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Daniels AJ, McDade E, Llibre-Guerra JJ, Xiong C, Perrin RJ, Ibanez L, Supnet-Bell C, Cruchaga C, Goate A, Renton AE, Benzinger TL, Gordon BA, Hassenstab J, Karch C, Popp B, Levey A, Morris J, Buckles V, Allegri RF, Chrem P, Berman SB, Chhatwal JP, Farlow MR, Fox NC, Day GS, Ikeuchi T, Jucker M, Lee JH, Levin J, Lopera F, Takada L, Sosa AL, Martins R, Mori H, Noble JM, Salloway S, Huey E, Rosa-Neto P, Sánchez-Valle R, Schofield PR, Roh JH, Bateman RJ. 15 Years of Longitudinal Genetic, Clinical, Cognitive, Imaging, and Biochemical Measures in DIAN. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.08.24311689. [PMID: 39148846 PMCID: PMC11326320 DOI: 10.1101/2024.08.08.24311689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
This manuscript describes and summarizes the Dominantly Inherited Alzheimer Network Observational Study (DIAN Obs), highlighting the wealth of longitudinal data, samples, and results from this human cohort study of brain aging and a rare monogenic form of Alzheimer's disease (AD). DIAN Obs is an international collaborative longitudinal study initiated in 2008 with support from the National Institute on Aging (NIA), designed to obtain comprehensive and uniform data on brain biology and function in individuals at risk for autosomal dominant AD (ADAD). ADAD gene mutations in the amyloid protein precursor (APP), presenilin 1 (PSEN1), or presenilin 2 (PSEN2) genes are deterministic causes of ADAD, with virtually full penetrance, and a predictable age at symptomatic onset. Data and specimens collected are derived from full clinical assessments, including neurologic and physical examinations, extensive cognitive batteries, structural and functional neuro-imaging, amyloid and tau pathological measures using positron emission tomography (PET), flurordeoxyglucose (FDG) PET, cerebrospinal fluid and blood collection (plasma, serum, and whole blood), extensive genetic and multi-omic analyses, and brain donation upon death. This comprehensive evaluation of the human nervous system is performed longitudinally in both mutation carriers and family non-carriers, providing one of the deepest and broadest evaluations of the human brain across decades and through AD progression. These extensive data sets and samples are available for researchers to address scientific questions on the human brain, aging, and AD.
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Affiliation(s)
- Alisha J. Daniels
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Eric McDade
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | | | - Chengjie Xiong
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Richard J. Perrin
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Laura Ibanez
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | | | - Carlos Cruchaga
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Alison Goate
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Alan E. Renton
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | - Brian A. Gordon
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Jason Hassenstab
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Celeste Karch
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Brent Popp
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Allan Levey
- Goizueta Alzheimer’s Disease Research Center, Emory University, Atlanta, GA, USA
| | - John Morris
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Virginia Buckles
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | | | - Patricio Chrem
- Institute of Neurological Research FLENI, Buenos Aires, Argentina
| | | | - Jasmeer P. Chhatwal
- Massachusetts General and Brigham & Women’s Hospitals, Harvard Medical School, Boston MA, USA
| | | | - Nick C. Fox
- UK Dementia Research Institute at University College London, London, United Kingdom
- University College London, London, United Kingdom
| | | | - Takeshi Ikeuchi
- Brain Research Institute, Niigata University, Niigata, Japan
| | - Mathias Jucker
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | | | - Johannes Levin
- DZNE, German Center for Neurodegenerative Diseases, Munich, Germany
- Ludwig-Maximilians-Universität München, Munich, Germany
| | | | | | - Ana Luisa Sosa
- Instituto Nacional de Neurologia y Neurocirugla Innn, Mexico City, Mexico
| | - Ralph Martins
- Edith Cowan University, Western Australia, Australia
| | | | - James M. Noble
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, and GH Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Edward Huey
- Brown University, Butler Hospital, Providence, RI, USA
| | - Pedro Rosa-Neto
- Centre de Recherche de L’hopital Douglas and McGill University, Montreal, Quebec
| | - Raquel Sánchez-Valle
- Hospital Clínic de Barcelona. IDIBAPS. University of Barcelona, Barcelona, Spain
| | - Peter R. Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Jee Hoon Roh
- Korea University, Korea University Anam Hospital, Seoul, South Korea
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Munro CE, Farrell M, Hanseeuw B, Rentz DM, Buckley R, Properzi M, Yuan Z, Vannini P, Amariglio RE, Quiroz YT, Blacker D, Sperling RA, Johnson KA, Marshall GA, Gatchel JR. Change in Depressive Symptoms and Longitudinal Regional Amyloid Accumulation in Unimpaired Older Adults. JAMA Netw Open 2024; 7:e2427248. [PMID: 39207757 PMCID: PMC11362871 DOI: 10.1001/jamanetworkopen.2024.27248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/13/2024] [Indexed: 09/04/2024] Open
Abstract
Importance Depressive symptoms in older adults may be a harbinger of Alzheimer disease (AD), even in preclinical stages. It is unclear whether worsening depressive symptoms are manifestations of regional distributions of core AD pathology (amyloid) and whether cognitive changes affect this relationship. Objective To evaluate whether increasing depressive symptoms are associated with amyloid accumulation in brain regions important for emotional regulation and whether those associations vary by cognitive performance. Design, Setting, and Participants Participants from the Harvard Aging Brain Study, a longitudinal cohort study, underwent annual assessments of depressive symptoms and cognition alongside cortical amyloid positron emission tomography (PET) imaging at baseline and every 2 to 3 years thereafter (mean [SD] follow-up, 8.6 [2.2] years). Data collection was conducted from September 2010 to October 2022 in a convenience sample of community-dwelling older adults who were cognitively unimpaired with, at most, mild baseline depression. Data were analyzed from October 2022 to December 2023. Main Outcomes and Measures Depression (Geriatric Depression Scale [GDS]-30-item), cognition (Preclinical Alzheimer Cognitive Composite-5 [PACC]), and a continuous measure of cerebral amyloid (Pittsburgh compound B [PiB] PET) examined in a priori-defined regions (medial orbitofrontal cortex [mOFC], lateral orbitofrontal cortex, middle frontal cortex [MFC], superior frontal cortex, anterior cingulate cortex, isthmus cingulate cortex [IC], posterior cingulate cortex, and amygdala). Associations between longitudinal GDS scores, regional amyloid slopes, and PACC slopes were assessed using linear mixed-effects models. Results In this sample of 154 individuals (94 [61%] female; mean [SD] age, 72.6 [6.4] years; mean (SD) education, 15.9 [3.1] years), increasing PiB slopes in the bilateral mOFC, IC, and MFC were associated with increasing GDS scores (mOFC: β = 11.07 [95% CI, 5.26-16.87]; t = 3.74 [SE, 2.96]; P = .004; IC: β = 12.83 [95% CI, 5.68-19.98]; t = 3.51 [SE, 3.65]; P = .004; MFC: β = 9.22 [95% CI, 2.25-16.20]; t = 2.59 [SE, 3.56]; P = .03). Even with PACC slope as an additional covariate, associations remained significant in these regions. Conclusions and Relevance In this cohort study of cognitively unimpaired older adults with, at most, mild baseline depressive symptoms, greater depressive symptoms over time were associated with amyloid accumulation in regions associated with emotional control. Furthermore, these associations persisted in most regions independent of cognitive changes. These results shed light on the neurobiology of depressive symptoms in older individuals and underscore the importance of monitoring for elevated mood symptoms early in AD.
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Affiliation(s)
- Catherine E. Munro
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Michelle Farrell
- Massachusetts General Hospital, Harvard Medical School, Boston
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts
| | - Bernard Hanseeuw
- Massachusetts General Hospital, Harvard Medical School, Boston
- Institute of Neuroscience, Université Catholique de Louvain/Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Dorene M. Rentz
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Rachel Buckley
- Massachusetts General Hospital, Harvard Medical School, Boston
| | | | - Ziwen Yuan
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Patrizia Vannini
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Rebecca E. Amariglio
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Yakeel T. Quiroz
- Massachusetts General Hospital, Harvard Medical School, Boston
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia
| | - Deborah Blacker
- Massachusetts General Hospital, Harvard Medical School, Boston
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Reisa A. Sperling
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Keith A. Johnson
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Gad A. Marshall
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Jennifer R. Gatchel
- Massachusetts General Hospital, Harvard Medical School, Boston
- McLean Hospital, Belmont, Massachusetts
- Baylor College of Medicine, Houston, Texas
- Michael E. Debakey Department of Veterans Affairs Medical Center, Houston, Texas
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Premnath PY, Locascio JJ, Mimmack KJ, Gonzalez C, Properzi MJ, Udeogu O, Rosenberg PB, Marshall GA, Gatchel JR. Longitudinal associations of apathy and regional tau in mild cognitive impairment and dementia: Findings from the Alzheimer's Disease Neuroimaging Initiative. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2024; 10:e12442. [PMID: 38356477 PMCID: PMC10865481 DOI: 10.1002/trc2.12442] [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: 05/06/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 02/16/2024]
Abstract
Introduction It is important to study apathy in Alzheimer's disease (AD) to better understand its underlying neurobiology and develop effective interventions. In the current study, we sought to examine the relationships between longitudinal apathy and regional tau burden in cognitively impaired older adults from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Methods Three hundred and nineteen ADNI participants with mild cognitive impairment (MCI) or AD dementia underwent flortaucipir (FTP) tau positron emission tomography (PET) imaging and clinical assessment with the Neuropsychiatric Inventory (NPI) annually. Longitudinal NPI Apathy (NPI-A) scores were examined in relation to baseline tau PET signal in three a priori selected regions implicated in AD and AD-related apathy (supramarginal gyrus, entorhinal cortex [EC] and rostral anterior cingulate cortex [rACC]). Secondary models were adjusted for global cognition (Mini-Mental State Examination score) and cortical amyloid (florbetapir PET). Results Higher baseline supramarginal gyrus and EC tau burden were each significantly associated with greater NPI-A over time, while rACC tau was associated with higher NPI-A but did not predict its trajectory over time. These results were retained for supramarginal and EC tau after adjusting models for global cognition and cortical amyloid. Discussion Our findings suggest that baseline in vivo tau burden in parietal and temporal brain regions affected in AD, and less so in a medial frontal region involved in motivational control, is associated with increasing apathy over time in older adults with MCI and AD dementia. Future work studying emergent apathy in relation to not only core AD pathology but also circuit level dysfunction may provide additional insight into the neurobiology of apathy in AD and opportunities for intervention. Highlights Tau (Flortaucipir PET) in regions implicated in AD was associated with increasing apathy over timeCortical amyloid was also found to be a robust predictor of the trajectory of apathyEvidence of synergy between regional tau and amyloid in overall higher levels of apathy.
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Affiliation(s)
- Pranitha Y. Premnath
- Department of PsychologyThe Graduate Center, City University of New YorkNew YorkNew YorkUSA
| | - Joseph J. Locascio
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
- Department of NeurologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Kayden J. Mimmack
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | | | - Michael J. Properzi
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
- Department of NeurologyAthinoula A. Martinos Center for Biomedical ImagingCharlestownMassachusettsUSA
| | - Onyinye Udeogu
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Paul B. Rosenberg
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Gad A. Marshall
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
- Department of NeurologyHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Center for Alzheimer Research and TreatmentBrigham and Women's HospitalBostonMassachusettsUSA
| | - Jennifer R. Gatchel
- Division of Geriatric PsychiatryMcLean HospitalBelmontMassachusettsUSA
- Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonTexasUSA
- Department of Veterans AffairsMichael E. DeBakey VA Medical CenterHoustonTexasUSA
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
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De Lucia N, Carbone G, Muzii B, Ferrara N, Rengo G, Maldonato NM, Femminella GD. Neuropsychiatric symptoms and their neural correlates in individuals with mild cognitive impairment. Int Psychogeriatr 2023; 35:623-632. [PMID: 36714990 DOI: 10.1017/s104161022200117x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Neuropsychiatric symptoms are common in subjects with MCI and associated with higher risk of progression to AD. The cognitive and neuroanatomical correlates of neuropsychiatric symptoms in MCI have not been fully elucidated. In this study, we sought to evaluate the association between neuropsychiatric symptoms, cognitive function, regional tau deposition, and brain volumes in MCI subjects. METHODS A total of 233 MCI and 305 healthy comparisons were selected from the ADNI-3 cohort. All the subjects underwent a comprehensive neuropsychological assessment, volumetric MR brain scan, and Flortaucipir PET for in vivo assessment of regional tau deposition. Prevalence of neuropsychiatric symptoms was evaluated by means of the NPI questionnaire. Multivariate analyses of variance were used to detect differences in cognitive and imaging markers in MCI subjects with and without neuropsychiatric symptoms. RESULTS 61.4% MCI subjects showed at least one neuropsychiatric symptom, with the most prevalent ones being depression (26.1%), irritability (23.6%), and sleep disturbances (23.6%). There was a significant effect of neuropsychiatric symptoms on cognitive tests of frontal and executive functions. MCI subjects with neuropsychiatric symptoms showed reduced brain volumes in the orbitofrontal and posterior cingulate cortices, while no effects were detected on regional tau deposition. Posterior cingulate cortex volume was the only predictor of global neuropsychiatric burden in this MCI population. CONCLUSIONS Neuropsychiatric symptoms occur early in the AD trajectory and are mainly related to defects of control executive abilities and to the reduction of gray matter volume in the orbitofrontal and posterior cingulate cortices. A better understanding of the cognitive and neuroanatomical mechanisms of neuropsychiatric symptoms in MCI could help develop more targeted and efficacious treatment alternatives.
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Affiliation(s)
- Natascia De Lucia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University, Naples, Italy
| | - Giovanni Carbone
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
| | - Benedetta Muzii
- Department of Humanistic Studies, "Federico II" University, Naples, Italy
| | - Nicola Ferrara
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
- Instituti Clinici Scientifici Maugeri IRCCS - Scientific Institute of Telese Terme (BN), Telese BN, Italy
| | - Nelson Mauro Maldonato
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University, Naples, Italy
| | - Grazia Daniela Femminella
- Department of Translational Medical Sciences, "Federico II" University, Naples, Italy
- Department of Brain Sciences, Imperial College London, London, UK
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Cozza M, Boccardi V. A narrative review on mild behavioural impairment: an exploration into its scientific perspectives. Aging Clin Exp Res 2023; 35:1807-1821. [PMID: 37392350 DOI: 10.1007/s40520-023-02472-1] [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] [Received: 05/01/2023] [Accepted: 06/06/2023] [Indexed: 07/03/2023]
Abstract
In clinical practice, the admission of patients with late-onset psychological and behavioural symptoms is frequent, regardless of the presence or absence of cognitive decline. These symptoms commonly occur in the prodromal stage of dementia and can precede the onset of dementia. While the concept of Mild Cognitive Impairment (MCI) -which is defined as a level of cognitive impairment insufficient to impact daily functioning- is well established, the notion of Mild Behavioural Impairment (MBI) is not yet widely recognized. However, studies have demonstrated that the presence of MBI in both cognitively normal patients and individuals with MCI is associated with an increased risk of dementia progression. Thus, MBI may serve as a neurobehavioral indicator of pre-dementia risk states. This narrative review aims to discuss the evolution of the term, the relevant clinical aspects, and potential biomarkers that may contribute to the clinical definition of MBI. The objective is to assist clinicians in recognizing the diagnosis and differentiating it from psychiatric syndromes, as well as identifying possible etiologies of neurodegeneration.
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Affiliation(s)
- Mariagiovanna Cozza
- Department of Integration, Intermediate Care Programme, AUSL Bologna, Bologna, Italy
| | - Virginia Boccardi
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Santa Maria della Misericordia Hospital, Piazzale Gambuli 1, 06132, Perugia, Italy.
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Sun L, Li W, Qiu Q, Hu Y, Yang Z, Xiao S. Anxiety adds the risk of cognitive progression and is associated with axon/synapse degeneration among cognitively unimpaired older adults. EBioMedicine 2023; 94:104703. [PMID: 37429081 PMCID: PMC10435838 DOI: 10.1016/j.ebiom.2023.104703] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Mental symptoms have been shown to be associated with dementia. As the most common neuropsychiatric disorder, it is unclear whether and why anxiety increases the risk of cognitive progression in elderly. METHODS The aim of this study was to investigate the longitudinal effects of anxiety on cognitive impairment in non-dementia elderly and to explore the underlying biological processes using multi-omics including microarray-based transcriptomics, mass spectrometry-based proteomics and metabolomics, cerebrospinal fluid (CSF) biochemical markers, and brain diffusion tensor imaging (DTI). The Alzheimer's Disease Neuroimaging Initiative (ADNI), Chinese Longitudinal Healthy Longevity Survey (CLHLS) and Shanghai Mental Health Centre (SMHC) cohorts were included. FINDINGS Anxiety was found to increase the risk of subsequent cognitive progression in the ADNI, and a similar result was observed in the CLHLS cohort. Enrichment analysis indicated activated axon/synapse pathways and suppressed mitochondrial pathways in anxiety, the former confirmed by deviations in frontolimbic tract morphology and altered levels of axon/synapse markers, and the latter supported by decreased levels of carnitine metabolites. Mediation analysis revealed that anxiety's effect on the longitudinal cognition was mediated by brain tau burden. Correlations of mitochondria-related expressed genes with axon/synapse proteins, carnitine metabolites, and cognitive changes were found. INTERPRETATION This study provides cross-validated epidemiological and biological evidence that anxiety is a risk factor for cognitive progression in non-dementia elderly, and that axon/synapse damage in the context of energy metabolism imbalance may contribute to this phenomenon. FUNDING The National Natural Science Foundation of China (82271607, 81971682, and 81830059) for data analysis and data collection.
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Affiliation(s)
- Lin Sun
- Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Wei Li
- Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Qi Qiu
- Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Institute of Psychological and Behavioural Science, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhi Yang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, PR China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, PR China.
| | - Shifu Xiao
- Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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Strijkert F, Huitema RB, van Munster BC, Spikman JM. Impaired Emotion Recognition: A Potential Marker for Social Behavioral Problems in Patients With Amnestic Mild Cognitive Impairment and Early Alzheimer Disease? Alzheimer Dis Assoc Disord 2023; 37:189-194. [PMID: 37561955 PMCID: PMC10443627 DOI: 10.1097/wad.0000000000000567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/19/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Emotion recognition, an important aspect of social cognition, can be impaired already in early Alzheimer disease dementia and amnestic mild cognitive impairment (aMCI) and may underly social behavioral changes, which can increase caregiver burden. However, social behavior is difficult to assess in outpatient settings. We evaluated whether impaired emotion recognition is related to proxy-rated social behavioral problems and thus can serve as a marker of these changes. PATIENTS AND METHOD Emotion recognition was assessed with Ekman 60 Faces Test (EFT-total, 6 separate emotions) in patients (n = 31 AD; n = 37 aMCI) and healthy controls (n = 60 HCs). Social behavioral problems were rated by proxies with the neuropsychiatric inventory (agitation, apathy, irritability, disinhibition, and a sum score). It tested whether EFT scores differed between patients with and without behavioral problems. RESULTS AD had worse EFT-total ( P <0.001), disgust ( P = 0.02), and fear ( P = 0.001) than HC, but not than aMCI, who did not differ from HC. AD displayed more disinhibition ( P < 0.05). EFT and neuropsychiatric inventory sum scores were not significantly correlated. Patients with apathy had lower EFT-total ( P = 0.02). CONCLUSIONS Measuring emotion recognition adds value: it is impaired in early neurodegeneration and associated with apathy but not necessarily related to overall changes in social behavior in this population.
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Dang M, Chen Q, Zhao X, Chen K, Li X, Zhang J, Lu J, Ai L, Chen Y, Zhang Z. Tau as a biomarker of cognitive impairment and neuropsychiatric symptom in Alzheimer's disease. Hum Brain Mapp 2023; 44:327-340. [PMID: 36647262 PMCID: PMC9842886 DOI: 10.1002/hbm.26043] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/28/2022] [Accepted: 07/28/2022] [Indexed: 01/25/2023] Open
Abstract
The A/T/N research framework has been proposed for the diagnosis and prognosis of Alzheimer's disease (AD). However, the spatial distribution of ATN biomarkers and their relationship with cognitive impairment and neuropsychiatric symptoms (NPS) need further clarification in patients with AD. We scanned 83 AD patients and 38 cognitively normal controls who independently completed the mini-mental state examination and Neuropsychiatric Inventory scales. Tau, Aβ, and hypometabolism spatial patterns were characterized using Statistical Parametric Mapping together with [18F]flortaucipir, [18F]florbetapir, and [18F]FDG positron emission tomography. Piecewise linear regression, two-sample t-tests, and support vector machine algorithms were used to explore the relationship between tau, Aβ, and hypometabolism and cognition, NPS, and AD diagnosis. The results showed that regions with tau deposition are region-specific and mainly occurred in inferior temporal lobes in AD, which extensively overlaps with the hypometabolic regions. While the deposition regions of Aβ were unique and the regions affected by hypometabolism were widely distributed. Unlike Aβ, tau and hypometabolism build up monotonically with increasing cognitive impairment in the late stages of AD. In addition, NPS in AD were associated with tau deposition closely, followed by hypometabolism, but not with Aβ. Finally, hypometabolism and tau had higher accuracy in differentiating the AD patients from controls (accuracy = 0.88, accuracy = 0.85) than Aβ (accuracy = 0.81), and the combined three were the highest (accuracy = 0.95). These findings suggest tau pathology is superior over Aβ and glucose metabolism to identify cognitive impairment and NPS. Its results support tau accumulation can be used as a biomarker of clinical impairment in AD.
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Affiliation(s)
- Mingxi Dang
- State Key Laboratory of Cognitive Neuroscience and LearningBeijing Normal UniversityBeijingChina
- BABRI CentreBeijing Normal UniversityBeijingChina
| | - Qian Chen
- Department of Nuclear Medicine, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Xiaobin Zhao
- Department of Nuclear Medicine, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Kewei Chen
- Banner Alzheimer's InstitutePhoenixArizonaUSA
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and LearningBeijing Normal UniversityBeijingChina
- BABRI CentreBeijing Normal UniversityBeijingChina
| | - Junying Zhang
- Institute of Basic Research in Clinical MedicineChina Academy of Chinese Medical SciencesBeijingChina
| | - Jie Lu
- Department of RadiologyXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Lin Ai
- Department of Nuclear Medicine, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and LearningBeijing Normal UniversityBeijingChina
- BABRI CentreBeijing Normal UniversityBeijingChina
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and LearningBeijing Normal UniversityBeijingChina
- BABRI CentreBeijing Normal UniversityBeijingChina
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Maito MA, Santamaría-García H, Moguilner S, Possin KL, Godoy ME, Avila-Funes JA, Behrens MI, Brusco IL, Bruno MA, Cardona JF, Custodio N, García AM, Javandel S, Lopera F, Matallana DL, Miller B, Okada de Oliveira M, Pina-Escudero SD, Slachevsky A, Sosa Ortiz AL, Takada LT, Tagliazuchi E, Valcour V, Yokoyama JS, Ibañez A. Classification of Alzheimer's disease and frontotemporal dementia using routine clinical and cognitive measures across multicentric underrepresented samples: A cross sectional observational study. LANCET REGIONAL HEALTH. AMERICAS 2023; 17:100387. [PMID: 36583137 PMCID: PMC9794191 DOI: 10.1016/j.lana.2022.100387] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/20/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
Background Global brain health initiatives call for improving methods for the diagnosis of Alzheimer's disease (AD) and frontotemporal dementia (FTD) in underrepresented populations. However, diagnostic procedures in upper-middle-income countries (UMICs) and lower-middle income countries (LMICs), such as Latin American countries (LAC), face multiple challenges. These include the heterogeneity in diagnostic methods, lack of clinical harmonisation, and limited access to biomarkers. Methods This cross-sectional observational study aimed to identify the best combination of predictors to discriminate between AD and FTD using demographic, clinical and cognitive data among 1794 participants [904 diagnosed with AD, 282 diagnosed with FTD, and 606 healthy controls (HCs)] collected in 11 clinical centres across five LAC (ReDLat cohort). Findings A fully automated computational approach included classical statistical methods, support vector machine procedures, and machine learning techniques (random forest and sequential feature selection procedures). Results demonstrated an accurate classification of patients with AD and FTD and HCs. A machine learning model produced the best values to differentiate AD from FTD patients with an accuracy = 0.91. The top features included social cognition, neuropsychiatric symptoms, executive functioning performance, and cognitive screening; with secondary contributions from age, educational attainment, and sex. Interpretation Results demonstrate that data-driven techniques applied in archival clinical datasets could enhance diagnostic procedures in regions with limited resources. These results also suggest specific fine-grained cognitive and behavioural measures may aid in the diagnosis of AD and FTD in LAC. Moreover, our results highlight an opportunity for harmonisation of clinical tools for dementia diagnosis in the region. Funding This work was supported by the Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat), funded by NIA/NIH (R01AG057234), Alzheimer's Association (SG-20-725707-ReDLat), Rainwater Foundation, Takeda (CW2680521), Global Brain Health Institute; as well as CONICET; FONCYT-PICT (2017-1818, 2017-1820); PIIECC, Facultad de Humanidades, Usach; Sistema General de Regalías de Colombia (BPIN2018000100059), Universidad del Valle (CI 5316); ANID/FONDECYT Regular (1210195, 1210176, 1210176); ANID/FONDAP (15150012); ANID/PIA/ANILLOS ACT210096; and Alzheimer's Association GBHI ALZ UK-22-865742.
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Affiliation(s)
- Marcelo Adrián Maito
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Hernando Santamaría-García
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Ph.D Program of Neuroscience, Psychiatry Department, Pontificia Universidad Javeriana, Bogotá, Colombia
- Center for Memory and Cognition Intellectus, Hospital San Ignacio, Bogotá, Colombia
| | - Sebastián Moguilner
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Katherine L. Possin
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - María E. Godoy
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - José Alberto Avila-Funes
- Geriatrics Department, Instituto Nacional de Ciencias médicas y nutrición Salvador Zubirán, Mexico City, Mexico
- Centre de Recherche Inserm, U897, Brodeaux, France
- University Victor Segalen Bourdeaux 2, Bordeaux, France
| | - María I. Behrens
- Centro de Investigación Clínica Avanzada (CICA) Hospital Clínico Universidad de Chile, Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Departamento de Neurociencia, Facultad de medicina Universidad de Chile and Departamento de Neurología y Psiquiatría, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Ignacio L. Brusco
- Universidad Buenos Aires & Consejo Nacional de Investigaciones Científicas y técnicas (CONICET), Argentina
| | - Martín A. Bruno
- Instituto de Ciencias Biomédicas de la Universidad Católica de Cuyo & Consejo Nacional de Investigaciones Científicas y técnicas (CONICET), Argentina
| | | | - Nilton Custodio
- Unit Cognitive Impairment and Dementia Prevention, Peruvian Institute of Neurosciences, Lima, Peru
| | - Adolfo M. García
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Shireen Javandel
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Francisco Lopera
- Neuroscience Research Group, Universidad de Antioquia, Medellín, Colombia
| | - Diana L. Matallana
- PhD Program of Neuroscience, Aging Institute, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Bruce Miller
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Maira Okada de Oliveira
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Hospital Santa Marcelina, São Paulo, SP, Brazil
- University of São Paulo, São Paulo, SP, Brazil
| | - Stefanie D. Pina-Escudero
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Andrea Slachevsky
- Neurology Department, Geroscience Center for Brain Health and Metabolism, Santiago, Chile
- Laboratory of Neuropsychology and Clinical Neuroscience (LANNEC), Physiopathology Program ICBM, East Neurologic and Neurosciences Departments, Faculty of Medicine, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana, Universidad del Desarrollo, University of Chile, Neuropsychiatry and Memory Disorders clinic (CMYN), Santiago, Chile
| | - Ana L. Sosa Ortiz
- Instituto Nacional de Neurología y neurocirugía, Ciudad de México, Mexico
| | - Leonel T. Takada
- Hospital de Clinicas, University of Sao Paulo Medical School, Brazil
| | - Enzo Tagliazuchi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Departamento de Física, Universidad de Buenos Aires & Instituto de Física de Buenos Aires (FIBA – CONICET), Buenos Aires, Argentina
| | - Victor Valcour
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Ph.D Program of Neuroscience, Psychiatry Department; Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA
| | - Jennifer S. Yokoyama
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Agustín Ibañez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Universidad de San Andrés & Consejo Nacional de Investigaciones Científicas y técnicas (CONICET), Argentina
- Global Brain Health Institute (GBHI), Trinity College Dublin, (TCD), Ireland
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10
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Pink A, Krell‐Roesch J, Syrjanen JA, Christenson LR, Lowe VJ, Vemuri P, Fields JA, Stokin GB, Kremers WK, Scharf EL, Jack CR, Knopman DS, Petersen RC, Vassilaki M, Geda YE. Interactions Between Neuropsychiatric Symptoms and Alzheimer's Disease Neuroimaging Biomarkers in Predicting Longitudinal Cognitive Decline. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2023; 5:4-15. [PMID: 36909142 PMCID: PMC9997077 DOI: 10.1176/appi.prcp.20220036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 01/22/2023] Open
Abstract
Objective To examine interactions between Neuropsychiatric symptoms (NPS) with Pittsburgh Compound B (PiB) and fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting cognitive trajectories. Methods We conducted a longitudinal study in the setting of the population-based Mayo Clinic Study of Aging in Olmsted County, MN, involving 1581 cognitively unimpaired (CU) persons aged ≥50 years (median age 71.83 years, 54.0% males, 27.5% APOE ɛ4 carriers). NPS at baseline were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Brain glucose hypometabolism was defined as a SUVR ≤ 1.47 (measured by FDG-PET) in regions typically affected in Alzheimer's disease. Abnormal cortical amyloid deposition was measured using PiB-PET (SUVR ≥ 1.48). Neuropsychological testing was done approximately every 15 months, and we calculated global and domain-specific (memory, language, attention, and visuospatial skills) cognitive z-scores. We ran linear mixed-effect models to examine the associations and interactions between NPS at baseline and z-scored PiB- and FDG-PET SUVRs in predicting cognitive z-scores adjusted for age, sex, education, and previous cognitive testing. Results Individuals at the average PiB and without NPS at baseline declined over time on cognitive z-scores. Those with increased PiB at baseline declined faster (two-way interaction), and those with increased PiB and NPS declined even faster (three-way interaction). We observed interactions between time, increased PiB and anxiety or irritability indicating accelerated decline on global z-scores, and between time, increased PiB and several NPS (e.g., agitation) showing faster domain-specific decline, especially on the attention domain. Conclusions NPS and increased brain amyloid deposition synergistically interact in accelerating global and domain-specific cognitive decline among CU persons at baseline.
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Affiliation(s)
- Anna Pink
- First Department of MedicineParacelsus Medical UniversitySalzburgAustria
| | - Janina Krell‐Roesch
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
- Institute of Sports and Sports ScienceKarlsruhe Institute of TechnologyKarlsruheGermany
| | - Jeremy A. Syrjanen
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
| | - Luke R. Christenson
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
| | - Val J. Lowe
- Department of RadiologyMayo Clinic RochesterRochesterMinnesotaUSA
| | | | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo Clinic RochesterRochesterMinnesotaUSA
| | - Gorazd B. Stokin
- International Clinical Research Center/St. Anne HospitalBrnoCzech Republic
| | - Walter K. Kremers
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
| | - Eugene L. Scharf
- Department of NeurologyMayo Clinic RochesterRochesterMinnesotaUSA
| | - Clifford R. Jack
- Department of RadiologyMayo Clinic RochesterRochesterMinnesotaUSA
| | - David S. Knopman
- Department of NeurologyMayo Clinic RochesterRochesterMinnesotaUSA
| | - Ronald C. Petersen
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
- Department of NeurologyMayo Clinic RochesterRochesterMinnesotaUSA
| | - Maria Vassilaki
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
| | - Yonas E. Geda
- Department of NeurologyFranke Global Neuroscience Education CenterBarrow Neurological InstitutePhoenixArizonaUSA
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11
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Chauvière L. Early cognitive comorbidities before disease onset: A common symptom towards prevention of related brain diseases? Heliyon 2022; 8:e12259. [PMID: 36590531 PMCID: PMC9800323 DOI: 10.1016/j.heliyon.2022.e12259] [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: 08/08/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
Brain diseases are very heterogeneous; however they also display multiple common risk factors and comorbidities. With a paucity of disease-modifying therapies, prevention became a health priority. Towards prevention, one strategy is to focus on similar symptoms of brain diseases occurring before disease onset. Cognitive deficits are a promising candidate as they occur across brain diseases before disease onset. Based on recent research, this review highlights the similarity of brain diseases and discusses how early cognitive deficits can be exploited to tackle disease prevention. After briefly introducing common risk factors, I review common comorbidities across brain diseases, with a focus on cognitive deficits before disease onset, reporting both experimental and clinical findings. Next, I describe network abnormalities associated with early cognitive deficits and discuss how these abnormalities can be targeted to prevent disease onset. A scenario on brain disease etiology with the idea that early cognitive deficits may constitute a common symptom of brain diseases is proposed.
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12
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Ng KP, Qian X, Ng KK, Ji F, Rosa-Neto P, Gauthier S, Kandiah N, Zhou JH. Stage-dependent differential influence of metabolic and structural networks on memory across Alzheimer's disease continuum. eLife 2022; 11:e77745. [PMID: 36053063 PMCID: PMC9477498 DOI: 10.7554/elife.77745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 09/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Large-scale neuronal network breakdown underlies memory impairment in Alzheimer's disease (AD). However, the differential trajectories of the relationships between network organisation and memory across pathology and cognitive stages in AD remain elusive. We determined whether and how the influences of individual-level structural and metabolic covariance network integrity on memory varied with amyloid pathology across clinical stages without assuming a constant relationship. Methods Seven hundred and eight participants from the Alzheimer's Disease Neuroimaging Initiative were studied. Individual-level structural and metabolic covariance scores in higher-level cognitive and hippocampal networks were derived from magnetic resonance imaging and [18F] fluorodeoxyglucose positron emission tomography using seed-based partial least square analyses. The non-linear associations between network scores and memory across cognitive stages in each pathology group were examined using sparse varying coefficient modelling. Results We showed that the associations of memory with structural and metabolic networks in the hippocampal and default mode regions exhibited pathology-dependent differential trajectories across cognitive stages using sparse varying coefficient modelling. In amyloid pathology group, there was an early influence of hippocampal structural network deterioration on memory impairment in the preclinical stage, and a biphasic influence of the angular gyrus-seeded default mode metabolic network on memory in both preclinical and dementia stages. In non-amyloid pathology groups, in contrast, the trajectory of the hippocampus-memory association was opposite and weaker overall, while no metabolism covariance networks were related to memory. Key findings were replicated in a larger cohort of 1280 participants. Conclusions Our findings highlight potential windows of early intervention targeting network breakdown at the preclinical AD stage. Funding Data collection and sharing for this project was funded by the Alzheimer's Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904) and DOD ADNI (Department of Defense award number W81XWH-12-2-0012). We also acknowledge the funding support from the Duke NUS/Khoo Bridge Funding Award (KBrFA/2019-0020) and NMRC Open Fund Large Collaborative Grant (OFLCG09May0035).
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Affiliation(s)
- Kok Pin Ng
- Department of Neurology, National Neuroscience InstituteSingaporeSingapore
- Duke-NUS Medical SchoolSingaporeSingapore
- Lee Kong Chian School of Medicine, Nanyang Technological University SingaporeSingaporeSingapore
| | - Xing Qian
- Centre for Sleep and Cognition and Centre for Translational MR Research,Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Kwun Kei Ng
- Centre for Sleep and Cognition and Centre for Translational MR Research,Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Fang Ji
- Centre for Sleep and Cognition and Centre for Translational MR Research,Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal, and Departments of Neurology, Neurosurgery, Psychiatry, Pharmacology and Therapeutics, McGill UniversityMontrealCanada
- Montreal Neurological Institute, McGill UniversityMontrealCanada
| | - Serge Gauthier
- Department of Neurology & Neurosurgery, McGill UniversityMontrealCanada
| | - Nagaendran Kandiah
- Lee Kong Chian School of Medicine, Nanyang Technological University SingaporeSingaporeSingapore
| | - Juan Helen Zhou
- Centre for Sleep and Cognition and Centre for Translational MR Research,Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
- Department of Electrical and Computer Engineering, National University of SingaporeSingaporeSingapore
- Integrative Sciences and Engineering Programme (ISEP), National University of SingaporeSingaporeSingapore
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13
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Tondo G, Boccalini C, Vanoli EG, Presotto L, Muscio C, Ciullo V, Banaj N, Piras F, Filippini G, Tiraboschi P, Tagliavini F, Frisoni GB, Cappa SF, Spalletta G, Perani D. Brain Metabolism and Amyloid Load in Individuals With Subjective Cognitive Decline or Pre-Mild Cognitive Impairment. Neurology 2022; 99:e258-e269. [PMID: 35487700 PMCID: PMC9302934 DOI: 10.1212/wnl.0000000000200351] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 02/21/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE This was a multicenter study aimed at investigating the characteristics of cognitive decline, neuropsychiatric symptoms, and brain imaging in individuals with subjective cognitive decline (SCD) and subtle cognitive decline (pre-mild cognitive impairment [pre-MCI]). METHODS Data were obtained from the Network-AD project (NET-2011-02346784). The included participants underwent baseline cognitive and neurobehavioral evaluation, FDG-PET, and amyloid PET. We used principal component analysis (PCA) to identify independent neuropsychological and neuropsychiatric dimensions and their association with brain metabolism. RESULTS A total of 105 participants (SCD = 49, pre-MCI = 56) were included. FDG-PET was normal in 45% of participants and revealed brain hypometabolism in 55%, with a frontal-like pattern as the most frequent finding (28%). Neuropsychiatric symptoms emerging from the Neuropsychiatric Inventory and the Starkstein Apathy Scale were highly prevalent in the whole sample (78%). An abnormal amyloid load was detected in the 18% of the participants who underwent amyloid PET (n = 60). PCA resulted in 3 neuropsychological factors: (1) executive/visuomotor, correlating with hypometabolism in frontal and occipital cortices and basal ganglia; (2) memory, correlating with hypometabolism in temporoparietal regions; and (3) visuospatial/constructional, correlating with hypometabolism in frontoparietal cortices. Two factors emerged from the neuropsychiatric PCA: (1) affective, correlating with hypometabolism in orbitofrontal and cingulate cortex and insula; (2) hyperactive/psychotic, correlating with hypometabolism in frontal, temporal, and parietal regions. DISCUSSION FDG-PET evidence suggests either normal brain function or different patterns of brain hypometabolism in SCD and pre-MCI. These results indicate that SCD and pre-MCI represent heterogeneous populations. Different neuropsychological and neuropsychiatric profiles emerged, which correlated with neuronal dysfunction in specific brain regions. Long-term follow-up studies are needed to assess the risk of progression to dementia in these conditions.
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Affiliation(s)
- Giacomo Tondo
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Cecilia Boccalini
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Emilia Giovanna Vanoli
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Luca Presotto
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Cristina Muscio
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Valentina Ciullo
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Nerisa Banaj
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Federica Piras
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Graziella Filippini
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Pietro Tiraboschi
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Fabrizio Tagliavini
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Giovanni Battista Frisoni
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Stefano F Cappa
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Gianfranco Spalletta
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy
| | - Daniela Perani
- From Vita-Salute San Raffaele University (G.T., C.B., D.P.); In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience (G.T., C.B., L.P., D.P.), IRCCS San Raffaele Scientific Institute; Nuclear Medicine Unit (E.G.V., L.P., D.P.), San Raffaele Hospital; Unit of Neurology and Neuropathology (P.T.), Fondazione IRCCS Istituto Neurologico Carlo Besta (C.M., G.F., F.T.), Milan; Laboratory of Neuropsychiatry (V.C., N.B., F.P., G.S.), IRCCS Santa Lucia Foundation, Rome; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli (G.B.F.), Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging (G.B.F.), University Hospitals and University of Geneva, Switzerland; ICoN (S.F.C.), Scuola Universitaria Superiore IUSS Pavia; and IRCCS Mondino Foundation (S.F.C.), Pavia, Italy.
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14
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Casagrande M, Forte G, Favieri F, Corbo I. Sleep Quality and Aging: A Systematic Review on Healthy Older People, Mild Cognitive Impairment and Alzheimer’s Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148457. [PMID: 35886309 PMCID: PMC9325170 DOI: 10.3390/ijerph19148457] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/27/2022] [Accepted: 07/07/2022] [Indexed: 02/01/2023]
Abstract
Aging is characterized by changes in the structure and quality of sleep. When the alterations in sleep become substantial, they can generate or accelerate cognitive decline, even in the absence of overt pathology. In fact, impaired sleep represents one of the earliest symptoms of Alzheimer’s disease (AD). This systematic review aimed to analyze the studies on sleep quality in aging, also considering mild cognitive impairment (MCI) and AD. The review process was conducted according to the PRISMA statement. A total of 71 studies were included, and the whole sample had a mean age that ranged from 58.3 to 93.7 years (62.8–93.7 healthy participants and 61.8–86.7 pathological populations). Of these selected studies, 33 adopt subjective measurements, 31 adopt objective measures, and 10 studies used both. Pathological aging showed a worse impoverishment of sleep than older adults, in both subjective and objective measurements. The most common aspect compromised in AD and MCI were REM sleep, sleep efficiency, sleep latency, and sleep duration. These results underline that sleep alterations are associated with cognitive impairment. In conclusion, the frequency and severity of sleep disturbance appear to follow the evolution of cognitive impairment. The overall results of objective measures seem more consistent than those highlighted by subjective measurements.
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Affiliation(s)
- Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Roma, Italy;
- Correspondence: (M.C.); (I.C.)
| | - Giuseppe Forte
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Roma, Italy;
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy;
| | - Francesca Favieri
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy;
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Roma, Italy
| | - Ilaria Corbo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Roma, Italy
- Correspondence: (M.C.); (I.C.)
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15
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Tataryn NM, Singh V, Dyke JP, Berk-Rauch HE, Clausen DM, Aronowitz E, Norris EH, Strickland S, Ahn HJ. Vascular endothelial growth factor associated dissimilar cerebrovascular phenotypes in two different mouse models of Alzheimer's Disease. Neurobiol Aging 2021; 107:96-108. [PMID: 34416494 PMCID: PMC8595520 DOI: 10.1016/j.neurobiolaging.2021.07.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 01/14/2023]
Abstract
Vascular perturbations and cerebral hypometabolism are emerging as important components of Alzheimer's disease (AD). While various in vivo imaging modalities have been designed to detect changes of cerebral perfusion and metabolism in AD patients and animal models, study results were often heterogenous with respect to imaging techniques and animal models. We therefore evaluated cerebral perfusion and glucose metabolism of two popular transgenic AD mouse strains, TgCRND8 and 5xFAD, at 7 and 12 months-of-age under identical conditions and analyzed possible molecular mechanisms underlying heterogeneous cerebrovascular phenotypes. Results revealed disparate findings in these two strains, displaying important aspects of AD progression. TgCRND8 mice showed significantly decreased cerebral blood flow and glucose metabolism with unchanged cerebral blood volume (CBV) at 12 months-of-age whereas 5xFAD mice showed unaltered glucose metabolism with significant increase in CBV at 12 months-of-age and a biphasic pattern of early hypoperfusion followed by a rebound to normal cerebral blood flow in late disease. Finally, immunoblotting assays suggested that VEGF dependent vascular tone change may restore normoperfusion and increase CBV in 5xFAD.
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Affiliation(s)
- Nicholas M Tataryn
- Tri-Institutional Training Program in Laboratory Animal Medicine and Science, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, New York, USA and Center for Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Patricia and John Rosenwald Laboratory of Neurobiology and Genetics, Rockefeller University, New York, NY, USA; Division of Comparative Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Vishal Singh
- Department of Pharmacology, Physiology and Neurosciences, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Jonathan P Dyke
- Citigroup Biomedical Imaging Center, Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Hanna E Berk-Rauch
- Patricia and John Rosenwald Laboratory of Neurobiology and Genetics, Rockefeller University, New York, NY, USA
| | - Dana M Clausen
- Department of Pharmacology, Physiology and Neurosciences, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Eric Aronowitz
- Citigroup Biomedical Imaging Center, Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Erin H Norris
- Patricia and John Rosenwald Laboratory of Neurobiology and Genetics, Rockefeller University, New York, NY, USA
| | - Sidney Strickland
- Patricia and John Rosenwald Laboratory of Neurobiology and Genetics, Rockefeller University, New York, NY, USA
| | - Hyung Jin Ahn
- Department of Pharmacology, Physiology and Neurosciences, Rutgers-New Jersey Medical School, Newark, NJ, USA; Brain Health Institute, Rutgers University, Piscataway, NJ, USA.
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16
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Malkov A, Popova I, Ivanov A, Jang SS, Yoon SY, Osypov A, Huang Y, Zilberter Y, Zilberter M. Aβ initiates brain hypometabolism, network dysfunction and behavioral abnormalities via NOX2-induced oxidative stress in mice. Commun Biol 2021; 4:1054. [PMID: 34504272 PMCID: PMC8429759 DOI: 10.1038/s42003-021-02551-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 08/12/2021] [Indexed: 12/30/2022] Open
Abstract
A predominant trigger and driver of sporadic Alzheimer’s disease (AD) is the synergy of brain oxidative stress and glucose hypometabolism starting at early preclinical stages. Oxidative stress damages macromolecules, while glucose hypometabolism impairs cellular energy supply and antioxidant defense. However, the exact cause of AD-associated glucose hypometabolism and its network consequences have remained unknown. Here we report NADPH oxidase 2 (NOX2) activation as the main initiating mechanism behind Aβ1-42-related glucose hypometabolism and network dysfunction. We utilize a combination of electrophysiology with real-time recordings of metabolic transients both ex- and in-vivo to show that Aβ1-42 induces oxidative stress and acutely reduces cellular glucose consumption followed by long-lasting network hyperactivity and abnormalities in the animal behavioral profile. Critically, all of these pathological changes were prevented by the novel bioavailable NOX2 antagonist GSK2795039. Our data provide direct experimental evidence for causes and consequences of AD-related brain glucose hypometabolism, and suggest that targeting NOX2-mediated oxidative stress is a promising approach to both the prevention and treatment of AD. Anton Malkov, Irina Popova et al. demonstrate that beta-amyloid application induces oxidative stress and reduces glucose consumption in the mouse brain, leading to network hyperactivity and behavioral changes—pathologies similar to those observed early on in Alzheimer’s disease patients. Inhibition of NADPH oxidase 2 (NOX2) rescued these phenotypes, suggesting that NOX2 may represent an important therapeutic target for Alzheimer’s disease.
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Affiliation(s)
- Anton Malkov
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Russia
| | - Irina Popova
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Russia
| | - Anton Ivanov
- Aix Marseille Université, Inserm, Marseille, France
| | - Sung-Soo Jang
- Gladstone Institute of Neurological Disease, San Francisco, CA, USA
| | - Seo Yeon Yoon
- Gladstone Institute of Neurological Disease, San Francisco, CA, USA
| | - Alexander Osypov
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Russia.,Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
| | - Yadong Huang
- Gladstone Institute of Neurological Disease, San Francisco, CA, USA.,Department of Neurology, University of California, San Francisco, CA, USA
| | | | - Misha Zilberter
- Gladstone Institute of Neurological Disease, San Francisco, CA, USA.
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17
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Gill S, Wang M, Mouches P, Rajashekar D, Sajobi T, MacMaster FP, Smith EE, Forkert ND, Ismail Z. Neural correlates of the impulse dyscontrol domain of mild behavioral impairment. Int J Geriatr Psychiatry 2021; 36:1398-1406. [PMID: 33778998 PMCID: PMC9292816 DOI: 10.1002/gps.5540] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/21/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Agitation and aggression are common in dementia and pre-dementia. The dementia risk syndrome mild behavioral impairment (MBI) includes these symptoms in the impulse dyscontrol domain. However, the neural circuitry associated with impulse dyscontrol in neurodegenerative disease is not well understood. The objective of this work was to investigate if regional micro- and macro-structural brain properties were associated with impulse dyscontrol symptoms in older adults with normal cognition, mild cognitive impairment, and Alzheimer's disease (AD). METHODS Clinical, neuropsychiatric, and T1-weighted and diffusion-tensor magnetic resonance imaging (DTI) data from 80 individuals with and 123 individuals without impulse dyscontrol were obtained from the AD Neuroimaging Initiative. Linear mixed effect models were used to assess if impulse dyscontrol was related to regional DTI and volumetric parameters. RESULTS Impulse dyscontrol was present in 17% of participants with NC, 43% with MCI, and 66% with AD. Impulse dyscontrol was associated with: (1) lower fractional anisotropy (FA), and greater mean, axial, and radial diffusivity in the fornix; (2) lesser FA and greater radial diffusivity in the superior fronto-occipital fasciculus; (3) greater axial diffusivity in the cingulum; (4) greater axial and radial diffusivity in the uncinate fasciculus; (5) gray matter atrophy, specifically, lower cortical thickness in the parahippocampal gyrus. CONCLUSION Our findings provide evidence that well-established atrophy patterns of AD are prominent in the presence of impulse dyscontrol, even when disease status is controlled for, and possibly in advance of dementia. Our findings support the growing evidence for impulse dyscontrol symptoms as an early manifestation of AD.
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Affiliation(s)
- Sascha Gill
- Hotchkiss Brain InstituteCumming School of Medicine, University of CalgaryCalgaryAlbertaCanada,Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Meng Wang
- Hotchkiss Brain InstituteCumming School of Medicine, University of CalgaryCalgaryAlbertaCanada,Department of Community Health ScienceUniversity of CalgaryCalgaryAlbertaCanada
| | - Pauline Mouches
- Hotchkiss Brain InstituteCumming School of Medicine, University of CalgaryCalgaryAlbertaCanada,Department of RadiologyUniversity of CalgaryCalgaryAlbertaCanada
| | - Deepthi Rajashekar
- Hotchkiss Brain InstituteCumming School of Medicine, University of CalgaryCalgaryAlbertaCanada,Department of RadiologyUniversity of CalgaryCalgaryAlbertaCanada
| | - Tolulope Sajobi
- Hotchkiss Brain InstituteCumming School of Medicine, University of CalgaryCalgaryAlbertaCanada,Department of Community Health ScienceUniversity of CalgaryCalgaryAlbertaCanada
| | - Frank P MacMaster
- Hotchkiss Brain InstituteCumming School of Medicine, University of CalgaryCalgaryAlbertaCanada,Department of PsychiatryUniversity of CalgaryCalgaryAlbertaCanada,Addiction and Mental Health Strategic Clinical NetworkAlberta Health ServicesAlbertaCanada
| | - Eric E Smith
- Hotchkiss Brain InstituteCumming School of Medicine, University of CalgaryCalgaryAlbertaCanada,Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Nils D Forkert
- Hotchkiss Brain InstituteCumming School of Medicine, University of CalgaryCalgaryAlbertaCanada,Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada,Department of RadiologyUniversity of CalgaryCalgaryAlbertaCanada
| | - Zahinoor Ismail
- Hotchkiss Brain InstituteCumming School of Medicine, University of CalgaryCalgaryAlbertaCanada,Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada,Department of Community Health ScienceUniversity of CalgaryCalgaryAlbertaCanada,Department of PsychiatryUniversity of CalgaryCalgaryAlbertaCanada,O'Brien Institute for Public HealthCumming School of Medicine, University of CalgaryCalgaryAlbertaCanada
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18
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Matuskova V, Ismail Z, Nikolai T, Markova H, Cechova K, Nedelska Z, Laczo J, Wang M, Hort J, Vyhnalek M. Mild Behavioral Impairment Is Associated With Atrophy of Entorhinal Cortex and Hippocampus in a Memory Clinic Cohort. Front Aging Neurosci 2021; 13:643271. [PMID: 34108874 PMCID: PMC8180573 DOI: 10.3389/fnagi.2021.643271] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/16/2021] [Indexed: 12/22/2022] Open
Abstract
Objectives Mild behavioral impairment (MBI) is a syndrome describing late-onset persistent neuropsychiatric symptoms (NPS) in non-demented older adults. Few studies to date have investigated the associations of MBI with structural brain changes. Our aim was to explore structural correlates of NPS in a non-demented memory clinic sample using the Mild Behavioral Impairment Checklist (MBI-C) that has been developed to measure MBI. Methods One hundred sixteen non-demented older adults from the Czech Brain Aging Study with subjective cognitive concerns were classified as subjective cognitive decline (n = 37) or mild cognitive impairment (n = 79). Participants underwent neurological and neuropsychological examinations and brain magnetic resonance imaging (MRI) (1.5 T). The Czech version of the MBI-C was administered to participants’ informants. Five a priori selected brain regions were measured, namely, thicknesses of the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), and entorhinal cortex (ERC) and volume of the hippocampus (HV), and correlated with MBI-C total and domain scores. Results Entorhinal cortex was associated with MBI-C total score (rS = −0.368, p < 0.001) and with impulse dyscontrol score (rS = −0.284, p = 0.002). HV was associated with decreased motivation (rS = −0.248, p = 0.008) and impulse dyscontrol score (rS = −0.240, p = 0.011). Conclusion Neuropsychiatric symptoms, particularly in the MBI impulse dyscontrol and motivation domains, are associated with medial temporal lobe atrophy in a clinical cohort of non-demented older adults. This study supports earlier involvement of temporal rather than frontal regions in NPS manifestation. Since these regions are typically affected early in the course of Alzheimer’s disease (AD), the MBI-C may potentially help further identify individuals at-risk of developing AD dementia.
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Affiliation(s)
- Veronika Matuskova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia
| | - Zahinoor Ismail
- Department of Psychiatry, Cumming School of Medicine, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, Calgary, AB, Canada.,Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Tomas Nikolai
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia
| | - Hana Markova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia
| | - Katerina Cechova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia
| | - Zuzana Nedelska
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia
| | - Jan Laczo
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia
| | - Meng Wang
- Department of Clinical Neurosciences, Cumming School of Medicine, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, Calgary, AB, Canada
| | - Jakub Hort
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia
| | - Martin Vyhnalek
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia
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19
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Fessel J. Does synaptic hypometabolism or synaptic dysfunction, originate cognitive loss? Analysis of the evidence. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12177. [PMID: 34027027 PMCID: PMC8129845 DOI: 10.1002/trc2.12177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/31/2021] [Indexed: 11/25/2022]
Abstract
Elderly persons with currently normal cognition who have cerebral hypometabolism as shown by low uptake of 18fluorine-fluorodeoxyglucose (18F-FDG), are at risk of future loss of cognition and, thus, of future Alzheimer's dementia (AD). Reduction of either 18F-FDG or cognition is assumed to reflect synaptic dysfunction, since synapses account for the majority of glucose use by the brain and cognition depends upon accurate synaptic function. The chronology of the connection between reduced cerebral synaptic function and hypometabolism is, therefore, a critical question, because if synaptic dysfunction came first, then correcting the hypometabolism would likely not benefit synaptic function; but if hypometabolism came first, then correcting the hypometabolism probably would benefit synaptic function. That correction might prevent initiation of the cognitive loss that eventuates in AD and, thereby, would benefit the vast numbers of persons in their eighth to tenth decades of life who are at risk for AD. Among the many citations reviewed in this presentation, seven show hypometabolism that precedes synaptic dysfunction, and two show the reverse. Thus the preponderance of evidence, 78%, suggests that the initiating event is synaptic hypometabolism and that it is 3.5-fold less likely that synaptic dysfunction is the initiator. In addition, it is inherently unlikely that synaptic dysfunction causes hypometabolism. This conclusion could be tested by a clinical trial whose primary objective would be to assess the benefit to cognition of improving synaptic metabolism in patients who are at risk for cognitive loss.
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Affiliation(s)
- Jeffrey Fessel
- Department of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
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20
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Cai WJ, Tian Y, Ma YH, Dong Q, Tan L, Yu JT. Associations of Anxiety with Amyloid, Tau, and Neurodegeneration in Older Adults without Dementia: A Longitudinal Study. J Alzheimers Dis 2021; 82:273-283. [PMID: 34024826 DOI: 10.3233/jad-210020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The pathophysiological process of amyloid-β, tau deposition, and neurodegeneration of Alzheimer's disease (AD) begin in a preclinical phase, while anxiety is associated with an increased risk of AD in preclinical phase. OBJECTIVE To examine the relationships between anxiety and amyloid-β, tau deposition, and neurodegeneration. To test the hypothesis that anxiety could predict clinical progression in the elderly without dementia. METHODS 1,400 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database were included in the study and were studied over a median period of 3 years. In multivariable models, the cross-sectional and longitudinal associations between anxiety and amyloid-β PET, tau PET, and FDG PET SUVRs in participants without dementia were explored using Spearman rank correlation, logistic regression model, multiple linear regression model, Kaplan-Meier survival curves, and Cox proportional hazards model. The association between baseline anxiety and clinical progression was also explored. RESULTS There was a positive correlation between anxiety and amyloid-β deposition (r = 0.11, p = 0.0017) and a negative correlation between anxiety and neurodegeneration (r = -0.13, p = 0.00022). MCI participants with anxiety showed a faster clinical progression of dementia (HR = 1.56, p = 0.04). Non-anxious participants with more amyloid-β deposition or more severe neurodegeneration displayed accelerated development into anxiety (HR = 2.352, p < 0.0001; HR = 2.254, p < 0.0001). CONCLUSION Anxiety was associated with amyloid-β deposition and neurodegeneration in non-dementia elderly. Anxiety in MCI predicted conversion to dementia. Anxiety may play a selective role and prediction of disease progression in the early phase of AD.
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Affiliation(s)
- Wen-Jie Cai
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yan Tian
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Ng KP, Chiew H, Rosa-Neto P, Kandiah N, Ismail Z, Gauthier S. Associations of AT(N) biomarkers with neuropsychiatric symptoms in preclinical Alzheimer's disease and cognitively unimpaired individuals. Transl Neurodegener 2021; 10:11. [PMID: 33789730 PMCID: PMC8011383 DOI: 10.1186/s40035-021-00236-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/09/2021] [Indexed: 12/12/2022] Open
Abstract
The development of in vivo biomarkers of Alzheimer's disease (AD) has advanced the diagnosis of AD from a clinical syndrome to a biological construct. The preclinical stage of AD continuum is defined by the identification of AD biomarkers crossing the pathological threshold in cognitively unimpaired individuals. While neuropsychiatric symptoms (NPS) are non-cognitive symptoms that are increasingly recognized as early manifestations of AD, the associations of NPS with AD pathophysiology in preclinical AD remain unclear. Here, we review the associations between NPS and AD biomarkers amyloid-β (Aβ), tau and neurodegeneration in preclinical AD and cognitively-unimpaired individuals in 19 eligible English-language publications (8 cross-sectional studies, 10 longitudinal, 1 both cross-sectional and longitudinal). The cross-sectional studies have consistently shown that NPS, particularly depressive and anxiety symptoms, are associated with higher Aβ. The longitudinal studies have suggested that greater NPS are associated with higher Aβ and cognitive decline in cognitively unimpaired subjects over time. However, most of the studies have either cross-sectionally or longitudinally shown no association between NPS and tau pathology. For the association of NPS and neurodegeneration, two studies have shown that the cerebrospinal fluid total-tau is linked to longitudinal increase in NPS and that the NPS may predict longitudinal metabolic decline in preclinical AD, respectively. However, evidence for the association between atrophy and NPS in preclinical AD is less consistent. Therefore, future longitudinal studies with well-designed methodologies and NPS measurements are required not only to determine the relationship among AT(N) biomarkers, NPS and cognitive decline, but also to elucidate the contribution of comorbid pathology to preclinical AD.
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Affiliation(s)
- Kok Pin Ng
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine - Imperial College London, Nanyang Technological University, Singapore, Singapore
| | - Hui Chiew
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine - Imperial College London, Nanyang Technological University, Singapore, Singapore
| | - Pedro Rosa-Neto
- The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine - Imperial College London, Nanyang Technological University, Singapore, Singapore
| | - Zahinoor Ismail
- Hotchkiss Brain Institute and O'Brien Institute for Public Health; Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Serge Gauthier
- The McGill University Research Centre for Studies in Aging, Montreal, Canada.
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22
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Ferini-Strambi L, Hensley M, Salsone M. Decoding Causal Links Between Sleep Apnea and Alzheimer’s Disease. J Alzheimers Dis 2021; 80:29-40. [DOI: 10.3233/jad-201066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Obstructive sleep apnea (OSA) and Alzheimer’s disease (AD) are two common chronic diseases with a well-documented association. Whether the association is causal has been highlighted by recent evidence reporting a neurobiological link between these disorders. This narrative review discusses the brain regions and networks involved in OSA as potential vulnerable areas for the development of AD neuropathology with a particular focus on gender-related implications. Using a neuroimaging perspective supported by neuropathological investigations, we provide a new model of neurodegeneration common to OSA and AD, that we have called OSA-AD neurodegeneration in order to decode the causal links between these two chronic conditions.
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Affiliation(s)
| | - Michael Hensley
- John Hunter Hospital and The University of Newcastle, Newcastle, Australia
| | - Maria Salsone
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology-Sleep Disorder Center, Milan, Italy
- Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
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23
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Krell-Roesch J, Syrjanen JA, Vassilaki M, Lowe VJ, Vemuri P, Mielke MM, Machulda MM, Stokin GB, Christianson TJ, Kremers WK, Jack CR, Knopman DS, Petersen RC, Geda YE. Brain Regional Glucose Metabolism, Neuropsychiatric Symptoms, and the Risk of Incident Mild Cognitive Impairment: The Mayo Clinic Study of Aging. Am J Geriatr Psychiatry 2021; 29:179-191. [PMID: 32646634 PMCID: PMC7744363 DOI: 10.1016/j.jagp.2020.06.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/20/2020] [Accepted: 06/09/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The authors conducted a prospective cohort study to examine the risk of incident mild cognitive impairment (MCI) as predicted by baseline neuropsychiatric symptoms (NPS) and brain regional glucose metabolic dysfunction. METHODS About 1,363 cognitively unimpaired individuals (52.8% males) aged ≥50 years were followed for a median of 4.8 years to the outcome of incident MCI. NPS were assessed using Beck Depression and Anxiety Inventories and Neuropsychiatric Inventory Questionnaire. Glucose hypometabolism was measured by fluorodeoxyglucose positron emission tomography and defined as standardized uptake value ratio ≤ 1.47 in regions typically affected in Alzheimer disease. Cox proportional hazards models were adjusted for age, sex, education, and APOE ε4 status. RESULTS Participants with regional glucose hypometabolism and depression (Beck Depression Inventory-II ≥13) had a more than threefold increased risk of incident MCI (hazard ratio [95% confidence interval], 3.66 [1.75, 7.65], p <0.001, χ2 = 11.83, degree of freedom [df] = 1) as compared to the reference group (normal regional glucose metabolism and no depression), and the risk was also significantly elevated (7.21 [3.54, 14.7], p <0.001, χ2 = 29.68, df = 1) for participants with glucose hypometabolism and anxiety (Beck Anxiety Inventory ≥10). Having glucose hypometabolism and ≥1 NPS (3.74 [2.40, 5.82], p <0.001, χ2 = 34.13, df = 1) or ≥2 NPS (3.89 [2.20, 6.86], p <0.001, χ2 = 21.92, df = 1) increased the risk of incident MCI by more than three times, and having ≥3 NPS increased the risk by more than four times (4.12 [2.03, 8.37], p <0.001, χ2 = 15.39, df = 1). CONCLUSION Combined presence of NPS with regional glucose hypometabolism is associated with an increased risk of incident MCI, with fluorodeoxyglucose positron emission tomography appearing to be a stronger driving force of cognitive decline than NPS.
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24
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Ng KP, Pascoal TA, Mathotaarachchi S, Chan YH, Jiang L, Therriault J, Benedet AL, Shin M, Kandiah N, Greenwood CMT, Rosa-Neto P, Gauthier S. Neuropsychiatric symptoms are early indicators of an upcoming metabolic decline in Alzheimer's disease. Transl Neurodegener 2021; 10:1. [PMID: 33390174 PMCID: PMC7780680 DOI: 10.1186/s40035-020-00225-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022] Open
Abstract
Background Neuropsychiatric symptoms (NPS) are increasingly recognized as early non-cognitive manifestations in the Alzheimer’s disease (AD) continuum. However, the role of NPS as an early marker of pathophysiological progression in AD remains unclear. Dominantly inherited AD (DIAD) mutation carriers are young individuals who are destined to develop AD in future due to the full penetrance of the genetic mutation. Hence, the study of DIAD mutation carriers enables the evaluation of the associations between pure AD pathophysiology and metabolic correlates of NPS without the confounding effects of co-existing pathologies. In this longitudinal study, we aimed to identify regional brain metabolic dysfunctions associated with NPS in cognitively intact DIAD mutation carriers. Methods We stratified 221 cognitively intact participants from the Dominantly Inherited Alzheimer’s Network according to their mutation carrier status. The interactions of NPS measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q), age, and estimated years to symptom onset (EYO) as a function of metabolism measured by [18F]flurodeoxyglucose ([18F]FDG) positron emission tomography, were evaluated by the mixed-effects regression model with family-level random effects in DIAD mutation carriers and non-carriers. Exploratory factor analysis was performed to identify the neuropsychiatric subsyndromes in DIAD mutation carriers using the NPI-Q sub-components. Then the effects of interactions between specific neuropsychiatric subsyndromes and EYO on metabolism were evaluated with the mixed-effects regression model. Results A total of 119 mutation carriers and 102 non-carriers were studied. The interaction of higher NPI-Q and shorter EYO was associated with more rapid declines of global and regional [18F]FDG uptake in the posterior cingulate and ventromedial prefrontal cortices, the bilateral parietal lobes and the right insula in DIAD mutation carriers. The neuropsychiatric subsyndromes of agitation, disinhibition, irritability and depression interacted with the EYO to drive the [18F]FDG uptake decline in the DIAD mutation carriers. The interaction of NPI and EYO was not associated with [18F]FDG uptake in DIAD mutation non-carriers. Conclusions The NPS in cognitively intact DIAD mutation carriers may be a clinical indicator of subsequent metabolic decline in brain networks vulnerable to AD, which supports the emerging conceptual framework that NPS represent early manifestations of neuronal injury in AD. Further studies using different methodological approaches to identify NPS in preclinical AD are needed to validate our findings.
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Affiliation(s)
- Kok Pin Ng
- Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, McGill University, Montréal, Québec, Canada.,Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada.,Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
| | - Tharick A Pascoal
- Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, McGill University, Montréal, Québec, Canada.,Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Sulantha Mathotaarachchi
- Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, McGill University, Montréal, Québec, Canada.,Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Lai Jiang
- Lady Davis Institute, McGill University, Montreal, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Joseph Therriault
- Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, McGill University, Montréal, Québec, Canada.,Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Andrea L Benedet
- Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, McGill University, Montréal, Québec, Canada.,Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Monica Shin
- Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, McGill University, Montréal, Québec, Canada.,Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
| | - Celia M T Greenwood
- Lady Davis Institute, McGill University, Montreal, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Pedro Rosa-Neto
- Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, McGill University, Montréal, Québec, Canada.,Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Serge Gauthier
- Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, McGill University, Montréal, Québec, Canada. .,Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada.
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25
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Zhang M, Chen B, Zhong X, Zhou H, Wang Q, Mai N, Wu Z, Chen X, Peng Q, Zhang S, Yang M, Lin G, Ning Y. Neuropsychiatric Symptoms Exacerbate the Cognitive Impairments in Patients With Late-Life Depression. Front Psychiatry 2021; 12:757003. [PMID: 34867543 PMCID: PMC8639522 DOI: 10.3389/fpsyt.2021.757003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/21/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Neuropsychiatric symptoms (NPS) and cognitive impairments are both common in patients with late-life depression (LLD). However, the relationship between NPS and cognitive functions in LLD patients remains unclear. The current study aims to explore the effects of NPS on cognitive impairments in LLD patients. Methods: Two hundred and sixty-two LLD patients and 141 normal controls (NC) were recruited. Exploratory factor analysis was used to extract factors from the Neuropsychiatric Inventory (NPI). Correlation, mediation, and moderation analyses were used to explore whether NPS exacerbated the cognitive impairments in LLD and whether NPS exhibited different effects on cognitive impairments in acute-state LLD (aLLD) and recovery-state LLD (rLLD). Results: Three main factors were extracted from the NPI, including emotional, behavioral, and psychotic factors. The patients with LLD exhibited worse cognition and higher NPI scores, and the scores of NPI-total and three extracted factors were negatively associated with cognitive scores. The mediation analyses exhibited that NPI-total and behavioral factor scores increase the difference in cognition scores between LLD and NC groups. The mediation analyses exhibited that behavioral factor score played a greater effect on impairing MMSE in the rLLD group than in the aLLD group. Additionally, behavioral factor score was in a trend to be negatively associated with Mini-Mental State Examination (MMSE) score changes at a one-year follow-up (p = 0.051). Conclusions: NPS, especially behavioral symptoms, exacerbate cognitive impairments in LLD and may contribute to residual cognitive impairment in rLLD patients. Early intervention for behavioral symptoms in LLD patients may be beneficial to their long-term clinical prognosis.
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Affiliation(s)
- Min Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ben Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaomei Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huarong Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Naikeng Mai
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhangying Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinru Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qi Peng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Si Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Minfeng Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Gaohong Lin
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
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26
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Lam J, Lee J, Liu CY, Lozano AM, Lee DJ. Deep Brain Stimulation for Alzheimer's Disease: Tackling Circuit Dysfunction. Neuromodulation 2020; 24:171-186. [PMID: 33377280 DOI: 10.1111/ner.13305] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/07/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Treatments for Alzheimer's disease are urgently needed given its enormous human and economic costs and disappointing results of clinical trials targeting the primary amyloid and tau pathology. On the other hand, deep brain stimulation (DBS) has demonstrated success in other neurological and psychiatric disorders leading to great interest in DBS as a treatment for Alzheimer's disease. MATERIALS AND METHODS We review the literature on 1) circuit dysfunction in Alzheimer's disease and 2) DBS for Alzheimer's disease. Human and animal studies are reviewed individually. RESULTS There is accumulating evidence of neural circuit dysfunction at the structural, functional, electrophysiological, and neurotransmitter level. Recent evidence from humans and animals indicate that DBS has the potential to restore circuit dysfunction in Alzheimer's disease, similarly to other movement and psychiatric disorders, and may even slow or reverse the underlying disease pathophysiology. CONCLUSIONS DBS is an intriguing potential treatment for Alzheimer's disease, targeting circuit dysfunction as a novel therapeutic target. However, further exploration of the basic disease pathology and underlying mechanisms of DBS is necessary to better understand how circuit dysfunction can be restored. Additionally, robust clinical data in the form of ongoing phase III clinical trials are needed to validate the efficacy of DBS as a viable treatment.
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Affiliation(s)
- Jordan Lam
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, 90033, USA.,Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, 90033, USA
| | - Justin Lee
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, 90033, USA.,Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, 90033, USA
| | - Charles Y Liu
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, 90033, USA.,Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, 90033, USA
| | - Andres M Lozano
- Division of Neurological Surgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, ON, M5T 2S8, Canada
| | - Darrin J Lee
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, 90033, USA.,Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, 90033, USA
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Bloniecki V, Zetterberg H, Aarsland D, Vannini P, Kvartsberg H, Winblad B, Blennow K, Freund-Levi Y. Are neuropsychiatric symptoms in dementia linked to CSF biomarkers of synaptic and axonal degeneration? ALZHEIMERS RESEARCH & THERAPY 2020; 12:153. [PMID: 33203439 PMCID: PMC7670701 DOI: 10.1186/s13195-020-00718-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 10/29/2020] [Indexed: 01/12/2023]
Abstract
Background The underlying disease mechanism of neuropsychiatric symptoms (NPS) in dementia remains unclear. Cerebrospinal fluid (CSF) biomarkers for synaptic and axonal degeneration may provide novel neuropathological information for their occurrence. The aim was to investigate the relationship between NPS and CSF biomarkers for synaptic (neurogranin [Ng], growth-associated protein 43 [GAP-43]) and axonal (neurofilament light [NFL]) injury in patients with dementia. Methods A total of 151 patients (mean age ± SD, 73.5 ± 11.0, females n = 92 [61%]) were included, of which 64 had Alzheimer’s disease (AD) (34 with high NPS, i.e., Neuropsychiatric Inventory (NPI) score > 10 and 30 with low levels of NPS) and 18 were diagnosed with vascular dementia (VaD), 27 with mixed dementia (MIX), 12 with mild cognitive impairment (MCI), and 30 with subjective cognitive impairment (SCI). NPS were primarily assessed using the NPI. CSF samples were analyzed using enzyme-linked immunosorbent assays (ELISAs) for T-tau, P-tau, Aβ1–42, Ng, NFL, and GAP-43. Results No significant differences were seen in the CSF levels of Ng, GAP-43, and NFL between AD patients with high vs low levels of NPS (but almost significantly decreased for Ng in AD patients < 70 years with high NPS, p = 0.06). No significant associations between NPS and CSF biomarkers were seen in AD patients. In VaD (n = 17), negative correlations were found between GAP-43, Ng, NFL, and NPS. Conclusion Our results could suggest that low levels of Ng may be associated with higher severity of NPS early in the AD continuum (age < 70). Furthermore, our data may indicate a potential relationship between the presence of NPS and synaptic as well as axonal degeneration in the setting of VaD pathology.
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Affiliation(s)
- Victor Bloniecki
- Department of Neurobiology, Caring Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden. .,Department of Dermatology, Karolinska University Hospital, Solna, Sweden.
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,UK Dementia Research Institute at UCL, London, UK.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Dag Aarsland
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Center for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway
| | - Patrizia Vannini
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hlin Kvartsberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Bengt Winblad
- Department of Neurobiology, Caring Sciences and Society (NVS), Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.,Theme Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Yvonne Freund-Levi
- Department of Neurobiology, Caring Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychiatry in Region Örebro County and School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Department of Old Age Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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28
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Lussier FZ, Pascoal TA, Chamoun M, Therriault J, Tissot C, Savard M, Kang MS, Mathotaarachchi S, Benedet AL, Parsons M, Qureshi MNI, Thomas ÉM, Shin M, Dion LA, Massarweh G, Soucy JP, Tsai IH, Vitali P, Ismail Z, Rosa-Neto P, Gauthier S. Mild behavioral impairment is associated with β-amyloid but not tau or neurodegeneration in cognitively intact elderly individuals. Alzheimers Dement 2020; 16:192-199. [PMID: 31914223 PMCID: PMC7041633 DOI: 10.1002/alz.12007] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/18/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Mild behavioral impairment (MBI) is characterized by the emergence of neuropsychiatric symptoms in elderly persons. Here, we examine the associations between MBI and Alzheimer's disease (AD) biomarkers in asymptomatic elderly individuals. METHODS Ninety-six cognitively normal elderly individuals underwent MRI, [18 F]AZD4694 β-amyloid-PET, and [18 F]MK6240 tau-PET. MBI was assessed using the MBI Checklist (MBI-C). Pearson's correlations and voxel-based regressions were used to evaluate the relationship between MBI-C score and [18 F]AZD4694 retention, [18 F]MK6240 retention, and gray matter (GM) volume. RESULTS Pearson correlations revealed a positive relationship between MBI-C score and global and striatal [18 F]AZD4694 standardized uptake value ratios (SUVRs). Voxel-based regression analyses revealed a positive correlation between MBI-C score and [18 F]AZD4694 retention. No significant correlations were found between MBI-C score and [18 F]MK6240 retention or GM volume. CONCLUSION We demonstrate for the first time a link between MBI and early AD pathology in a cognitively intact elderly population, supporting the use of the MBI-C as a metric to enhance clinical trial enrolment.
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Affiliation(s)
- Firoza Z Lussier
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Tharick A Pascoal
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Mira Chamoun
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Joseph Therriault
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Cécile Tissot
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Mélissa Savard
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada
| | - Min Su Kang
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.,Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Sulantha Mathotaarachchi
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada
| | - Andrea L Benedet
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Marlee Parsons
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Muhammad Naveed Iqbal Qureshi
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Émilie M Thomas
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Monica Shin
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Laurie-Anne Dion
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada
| | - Gassan Massarweh
- Montreal Neurological Institute, Montreal, Quebec, Canada.,Department of Radiochemistry, McGill University, Montreal, Quebec, Canada
| | - Jean-Paul Soucy
- Montreal Neurological Institute, Montreal, Quebec, Canada.,Department of Radiochemistry, McGill University, Montreal, Quebec, Canada
| | - I-Huang Tsai
- Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Paolo Vitali
- Alzheimer's Disease Research Unit, The McGill University Research Centre for Studies in Aging, Verdun, Quebec, Canada
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.,Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Serge Gauthier
- Alzheimer's Disease Research Unit, The McGill University Research Centre for Studies in Aging, Verdun, Quebec, Canada
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Ruthirakuhan M, Herrmann N, Andreazza AC, Verhoeff NPLG, Gallagher D, Black SE, Kiss A, Lanctôt KL. 24S-Hydroxycholesterol Is Associated with Agitation Severity in Patients with Moderate-to-Severe Alzheimer's Disease: Analyses from a Clinical Trial with Nabilone. J Alzheimers Dis 2020; 71:21-31. [PMID: 31322567 PMCID: PMC6839471 DOI: 10.3233/jad-190202] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Agitation is a prevalent and difficult-to-treat symptom of Alzheimer’s disease (AD). The endocannabinoid system (ECS) has been a target of interest for the treatment of agitation. However, ECS signaling may interact with AD-related changes in brain cholesterol metabolism. Elevated brain cholesterol, reflected by reduced serum 24-S-hydroxycholesterol (24S-OHC), is associated with reduced membrane fluidity, preventing ligand binding to cannabinoid receptor 1. Objective: To assess whether 24S-OHC was associated with agitation severity and response to nabilone. Methods: 24S-OHC was collected from AD patients enrolled in a clinical trial on nabilone at the start and end of each phase. This allowed for the cross-sectional and longitudinal investigation between 24S-OHC and agitation (Cohen Mansfield Agitation Inventory, CMAI). Post-hoc analyses included adjustments for baseline standardized Mini-Mental Status Exam (sMMSE), and analyses with CMAI subtotals consistent with the International Psychogeriatric Association (IPA) definition for agitation (physical aggression and nonaggression, and verbal aggression). Results: 24S-OHC was not associated with CMAI scores cross-sectionally or longitudinally, before and after adjusting for baseline sMMSE. However, 24S-OHC was associated with greater CMAI IPA scores at baseline (F(1,36) = 4.95, p = 0.03). In the placebo phase only, lower 24S-OHC at baseline was associated with increases in CMAI IPA scores (b = –35.2, 95% CI –65.6 to –5.0, p = 0.02), and decreases in 24S-OHC were associated with increases in CMAI IPA scores (b = –20.94, 95% CI –57.9 to –4.01, p = 0.03). Conclusion: 24S-OHC was associated with agitation severity cross-sectionally, and longitudinally in patients with AD. However, 24S-OHC did not predict treatment response, and does not change over time with nabilone.
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Affiliation(s)
- Myuri Ruthirakuhan
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Ana C Andreazza
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | | | - Damien Gallagher
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Sandra E Black
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto and Sunnybrook HSC, Toronto, ON, Canada
| | - Alex Kiss
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Research Design and Biostatistics, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Bateman DR, Gill S, Hu S, Foster ED, Ruthirakuhan MT, Sellek AF, Mortby ME, Matušková V, Ng KP, Tarawneh RM, Freund-Levi Y, Kumar S, Gauthier S, Rosenberg PB, Ferreira de Oliveira F, Devanand DP, Ballard C, Ismail Z. Agitation and impulsivity in mid and late life as possible risk markers for incident dementia. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12016. [PMID: 32995467 PMCID: PMC7507499 DOI: 10.1002/trc2.12016] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/17/2020] [Indexed: 12/14/2022]
Abstract
To identify knowledge gaps regarding new-onset agitation and impulsivity prior to onset of cognitive impairment or dementia the International Society to Advance Alzheimer's Research and Treatment Neuropsychiatric Syndromes (NPS) Professional Interest Area conducted a scoping review. Extending a series of reviews exploring the pre-dementia risk syndrome Mild Behavioral Impairment (MBI), we focused on late-onset agitation and impulsivity (the MBI impulse dyscontrol domain) and risk of incident cognitive decline and dementia. This scoping review of agitation and impulsivity pre-dementia syndromes summarizes the current biomedical literature in terms of epidemiology, diagnosis and measurement, neurobiology, neuroimaging, biomarkers, course and prognosis, treatment, and ongoing clinical trials. Validations for pre-dementia scales such as the MBI Checklist, and incorporation into longitudinal and intervention trials, are needed to better understand impulse dyscontrol as a risk factor for mild cognitive impairment and dementia.
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Affiliation(s)
- Daniel R Bateman
- Department of Psychiatry Indiana University School of Medicine Indianapolis Indiana
- Indiana University Center for Aging Research Regenstrief Institute Indianapolis Indiana
| | - Sascha Gill
- Department of Clinical Neurosciences; and the Ron and Rene Ward Centre for Healthy Brain Aging Research; Hotchkiss Brain Institute University of Calgary Calgary Alberta Canada
| | - Sophie Hu
- Community Health Sciences, and O'Brien Institute for Public Health University of Calgary Calgary Alberta Canada
| | - Erin D Foster
- Ruth Lilly Medical Library Indiana University School of Medicine Indianapolis Indiana
- University of California Berkeley Berkeley CA
| | - Myuri T Ruthirakuhan
- Hurvitz Brain Sciences Research Program Sunnybrook Research Institute Toronto Ontario Canada
- Department of Pharmacology and Toxicology University of Toronto Ontario Canada
| | | | - Moyra E Mortby
- School of Psychology University of New South Wales Sydney New South Wales Australia
- Neuroscience Research Australia University of New South Wales Sydney New South Wales Australia
| | - Veronika Matušková
- International Clinical Research Center St. Anne's University Hospital Brno Brno Czech Republic
- Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine Charles University in Prague and Motol University Hospital Prague Czech Republic
| | - Kok Pin Ng
- Department of Neurology National Neuroscience Institute Singapore Singapore
| | - Rawan M Tarawneh
- Department of Neurology, College of Medicine The Ohio State University Columbus Ohio USA
| | - Yvonne Freund-Levi
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society Karolinska Institute Stockholm Sweden
- School of Medical Sciences Örebro University Örebro Sweden
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychiatry University of Toronto Ontario Canada
| | - Serge Gauthier
- McGill Center for Studies in Aging McGill University Montreal Quebec Canada
| | - Paul B Rosenberg
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral, Sciences Johns Hopkins University School of Medicine Baltimore Maryland
| | - Fabricio Ferreira de Oliveira
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina Federal University of São Paulo (UNIFESP), São Paulo São Paulo Brazil
| | - D P Devanand
- New York State Psychiatric Institute and Department of Psychiatry and Department of Psychiatry, College of Physicians and Surgeons Columbia University New York New York
| | - Clive Ballard
- College of Medicine and Health The University of Exeter Exeter UK
| | - Zahinoor Ismail
- Department of Clinical Neurosciences; and the Ron and Rene Ward Centre for Healthy Brain Aging Research; Hotchkiss Brain Institute University of Calgary Calgary Alberta Canada
- Community Health Sciences, and O'Brien Institute for Public Health University of Calgary Calgary Alberta Canada
- Department of Psychiatry, and the Mathison Centre for Mental Health Research & Education Cumming School of Medicine, University of Calgary Calgary Alberta Canada
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Yin J, Nielsen M, Li S, Shi J. Ketones improves Apolipoprotein E4-related memory deficiency via sirtuin 3. Aging (Albany NY) 2020; 11:4579-4586. [PMID: 31280254 PMCID: PMC6660057 DOI: 10.18632/aging.102070] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 06/25/2019] [Indexed: 12/18/2022]
Abstract
Background: Apolipoprotein E4 (ApoE4) is the major genetic risk factor of Alzheimer’s disease (AD). ApoE4 carriers have cerebral hypometabolism which is thought as a harbinger of AD. Our previous studies indicated ketones improved mitochondria energy metabolism via sirtuin 3 (Sirt3). However, it is unclear whether ketones upregulate Sirt3 and improve ApoE4-related learning and memory deficits. Results: Ketones improved learning and memory abilities of ApoE4 mice but not ApoE3 mice. Sirt3, synaptic proteins, the NAD+/ NADH ratio, and ATP production were significantly increased in the hippocampus and the cortex from ketone treatment. Methods: Human ApoE3 and ApoE4 transgenic mice (9-month-old) were treated with either ketones or normal saline by daily subcutaneous injections for 3 months (ketones, beta-hydroxybutyrate (BHB): 600 mg/kg/day; acetoacetate (ACA): 150 mg/kg/day). Learning and memory ability of these mice were assessed. Sirt3 protein, synaptic proteins (PSD95, Synaptophysin), the NAD+/ NADH ratio, and ATP levels were measured in the hippocampus and the cortex. Conclusion: Our current studies suggest that ketones improve learning and memory abilities of ApoE4 transgenic mice. Sirt3 may mediate the neuroprotection of ketones by increasing neuronal energy metabolism in ApoE4 transgenic mice. This provides the foundation for Sirt3’s potential role in the prevention and treatment of AD.
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Affiliation(s)
- Junxiang Yin
- Barrow Neurological Institute, St. Joseph Hospital and Medical Center, Dignity Health Organization, Phoenix, AZ 85013, USA
| | - Megan Nielsen
- Barrow Neurological Institute, St. Joseph Hospital and Medical Center, Dignity Health Organization, Phoenix, AZ 85013, USA.,School of Life Sciences, Arizona State University, Tempe, AZ 85257, USA
| | - Shiping Li
- Barrow Neurological Institute, St. Joseph Hospital and Medical Center, Dignity Health Organization, Phoenix, AZ 85013, USA.,Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Jiong Shi
- Barrow Neurological Institute, St. Joseph Hospital and Medical Center, Dignity Health Organization, Phoenix, AZ 85013, USA.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100160, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100160, China
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Hu M, Shu X, Wu X, Chen F, Hu H, Zhang J, Yan P, Feng H. Neuropsychiatric symptoms as prognostic makers for the elderly with mild cognitive impairment: a meta-analysis. J Affect Disord 2020; 271:185-192. [PMID: 32479315 DOI: 10.1016/j.jad.2020.03.061] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/11/2020] [Accepted: 03/22/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Although several neuropsychiatric symptoms (NPSs) have been demonstrated to have value in the prediction of the progression of mild cognitive impairment (MCI) to dementia, these symptoms are less studied for the prediction of the transition from normal cognition (NC) to MCI. METHODS Prospective cohort studies were included if they reported on at least one NPS at baseline and had MCI as the outcome. RESULTS We obtained 13 cohort studies with a total population of 33,066. Depression was the most common neuropsychiatric symptom and could significantly predict transition to MCI (RR = 1.49, 95% CI: 1.13-1.86). However, depression was more capable of predicting amnestic MCI (RR=1.43, 95% CI: 1.04-1.83) than non-aMCI (RR= 0.96, 95% CI 95% CI: 0.60-1.33). Subgroup analysis suggested that the association between depression and MCI changed with depression severity, depression criteria, apolipoprotein-E-adjusted status, age, the percentage of females, and follow-up times, but some data were too sparse for a reliable estimate. Regarding other NPSs, there were insufficient data to assess their effect on the development of MCI. However, apathy, anxiety, sleep disturbances, irritability, and agitation might be risk factors for the prediction of NC-MCI transition with strong predictive value. CONCLUSIONS Depression was associated with an approximately 1.5-fold sincreased risk of the progression to MCI in the population with normal cognition. Other NPSs with underlying predictive value deserve more attention.
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Affiliation(s)
- Mingyue Hu
- Department of Nursing, XiangYa School of Medicine, Central South University, Changsha, China
| | - Xinhui Shu
- Department of Hematology, Tumor Hospital of Henan Province, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinyin Wu
- Department of Public Health, XiangYa School of Medicine, Central South University, Changsha, China
| | - Fenghui Chen
- Department of Nursing, XiangYa School of Medicine, Central South University, Changsha, China; Department of Nursing, Xinjiang Medical University, Xinjiang, China
| | - Hengyu Hu
- Department of Nursing, XiangYa School of Medicine, Central South University, Changsha, China
| | - Junmei Zhang
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Ping Yan
- Department of Nursing, Xinjiang Medical University, Xinjiang, China
| | - Hui Feng
- Department of Nursing, XiangYa School of Medicine, Central South University, Changsha, China; Oceanwide Health management institute, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University, Changsha, China.
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Mattsson-Carlgren N, Leuzy A, Janelidze S, Palmqvist S, Stomrud E, Strandberg O, Smith R, Hansson O. The implications of different approaches to define AT(N) in Alzheimer disease. Neurology 2020; 94:e2233-e2244. [PMID: 32398359 PMCID: PMC7357296 DOI: 10.1212/wnl.0000000000009485] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/19/2019] [Indexed: 12/05/2022] Open
Abstract
Objective To compare different β-amyloid (Aβ), tau, and neurodegeneration (AT[N]) variants within the Swedish BioFINDER studies. Methods A total of 490 participants were classified into AT(N) groups. These include 53 cognitively unimpaired (CU) and 48 cognitively impaired (CI) participants (14 mild cognitive impairment [MCI] and 34 Alzheimer disease [AD] dementia) from BioFINDER-1 and 389 participants from BioFINDER-2 (245 CU and 144 CI [138 MCI and 6 AD dementia]). Biomarkers for A were CSF Aβ42 and amyloid-PET ([18F]flutemetamol); for T, CSF phosphorylated tau (p-tau) and tau PET ([18F]flortaucipir); and for (N), hippocampal volume, temporal cortical thickness, and CSF neurofilament light (NfL). Binarization of biomarkers was achieved using cutoffs defined in other cohorts. The relationship between different AT(N) combinations and cognitive trajectories (longitudinal Mini-Mental State Examination scores) was examined using linear mixed modeling and coefficient of variation. Results Among CU participants, A−T−(N)− or A+T−(N)− variants were most common. However, more T+ cases were seen using p-tau than tau PET. Among CI participants, A+T+(N)+ was more common; however, more (N)+ cases were seen for MRI measures relative to CSF NfL. Tau PET best predicted longitudinal cognitive decline in CI and p-tau in CU participants. Among CI participants, continuous T (especially tau PET) and (N) measures improved the prediction of cognitive decline compared to binary measures. Conclusions Our findings show that different AT(N) variants are not interchangeable, and that optimal variants differ by clinical stage. In some cases, dichotomizing biomarkers may result in loss of important prognostic information.
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Affiliation(s)
- Niklas Mattsson-Carlgren
- From the Clinical Memory Research Unit, Department of Clinical Sciences (N.M.-C., A.L., S.J., S.P., E.S., O.S., R.S., O.H.), and Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Malmö; and Department of Neurology (N.M.-C., S.P., R.S.) and Memory Clinic (E.S., O.H.), Skåne University Hospital, Lund, Sweden.
| | - Antoine Leuzy
- From the Clinical Memory Research Unit, Department of Clinical Sciences (N.M.-C., A.L., S.J., S.P., E.S., O.S., R.S., O.H.), and Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Malmö; and Department of Neurology (N.M.-C., S.P., R.S.) and Memory Clinic (E.S., O.H.), Skåne University Hospital, Lund, Sweden
| | - Shorena Janelidze
- From the Clinical Memory Research Unit, Department of Clinical Sciences (N.M.-C., A.L., S.J., S.P., E.S., O.S., R.S., O.H.), and Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Malmö; and Department of Neurology (N.M.-C., S.P., R.S.) and Memory Clinic (E.S., O.H.), Skåne University Hospital, Lund, Sweden
| | - Sebastian Palmqvist
- From the Clinical Memory Research Unit, Department of Clinical Sciences (N.M.-C., A.L., S.J., S.P., E.S., O.S., R.S., O.H.), and Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Malmö; and Department of Neurology (N.M.-C., S.P., R.S.) and Memory Clinic (E.S., O.H.), Skåne University Hospital, Lund, Sweden
| | - Erik Stomrud
- From the Clinical Memory Research Unit, Department of Clinical Sciences (N.M.-C., A.L., S.J., S.P., E.S., O.S., R.S., O.H.), and Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Malmö; and Department of Neurology (N.M.-C., S.P., R.S.) and Memory Clinic (E.S., O.H.), Skåne University Hospital, Lund, Sweden
| | - Olof Strandberg
- From the Clinical Memory Research Unit, Department of Clinical Sciences (N.M.-C., A.L., S.J., S.P., E.S., O.S., R.S., O.H.), and Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Malmö; and Department of Neurology (N.M.-C., S.P., R.S.) and Memory Clinic (E.S., O.H.), Skåne University Hospital, Lund, Sweden
| | - Ruben Smith
- From the Clinical Memory Research Unit, Department of Clinical Sciences (N.M.-C., A.L., S.J., S.P., E.S., O.S., R.S., O.H.), and Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Malmö; and Department of Neurology (N.M.-C., S.P., R.S.) and Memory Clinic (E.S., O.H.), Skåne University Hospital, Lund, Sweden
| | - Oskar Hansson
- From the Clinical Memory Research Unit, Department of Clinical Sciences (N.M.-C., A.L., S.J., S.P., E.S., O.S., R.S., O.H.), and Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Malmö; and Department of Neurology (N.M.-C., S.P., R.S.) and Memory Clinic (E.S., O.H.), Skåne University Hospital, Lund, Sweden.
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Ba M, Kong M. Reader response: Type 2 diabetes mellitus, brain atrophy, and cognitive decline. Neurology 2020; 94:48-49. [PMID: 31889017 DOI: 10.1212/wnl.0000000000008712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Gill S, Mouches P, Hu S, Rajashekar D, MacMaster FP, Smith EE, Forkert ND, Ismail Z. Using Machine Learning to Predict Dementia from Neuropsychiatric Symptom and Neuroimaging Data. J Alzheimers Dis 2020; 75:277-288. [PMID: 32250302 PMCID: PMC7306896 DOI: 10.3233/jad-191169] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Machine learning (ML) is a promising technique for patient-specific prediction of mild cognitive impairment (MCI) and dementia development. Neuropsychiatric symptoms (NPS) might improve the accuracy of ML models but have barely been used for this purpose. OBJECTIVES To investigate if baseline mild behavioral impairment (MBI) status used for NPS quantification along with brain morphology features are predictive of follow-up diagnosis, median 40 months later in patients with normal cognition (NC) or MCI. METHOD Baseline neuroimaging, neuropsychiatric, and clinical data from 102 individuals with NC and 239 with MCI were extracted from the Alzheimer's Disease Neuroimaging Initiative database. Neuropsychiatric inventory questionnaire items were transformed to MBI domains using a published algorithm. Diagnosis at latest follow-up was used as the outcome variable and ground truth classification. A logistic model tree classifier combined with information gain feature selection was trained to predict follow-up diagnosis. RESULTS In the binary classification (NC versus MCI/AD), the optimal ML model required only two features from over 200, MBI total score and left hippocampal volume. These features correctly classified participants as remaining normal or developing cognitive impairment with 84.4% accuracy (area under the receiver operating characteristics curve [ROC-AUC] = 0.86). Seven features were selected for the three-class model (NC versus MCI versus dementia) achieving an accuracy of 58.8% (ROC-AUC=0.73). CONCLUSION Baseline NPS, categorized for MBI domain and duration, have prognostic utility in addition to brain morphology measures for predicting diagnosis change using ML. MBI total score, followed by impulse dyscontrol and affective dysregulation were most predictive of future diagnosis.
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Affiliation(s)
- Sascha Gill
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Pauline Mouches
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Sophie Hu
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Science, University of Calgary, Calgary, Alberta, Canada
| | - Deepthi Rajashekar
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Frank P. MacMaster
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Addictions and Mental Health Strategic Clinical Network, Alberta, Canada
| | - Eric E. Smith
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Nils D. Forkert
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Zahinoor Ismail
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Science, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
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Ng KP, Chiew HJ, Rosa-Neto P, Kandiah N, Ismail Z, Gauthier S. Brain Metabolic Dysfunction in Early Neuropsychiatric Symptoms of Dementia. Front Pharmacol 2019; 10:1398. [PMID: 31824321 PMCID: PMC6882863 DOI: 10.3389/fphar.2019.01398] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 11/01/2019] [Indexed: 12/11/2022] Open
Abstract
Neuropsychiatric symptoms (NPS) including behavioral and psychiatric symptoms are common in the dementia stages of Alzheimer's disease (AD) and are associated with poorer outcomes in cognition, functional states, quality of life, and accelerated progression to severe dementia or death. NPS are also increasingly observed in the mild cognitive impairment stage of AD and may predict incipient dementia. As such, there is an emerging conceptual framework, which support NPS as early non-cognitive symptoms of dementia. [18F]fluorodeoxyglucosepositron emission tomography is a technique that is sensitive in detecting resting metabolism associated with NPS in neuropsychiatric conditions, and there is a growing body of literature evaluating the role of NPS as early indicators of brain metabolic dysfunctions in AD. In this mini-review, we examine the frequency and associations of NPS with metabolic dysfunction in the AD continuum, including preclinical, prodromal, and dementia stages of AD. We will also present the validated neurobehavioral syndrome, mild behavioral impairment describes the later life emergence of sustained NPS as an at-risk state for incident cognitive decline and dementia, and an early presentation of neurodegenerative diseases in some. Lastly, we will discuss future directions in the field so as to better understand the neurobiological basis of NPS in the early stages of the AD continuum, and their role in predicting AD pathophysiological progression and incident dementia.
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Affiliation(s)
- Kok Pin Ng
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Hui Jin Chiew
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Pedro Rosa-Neto
- The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Serge Gauthier
- The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada
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Ng KP, Therriault J, Kang MS, Struyfs H, Pascoal TA, Mathotaarachchi S, Shin M, Benedet AL, Massarweh G, Soucy JP, Rosa-Neto P, Gauthier S. Rasagiline, a monoamine oxidase B inhibitor, reduces in vivo [ 18F]THK5351 uptake in progressive supranuclear palsy. NEUROIMAGE-CLINICAL 2019; 24:102091. [PMID: 31795034 PMCID: PMC6889764 DOI: 10.1016/j.nicl.2019.102091] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 11/10/2019] [Accepted: 11/12/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND [18F]THK5351 is a tau positron emission tomography tracer that has shown promise in quantifying tau distribution in tauopathies such as Alzheimer's disease (AD) and progressive supranuclear palsy (PSP). However, the interpretation of [18F]THK5351 uptake has been shown to be confounded by high monoamine oxidase B (MAO-B) availability across the brain in AD. OBJECTIVES To test the hypothesis that the MAO-B inhibitor, rasagiline reduces [18F]THK5351 uptake in PSP. METHODS Six individuals (4: PSP; 2: cognitively unimpaired, CU) underwent [18F]THK5351 and [18F]AZD4694 to quantify baseline tau and amyloid deposition, respectively. Following a 10-day course of 1 mg rasagiline, all participants received a post-challenge [18F]THK5351 scan. The baseline and post-rasagiline challenge standardized uptake value (SUV) were generated normalized for patient weight and injected radioactivity. RESULTS The post-rasagiline regional SUV was reduced on average by 69-89% in PSP, and 53-81% in CU. The distributions of post-rasagiline [18F]THK5351 SUV among PSP individuals were not consistent with the typical pattern of tau aggregates in PSP. CONCLUSIONS Similar to AD, the interpretation of [18F]THK5351 uptake in PSP is likely confounded by off-target binding to MAO-B binding sites. [18F]THK5351 is not sufficient in quantifying tau aggregates in PSP using the proposed rasagiline dosing regimen.
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Affiliation(s)
- Kok Pin Ng
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, 6825 Boulevard LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Alzheimer's Disease Research Unit, Douglas Hospital, McGill University, Montreal, Canada; Department of Neurology, National Neuroscience Institute, Singapore
| | - Joseph Therriault
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, 6825 Boulevard LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Alzheimer's Disease Research Unit, Douglas Hospital, McGill University, Montreal, Canada
| | - Min Su Kang
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, 6825 Boulevard LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Alzheimer's Disease Research Unit, Douglas Hospital, McGill University, Montreal, Canada
| | - Hanne Struyfs
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, 6825 Boulevard LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Tharick A Pascoal
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, 6825 Boulevard LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Alzheimer's Disease Research Unit, Douglas Hospital, McGill University, Montreal, Canada
| | - Sulantha Mathotaarachchi
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, 6825 Boulevard LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Alzheimer's Disease Research Unit, Douglas Hospital, McGill University, Montreal, Canada
| | - Monica Shin
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, 6825 Boulevard LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Alzheimer's Disease Research Unit, Douglas Hospital, McGill University, Montreal, Canada
| | - Andrea L Benedet
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, 6825 Boulevard LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Alzheimer's Disease Research Unit, Douglas Hospital, McGill University, Montreal, Canada
| | - Gassan Massarweh
- McConnell Brain Imaging Centre, McGill University, 3801 University Street, Montreal, Québec H3A 2B4, Canada
| | - Jean-Paul Soucy
- McConnell Brain Imaging Centre, McGill University, 3801 University Street, Montreal, Québec H3A 2B4, Canada
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, 6825 Boulevard LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Alzheimer's Disease Research Unit, Douglas Hospital, McGill University, Montreal, Canada; Montreal Neurological Institute, 3801 University Street, Montreal, Québec H3A 2B4, Canada; Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Québec H3A 2B4, Canada
| | - Serge Gauthier
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, 6825 Boulevard LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Alzheimer's Disease Research Unit, Douglas Hospital, McGill University, Montreal, Canada.
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Yoshida K, Hata Y, Ichimata S, Nishida N. Tau and Amyloid-β Pathology in Japanese Forensic Autopsy Series Under 40 Years of Age: Prevalence and Association with APOE Genotype and Suicide Risk. J Alzheimers Dis 2019; 72:641-652. [DOI: 10.3233/jad-190196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Koji Yoshida
- Department of Neurology, Hyogo Brain and Heart Center, Hyogo, Japan
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Yukiko Hata
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Shojiro Ichimata
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Naoki Nishida
- Department of Legal Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
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Santacruz Escudero JM, Beltrán J, Palacios Á, Chimbí CM, Matallana D, Reyes P, Perez-Sola V, Santamaría-García H. Neuropsychiatric Symptoms as Predictors of Clinical Course in Neurodegeneration. A Longitudinal Study. Front Aging Neurosci 2019; 11:176. [PMID: 31396074 PMCID: PMC6668630 DOI: 10.3389/fnagi.2019.00176] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 07/01/2019] [Indexed: 12/22/2022] Open
Abstract
Background: To study the extent to which neuropsychiatric symptoms (NPS) influence the cognitive and functional decline in frontotemporal degeneration (FTD) and Alzheimer’s disease (AD). Methods: We assessed the progression of NPS and their influence on cognitive and functional progression in a group of FTD (n = 36) and AD patients (n = 47) at two different stages of the disease (2.5 years). A standardized scale was used to assess NPS—the Columbia University Scale for Psychopathology in Alzheimer’s Disease (CUSPAD)—which tracks different symptoms including depression, psychotic symptoms, as well as sleep and conduct problems. In addition, in a subsample of patients (AD n = 14 and FTD n = 14), we analyzed another group of NPS by using the Neuropsychiatric Inventory (NPI). Cognitive declines were tracked by using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE), while functionality was tracked by using the Lawton scale and the Barthel Index. Results: The presence of NPS impacts cognitive and functional decline in both groups of patients 2.5 years after disease onset. However, we observed a dissociable profile of the affectation of NPS in each group. In the AD group, results indicate that the progression of depressive symptoms and sleep problems predict cognitive and functional decline. In contrast, the progression of a mixed group of NPS, including conduct problems and delusions, predicts cognitive and functional decline in FTD. Conclusion: The presence of NPS has a critical impact on the prediction of cognitive decline in FTD and AD patients after 2.5 years of disease progression. Our results demonstrate the importance of assessing different types of NPS in neurodegenerative disorders which, in turn, predict disease progression. Future studies should assess the role of NPS in predicting different neurocognitive pathways and in neurodegeneration.
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Affiliation(s)
- José Manuel Santacruz Escudero
- Departments of Psychiatry, Physiology and Institute for Studies on the Aging, Pontificia Universidad Javeriana, Bogotá, Colombia.,Intellectus Memory and Cognition Center, Hospital Universitario San Ignacio, Bogotá, Colombia.,Department of Psychiatry and Forensic Medicine, Univesitat Autonòma de Bercelona, Barcelona, Spain
| | - Jonathan Beltrán
- Departments of Psychiatry, Physiology and Institute for Studies on the Aging, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Álvaro Palacios
- Departments of Psychiatry, Physiology and Institute for Studies on the Aging, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Claudia Marcela Chimbí
- Intellectus Memory and Cognition Center, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Diana Matallana
- Departments of Psychiatry, Physiology and Institute for Studies on the Aging, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Pablo Reyes
- Departments of Psychiatry, Physiology and Institute for Studies on the Aging, Pontificia Universidad Javeriana, Bogotá, Colombia.,Intellectus Memory and Cognition Center, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Victor Perez-Sola
- Department of Psychiatry and Forensic Medicine, Univesitat Autonòma de Bercelona, Barcelona, Spain
| | - Hernando Santamaría-García
- Departments of Psychiatry, Physiology and Institute for Studies on the Aging, Pontificia Universidad Javeriana, Bogotá, Colombia.,Intellectus Memory and Cognition Center, Hospital Universitario San Ignacio, Bogotá, Colombia
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40
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Zegarra-Valdivia JA, Santi A, Fernández de Sevilla ME, Nuñez A, Torres Aleman I. Serum Insulin-Like Growth Factor I Deficiency Associates to Alzheimer’s Disease Co-Morbidities. J Alzheimers Dis 2019; 69:979-987. [DOI: 10.3233/jad-190241] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | - Andrea Santi
- Cajal Institute (CSIC), Madrid, Spain
- CIBERNED, Spain
| | | | - Angel Nuñez
- Department of Neurosciences, School of Medicine, UAM, Madrid, Spain
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41
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Gauthier S, Ng KP, Pascoal TA, Zhang H, Rosa-Neto P. Targeting Alzheimer's Disease at the Right Time and the Right Place: Validation of a Personalized Approach to Diagnosis and Treatment. J Alzheimers Dis 2019; 64:S23-S31. [PMID: 29504543 PMCID: PMC6004905 DOI: 10.3233/jad-179924] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cautious optimism is appropriate for a near future (five years) time frame for a number of drugs acting on the different pathophysiological components of Alzheimer’s disease (amyloid deposition, tau hyperphosphorylation, neuroinflammation, vascular changes, to name the most important known so far). Since the relative weight of these components will be different between individuals and will even change over time for each individual, a ‘one drug fit for all’ approach is no longer defensible. Precision medicine using biomarkers in the diagnosis and treatment of Alzheimer’s disease is the new strategy.
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Affiliation(s)
- Serge Gauthier
- McGill Center for Studies in Aging, Douglas Mental Health Research Institute, Montreal, Canada
| | - Kok Pin Ng
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Tharick A Pascoal
- McGill Center for Studies in Aging, Douglas Mental Health Research Institute, Montreal, Canada
| | - Hua Zhang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Pedro Rosa-Neto
- McGill Center for Studies in Aging, Douglas Mental Health Research Institute, Montreal, Canada
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42
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Matsuoka T, Imai A, Fujimoto H, Kato Y, Shibata K, Nakamura K, Yokota H, Yamada K, Narumoto J. Neural Correlates of Sleep Disturbance in Alzheimer's Disease: Role of the Precuneus in Sleep Disturbance. J Alzheimers Dis 2019; 63:957-964. [PMID: 29710710 PMCID: PMC6004892 DOI: 10.3233/jad-171169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Sleep disturbance may affect the development of Alzheimer’s disease (AD), but the neural correlates of sleep disturbance in AD have not been fully clarified. Objective: To examine the factors associated with sleep disturbance in AD. Methods: A retrospective study was performed in 63 patients with AD. None of the patients had been prescribed antidementia or psychoactive drugs, and all underwent brain magnetic resonance imaging (MRI) before medication. Sleep disturbance was defined as a score of at least 1 point on the sleep disturbance subscale of the Neuropsychiatric Inventory (NPI). Whole brain image analysis was performed using SPM8 and VBM8. A two-sample t-test was used to compare patients with AD with (n = 19) and without (n = 44) sleep disturbance, with age and gender included as covariates. The statistical thresholds were set to an uncorrected p-value of 0.001 at the voxel level and a corrected p-value of 0.05 at the cluster level. In addition, pineal gland volume (PGV) measured using MRI, and white matter hyperintensity (WMH) assessed with the modified Fazekas scale were compared between patients with AD with and without sleep disturbance using independent group t-tests. Results: In whole brain analysis, the precuneus volume in patients with AD with sleep disturbance was significantly smaller than those without sleep disturbance. There were no significant differences in PGV and WMH between the two groups. Conclusion: Sleep disturbance in AD was associated with reduction of precuneus volume. This suggests that the precuneus might be an important region in sleep disturbance in AD.
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Affiliation(s)
- Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ayu Imai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Yuka Kato
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keisuke Shibata
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kaeko Nakamura
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hajime Yokota
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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43
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Primary fatty amides in plasma associated with brain amyloid burden, hippocampal volume, and memory in the European Medical Information Framework for Alzheimer's Disease biomarker discovery cohort. Alzheimers Dement 2019; 15:817-827. [PMID: 31078433 PMCID: PMC6849698 DOI: 10.1016/j.jalz.2019.03.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 02/06/2019] [Accepted: 03/04/2019] [Indexed: 12/24/2022]
Abstract
Introduction: A critical and as-yet unmet need in Alzheimer’s disease (AD) is the discovery of peripheral small molecule biomarkers. Given that brain pathology precedes clinical symptom onset, we set out to test whether metabolites in blood associated with pathology as indexed by cerebrospinal fluid (CSF) AD biomarkers. Methods: This study analyzed 593 plasma samples selected from the European Medical Information Framework for Alzheimer’s Disease Multimodal Biomarker Discovery study, of individuals who were cognitively healthy (n = 242), had mild cognitive impairment (n = 236), or had AD-type dementia (n = 115). Logistic regressions were carried out between plasma metabolites (n = 883) and CSF markers, magnetic resonance imaging, cognition, and clinical diagnosis. Results: Eight metabolites were associated with amyloid b and one with t-tau in CSF, these were primary fatty acid amides (PFAMs), lipokines, and amino acids. From these, PFAMs, glutamate, and aspartate also associated with hippocampal volume and memory. Discussion: PFAMs have been found increased and associated with amyloid b burden in CSF and clinical measures.
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Neuropsychiatric symptoms differently affect mild cognitive impairment and Alzheimer's disease patients: a retrospective observational study. Neurol Sci 2019; 40:1377-1382. [PMID: 30903419 DOI: 10.1007/s10072-019-03840-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 03/12/2019] [Indexed: 01/28/2023]
Abstract
Alzheimer's disease (AD) is the most common form of dementia characterized by the prevalent memory impairment. Mild cognitive impairment (MCI) may represent the early stage of AD, in particular when MCI patients show biomarkers consistent with AD pathology (MCI due to AD). Neuropsychiatric symptoms (NPS) frequently affect both MCI and AD patients. Cerebrospinal-fluid (CSF) tau and β-amyloid42 (Aβ42) levels are actually considered the most sensitive and specific biomarkers for AD neurodegeneration. In the present retrospective observational study, we evaluated CSF biomarkers and neuropsychological data (also including NPS measured by the neuropsychiatric inventory-NPI) in a population of patients affected by MCI due to AD compared with mild to moderate AD patients. We documented higher NPI scores in MCI compared with AD patients. In particular, sub-items related to sleep, appetite, irritability, depression, and anxiety were higher in MCI than AD. We also found the significant correlation between NPS and CSF AD biomarkers in the whole population of MCI and AD patients. Consistently, t-tau/Aβ42 ratio correlated with NPS in all the MCI and AD patients. These results suggest the more prevalent occurrence of NPS in MCI patients showing AD pathology and converting to dementia than AD patients. Moreover, a more significant degree of AD neurodegeneration, featured by high t-tau/Aβ42 ratio, correlated with more severe NPS, thus supposing that in MCI and AD patients a more extensive AD neurodegeneration is related to more severe behavioral disturbances.
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45
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Liguori C, Mercuri NB, Nuccetelli M, Izzi F, Bernardini S, Placidi F. Cerebrospinal Fluid Orexin Levels and Nocturnal Sleep Disruption in Alzheimer’s Disease Patients Showing Neuropsychiatric Symptoms. J Alzheimers Dis 2018; 66:993-999. [DOI: 10.3233/jad-180769] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Claudio Liguori
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Systems Medicine, Neurology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - Marzia Nuccetelli
- Department of Clinical Biochemistry and Molecular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Francesca Izzi
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
| | - Sergio Bernardini
- Department of Clinical Biochemistry and Molecular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
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46
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Generation and quality control of lipidomics data for the alzheimer's disease neuroimaging initiative cohort. Sci Data 2018; 5:180263. [PMID: 30457571 PMCID: PMC6244184 DOI: 10.1038/sdata.2018.263] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 10/04/2018] [Indexed: 11/30/2022] Open
Abstract
Alzheimer’s disease (AD) is a major public health priority with a large socioeconomic burden and complex etiology. The Alzheimer Disease Metabolomics Consortium (ADMC) and the Alzheimer Disease Neuroimaging Initiative (ADNI) aim to gain new biological insights in the disease etiology. We report here an untargeted lipidomics of serum specimens of 806 subjects within the ADNI1 cohort (188 AD, 392 mild cognitive impairment and 226 cognitively normal subjects) along with 83 quality control samples. Lipids were detected and measured using an ultra-high-performance liquid chromatography quadruple/time-of-flight mass spectrometry (UHPLC-QTOF MS) instrument operated in both negative and positive electrospray ionization modes. The dataset includes a total 513 unique lipid species out of which 341 are known lipids. For over 95% of the detected lipids, a relative standard deviation of better than 20% was achieved in the quality control samples, indicating high technical reproducibility. Association modeling of this dataset and available clinical, metabolomics and drug-use data will provide novel insights into the AD etiology. These datasets are available at the ADNI repository at http://adni.loni.usc.edu/
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47
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Mallo SC, Ismail Z, Pereiro AX, Facal D, Lojo-Seoane C, Campos-Magdaleno M, Juncos-Rabadán O. Assessing Mild Behavioral Impairment with the Mild Behavioral Impairment-Checklist in People with Mild Cognitive Impairment. J Alzheimers Dis 2018; 66:83-95. [DOI: 10.3233/jad-180131] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Sabela C. Mallo
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago, de Compostela, Galicia, Spain
| | - Zahinoor Ismail
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada
| | - Arturo X. Pereiro
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago, de Compostela, Galicia, Spain
| | - David Facal
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago, de Compostela, Galicia, Spain
| | - Cristina Lojo-Seoane
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago, de Compostela, Galicia, Spain
| | - María Campos-Magdaleno
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago, de Compostela, Galicia, Spain
| | - Onésimo Juncos-Rabadán
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago, de Compostela, Galicia, Spain
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48
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Veitch DP, Weiner MW, Aisen PS, Beckett LA, Cairns NJ, Green RC, Harvey D, Jack CR, Jagust W, Morris JC, Petersen RC, Saykin AJ, Shaw LM, Toga AW, Trojanowski JQ. Understanding disease progression and improving Alzheimer's disease clinical trials: Recent highlights from the Alzheimer's Disease Neuroimaging Initiative. Alzheimers Dement 2018; 15:106-152. [PMID: 30321505 DOI: 10.1016/j.jalz.2018.08.005] [Citation(s) in RCA: 249] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 08/21/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The overall goal of the Alzheimer's Disease Neuroimaging Initiative (ADNI) is to validate biomarkers for Alzheimer's disease (AD) clinical trials. ADNI is a multisite, longitudinal, observational study that has collected many biomarkers since 2004. Recent publications highlight the multifactorial nature of late-onset AD. We discuss selected topics that provide insights into AD progression and outline how this knowledge may improve clinical trials. METHODS We used standard methods to identify nearly 600 publications using ADNI data from 2016 and 2017 (listed in Supplementary Material and searchable at http://adni.loni.usc.edu/news-publications/publications/). RESULTS (1) Data-driven AD progression models supported multifactorial interactions rather than a linear cascade of events. (2) β-Amyloid (Aβ) deposition occurred concurrently with functional connectivity changes within the default mode network in preclinical subjects and was followed by specific and progressive disconnection of functional and anatomical networks. (3) Changes in functional connectivity, volumetric measures, regional hypometabolism, and cognition were detectable at subthreshold levels of Aβ deposition. 4. Tau positron emission tomography imaging studies detailed a specific temporal and spatial pattern of tau pathology dependent on prior Aβ deposition, and related to subsequent cognitive decline. 5. Clustering studies using a wide range of modalities consistently identified a "typical AD" subgroup and a second subgroup characterized by executive impairment and widespread cortical atrophy in preclinical and prodromal subjects. 6. Vascular pathology burden may act through both Aβ dependent and independent mechanisms to exacerbate AD progression. 7. The APOE ε4 allele interacted with cerebrovascular disease to impede Aβ clearance mechanisms. 8. Genetic approaches identified novel genetic risk factors involving a wide range of processes, and demonstrated shared genetic risk for AD and vascular disorders, as well as the temporal and regional pathological associations of established AD risk alleles. 9. Knowledge of early pathological changes guided the development of novel prognostic biomarkers for preclinical subjects. 10. Placebo populations of randomized controlled clinical trials had highly variable trajectories of cognitive change, underscoring the importance of subject selection and monitoring. 11. Selection criteria based on Aβ positivity, hippocampal volume, baseline cognitive/functional measures, and APOE ε4 status in combination with improved cognitive outcome measures were projected to decrease clinical trial duration and cost. 12. Multiple concurrent therapies targeting vascular health and other AD pathology in addition to Aβ may be more effective than single therapies. DISCUSSION ADNI publications from 2016 and 2017 supported the idea of AD as a multifactorial disease and provided insights into the complexities of AD disease progression. These findings guided the development of novel biomarkers and suggested that subject selection on the basis of multiple factors may lower AD clinical trial costs and duration. The use of multiple concurrent therapies in these trials may prove more effective in reversing AD disease progression.
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Affiliation(s)
- Dallas P Veitch
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Northern California Institute for Research and Education (NCIRE), Department of Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Michael W Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA; Department of Neurology, University of California, San Francisco, CA, USA.
| | - Paul S Aisen
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA
| | - Laurel A Beckett
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Nigel J Cairns
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA; Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Robert C Green
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Danielle Harvey
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | | | - William Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | | | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Arthur W Toga
- Laboratory of Neuroimaging, Institute of Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Alzheimer's Disease Core Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Udall Parkinson's Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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49
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Cortés N, Andrade V, Maccioni RB. Behavioral and Neuropsychiatric Disorders in Alzheimer’s Disease. J Alzheimers Dis 2018; 63:899-910. [DOI: 10.3233/jad-180005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Nicole Cortés
- International Center for Biomedicine (ICC), Santiago, Chile
- Laboratory of Cellular and Molecular Neurosciences, Faculty of Sciences, University of Chile, Santiago, Chile
| | - Víctor Andrade
- International Center for Biomedicine (ICC), Santiago, Chile
- Laboratory of Cellular and Molecular Neurosciences, Faculty of Sciences, University of Chile, Santiago, Chile
| | - Ricardo B. Maccioni
- International Center for Biomedicine (ICC), Santiago, Chile
- Laboratory of Cellular and Molecular Neurosciences, Faculty of Sciences, University of Chile, Santiago, Chile
- Department of Neurological Sciences, Faculty of Medicine, East Campus, University of Chile, Santiago, Chile
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50
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Cerebral Responses to Acupuncture at GV24 and Bilateral GB13 in Rat Models of Alzheimer's Disease. Behav Neurol 2018; 2018:8740284. [PMID: 29854022 PMCID: PMC5952587 DOI: 10.1155/2018/8740284] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 03/12/2018] [Indexed: 12/17/2022] Open
Abstract
Acupuncture has been widely used in China to treat neurological diseases including Alzheimer's disease (AD). However, its mechanism remains unclear. In the present study, eighty healthy Wistar rats were divided into a normal control group (n = 15) and premodel group (n = 65). Forty-five rats that met the criteria for the AD model were then randomly divided into the model group (MG), the nonacupoint group (NG), and the acupoint group (AG). All rats received positron emission tomography (PET) scanning, and the images were analyzed with Statistical Parametric Mapping 8.0. MG exhibited hypometabolism in the olfactory bulb, insular cortex, orbital cortex, prelimbic cortex, striatum, parietal association cortex, visual cortex, cingulate gyrus, and retrosplenial cortex. AG exhibited prominent and extensive hypermetabolism in the thalamus, hypothalamus, bed nucleus of the stria terminalis, cerebral peduncle, midbrain tegmentum, and pontine tegmentum compared to NG. These results demonstrated that acupuncturing at GV24 and bilateral GB13 acupoints may improve the learning and memory abilities of the AD rats, probably via altering cerebral glucose metabolism (CGM) in the hypothalamus, thalamus, and brain stem. The observed effects of acupuncture may be caused by regulating the distribution of certain kinds of neurotransmitters and enhancing synaptic plasticity.
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