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Rauscher FG, Bernardes R. Retinal OCT biomarkers and their association with cognitive function-clinical and AI approaches. DIE OPHTHALMOLOGIE 2024:10.1007/s00347-024-01988-9. [PMID: 38381373 DOI: 10.1007/s00347-024-01988-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/22/2024]
Abstract
Retinal optical coherence tomography (OCT) biomarkers have the potential to serve as early, noninvasive, and cost-effective markers for identifying individuals at risk for cognitive impairments and neurodegenerative diseases. They may also aid in monitoring disease progression and evaluating the effectiveness of interventions targeting cognitive decline. The association between retinal OCT biomarkers and cognitive performance has been demonstrated in several studies, and their importance in cognitive assessment is increasingly being recognized. Machine learning (ML) is a branch of artificial intelligence (AI) with an exponential number of applications in the medical field, particularly its deep learning (DL) subset, which is widely used for the analysis of medical images. These techniques efficiently deal with novel biomarkers when their outcome for the applications of interest is unclear, e.g., for diagnosis, prognosis prediction, disease staging, or any other relevance to clinical practice. However, using AI-based tools for medical purposes must be approached with caution, despite the many efforts to address the black-box nature of such approaches, especially due to the general underperformance in datasets other than those used for their development. Retinal OCT biomarkers are promising as potential indicators for decline in cognitive function. The underlying mechanisms are currently being explored to gain deeper insights into this relationship linking retinal health and cognitive function. Insights from neurovascular coupling and retinal microvascular changes play an important role. Further research is needed to establish the validity and utility of retinal OCT biomarkers as early indicators of cognitive decline and neurodegenerative diseases in routine clinical practice. Retinal OCT biomarkers could then provide a new avenue for early detection, monitoring and intervention in cognitive impairment with the potential to improve patient care and outcomes.
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Affiliation(s)
- Franziska G Rauscher
- Leipzig Research Centre for Civilisation Diseases (LIFE), Leipzig University, Leipzig, Germany.
- Institute for Medical Informatics, Statistics, and Epidemiology, Leipzig University, Haertelstraße 16-18, 04107, Leipzig, Germany.
- Centre for Medical Informatics - Department of Medical Data Science, Leipzig University Medical Center, Leipzig, Germany.
| | - Rui Bernardes
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Faculty of Medicine (FMUC), University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal
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Rauscher FG, Bernardes R. [Retinal optical coherence tomography biomarkers and their association with cognitive functions : Clinical and artificial intelligence approaches. German version]. DIE OPHTHALMOLOGIE 2024; 121:105-115. [PMID: 38285070 DOI: 10.1007/s00347-024-01985-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
Retinal optical coherence tomography (OCT) biomarkers have the potential to serve as early, noninvasive, and cost-effective markers for identifying individuals at risk for cognitive impairments and neurodegenerative diseases. They may also aid in monitoring disease progression and evaluating the effectiveness of interventions targeting cognitive decline. The association between retinal OCT biomarkers and cognitive performance has been demonstrated in several studies, and their importance in cognitive assessment is increasingly being recognized. Machine learning (ML) is a branch of artificial intelligence (AI) with an exponential number of applications in the medical field, particularly its deep learning (DL) subset, which is widely used for the analysis of medical images. These techniques efficiently deal with novel biomarkers when their outcome for the applications of interest are unclear, e.g., for the diagnosis, prognosis prediction and disease staging. However, using AI-based tools for medical purposes must be approached with caution, despite the many efforts to address the black-box nature of such approaches, especially due to the general underperformance in datasets other than those used for their development. Retinal OCT biomarkers are promising as potential indicators for decline in cognitive function. The underlying mechanisms are currently being explored to gain deeper insights into this relationship linking retinal health and cognitive function. Insights from neurovascular coupling and retinal microvascular changes play an important role. Further research is needed to establish the validity and utility of retinal OCT biomarkers as early indicators of cognitive decline and neurodegenerative diseases in routine clinical practice. Retinal OCT biomarkers could then provide a new avenue for early detection, monitoring and intervention in cognitive impairment with the potential to improve patient care and outcomes.
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Affiliation(s)
- Franziska G Rauscher
- Leipzig Research Centre for Civilisation Diseases (LIFE), Leipzig University, Leipzig, Deutschland.
- Institute for Medical Informatics, Statistics, and Epidemiology , Leipzig University, Härtelstr 16-18, 04107, Leipzig, Deutschland.
- Centre for Medical Informatics - Department of Medical Data Science, Leipzig University Medical Center, Leipzig, Deutschland.
| | - Rui Bernardes
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Faculty of Medicine (FMUC), University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal
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Shew W, Zhang DJ, Menkes DB, Danesh-Meyer HV. Optical Coherence Tomography in Schizophrenia Spectrum Disorders: A Systematic Review and Meta-analysis. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:19-30. [PMID: 38021252 PMCID: PMC10654004 DOI: 10.1016/j.bpsgos.2023.08.013] [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: 01/20/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 12/01/2023] Open
Abstract
Background Inner retinal atrophy has been demonstrated in schizophrenia spectrum disorder (SSD) using optical coherence tomography (OCT). This systematic review and meta-analysis investigated the role of contemporary Fourier domain OCT devices in SSD. Methods MEDLINE, PubMed, Scopus, Embase, PsycInfo, PYSNDEX, World Health Organization, and Cochrane databases were searched from inception until May 2022. All peer-reviewed adult SSD case-control studies using Fourier domain OCT were included. Ocular pathologies known to affect retinal OCT scans were excluded. Search, data appraisal, and summary data extraction were independently performed by 2 authors. Results The review criteria was met by k = 36 studies, with k = 24 studies (1074 cases, 854 controls) suitable for meta-analysis. The SSD group exhibited a thinner global peripapillary retinal nerve fiber layer (-3.26 μm, 95% CI, -5.07 to -1.45, I2 = 64%, k = 21), thinner average macular layer (-7.88 μm, 95% CI, -12.73 to -3.04, I2 = 65%, k = 11), and thinner macular ganglion cell-inner plexiform sublayer (-2.44 μm, 95% CI, -4.13 to -0.76, I2 = 30%, k = 8) compared with the control group. Retinal nerve fiber layer findings remained significant after exclusion of metabolic disease, low quality, outlier, and influential studies. Studies involving eye examinations to exclude eye disease were associated with greater atrophy in SSD. Except for cardiometabolic disease, most studies did not report clinically significant covariate data known to influence retinal thickness. Conclusions Individuals with SSD generally exhibited retinal atrophy, possibly paralleling reduced brain volumes documented in clinical imaging. Prospective longitudinal studies that collect clinical data, including various illness phases, and control for confounders will be necessary to evaluate retinal atrophy as a biomarker in SSD.
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Affiliation(s)
- William Shew
- Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
| | - Daniel J. Zhang
- Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - David B. Menkes
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Helen V. Danesh-Meyer
- Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
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van der Heide FCT, Steens ILM, Limmen B, Mokhtar S, van Boxtel MPJ, Schram MT, Köhler S, Kroon AA, van der Kallen CJH, Dagnelie PC, van Dongen MCJM, Eussen SJPM, Berendschot TTJM, Webers CAB, van Greevenbroek MMJ, Koster A, van Sloten TT, Jansen JFA, Backes WH, Stehouwer CDA. Thinner inner retinal layers are associated with lower cognitive performance, lower brain volume, and altered white matter network structure-The Maastricht Study. Alzheimers Dement 2024; 20:316-329. [PMID: 37611119 PMCID: PMC10917009 DOI: 10.1002/alz.13442] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION The retina may provide non-invasive, scalable biomarkers for monitoring cerebral neurodegeneration. METHODS We used cross-sectional data from The Maastricht study (n = 3436; mean age 59.3 years; 48% men; and 21% with type 2 diabetes [the latter oversampled by design]). We evaluated associations of retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer thicknesses with cognitive performance and magnetic resonance imaging indices (global grey and white matter volume, hippocampal volume, whole brain node degree, global efficiency, clustering coefficient, and local efficiency). RESULTS After adjustment, lower thicknesses of most inner retinal layers were significantly associated with worse cognitive performance, lower grey and white matter volume, lower hippocampal volume, and worse brain white matter network structure assessed from lower whole brain node degree, lower global efficiency, higher clustering coefficient, and higher local efficiency. DISCUSSION The retina may provide biomarkers that are informative of cerebral neurodegenerative changes in the pathobiology of dementia.
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Grants
- 31O.041 OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs
- Stichting De Weijerhorst (Maastricht, the Netherlands), the Pearl String Initiative Diabetes (Amsterdam, the Netherlands), the Cardiovascular Center (CVC, Maastricht, the Netherlands), CARIM School for Cardiovascular Diseases (Maastricht, the Netherlands), CAPHRI School for Public Health and Primary Care (Maastricht, the Netherlands), NUTRIM School for Nutrition and Translational Research in Metabolism (Maastricht, the Netherlands), Stichting Annadal (Maastricht, the Netherlands), Health Foundation Limburg (Maastricht, the Netherlands), Perimed (Järfälla, Sweden), and by unrestricted grants from Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands), and Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands)
- 916.19.074 VENI research
- 2018T025 Netherlands Organization for Scientific Research and the Netherlands Organization for Health Research and Development, and a Dutch Heart Foundation research
- 2021.81.004 Diabetes Fonds Fellowship
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Tower J. Markers and mechanisms of death in Drosophila. FRONTIERS IN AGING 2023; 4:1292040. [PMID: 38149028 PMCID: PMC10749947 DOI: 10.3389/fragi.2023.1292040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/30/2023] [Indexed: 12/28/2023]
Abstract
Parameters correlated with age and mortality in Drosophila melanogaster include decreased negative geotaxis and centrophobism behaviors, decreased climbing and walking speed, and darkened pigments in oenocytes and eye. Cessation of egg laying predicts death within approximately 5 days. Endogenous green fluorescence in eye and body increases hours prior to death. Many flies exhibit erratic movement hours before death, often leading to falls. Loss of intestinal barrier integrity (IBI) is assayed by feeding blue dye ("Smurf" phenotype), and Smurf flies typically die within 0-48 h. Some studies report most flies exhibit Smurf, whereas multiple groups report most flies die without exhibiting Smurf. Transgenic reporters containing heat shock gene promoters and innate immune response gene promoters progressively increase expression with age, and partly predict remaining life span. Innate immune reporters increase with age in every fly, prior to any Smurf phenotype, in presence or absence of antibiotics. Many flies die on their side or supine (on their back) position. The data suggest three mechanisms for death of Drosophila. One is loss of IBI, as revealed by Smurf assay. The second is nervous system malfunction, leading to erratic behavior, locomotor malfunction, and falls. The aged fly is often unable to right itself after a fall to a side-ways or supine position, leading to inability to access the food and subsequent dehydration/starvation. Finally, some flies die upright without Smurf phenotype, suggesting a possible third mechanism. The frequency of these mechanisms varies between strains and culture conditions, which may affect efficacy of life span interventions.
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Affiliation(s)
- John Tower
- Molecular and Computational Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, CA, United States
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Li C, Zhu X, Yang K, Ju Y, Shi K, Xiao Y, Su B, Lu F, Cui L, Li M. Relationship of retinal capillary plexus and ganglion cell complex with mild cognitive impairment and dementia. Eye (Lond) 2023; 37:3743-3750. [PMID: 37270614 PMCID: PMC10698172 DOI: 10.1038/s41433-023-02592-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/08/2023] [Accepted: 05/17/2023] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVE To investigate relationship of the retinal capillary plexus (RCP) and ganglion cell complex (GCC) with mild cognitive impairment (MCI) and dementia in a community-based study1. METHODS This cross-sectional study incorporated the participants of the Jidong Eye Cohort Study. Optical coherence tomography angiography was performed to obtain RCP vessel density and GCC thickness with detailed segments. The Mini-mental State Examination and Montreal Cognitive Assessment were used to assess cognitive status by professional neuropsychologists. Participants were thus divided into three groups: normal, mild cognitive impairment, and dementia. Multivariable analysis was used to measure relationship of ocular parameters with cognitive impairment. RESULTS Of the 2678 participants, the mean age was 44.1 ± 11.7 years. MCI and dementia occurred in 197 (7.4%) and 80 (3%) participants, respectively. Compared to the normal group, the adjusted odds ratio (OR) with the 95% confidence interval was 0.76 (0.65-0.90) for the correlation of lower deep RCP with MCI. We found the following items significantly associated with dementia compared with the normal group: a superficial (OR, 0.68 [0.54-0.86]) and deep (OR, 0.75 [0.57-0.99]) RCP, as well as the GCC (OR, 0.68 [0.54-0.85]). Compared to the MCI group, those with dementia had decreased GCC (OR, 0.75 [0.58-0.97]). CONCLUSIONS Decreased deep RCP density was associated with MCI. Decreased superficial and deep RCP and the thin GCC were correlated with dementia. These implied that the retinal microvasculature may develop into a promising non-invasive imaging marker to predict severity of cognitive impairment.
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Affiliation(s)
- Chunmei Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiaoxuan Zhu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Kai Yang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Ying Ju
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Keai Shi
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yunfan Xiao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Binbin Su
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Fan Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Lele Cui
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Ming Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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Blose BA, Lai A, Crosta C, Thompson JL, Silverstein SM. Retinal Neurodegeneration as a Potential Biomarker of Accelerated Aging in Schizophrenia Spectrum Disorders. Schizophr Bull 2023; 49:1316-1324. [PMID: 37459382 PMCID: PMC10483469 DOI: 10.1093/schbul/sbad102] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND AND HYPOTHESES Several biological markers are believed to reflect accelerated aging in schizophrenia spectrum disorders; however, retinal neural changes have not yet been explored as potential CNS biomarkers of accelerated aging in this population. The aim of this study was to determine whether retinal neural layer thinning is more strongly related to age in schizophrenia and schizoaffective disorder patients (SZ) than in a psychiatrically healthy control group (CON). STUDY DESIGN Schizophrenia (n = 60) and CON participants (n = 69) underwent spectral domain optical coherence tomography (OCT) scans to examine the following variables in both eyes: retinal nerve fiber layer (RNFL) thickness, macula central subfield (CSF) thickness, macula volume, ganglion cell layer-inner plexiform layer (GCL-IPL) thickness, optic cup volume, and cup-to-disc ratio. Eleven participants in each group had diabetes or hypertension. STUDY RESULTS Significant negative relationships between age and RNFL thickness, macula volume, and GCL-IPL thickness were observed in the SZ group, while no significant relationships were observed in the CON group. However, many of the findings in the SZ group lost significance when participants with diabetes/hypertension were removed from analyses. A notable exception to this was that the age × SZ interaction accounted for a unique proportion of variance in GCL-IPL thinning over and above the effect of diabetes/hypertension. CONCLUSIONS The results suggest that retinal atrophy occurs at an increased rate in schizophrenia spectrum disorders, potentially reflecting accelerated aging inherent to these conditions, with considerable contributions from systemic medical diseases closely linked to this population.
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Affiliation(s)
- Brittany A Blose
- Department of Psychology, University of Rochester, Rochester, NY, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Adriann Lai
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- University Behavioral Health Care, Rutgers University, Piscataway, NJ, USA
| | - Christen Crosta
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA
| | - Judy L Thompson
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, NJ, USA
| | - Steven M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- University Behavioral Health Care, Rutgers University, Piscataway, NJ, USA
- Department of Psychiatry, Rutgers University, Piscataway, NJ, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
- Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA
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Storp JJ, Storp NH, Danzer MF, Eter N, Biermann J. Evaluation of Retinal Nerve Fiber Layer and Macular Ganglion Cell Layer Thickness in Relation to Optic Disc Size. J Clin Med 2023; 12:jcm12072471. [PMID: 37048556 PMCID: PMC10095471 DOI: 10.3390/jcm12072471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
To investigate whether optic nerve ganglion cell amount is dependent on optic disc size, this trial analyzes the correlation between Bruch's membrane opening area (BMOA) and retinal nerve fiber layer (RNFL) thickness as well as macular ganglion cell layer thickness (mGCLT). Additionally, differences in RNFL and mGCLT regarding various optic disc cohorts are evaluated. This retrospective, monocentric study included 501 healthy eyes of 287 patients from the University Hospital Münster, Germany, who received macular and optic disc optical coherence tomography (OCT) scans. Rank correlation coefficients for clustered data were calculated to investigate the relationship between BMOA and thickness values of respective retinal layers. Furthermore, these values were compared between different optic disc groups based on BMOA. Statistical analysis did not reveal a significant correlation between BMOA and RNFL thickness, nor between BMOA and mGCLT. However, groupwise analysis showed global RNFL to be significantly decreased in small and large discs in comparison to medium discs. This was not observed for global mGCLT. This study extends existing normative data for mGCLT taking optic disc size into account. While the ganglion cell amount represented by the RNFL and mGCLT seemed independent of BMOA, mGCLT was superior to global RNFL in displaying optic nerve integrity in very small and very large optic discs.
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Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Nils Hendrik Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Moritz Fabian Danzer
- Institute of Biostatistics and Clinical Research, University of Muenster, 48149 Muenster, Germany
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Julia Biermann
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
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Taşdelen R, Ayık B, Kaya H, Sevimli N. Investigation of the Relationship Between Cognitive Functions and Retinal Findings From Spectral Optical Coherence Tomography in Patients With Schizophrenia and Their Healthy Siblings. Psychiatry Investig 2023; 20:236-244. [PMID: 36990667 PMCID: PMC10064210 DOI: 10.30773/pi.2022.0268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/11/2022] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE Retinal structural changes which were investigated by optical coherence tomography (OCT) have been reported in schizophrenia. Since cognitive dysfunction is a core feature of schizophrenia, the correlations between retinal findings and cognitive functions of patients and their healthy siblings may provide insight into the pathophysiological processes of the disorder. We aimed to investigate the relationship between neuropsychiatric tests and retinal changes in schizophrenia patients and their healthy siblings. METHODS We measured OCT parameters and cognitive performance (via Trail Making Tests, verbal fluency tests, and The Digit Span Tests) of 72 participants (36 patients with schizophrenia and 36 healthy siblings) and disease severity (with Positive and Negative Syndrome Scale, Global Assessment of Functioning, and Clinical Global Impression scales) in patients with schizophrenia and evaluated the relationship between retinal findings and clinical parameters, especially neurocognitive tests. RESULTS We found decreased ganglion cell layer-inner plexiform layer thickness and macular volume in the patient group. There were strong correlations between neurocognitive tests and OCT findings in both groups. On the other hand, there was not any correlation between retinal findings and disease parameters. CONCLUSION The cognitive symptoms of schizophrenia may be more closely related to structural changes in the retina.
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Affiliation(s)
- Rümeysa Taşdelen
- Department of Psychiatry, Marmara University Istanbul Pendik Education and Research Hospital, Istanbul, Türkiye
| | - Batuhan Ayık
- Department of Psychiatry, Sancaktepe Community Mental Health Center, Istanbul Erenkoy Education and Research Hospital, Istanbul, Türkiye
| | - Hatice Kaya
- Department of Psychiatry, Sultanbeyli Community Mental Health Center, Istanbul Sultanbeyli State Hospital, Istanbul, Türkiye
| | - Neslihan Sevimli
- Department of Ophthalmology, Istanbul Sultanbeyli State Hospital, Istanbul, Türkiye
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10
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Xia X, Qin Q, Peng Y, Wang M, Yin Y, Tang Y. Retinal Examinations Provides Early Warning of Alzheimer's Disease. J Alzheimers Dis 2022; 90:1341-1357. [PMID: 36245377 DOI: 10.3233/jad-220596] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Patients with Alzheimer's disease have difficulty maintaining independent living abilities as the disease progresses, causing an increased burden of care on family caregivers and the healthcare system and related financial strain. This patient group is expected to continue to expand as life expectancy climbs. Current diagnostics for Alzheimer's disease are complex, unaffordable, and invasive without regard to diagnosis quality at early stages, which urgently calls for more technical improvements for diagnosis specificity. Optical coherence tomography or tomographic angiography has been shown to identify retinal thickness loss and lower vascular density present earlier than symptom onset in these patients. The retina is an extension of the central nervous system and shares anatomic and functional similarities with the brain. Ophthalmological examinations can be an efficient tool to offer a window into cerebral pathology with the merit of easy operation. In this review, we summarized the latest observations on retinal pathology in Alzheimer's disease and discussed the feasibility of retinal imaging in diagnostic prediction, as well as limitations in current retinal examinations for Alzheimer's disease diagnosis.
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Affiliation(s)
- Xinyi Xia
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Qi Qin
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Yankun Peng
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Meng Wang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yunsi Yin
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yi Tang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Xie K, Fuchs H, Scifo E, Liu D, Aziz A, Aguilar-Pimentel JA, Amarie OV, Becker L, da Silva-Buttkus P, Calzada-Wack J, Cho YL, Deng Y, Edwards AC, Garrett L, Georgopoulou C, Gerlini R, Hölter SM, Klein-Rodewald T, Kramer M, Leuchtenberger S, Lountzi D, Mayer-Kuckuk P, Nover LL, Oestereicher MA, Overkott C, Pearson BL, Rathkolb B, Rozman J, Russ J, Schaaf K, Spielmann N, Sanz-Moreno A, Stoeger C, Treise I, Bano D, Busch DH, Graw J, Klingenspor M, Klopstock T, Mock BA, Salomoni P, Schmidt-Weber C, Weiergräber M, Wolf E, Wurst W, Gailus-Durner V, Breteler MMB, Hrabě de Angelis M, Ehninger D. Deep phenotyping and lifetime trajectories reveal limited effects of longevity regulators on the aging process in C57BL/6J mice. Nat Commun 2022; 13:6830. [PMID: 36369285 PMCID: PMC9652467 DOI: 10.1038/s41467-022-34515-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022] Open
Abstract
Current concepts regarding the biology of aging are primarily based on studies aimed at identifying factors regulating lifespan. However, lifespan as a sole proxy measure for aging can be of limited value because it may be restricted by specific pathologies. Here, we employ large-scale phenotyping to analyze hundreds of markers in aging male C57BL/6J mice. For each phenotype, we establish lifetime profiles to determine when age-dependent change is first detectable relative to the young adult baseline. We examine key lifespan regulators (putative anti-aging interventions; PAAIs) for a possible countering of aging. Importantly, unlike most previous studies, we include in our study design young treated groups of animals, subjected to PAAIs prior to the onset of detectable age-dependent phenotypic change. Many PAAI effects influence phenotypes long before the onset of detectable age-dependent change, but, importantly, do not alter the rate of phenotypic change. Hence, these PAAIs have limited effects on aging.
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Affiliation(s)
- Kan Xie
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Helmut Fuchs
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Enzo Scifo
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Dan Liu
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Ahmad Aziz
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany.,Department of Neurology, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Juan Antonio Aguilar-Pimentel
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Oana Veronica Amarie
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Lore Becker
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Patricia da Silva-Buttkus
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Julia Calzada-Wack
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Yi-Li Cho
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Yushuang Deng
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - A Cole Edwards
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Lillian Garrett
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany.,Institute of Developmental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Christina Georgopoulou
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Raffaele Gerlini
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Sabine M Hölter
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany.,Institute of Developmental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Tanja Klein-Rodewald
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | | | - Stefanie Leuchtenberger
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Dimitra Lountzi
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Phillip Mayer-Kuckuk
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Lena L Nover
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Manuela A Oestereicher
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Clemens Overkott
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Brandon L Pearson
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany.,Mailman School of Public Health, Columbia University, 630W. 168th St., New York, NY, 10032, USA
| | - Birgit Rathkolb
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany.,Member of German Center for Diabetes Research (DZD), 85764, Neuherberg, Germany.,Institute of Molecular Animal Breeding and Biotechnology, Gene Center, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Jan Rozman
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany.,Member of German Center for Diabetes Research (DZD), 85764, Neuherberg, Germany.,Institute of Molecular Genetics of the Czech Academy of Sciences, Czech Centre for Phenogenomics, Prumyslova 595, Vestec, 252 50, Czech Republic
| | - Jenny Russ
- Nuclear Function Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Kristina Schaaf
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Nadine Spielmann
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Adrián Sanz-Moreno
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Claudia Stoeger
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Irina Treise
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Daniele Bano
- Aging and Neurodegeneration Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Dirk H Busch
- Institute for Medical Microbiology, Immunology, and Hygiene, Technische Universität München, 81675, Munich, Germany
| | - Jochen Graw
- Institute of Developmental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Martin Klingenspor
- Molecular Nutritional Medicine, Else Kröner-Fresenius Center, Technische Universität München, 85350, Freising-Weihenstephan, Germany
| | - Thomas Klopstock
- Friedrich-Baur-Institut, Department of Neurology, Ludwig-Maximilians-University Munich, 80336, Munich, Germany.,DZNE, German Center for Neurodegenerative Diseases, 80336, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), 80336, Munich, Germany
| | - Beverly A Mock
- Laboratory of Cancer Biology and Genetics, CCR, NCI, NIH, Bethesda, MD, 20892, USA
| | - Paolo Salomoni
- Nuclear Function Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Carsten Schmidt-Weber
- Center of Allergy & Environment (ZAUM), Technische Universität München, and Helmholtz Zentrum München, 85764, Neuherberg, Germany
| | - Marco Weiergräber
- Research Group Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices, 53175, Bonn, Germany
| | - Eckhard Wolf
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Wolfgang Wurst
- Institute of Developmental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany.,DZNE, German Center for Neurodegenerative Diseases, 80336, Munich, Germany.,Chair of Developmental Genetics, TUM School of Life Sciences (SoLS), Technische Universität München, Freising, Germany
| | - Valérie Gailus-Durner
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany.,Institute for Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Martin Hrabě de Angelis
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764, Neuherberg, Germany.,Member of German Center for Diabetes Research (DZD), 85764, Neuherberg, Germany.,Chair of Experimental Genetics, TUM School of Life Sciences (SoLS), Technische Universität München, 85354, Freising, Germany
| | - Dan Ehninger
- Translational Biogerontology Lab, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127, Bonn, Germany.
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12
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Fox FAU, Diers K, Lee H, Mayr A, Reuter M, Breteler MMB, Aziz NA. Association Between Accelerometer-Derived Physical Activity Measurements and Brain Structure: A Population-Based Cohort Study. Neurology 2022; 99:e1202-e1215. [PMID: 35918154 PMCID: PMC9536740 DOI: 10.1212/wnl.0000000000200884] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES While there is growing evidence that physical activity promotes neuronal health, studies examining the relation between physical activity and brain morphology remain inconclusive. We therefore examined whether objectively quantified physical activity is related to brain volume, cortical thickness, and gray matter density in a large cohort study. In addition, we assessed molecular pathways that may underlie the effects of physical activity on brain morphology. METHODS We used cross-sectional baseline data from 2,550 eligible participants (57.6% women; mean age: 54.7 years, range: 30-94 years) of a prospective cohort study. Physical activity dose (metabolic equivalent hours and step counts) and intensity (sedentary and light-intensity and moderate-to-vigorous intensity activities) were recorded with accelerometers. Brain volumetric, gray matter density, and cortical thickness measures were obtained from 3T MRI scans using FreeSurfer and Statistical Parametric Mapping. The relation of physical activity (independent variable) and brain structure (outcome) was examined with polynomial multivariable regression, while adjusting for age, sex, intracranial volume, education, and smoking. Using gene expression profiles from the Allen Brain Atlas, we extracted molecular signatures associated with the effects of physical activity on brain morphology. RESULTS Physical activity dose and intensity were independently associated with larger brain volumes, gray matter density, and cortical thickness of several brain regions. The effects of physical activity on brain volume were most pronounced at low physical activity quantities and differed between men and women and across age. For example, more time spent in moderate-to-vigorous intensity activities was associated with greater total gray matter volume, but the relation leveled off with more activity (standardized β [95% CIs]: 1.37 [0.35-2.39] and -0.70 [-1.25 to -0.15] for the linear and quadratic terms, respectively). The strongest effects of physical activity were observed in motor regions and cortical regions enriched for genes involved in mitochondrial respiration. DISCUSSION Our findings suggest that physical activity benefits brain health, with the strongest effects in motor regions and regions with a high oxidative demand. While young adults may particularly profit from additional high-intensity activities, older adults may already benefit from light-intensity activities. Physical activity and reduced sedentary time may be critical in the prevention of age-associated brain atrophy and neurodegenerative diseases.
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Affiliation(s)
- Fabienne A U Fox
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - Kersten Diers
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - Hweeling Lee
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - Andreas Mayr
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - Martin Reuter
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - Monique M B Breteler
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - N Ahmad Aziz
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany.
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13
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Yang K, Cui L, Chen X, Yang C, Zheng J, Zhu X, Xiao Y, Su B, Li C, Shi K, Lu F, Qu J, Li M. Decreased Vessel Density in Retinal Capillary Plexus and Thinner Ganglion Cell Complex Associated With Cognitive Impairment. Front Aging Neurosci 2022; 14:872466. [PMID: 35557840 PMCID: PMC9087336 DOI: 10.3389/fnagi.2022.872466] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo determine the association of the retinal capillary plexus (RCP) and ganglion cell complex (GCC) with cognitive impairment using optical coherence tomography angiography (OCTA).MethodsA cross-sectional, community-based study utilizing data from the participants enrolled between August 2019 and January 2020 in the Jidong Eye Cohort Study. We assessed the vessel density in RCP and GCC thickness using OCTA, and cognitive testing using the Montreal Cognitive Assessment (MoCA). Cognitive impairment in this study was defined as MoCA score < 24. We used multivariable analysis to evaluate the association of RCP and GCC with cognitive impairment after adjusting for confounders.ResultsThis study analyzed 1555 participants. The mean age of participants was 52.3 (8.4) years, and 861 (55.4%) were women. Cognitive impairment was observed in 268 (17.2%) participants. The adjusted odds ratio (OR) with 95% confidence interval (95% CI) for parafovea vessel density in the deep RCP with cognitive impairment was 1.20 (1.03–1.39). For vessel area and length density surrounding foveal avascular zone with cognitive impairment, the ORs with 95% CIs were 1.23 (1.07–1.41) and 1.30 (1.13–1.49), respectively. For thickness in the superior GCC with cognitive impairment, the OR with 95% CI was 1.16 (1.01–1.32).ConclusionLower vessel density in the RCP and thinner GCC were associated with cognitive impairment. Our results suggest that alterations in the RCP and GCC could provide further evidence when assessing the cognitive function and may even be potentially useful biomarkers in the detection of cognitive impairment.
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Affiliation(s)
- Kai Yang
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
| | - Lele Cui
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
| | - Xueyu Chen
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chuang Yang
- Department of Mental Health, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jingwei Zheng
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
| | - Xiaoxuan Zhu
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
| | - Yunfan Xiao
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
| | - Binbin Su
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
| | - Chunmei Li
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
| | - Keai Shi
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
| | - Jia Qu
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Jia Qu,
| | - Ming Li
- Eye Hospital and School of Ophthalmology and Optometry, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, China
- Ming Li,
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14
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Mauschitz MM, Lohner V, Koch A, Stöcker T, Reuter M, Holz FG, Finger RP, Breteler MMB. Retinal layer assessments as potential biomarkers for brain atrophy in the Rhineland Study. Sci Rep 2022; 12:2757. [PMID: 35177781 PMCID: PMC8854401 DOI: 10.1038/s41598-022-06821-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/20/2022] [Indexed: 01/09/2023] Open
Abstract
Retinal assessments have been discussed as biomarkers for brain atrophy. However, available studies did not investigate all retinal layers due to older technology, reported inconsistent results, or were based on small sample sizes. We included 2872 eligible participants of the Rhineland Study with data on spectral domain-optical coherence tomography (SD-OCT) and brain magnetic resonance imaging (MRI). We used multiple linear regression to examine relationships between retinal measurements and volumetric brain measures as well as fractional anisotropy (FA) as measure of microstructural integrity of white matter (WM) for different brain regions. Mean (SD) age was 53.8 ± 13.2 years (range 30-94) and 57% were women. Volumes of the inner retina were associated with total brain and grey matter (GM) volume, and even stronger with WM volume and FA. In contrast, the outer retina was mainly associated with GM volume, while both, inner and outer retina, were associated with hippocampus volume. While we extend previously reported associations between the inner retina and brain measures, we found additional associations of the outer retina with parts of the brain. This indicates that easily accessible retinal SD-OCT assessments may serve as biomarkers for clinical monitoring of neurodegenerative diseases and merit further research.
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Affiliation(s)
- Matthias M. Mauschitz
- grid.424247.30000 0004 0438 0426Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127 Bonn, Germany ,grid.15090.3d0000 0000 8786 803XDepartment of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Valerie Lohner
- grid.424247.30000 0004 0438 0426Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127 Bonn, Germany
| | - Alexandra Koch
- grid.424247.30000 0004 0438 0426Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127 Bonn, Germany
| | - Tony Stöcker
- grid.424247.30000 0004 0438 0426MR Physics, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany ,grid.10388.320000 0001 2240 3300Department of Physics and Astronomy, University of Bonn, Bonn, Germany
| | - Martin Reuter
- grid.424247.30000 0004 0438 0426Image Analysis, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Frank G. Holz
- grid.15090.3d0000 0000 8786 803XDepartment of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Robert P. Finger
- grid.15090.3d0000 0000 8786 803XDepartment of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Monique M. B. Breteler
- grid.424247.30000 0004 0438 0426Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1/99, 53127 Bonn, Germany ,grid.10388.320000 0001 2240 3300Institute for Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany
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15
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van der Heide FCT, van Sloten TT, Willekens N, Stehouwer CDA. Neurovascular coupling unit dysfunction and dementia: Retinal measurements as tools to move towards population-based evidence. Front Endocrinol (Lausanne) 2022; 13:1014287. [PMID: 36506058 PMCID: PMC9727310 DOI: 10.3389/fendo.2022.1014287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Dysfunction of the neurovascular coupling unit may be an important contributor to dementia. The neurovascular coupling unit comprises neuronal structures (e.g. astrocytes) and vascular structures (e.g. endothelial cells) that functionally interact both at the level of the arterioles as well as at the capillary level (blood-brain barrier) to regulate optimal metabolic conditions in the brain. However, it remains unclear how and to what extent dysfunction of the neurovascular coupling unit contributes to the early-stage pathobiology of dementia. Currently, limited data are available on the association between neurovascular coupling unit dysfunction, as quantified by cerebral imaging techniques, and cognitive performance. In particular, there is a lack of population-based human data (defined as studies with a sample size ~n>500). This is an important limitation because population-based studies, in comparison with smaller clinical studies, provide data which is better representative of the general population; are less susceptible to selection bias; and have a larger statistical power to detect small associations. To acquire population-based data, however, alternative imaging techniques than cerebral imaging techniques may be required. Disadvantages of cerebral imaging techniques, which limit use in population-based studies, are that these techniques are relatively expensive, time-consuming, and/or invasive. In this review, we propose that retinal imaging techniques can be used for population-based studies: on the one hand the retina and brain have many anatomical and physiological similarities; and on the other hand retinal imaging techniques are non-invasive, highly accurate, relatively inexpensive, and require relatively short measurement time. To provide support for this concept, we provide an overview on the human (population-based) evidence on the associations of retinal indices of neurodegeneration, microvascular dysfunction, and dysfunction of the neurovascular coupling unit with magnetic resonance imaging (MRI) features of structural brain abnormalities and cognitive performance.
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Affiliation(s)
- Frank C. T. van der Heide
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, Netherlands
- Department of Psychiatry and Neuropsychology, MUMC+, Maastricht, Netherlands
- School of Mental Health and Neuroscience, MUMC+, Maastricht, Netherlands
- *Correspondence: Frank C. T. van der Heide,
| | - Thomas T. van Sloten
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, Netherlands
| | - Nele Willekens
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, Netherlands
| | - Coen D. A. Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, Netherlands
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16
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Merten N, Pinto AA, Paulsen AJ, Chen Y, Dillard LK, Fischer ME, Ryff CD, Schubert CR, Cruickshanks KJ. The Association of Psychological Well-Being With Sensory and Cognitive Function and Neuronal Health in Aging Adults. J Aging Health 2021; 34:529-538. [PMID: 34620009 DOI: 10.1177/08982643211046820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Psychological well-being (PWB) may be a potential modifiable risk factor of age-related diseases. We aimed to determine associations of PWB with sensorineural and cognitive function and neuronal health in middle-aged adults. METHODS This study included 2039 Beaver Dam Offspring Study participants. We assessed PWB, hearing, visual acuity, contrast sensitivity impairment, olfactory impairment, cognition, and retinal (macular ganglion cell inner-plexiform layer, mGCIPL) thickness. Age-sex-education-adjusted multivariable linear, logistic regression, and generalized estimating equation models were used and then further adjusted for health-related confounders. RESULTS Individuals with higher PWB had better hearing functions, visual acuity, and thicker mGCIPL and reduced odds for hearing, contrast sensitivity and olfactory impairment in age-sex-education-adjusted models. Effects on mGCIPL and visual and olfactory measures decreased with adjustment. Higher PWB was associated with better cognition, better combined sensorineural-cognitive function, and decreased cognitive impairment. DISCUSSION Psychological well-being was associated with sensorineural-cognitive health indicating a potential of PWB interventions for healthy aging.
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Affiliation(s)
- Natascha Merten
- Department of Population Health Sciences, School of Medicine and Public Health, 5232University of Wisconsin-Madison, Madison, WI, USA
| | - Aaron Alex Pinto
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, 5232University of Wisconsin-Madison, Madison, WI, USA
| | - Adam J Paulsen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, 5232University of Wisconsin-Madison, Madison, WI, USA
| | - Yanjun Chen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, 5232University of Wisconsin-Madison, Madison, WI, USA
| | - Lauren K Dillard
- Department of Communication Sciences and Disorders, College of Letters and Science, 144149University of Wisconsin-Madison, Madison, WI, USA
| | - Mary E Fischer
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, 5232University of Wisconsin-Madison, Madison, WI, USA
| | - Carol D Ryff
- Institute on Aging/Psychology, 5228University of Wisconsin-Madison, Madison, WI, USA
| | - Carla R Schubert
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, 5232University of Wisconsin-Madison, Madison, WI, USA
| | - Karen J Cruickshanks
- Department of Population Health Sciences, School of Medicine and Public Health, 5232University of Wisconsin-Madison, Madison, WI, USA.,Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, 5232University of Wisconsin-Madison, Madison, WI, USA
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17
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Zhang Y, Wang Y, Shi C, Shen M, Lu F. Advances in retina imaging as potential biomarkers for early diagnosis of Alzheimer's disease. Transl Neurodegener 2021; 10:6. [PMID: 33517891 PMCID: PMC7849105 DOI: 10.1186/s40035-021-00230-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/07/2021] [Indexed: 12/20/2022] Open
Abstract
As the most common form of dementia, Alzheimer’s disease (AD) is characterized by progressive cognitive impairments and constitutes a major social burden. Currently, the invasiveness and high costs of tests have limited the early detection and intervention of the disease. As a unique window of the brain, retinal changes can reflect the pathology of the brain. In this review, we summarize current understanding of retinal structures in AD, mild cognitive impairment (MCI) and preclinical AD, focusing on neurodegeneration and microvascular changes measured using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) technologies. The literature suggests that the impairment of retinal microvascular network and neural microstructure exists in AD, MCI and even preclinical AD. These findings provide valuable insights into a better understanding of disease pathogenesis and demonstrate that retinal changes are potential biomarkers for early diagnosis of AD and monitoring of disease progression.
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Affiliation(s)
- Ying Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, 325027, China
| | - Yanjiang Wang
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Ce Shi
- School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, 325027, China
| | - Meixiao Shen
- School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, 325027, China.
| | - Fan Lu
- School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, 325027, China.
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