez
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - A Tournay
- Department of Pediatrics, Division of Child Neurology, University of California, Irvine, CA, USA
| | - P Touchette
- Department of Pediatrics, Division of Child Neurology, University of California, Irvine, CA, USA
| | - I T Lott
- Department of Pediatrics, Division of Child Neurology, University of California, Irvine, CA, USA
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18
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Mortillo M, Mulle JG. A cross-comparison of cognitive ability across 8 genomic disorders. Curr Opin Genet Dev 2021; 68:106-116. [PMID: 34082144 DOI: 10.1016/j.gde.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/01/2021] [Accepted: 04/08/2021] [Indexed: 12/23/2022]
Abstract
Genomic disorders result from rearrangement of the human genome. Most genomic disorders are caused by copy number variants (CNV), deletions or duplications of several hundred kilobases. Many CNV loci are associated with autism, schizophrenia, and most commonly, intellectual disability (ID). However, there is little comparison of cognitive ability measures across these CNV disorders. This study aims to understand whether existing data can be leveraged for a cross-comparison of cognitive ability among multiple CNV. We found there is a lack of harmonization among assessment instruments and little standardization for reporting summary data across studies. Despite these limitations, we identified a differential impact of CNV loci on cognitive ability. Our data suggest that future cross-comparisons of CNV disorders will reveal meaningful differences across the phenotypic spectrum, especially if standardized phenotypic assessment is achieved.
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Affiliation(s)
- Michael Mortillo
- Department of Human Genetics, Emory University, Atlanta, GA, United States
| | - Jennifer G Mulle
- Department of Human Genetics, Emory University, Atlanta, GA, United States.
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19
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Koenig KA, Oh SH, Stasko MR, Roth EC, Taylor HG, Ruedrich S, Wang ZI, Leverenz JB, Costa ACS. High resolution structural and functional MRI of the hippocampus in young adults with Down syndrome. Brain Commun 2021; 3:fcab088. [PMID: 33977271 PMCID: PMC8100000 DOI: 10.1093/braincomms/fcab088] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 02/19/2021] [Accepted: 03/22/2021] [Indexed: 11/29/2022] Open
Abstract
Down syndrome is the phenotypic consequence of trisomy 21, with clinical presentation including both neurodevelopmental and neurodegenerative components. Although the intellectual disability typically displayed by individuals with Down syndrome is generally global, it also involves disproportionate deficits in hippocampally-mediated cognitive processes. Hippocampal dysfunction may also relate to Alzheimer’s disease-type pathology, which can appear in as early as the first decade of life and becomes universal by age 40. Using 7-tesla MRI of the brain, we present an assessment of the structure and function of the hippocampus in 34 individuals with Down syndrome (mean age 24.5 years ± 6.5) and 27 age- and sex-matched typically developing healthy controls. In addition to increased whole-brain mean cortical thickness and lateral ventricle volumes (P < 1.0 × 10−4), individuals with Down syndrome showed selective volume reductions in bilateral hippocampal subfields cornu Ammonis field 1, dentate gyrus, and tail (P < 0.005). In the group with Down syndrome, bilateral hippocampi showed widespread reductions in the strength of functional connectivity, predominately to frontal regions (P < 0.02). Age was not related to hippocampal volumes or functional connectivity measures in either group, but both groups showed similar relationships of age to whole-brain volume measures (P < 0.05). Finally, we performed an exploratory analysis of a subgroup of individuals with Down syndrome with both imaging and neuropsychological assessments. This analysis indicated that measures of spatial memory were related to mean cortical thickness, total grey matter volume and right hemisphere hippocampal subfield volumes (P < 0.02). This work provides a first demonstration of the usefulness of high-field MRI to detect subtle differences in structure and function of the hippocampus in individuals with Down syndrome, and suggests the potential for development of MRI-derived measures as surrogate markers of drug efficacy in pharmacological studies designed to investigate enhancement of cognitive function.
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Affiliation(s)
- Katherine A Koenig
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Se-Hong Oh
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Department of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin 449-791, Republic of Korea
| | - Melissa R Stasko
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Elizabeth C Roth
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH 44106, USA
| | - H Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, The Ohio State University, Columbus, OH 43215, USA
| | - Stephen Ruedrich
- Department of Psychiatry, University Hospitals, Cleveland, OH 44106, USA
| | - Z Irene Wang
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - James B Leverenz
- Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Alberto C S Costa
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH 44106, USA.,Department of Psychiatry, University Hospitals, Cleveland, OH 44106, USA
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20
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Complexity Analysis of the Default Mode Network Using Resting-State fMRI in Down Syndrome: Relationships Highlighted by a Neuropsychological Assessment. Brain Sci 2021; 11:brainsci11030311. [PMID: 33801471 PMCID: PMC8001398 DOI: 10.3390/brainsci11030311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/21/2021] [Accepted: 02/25/2021] [Indexed: 01/04/2023] Open
Abstract
Background: Studies on complexity indicators in the field of functional connectivity derived from resting-state fMRI (rs-fMRI) in Down syndrome (DS) samples and their possible relationship with cognitive functioning variables are rare. We analyze how some complexity indicators estimated in the subareas that constitute the default mode network (DMN) might be predictors of the neuropsychological outcomes evaluating Intelligence Quotient (IQ) and cognitive performance in persons with DS. Methods: Twenty-two DS people were assessed with the Kaufman Brief Test of Intelligence (KBIT) and Frontal Assessment Battery (FAB) tests, and fMRI signals were recorded in a resting state over a six-minute period. In addition, 22 controls, matched by age and sex, were evaluated with the same rs-fMRI procedure. Results: There was a significant difference in complexity indicators between groups: the control group showed less complexity than the DS group. Moreover, the DS group showed more variance in the complexity indicator distributions than the control group. In the DS group, significant and negative relationships were found between some of the complexity indicators in some of the DMN networks and the cognitive performance scores. Conclusions: The DS group is characterized by more complex DMN networks and exhibits an inverse relationship between complexity and cognitive performance based on the negative parameter estimates.
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