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Soh C, Hervault M, Chalkley NH, Moore CM, Rohl A, Zhang Q, Uc EY, Greenlee JDW, Wessel JR. The human subthalamic nucleus transiently inhibits active attentional processes. Brain 2024; 147:3204-3215. [PMID: 38436939 PMCID: PMC11370801 DOI: 10.1093/brain/awae068] [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: 12/06/2023] [Revised: 01/29/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
The subthalamic nucleus (STN) of the basal ganglia is key to the inhibitory control of movement. Consequently, it is a primary target for the neurosurgical treatment of movement disorders like Parkinson's disease, where modulating the STN via deep brain stimulation (DBS) can release excess inhibition of thalamocortical motor circuits. However, the STN is also anatomically connected to other thalamocortical circuits, including those underlying cognitive processes like attention. Notably, STN-DBS can also affect these processes. This suggests that the STN may also contribute to the inhibition of non-motor activity and that STN-DBS may cause changes to this inhibition. Here we tested this hypothesis in humans. We used a novel, wireless outpatient method to record intracranial local field potentials (LFP) from STN DBS implants during a visual attention task (Experiment 1, n = 12). These outpatient measurements allowed the simultaneous recording of high-density EEG, which we used to derive the steady state visual evoked potential (SSVEP), a well established neural index of visual attentional engagement. By relating STN activity to this neural marker of attention (instead of overt behaviour), we avoided possible confounds resulting from STN's motor role. We aimed to test whether the STN contributes to the momentary inhibition of the SSVEP caused by unexpected, distracting sounds. Furthermore, we causally tested this association in a second experiment, where we modulated STN via DBS across two sessions of the task, spaced at least 1 week apart (n = 21, no sample overlap with Experiment 1). The LFP recordings in Experiment 1 showed that reductions of the SSVEP after distracting sounds were preceded by sound-related γ-frequency (>60 Hz) activity in the STN. Trial-to-trial modelling further showed that this STN activity statistically mediated the sounds' suppressive effect on the SSVEP. In Experiment 2, modulating STN activity via DBS significantly reduced these sound-related SSVEP reductions. This provides causal evidence for the role of the STN in the surprise-related inhibition of attention. These findings suggest that the human STN contributes to the inhibition of attention, a non-motor process. This supports a domain-general view of the inhibitory role of the STN. Furthermore, these findings also suggest a potential mechanism underlying some of the known cognitive side effects of STN-DBS treatment, especially on attentional processes. Finally, our newly established outpatient LFP recording technique facilitates the testing of the role of subcortical nuclei in complex cognitive tasks, alongside recordings from the rest of the brain, and in much shorter time than peri-surgical recordings.
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Affiliation(s)
- Cheol Soh
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
- Cognitive Control Collaborative, University of Iowa, Iowa City, IA 52242, USA
| | - Mario Hervault
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
- Cognitive Control Collaborative, University of Iowa, Iowa City, IA 52242, USA
| | - Nathan H Chalkley
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
- Cognitive Control Collaborative, University of Iowa, Iowa City, IA 52242, USA
- Department of Neurology, University of Iowa, Iowa City, IA 52242, USA
| | - Cathleen M Moore
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
| | - Andrea Rohl
- Department of Neurosurgery, University of Iowa, Iowa City, IA 52242, USA
| | - Qiang Zhang
- Department of Neurology, University of Iowa, Iowa City, IA 52242, USA
| | - Ergun Y Uc
- Department of Neurology, University of Iowa, Iowa City, IA 52242, USA
- Neurology Service, Iowa City VA Medical Center, Iowa City, IA 52246, USA
| | | | - Jan R Wessel
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
- Cognitive Control Collaborative, University of Iowa, Iowa City, IA 52242, USA
- Department of Neurology, University of Iowa, Iowa City, IA 52242, USA
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Çekok FK, Kahraman T, Genç A, Duran G, Çolakoğlu BD, Yerlikaya D, Yener G. Association between executive and physical functions in people with Parkinson's disease. Somatosens Mot Res 2024; 41:142-148. [PMID: 36908266 DOI: 10.1080/08990220.2023.2186393] [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: 09/27/2022] [Accepted: 02/27/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE People with Parkinson's disease (PD) can develop cognitive and physical impairments. There is limited evidence on the association between executive function and physical function in people with PD. OBJECTIVE We aimed to investigate the association between the executive and physical functions in people with Parkinson's disease (PD) by comparing healthy controls. METHOD Thirty-three patients diagnosed with PD and 33 healthy controls were included in the study. PD group was divided into two subgroups according to their scores on executive tests as high performers (PD-HPs; n = 17) and low performers (PD-LPs; n = 16). The severity of motor symptoms disease severity, executive function, global cognitive function, reaction time, hand function, functional capacity, physical activity, and balance confidence was assessed by the validated instruments. RESULTS The PD group had less physical function and executive function compared to healthy controls (p < 0.05). The PD-LPs group had less physical and cognitive function than the PD-HPs group (p < 0.05). The executive functions were significantly correlated with almost all variables in both people with PD and healthy people, and correlations were moderate to strong (p < 0.05). However, the correlation coefficients were relatively higher in people with PD compared to healthy controls. CONCLUSION There was a significant association between executive and physical function in people with PD. Future studies should be conducted to determine whether the treatment of one of these dysfunctions affects the other.
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Affiliation(s)
- Fatma Kübra Çekok
- Department of Physiotherapy and Rehabilition, School of Health Sciences, Tarsus University, Mersin, Turkey
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Arzu Genç
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Gözde Duran
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | | | - Deniz Yerlikaya
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | - Görsev Yener
- Department of Neurology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
- Izmir Biomedicine and Genome Center, Dokuz Eylül University, Izmir, Turkey
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Wilhelm E, Derosiere G, Quoilin C, Cakiroglu I, Paço S, Raftopoulos C, Nuttin B, Duque J. Subthalamic DBS does not restore deficits in corticospinal suppression during movement preparation in Parkinson's disease. Clin Neurophysiol 2024; 165:107-116. [PMID: 38996612 DOI: 10.1016/j.clinph.2024.06.002] [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: 10/02/2023] [Revised: 03/27/2024] [Accepted: 06/03/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE Parkinson's disease (PD) patients exhibit changes in mechanisms underlying movement preparation, particularly the suppression of corticospinal excitability - termed "preparatory suppression" - which is thought to facilitate movement execution in healthy individuals. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) being an attractive treatment for advanced PD, we aimed to study the potential contribution of this nucleus to PD-related changes in such corticospinal dynamics. METHODS On two consecutive days, we applied single-pulse transcranial magnetic stimulation to the primary motor cortex of 20 advanced PD patients treated with bilateral STN-DBS (ON vs. OFF), as well as 20 healthy control subjects. Motor-evoked potentials (MEPs) were elicited at rest or during movement preparation in an instructed-delay choice reaction time task including left- or right-hand responses. Preparatory suppression was assessed by expressing MEPs during movement preparation relative to rest. RESULTS PD patients exhibited a deficit in preparatory suppression when it was probed on the responding hand side, particularly when this corresponded to their most-affected hand, regardless of their STN-DBS status. CONCLUSIONS Advanced PD patients displayed a reduction in preparatory suppression which was not restored by STN-DBS. SIGNIFICANCE The current findings confirm that PD patients lack preparatory suppression, as previously reported. Yet, the fact that this deficit was not responsive to STN-DBS calls for future studies on the neural source of this regulatory mechanism during movement preparation.
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Affiliation(s)
- Emmanuelle Wilhelm
- Institute of Neuroscience, Catholic University of Louvain, 1200 Brussels, Belgium; Department of Adult Neurology, Saint-Luc University Hospital, 1200 Brussels, Belgium.
| | - Gerard Derosiere
- Institute of Neuroscience, Catholic University of Louvain, 1200 Brussels, Belgium
| | - Caroline Quoilin
- Institute of Neuroscience, Catholic University of Louvain, 1200 Brussels, Belgium
| | - Inci Cakiroglu
- Institute of Neuroscience, Catholic University of Louvain, 1200 Brussels, Belgium
| | - Susana Paço
- NOVA IMS, Universidade Nova de Lisboa, 1070-312 Lisbon, Portugal
| | | | - Bart Nuttin
- Department of Neurosurgery, UZ Leuven, 3000 Leuven, Belgium
| | - Julie Duque
- Institute of Neuroscience, Catholic University of Louvain, 1200 Brussels, Belgium
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Amitrano NR, Lord AR, González DA. Montreal Cognitive Assessment's auditory items (MoCA-22): Normative data and reliable change indices. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-8. [PMID: 39207946 DOI: 10.1080/23279095.2024.2396380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Our objective was to establish normative data and reliable change indices (RCI) for the Montreal Cognitive Assessment's auditory items (MoCA-22). 4,935 cognitively unimpaired participants were administered the MoCA during an in-person visit to an Alzheimer's Disease Research Center (Mage = 67.9, Meducation = 16.2, 65.8% women, 75.9% non-Hispanic-White), with 2,319 unimpaired participants returning for follow-up. Normative values and cutoffs were developed using demographic predictions from ordinary and quantile regression. Test-retest reliability was calculated using Spearman and intraclass correlations. RCI values were calculated using Chelune and colleagues' (1993) formula. Education, age, and sex were all statistically related to MoCA-22 scores, with education having the strongest relationship. Notably, these relationships were not consistent across MoCA-22 quantiles, with education becoming more important and sex becoming less important for predicting low scores. These models were integrated into a calculator for deriving normative scores for an individual case. Furthermore, there was adequate-to-good test-retest reliability (ϱ = 0.56 95% CI [.54, .59]; ICC = 0.75, 95% CI [.73, .77]) and changes of at least 2-3 points are necessary to identify reliable change at 1-3-year follow-up. These findings add to the literature regarding utility of the MoCA-22 in the cognitive screening of older adults.
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Affiliation(s)
- Nicholas R Amitrano
- Department of Psychology, Wheaton College, Wheaton, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Alinda Rafaela Lord
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Psychology, Adler University, Chicago, IL, USA
| | - David Andrés González
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Bezdicek O, Mana J, Schneiderová M, Kasáková Z, Kopecek M, Georgi H. An interplay between cross-cultural and psychometric factors in the Montreal Cognitive Assessment: Experience from the language of a small nation. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-8. [PMID: 39207955 DOI: 10.1080/23279095.2024.2397041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
The present study aimed to test the hypothesis that the total word length on the Memory subtest of the Czech version of the MoCA, which is 12 syllables compared to the English version of 7 syllables, would have a significant effect on Delayed Recall scores compared to the newly created well-balanced version of the test (further MoCA-WLE). In the original Czech version of MoCA, we replaced the 12-syllable word list in the Memory subtest with a 7-syllable list (MoCA-WLE) to make it equivalent to the standard English version in this respect. We analyzed data from 83 participants in the original MoCA group (70.63 ± 7.01 years old, 14.61 ± 3.17 years of education, 30.12% males) and 83 participants in the MoCA-WLE group (70.72 ± 6.95 years old, 14.93 ± 3.48 years of education, 30.12% males). We did not find evidence for a significant word-length effect in the original MoCA versus MoCA-WLE Delayed Recall in either the Mann-Whitney U test (W = 3418.0, p = .932) or multilevel binomial regression (b = 0.10, 95% posterior probability interval [-0.46, 0.68]). The present study shows cross-cultural limits in the adaptation of the test material. The results underline the caveats of such an approach to test adaptation. Fortunately, 12-syllables in the MoCA Memory Czech version versus the original 7-syllable list did not show a detectable word-length effect. We did not find evidence for differential item functioning or cultural item bias. The original MoCA Czech version is psychometrically comparable to the original English version.
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Affiliation(s)
- Ondrej Bezdicek
- Prague College of Psychosocial Studies, Prague, Czech Republic
- Department of Psychology, Faculty of Arts, Charles University, Praha, Czech Republic
| | - Josef Mana
- Prague College of Psychosocial Studies, Prague, Czech Republic
| | | | - Zuzana Kasáková
- Prague College of Psychosocial Studies, Prague, Czech Republic
| | - Miloslav Kopecek
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Praha, Czech Republic
| | - Hana Georgi
- Prague College of Psychosocial Studies, Prague, Czech Republic
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Gallucci L, Sperber C, Monsch AU, Klöppel S, Arnold M, Umarova RM. Improving diagnostic accuracy of the Montreal Cognitive Assessment to identify post-stroke cognitive impairment. Sci Rep 2024; 14:20125. [PMID: 39209968 PMCID: PMC11362592 DOI: 10.1038/s41598-024-71184-x] [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: 05/03/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024] Open
Abstract
Given advantages in reperfusion therapy leading to mild stroke, less apparent cognitive deficits can be overseen in a routine neurological examination. Despite the widespread use of the Montreal Cognitive Assessment (MoCA), age- and education-specific cutoffs for the detection of post-stroke cognitive impairment (PSCI) are not established, hampering its valid application in stroke. We aimed to establish age- and education-specific MoCA cutoffs to better discriminate patients with and without acute PSCI. Patients with acute ischemic stroke underwent the MoCA and a detailed neuropsychological assessment. PSCI was defined as a performance < - 1.5 SD in ≥ 2 cognitive domains. As secondary data analysis, the discriminant abilities of the MoCAraw-score (not adding + 1 as correction for ≤ 12 years of education, YoE) cutoffs were automatically derived based on Youden Index and evaluated by receiver operating characteristic analyses across age- (< 55, 55-70, > 70 years old) and education-specific (≤ 12 and > 12 YoE) groups. 351 stroke patients (67.4 ± 14.1 years old; 13.1 ± 2.8 YoE) underwent the neuropsychological assessment 2.7 ± 2.0 days post-stroke. The original MoCA cutoff < 26 falsely classified 26.2% of examined patients, with poor sensitivity in younger adults (34.8% in patients < 55 years > 12 YoE) and poor specificity in older adults (55.0%, in > 70 years ≤ 12 YoE). By maximizing both sensitivity and specificity, the optimal MoCAraw cutoffs were: (i) < 28 in patients aged < 55 with > 12 YoE (sensitivity = 69.6%, specificity = 77.8%); (ii) < 22 and < 25 in patients > 70 years with ≤ 12 and > 12 YoE (sensitivity = 61.6%, specificity = 90.0%; sensitivity = 63.3%, specificity = 84.0%, respectively). In other groups the optimal MoCAraw cutoff was < 26. Age and education level should be considered when interpreting MoCA-scores. Though new age- and education-specific cutoffs demonstrated higher discriminant ability for PSCI, their performance in young stroke and adults with higher education level was low due to ceiling effects and MoCA subtests structure, and cautious interpretation in these patients is warranted.Trial registration: ClinicalTrials.gov Identifier: NCT05653141.
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Affiliation(s)
- Laura Gallucci
- Department of Neurology, University Hospital, Inselspital, University of Bern, Freiburgstr. 16, 3010, Bern, Switzerland
- Graduate School of Health Sciences, University of Bern, Bern, Switzerland
| | - Christoph Sperber
- Department of Neurology, University Hospital, Inselspital, University of Bern, Freiburgstr. 16, 3010, Bern, Switzerland
| | | | - Stefan Klöppel
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
| | - Marcel Arnold
- Department of Neurology, University Hospital, Inselspital, University of Bern, Freiburgstr. 16, 3010, Bern, Switzerland
| | - Roza M Umarova
- Department of Neurology, University Hospital, Inselspital, University of Bern, Freiburgstr. 16, 3010, Bern, Switzerland.
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Ratcliffe LN, Hale AC, McDonald T, Hewitt KC, Nguyen CM, Spencer RJ, Loring DW. The Montreal Cognitive Assessment: Norms and Reliable Change Indices for Standard and MoCA-22 Administrations. Arch Clin Neuropsychol 2024; 39:747-765. [PMID: 38441951 PMCID: PMC11345112 DOI: 10.1093/arclin/acae013] [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: 04/19/2023] [Revised: 01/28/2024] [Accepted: 01/30/2024] [Indexed: 08/22/2024] Open
Abstract
OBJECTIVE The Montreal Cognitive Assessment (MoCA) is among the most frequently administered cognitive screening tests, yet demographically diverse normative data are needed for repeated administrations. METHOD Data were obtained from 18,410 participants using the National Alzheimer's Coordinating Center Uniform Data Set. We developed regression-based norms using Tobit regression to account for ceiling effects, explored test-retest reliability of total scores and by domain stratified by age and diagnosis with Cronbach's alpha, and reported the cumulative change frequencies for individuals with serial MoCA administrations to gage expected change. RESULTS Strong ceiling effects and negative skew were observed at the total score, domain, and item levels for the cognitively normal group, and performances became more normally distributed as the degree of cognitive impairment increased. In regression models, years of education was associated with higher MoCA scores, whereas older age, male sex, Black and American Indian or Alaska Native race, and Hispanic ethnicity were associated with lower predicted scores. Temporal stability was adequate and good at the total score level for the cognitively normal and cognitive disorders groups, respectively, but fell short of reliability standards at the domain level. CONCLUSIONS MoCA total scores are adequately reproducible among those with cognitive diagnoses, but domain scores are unstable. Robust regression-based norms should be used to adjust for demographic performance differences, and the limited reliability, along with the ceiling effects and negative skew, should be considered when interpreting MoCA scores.
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Affiliation(s)
- Lauren N Ratcliffe
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Neuropsychology Section, Michigan Medicine, Ann Arbor, MI, USA
- Department of Clinical Psychology, Mercer University College of Health Professions, Atlanta, GA, USA
| | - Andrew C Hale
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Neuropsychology Section, Michigan Medicine, Ann Arbor, MI, USA
| | - Taylor McDonald
- Department of Clinical Psychology, Mercer University College of Health Professions, Atlanta, GA, USA
| | - Kelsey C Hewitt
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Christopher M Nguyen
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Robert J Spencer
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Neuropsychology Section, Michigan Medicine, Ann Arbor, MI, USA
| | - David W Loring
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
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Al-Ezzi A, Arechavala RJ, Butler R, Nolty A, Kang JJ, Shimojo S, Wu DA, Fonteh AN, Kleinman MT, Kloner RA, Arakaki X. Disrupted brain functional connectivity as early signature in cognitively healthy individuals with pathological CSF amyloid/tau. Commun Biol 2024; 7:1037. [PMID: 39179782 PMCID: PMC11344156 DOI: 10.1038/s42003-024-06673-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 08/01/2024] [Indexed: 08/26/2024] Open
Abstract
Alterations in functional connectivity (FC) have been observed in individuals with Alzheimer's disease (AD) with elevated amyloid (Aβ) and tau. However, it is not yet known whether directed FC is already influenced by Aβ and tau load in cognitively healthy (CH) individuals. A 21-channel electroencephalogram (EEG) was used from 46 CHs classified based on cerebrospinal fluid (CSF) Aβ tau ratio: pathological (CH-PAT) or normal (CH-NAT). Directed FC was estimated with Partial Directed Coherence in frontal, temporal, parietal, central, and occipital regions. We also examined the correlations between directed FC and various functional metrics, including neuropsychology, cognitive reserve, MRI volumetrics, and heart rate variability between both groups. Compared to CH-NATs, the CH-PATs showed decreased FC from the temporal regions, indicating a loss of relative functional importance of the temporal regions. In addition, frontal regions showed enhanced FC in the CH-PATs compared to CH-NATs, suggesting neural compensation for the damage caused by the pathology. Moreover, CH-PATs showed greater FC in the frontal and occipital regions than CH-NATs. Our findings provide a useful and non-invasive method for EEG-based analysis to identify alterations in brain connectivity in CHs with a pathological versus normal CSF Aβ/tau.
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Affiliation(s)
- Abdulhakim Al-Ezzi
- Department of Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, USA.
| | - Rebecca J Arechavala
- Department of Environmental and Occupational Health, Center for Occupational and Environmental Health (COEH), University of California, Irvine, CA, USA
| | - Ryan Butler
- Department of Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Anne Nolty
- Fuller Theological Seminary, Pasadena, CA, USA
| | | | - Shinsuke Shimojo
- The Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Daw-An Wu
- The Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Alfred N Fonteh
- Department of Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Michael T Kleinman
- Department of Environmental and Occupational Health, Center for Occupational and Environmental Health (COEH), University of California, Irvine, CA, USA
| | - Robert A Kloner
- Department of Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, USA
- Department of Cardiovascular Research, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Xianghong Arakaki
- Department of Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, USA.
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Kalbe E, Folkerts AK, Witt K, Buhmann C, Liepelt-Scarfone I. German Society of Neurology guidelines for the diagnosis and treatment of cognitive impairment and affective disorders in people with Parkinson's disease: new spotlights on diagnostic procedures and non-pharmacological interventions. J Neurol 2024:10.1007/s00415-024-12503-0. [PMID: 39120709 DOI: 10.1007/s00415-024-12503-0] [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: 04/10/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND AND OBJECTIVE Cognitive impairment and dementia as well as affective disorders are common and debilitating syndromes that develop in people with Parkinson's disease (PwPD). The authors summarized recommendations for the 2023 updated German guidelines on "Parkinson's disease" from the German Neurological Society (DGN), focusing on the diagnosis and treatment of these disorders. METHODS The recommendations were based on literature reviews, other relevant guidelines, and expert opinions. RESULTS Measurements to assess cognitive and affective states were reviewed for psychometric properties, use in routine clinical practice, and availability in German. To improve mild cognitive impairment, cognitive training and physical aerobic training are recommended. To treat Parkinson's disease (PD)-related dementia, cognitive stimulation (as a non-pharmacological intervention) and acetylcholinesterase inhibitors (AChEIs, i.e., rivastigmine) are recommended. Cognitive behavioral therapy is recommended to treat depression, anxiety, and fear of progression. Physical interventions are recommended to treat depression, fatigue, and apathy. Optimized dopaminergic treatment is the first-line pharmacological strategy recommended to manage depression, apathy, anhedonia, fatigue, and mood swings. Major depression can be additionally treated using venlafaxine or desipramine, while moderate depression can be treated pharmacologically according to its clinical phenotype (psychomotor retardation or agitation) and comorbidities (e.g., sleep disturbances, pain). Venlafaxine and nortriptyline can be used to treat anhedonia, while citalopram can be used for anxiety. CONCLUSIONS In addition to the updated pharmacological treatment options, new insights into recommendations for standardized diagnostics and non-pharmacological interventions were provided for the German health care system. However, more studies are needed to explore the full potential of non-pharmacological interventions to treat and prevent cognitive impairment and affective disorders.
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Affiliation(s)
- Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Ann-Kristin Folkerts
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Karsten Witt
- Department of Neurology, School of Medicine and Health Science, Carl Von Ossietzky University of Oldenburg, Oldenburg, Germany
- Research Center of Neurosensory Science, Carl Von Ossietzky University of Oldenburg, Oldenburg, Germany
- Department of Neurology, Evangelical Hospital, Oldenburg, Germany
| | - Carsten Buhmann
- Department of Neurology, University Clinic Eppendorf, Hamburg, Germany
| | - Inga Liepelt-Scarfone
- Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, Eberhard Karls Universität Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- IB-Hochschule, Stuttgart, Germany
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Sivaranjini S, Sujatha CM. Analysis of cognitive dysfunction in Parkinson's disease using voxel based morphometry and radiomics. Cogn Process 2024; 25:521-532. [PMID: 38714621 DOI: 10.1007/s10339-024-01197-x] [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: 08/19/2023] [Accepted: 04/19/2024] [Indexed: 05/10/2024]
Abstract
Cognitive impairment in Parkinson's disease (PD) is associated with changes in the brain anatomical structures. The objective of this study, is to identify the atrophy patterns based on the severity of cognitive decline and evaluate the disease progression. In this study, gray matter alterations are analysed in 135 PD subjects under 3 cognitive domains (91 Cognitively normal PD (NC-PD), 25 PD with Mild Cognitive Impairment (PD-MCI) and 19 PD with Dementia (PD-D)) by comparing them with 58 Healthy Control (HC) subjects. Voxel Based Morphometry (VBM) is used to segment the gray matter regions in magnetic resonance images and analyse the atrophy patterns statistically. Significant patterns of gray matter variations observed in the middle temporal and medial frontal region differentiate between HC and PD subject groups based on the severity of cognitive decline. Abnormalities in gray matter is substantiated through radiomic features extracted from the significant gray matter clusters. Significant radiomic features of the clusters are able to differentiate between the HC and PD-D subjects with an accuracy of 81.82%. Higher atrophy levels identified in PD-D subjects compared to NC-PD and PD-MCI group enables early diagnosis and treatment procedures. The combined and comprehensive analysis of gray matter alterations through VBM and radiomic features gives better assessment of cognitive impairment in PD.
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Affiliation(s)
- S Sivaranjini
- Department of Electronics and Communication Engineering, College of Engineering (CEG), Anna University, Chennai, India.
| | - C M Sujatha
- Department of Electronics and Communication Engineering, College of Engineering (CEG), Anna University, Chennai, India
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Wang J, Christensen D, Coombes SA, Wang Z. Cognitive and brain morphological deviations in middle-to-old aged autistic adults: A systematic review and meta-analysis. Neurosci Biobehav Rev 2024; 163:105782. [PMID: 38944227 PMCID: PMC11283673 DOI: 10.1016/j.neubiorev.2024.105782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 06/07/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024]
Abstract
Cognitive challenges and brain structure variations are common in autism spectrum disorder (ASD) but are rarely explored in middle-to-old aged autistic adults. Cognitive deficits that overlap between young autistic individuals and elderlies with dementia raise an important question: does compromised cognitive ability and brain structure during early development drive autistic adults to be more vulnerable to pathological aging conditions, or does it protect them from further decline? To answer this question, we have synthesized current theoretical models of aging in ASD and conducted a systematic literature review (Jan 1, 1980 - Feb 29, 2024) and meta-analysis to summarize empirical studies on cognitive and brain deviations in middle-to-old aged autistic adults. We explored findings that support different aging theories in ASD and addressed study limitations and future directions. This review sheds light on the poorly understood consequences of aging question raised by the autism community to pave the way for future studies to identify sensitive and reliable measures that best predict the onset, progression, and prognosis of pathological aging in ASD.
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Affiliation(s)
- Jingying Wang
- Neurocognitive and Behavioral Development Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL 32611-8205, USA
| | - Danielle Christensen
- Neurocognitive and Behavioral Development Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL 32611-8205, USA; Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL 32611-8205, USA
| | - Stephen A Coombes
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL 32611-8205, USA; Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Zheng Wang
- Neurocognitive and Behavioral Development Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL 32611-8205, USA.
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Zhou X, Dai N, Yu D, Niu T, Wang S. Exploring galectin-3's role in predicting mild cognitive impairment in type 2 diabetes and its regulation by miRNAs. Front Med (Lausanne) 2024; 11:1443133. [PMID: 39144658 PMCID: PMC11322075 DOI: 10.3389/fmed.2024.1443133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/22/2024] [Indexed: 08/16/2024] Open
Abstract
Objective This study aimed to investigate the role of galectin-3 (Gal-3; coded by LGALS3 gene), as a biomarker for MCI in T2DM patients and to develop and validate a predictive nomogram integrating galectin-3 with clinical risk factors for MCI prediction. Additionally, microRNA regulation of LGALS3 was explored. Methods The study employed a cross-sectional design. A total of 329 hospitalized T2DM patients were recruited and randomly allocated into a training cohort (n = 231) and a validation cohort (n = 98) using 7:3 ratio. Demographic data and neuropsychological assessments were recorded for all participants. Plasma levels of galectin-3 were measured using ELISA assay. We employed Spearman's correlation and multivariable linear regression to analyze the relationship between galectin-3 levels and cognitive performance. Furthermore, univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for MCI in T2DM patients. Based on these analyses, a predictive nomogram incorporating galectin-3 and clinical predictors was developed. The model's performance was evaluated in terms of discrimination, calibration, and clinical utility. Regulatory miRNAs were identified using bioinformatics and their interactions with LGALS3 were confirmed through qRT-PCR and luciferase reporter assays. Results Galectin-3 was identified as an independent risk factor for MCI, with significant correlations to cognitive decline in T2DM patients. The developed nomogram, incorporating Gal-3, age, and education levels, demonstrated excellent predictive performance with an AUC of 0.813 in the training cohort and 0.775 in the validation cohort. The model outperformed the baseline galectin-3 model and showed a higher net benefit in clinical decision-making. Hsa-miR-128-3p was significantly downregulated in MCI patients, correlating with increased Gal-3 levels, while Luciferase assays confirmed miR-128-3p's specific binding and influence on LGALS3. Conclusion Our findings emphasize the utility of Gal-3 as a viable biomarker for early detection of MCI in T2DM patients. The validated nomogram offers a practical tool for clinical decision-making, facilitating early interventions to potentially delay the progression of cognitive impairment. Additionally, further research on miRNA128's regulation of Gal-3 levels is essential to substantiate our results.
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Affiliation(s)
- Xueling Zhou
- School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Ning Dai
- Department of ENT, Maanshan People’s Hospital, Maanshan, China
| | - Dandan Yu
- School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Tong Niu
- School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Shaohua Wang
- School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
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Zhou C, Jeryous Fares B, Thériault K, Trinh B, Joseph M, Jauhal T, Sheppard C, Labelle PR, Krishnan A, Rabin L, Taler V. Subjective cognitive decline and objective cognitive performance in older adults: A systematic review of longitudinal and cross-sectional studies. J Neuropsychol 2024. [PMID: 39075723 DOI: 10.1111/jnp.12384] [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: 01/24/2024] [Revised: 06/22/2024] [Accepted: 07/09/2024] [Indexed: 07/31/2024]
Abstract
Older adults with subjective cognitive decline (SCD) have a higher risk of developing future cognitive decline than those without SCD. However, the association between SCD and objective cognitive performance remains unclear. This PRISMA 2020-compliant systematic review aims to provide a qualitative assessment of the longitudinal and cross-sectional relationship between SCD and objective cognitive performance in different cognitive domains, in neuropsychologically healthy, community-dwelling older adults (average age of 55 or older). To identify pertinent studies, a comprehensive search was conducted from seven databases. The National Heart, Lung and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the quality of included studies. Inclusion criteria were met by 167 studies, which were full-text and published between 1 January 1982 and 16 May 2023 (inclusive) in the languages of English, French, or Spanish and presenting data on objective cognitive performance in older adults with SCD. Overall, we found that SCD was associated with poorer objective cognitive performance on measures of global cognition and memory longitudinally compared to non-SCD status, but this association was inconsistent in cross-sectional studies. This association became stronger with the use of continuous measures of SCD as opposed to dichotomous measures. Additionally, results highlight the known lack of consistency in SCD assessment among studies and comparatively small number of longitudinal studies in SCD research.
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Affiliation(s)
- Carl Zhou
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Kim Thériault
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Brian Trinh
- Department of Biology, University of Ottawa, Ottawa, Ontario, Canada
| | - Morgan Joseph
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Tegh Jauhal
- School of Medicine, New York Medical College, Valhalla, New York, USA
| | | | | | - Anjali Krishnan
- Brooklyn College of the City University of New York, Brooklyn, New York, USA
| | - Laura Rabin
- Brooklyn College of the City University of New York, Brooklyn, New York, USA
| | - Vanessa Taler
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
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Suchy-Dicey AM, Vo TT, Oziel K, Buchwald DS, Rhoads K, French BF. Psychometric Reliability, Validity, and Generalizability of MoCA in American Indian Adults: The Strong Heart Study. Assessment 2024:10731911241261436. [PMID: 39046194 DOI: 10.1177/10731911241261436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Standardized neuropsychological instruments are used to evaluate cognitive impairment, but few have been psychometrically evaluated in American Indians. We collected Montreal Cognitive Assessment (MoCA) in 403 American Indians 70 to 95 years, as well as age, sex, education, bilingual status, depression symptoms, and other neuropsychological instruments. We evaluated inferences of psychometric validity, including scoring inference using confirmatory factor analysis and structural equation modeling, generalizability inference using reliability coefficient, and extrapolation inference by examining performance across different contexts and substrata. The unidimensional (total score) model had good fit criteria. Internal consistency reliability was high. MoCA scores were positively associated with crystallized cognition (ρ = 0.48, p < .001) and inversely with depression symptoms (ρ = -0.27, p < .001). Significant differences were found by education (d = 0.79, p < .05) depression (d = 0.484, p < .05), and adjudicated cognitive status (p = .0001) strata; however, MoCA was not sensitive or specific in discriminating cognitive impairment from normal cognition (area under the curve <0.5). MoCA scores had psychometric validity in older American Indians, but education and depression are important contextual features for score interpretability. Future research should evaluate cultural or community-specific adaptations, to improve test discriminability in this underserved population.
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Affiliation(s)
- Astrid M Suchy-Dicey
- Huntington Medical Research Institutes, Pasadena, CA, USA
- Washington State University Elson S. Floyd College of Medicine, Spokane, USA
- University of Washington Alzheimer's Disease Research Center, Seattle, USA
| | - Thao T Vo
- Washington State University College of Education, Pullman, USA
| | - Kyra Oziel
- Washington State University Elson S. Floyd College of Medicine, Spokane, USA
| | - Dedra S Buchwald
- Washington State University Elson S. Floyd College of Medicine, Spokane, USA
| | - Kristoffer Rhoads
- University of Washington Alzheimer's Disease Research Center, Seattle, USA
| | - Brian F French
- Washington State University College of Education, Pullman, USA
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Piña Méndez Á, Taitz A, Palacios Rodríguez O, Rodríguez Leyva I, Assaneo MF. Speech's syllabic rhythm and articulatory features produced under different auditory feedback conditions identify Parkinsonism. Sci Rep 2024; 14:15787. [PMID: 38982177 PMCID: PMC11233651 DOI: 10.1038/s41598-024-65974-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/25/2024] [Indexed: 07/11/2024] Open
Abstract
Diagnostic tests for Parkinsonism based on speech samples have shown promising results. Although abnormal auditory feedback integration during speech production and impaired rhythmic organization of speech are known in Parkinsonism, these aspects have not been incorporated into diagnostic tests. This study aimed to identify Parkinsonism using a novel speech behavioral test that involved rhythmically repeating syllables under different auditory feedback conditions. The study included 30 individuals with Parkinson's disease (PD) and 30 healthy subjects. Participants were asked to rhythmically repeat the PA-TA-KA syllable sequence, both whispering and speaking aloud under various listening conditions. The results showed that individuals with PD had difficulties in whispering and articulating under altered auditory feedback conditions, exhibited delayed speech onset, and demonstrated inconsistent rhythmic structure across trials compared to controls. These parameters were then fed into a supervised machine-learning algorithm to differentiate between the two groups. The algorithm achieved an accuracy of 85.4%, a sensitivity of 86.5%, and a specificity of 84.3%. This pilot study highlights the potential of the proposed behavioral paradigm as an objective and accessible (both in cost and time) test for identifying individuals with Parkinson's disease.
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Affiliation(s)
- Ángeles Piña Méndez
- Faculty of Psychology, Autonomous University of San Luis Potosí, San Luis Potosí, Mexico
| | | | | | | | - M Florencia Assaneo
- Institute of Neurobiology, National Autonomous University of Mexico, Querétaro, Mexico.
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Stagge F, Lanzi AM, Saylor AK, Cohen ML. Montreal Cognitive Assessment Scores Do Not Associate With Communication Challenges Reported by Adults With Alzheimer's Disease or Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1902-1910. [PMID: 38713811 DOI: 10.1044/2024_ajslp-23-00248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
PURPOSES Screening for cognitive-communication challenges in people with Alzheimer's disease (AD) or Parkinson's disease (PD) may benefit from multiple kinds of information about the client (e.g., patient-reported, performance-based). The purposes of this report are (a) to describe, using recently published score range descriptors (e.g., "mild," "moderate"), the patient-reported communication challenges of people with AD or PD using the Communicative Participation Item Bank (CPIB) and the Aphasia Communication Outcome Measure (ACOM); and (b) to examine the relationships between the performance-based Montreal Cognitive Assessment (MoCA), a cognitive screener, and patient-reported CPIB and ACOM scores. METHOD Participants were a convenience sample of 49 community-dwelling adults with AD or PD. Participants completed the measures in person as part of a larger assessment battery. RESULTS MoCA total scores ranged from 7 to 28. CPIB T-scores fell in the following ranges: 31% were "within normal limits," 57% reflected "mildly" restricted participation, and 12% reflected "moderately" restricted participation. ACOM T-scores fell in the following ranges: 50% were either "within normal limits" or reflected "mild" impairment, 29% reflected "mild-moderately" impaired functional communication, and 21% reflected "moderately" impaired functional communication. There were only weak and nonsignificant correlations between T-scores on the ACOM or CPIB and scores on the MoCA, and there were no group differences on the ACOM or CPIB between individuals who screened positive versus negative on the MoCA. CONCLUSION When screening individuals with AD or PD, patient-reported communication challenges seem to be complementary to information provided by the MoCA and perhaps most useful in screening for mild communication challenges.
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Affiliation(s)
- Faith Stagge
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Alyssa M Lanzi
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Anna K Saylor
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Matthew L Cohen
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
- Center for Health Assessment Research and Translation, University of Delaware, Newark
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Zimmermann M, Fandrich M, Jakobi M, Röben B, Wurster I, Lerche S, Schulte C, Zimmermann S, Deuschle C, Schneiderhan-Marra N, Gasser T, Brockmann K. Association of elevated cerebrospinal fluid levels of the longevity protein α-Klotho with a delayed onset of cognitive impairment in Parkinson's disease patients. Eur J Neurol 2024:e16388. [PMID: 38946703 DOI: 10.1111/ene.16388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND AND PURPOSE Parkinson's disease (PD) is an age-related condition characterized by substantial phenotypic variability. Consequently, pathways and proteins involved in biological aging, such as the central aging pathway comprising insulin-like growth factor 1-α-Klotho-sirtuin 1-forkhead box O3-peroxisome proliferator-activated receptor γ, may potentially influence disease progression. METHODS Cerebrospinal fluid (CSF) levels of α-Klotho in 471 PD patients were examined. Of the 471 patients, 96 carried a GBA1 variant (PD GBA1), whilst the 375 non-carriers were classified as PD wild-type (PD WT). Each patient was stratified into a CSF α-Klotho tertile group based on the individual level. Kaplan-Meier survival curves and Cox regression analysis stratified by tertile groups were conducted. These longitudinal data were available for 255 patients. Follow-up times reached from 8.4 to 12.4 years. The stratification into PD WT and PD GBA1 was undertaken to evaluate potential continuum patterns, particularly in relation to CSF levels. RESULTS Higher CSF levels of α-Klotho were associated with a significant later onset of cognitive impairment. Elevated levels of α-Klotho in CSF were linked to higher Montreal Cognitive Assessment scores in male PD patients with GBA1 mutations. CONCLUSIONS Our results indicate that higher CSF levels of α-Klotho are associated with a delayed cognitive decline in PD. Notably, this correlation is more prominently observed in PD patients with GBA1 mutations, potentially reflecting the accelerated biological aging profile characteristic of individuals harboring GBA1 variants.
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Affiliation(s)
- Milan Zimmermann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Germany
| | - Madeleine Fandrich
- Natural and Medical Sciences Institute, University of Tuebingen, Reutlingen, Germany
| | - Meike Jakobi
- Natural and Medical Sciences Institute, University of Tuebingen, Reutlingen, Germany
| | - Benjamin Röben
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Germany
| | - Isabel Wurster
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Germany
| | - Stefanie Lerche
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Germany
| | - Claudia Schulte
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Germany
| | - Shahrzad Zimmermann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany
| | - Christian Deuschle
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Germany
| | | | - Thomas Gasser
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Germany
| | - Kathrin Brockmann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Germany
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Zhang L, Zhang H, Cao X, Wang L, Gan C, Sun H, Shan A, Yuan Y, Zhang K. Association between the functional connectivity of ventral tegmental area-prefrontal network and pure apathy in Parkinson's disease: a cross-sectional study. Quant Imaging Med Surg 2024; 14:4735-4748. [PMID: 39022244 PMCID: PMC11250350 DOI: 10.21037/qims-23-1673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 05/14/2024] [Indexed: 07/20/2024]
Abstract
Background Apathy, characterized by diminished goal-directed behaviors, frequently occurs in patients with Parkinson's disease (PD). The dopamine-releasing neurons of the ventral tegmental area (VTA) have been closely related to this behavioral disruption and project widely to the corticolimbic areas, yet their functional and structural connectivity in regard to other brain regions remain unknown in patients with PD and pure apathy (PD-PA). This study thus aimed to characterize the alterations of functional connectivity (FC) of the VTA and white matter structural connectivity in PD-PA. Methods In this study, 29 patients with PD-PA, 37 with PD but not pure apathy (PD-NPA), and 28 matched healthy controls (HCs) underwent T1-weighted, resting state functional magnetic resonance imaging, and diffusion tensor imaging scans. Patients of this cross-sectional retrospective study were consecutively recruited from The First Affiliated Hospital of Nanjing Medical University between April 2017 and October 2021. Meanwhile, HCs were consecutively recruited from the local community and the Health Examination Center of our hospital. An analysis of covariance and a general linear model were respectively conducted to investigate the functional and structural connectivity among three groups. The tract-based spatial statistics (TBSS) approach was used to investigate the white matter structural connectivity. Results Patients with PD-PA showed reduced FC of the VTA with the left medial superior frontal gyrus (SFGmed) when compared to the patients with PD-NPA [t=-3.67; voxel-level P<0.001; cluster-level family-wise error-corrected P (PFWE)<0.05]. Relative to the HCs, patients with PD-PA demonstrated reduced FC of the VTA with the left SFGmed (t=-4.98; voxel-level P<0.001; cluster-level PFWE<0.05), right orbital superior frontal gyrus (SFGorb) (t=-5.08; voxel-level P<0.001; cluster-level PFWE<0.05), and right middle frontal gyrus (MFG) (t=-5.08; voxel-level P<0.001; cluster-level PFWE<0.05). Moreover, the reductions in VTA FC with the left SFGmed were associated with severe apathy symptoms in patients with PD-PA (r=-0.600; P=0.003). However, a TBSS approach did not reveal any significant differences in fiber tracts between the three groups. Conclusions This study identified reduced FC within the mesocortical network (VTA-SFGmed) of patients with PD-PA. These findings may provide valuable information for administering neuromodulation therapies in the alleviation of apathy symptoms in those with PD.
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Affiliation(s)
- Li Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Heng Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xingyue Cao
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lina Wang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Caiting Gan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huimin Sun
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Aidi Shan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yongsheng Yuan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Kezhong Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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McKay NS, Millar PR, Nicosia J, Aschenbrenner AJ, Gordon BA, Benzinger TLS, Cruchaga CC, Schindler SE, Morris JC, Hassenstab J. Pick a PACC: Comparing domain-specific and general cognitive composites in Alzheimer disease research. Neuropsychology 2024; 38:443-464. [PMID: 38602816 PMCID: PMC11176005 DOI: 10.1037/neu0000949] [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] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVE We aimed to illustrate how complex cognitive data can be used to create domain-specific and general cognitive composites relevant to Alzheimer disease research. METHOD Using equipercentile equating, we combined data from the Charles F. and Joanne Knight Alzheimer Disease Research Center that spanned multiple iterations of the Uniform Data Set. Exploratory factor analyses revealed four domain-specific composites representing episodic memory, semantic memory, working memory, and attention/processing speed. The previously defined preclinical Alzheimer disease cognitive composite (PACC) and a novel alternative, the Knight-PACC, were also computed alongside a global composite comprising all available tests. These three composites allowed us to compare the usefulness of domain and general composites in the context of predicting common Alzheimer disease biomarkers. RESULTS General composites slightly outperformed domain-specific metrics in predicting imaging-derived amyloid, tau, and neurodegeneration burden. Power analyses revealed that the global, Knight-PACC, and attention and processing speed composites would require the smallest sample sizes to detect cognitive change in a clinical trial, while the Alzheimer Disease Cooperative Study-PACC required two to three times as many participants. CONCLUSIONS Analyses of cognition with the Knight-PACC and our domain-specific composites offer researchers flexibility by providing validated outcome assessments that can equate across test versions to answer a wide range of questions regarding cognitive decline in normal aging and neurodegenerative disease. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Longo C, Romano DL, Pennacchio M, Malaguti MC, Di Giacopo R, Giometto B, Papagno C. Are the criteria for PD-MCI diagnosis comprehensive? A Machine Learning study with modified criteria. Parkinsonism Relat Disord 2024; 124:106987. [PMID: 38701720 DOI: 10.1016/j.parkreldis.2024.106987] [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] [Received: 01/10/2024] [Revised: 04/11/2024] [Accepted: 04/28/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Mild cognitive impairment in Parkinson's disease (PD-MCI) includes deficits in different cognitive domains, and one domain to explore for neurocognitive impairment following the DSM-V is social cognition. However, this domain is not included in current criteria for PD-MCI diagnosis. Moreover, tests vary across studies. It is, therefore, crucial to optimize cognitive assessment in PD-MCI. We aimed to do so by using Machine Learning. METHODS 275 PD patients were included. Four cognitive batteries were created: two Standard ones (Levels I and II), applying current criteria and "traditional" tests; two Alternative ones (Levels I and II), which incorporated a test of social cognition. These batteries were included in the Random Forest (RF) classifier. To assess RF performance, the AUC was considered, and the Variable Importance Index was estimated to understand the contribution of each test in PD-MCI classification. RESULTS Standard Level I and II showed an AUC of 0.852 and 0.892, while Alternative Level I and II showed an AUC of 0.898 and of 0.906. Variable Importance Index revealed that TMT B-A, Ekman test, RAVLT-IR, MoCA, and Action Naming were tests that most contributed to PD-MCI classification. CONCLUSION The Alternative level I assessment demonstrated a similar classification capacity to the Standard level II assessment. This finding suggests that in the cognitive assessment of PD patients, it is crucial to consider the most affected cognitive domains in this clinical population, including social cognition. Taken together, these results suggest to revise current criteria for the diagnosis of PD-MCI.
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Affiliation(s)
- Chiara Longo
- Department of Neurology, "Santa Chiara Hospital", Azienda Provinciale per I Servizi Sanitari (APSS), 38122, Trento, Italy; Department of Psychology, University of Milano-Bicocca, 20126, Milan, Italy.
| | | | - Maria Pennacchio
- Department of Psychology, University of Milano-Bicocca, 20126, Milan, Italy; Center for Mind/Brain Sciences (CIMeC), University of Trento, 38068, Rovereto, Italy
| | - Maria Chiara Malaguti
- Department of Neurology, "Santa Chiara Hospital", Azienda Provinciale per I Servizi Sanitari (APSS), 38122, Trento, Italy
| | - Raffaella Di Giacopo
- Department of Neurology, "Santa Maria del Carmine Hospital", Azienda Provinciale per I Servizi Sanitari (APSS), 38068, Rovereto, Italy
| | - Bruno Giometto
- Department of Neurology, "Santa Chiara Hospital", Azienda Provinciale per I Servizi Sanitari (APSS), 38122, Trento, Italy; Center for Mind/Brain Sciences (CIMeC), University of Trento, 38068, Rovereto, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences (CIMeC), University of Trento, 38068, Rovereto, Italy
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Cao LX, Kong WL, Chan P, Zhang W, Morris MJ, Huang Y. Assessment tools for cognitive performance in Parkinson's disease and its genetic contributors. Front Neurol 2024; 15:1413187. [PMID: 38988604 PMCID: PMC11233456 DOI: 10.3389/fneur.2024.1413187] [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: 04/08/2024] [Accepted: 06/14/2024] [Indexed: 07/12/2024] Open
Abstract
Background We have shown that genetic factors associating with motor progression of Parkinson's disease (PD), but their roles in cognitive function is poorly understood. One reason is that while cognitive performance in PD can be evaluated by various cognitive scales, there is no definitive guide indicating which tool performs better. Methods Data were obtained from the Parkinson's Progression Markers Initiative, where cognitive performance was assessed using five cognitive screening tools, including Symbol Digit Modalities Test (SDMT), Montreal Cognitive Assessment, Benton Judgment of Line Orientation, Modified Semantic Fluency Test, and Letter Number Sequencing Test, at baseline and subsequent annual follow-up visit for 5 years. Genetic data including ApoE and other PD risk genetic information were also obtained. We used SPSS-receiver operating characteristic and ANOVA repeated measures to evaluate which cognitive assessment is the best reflecting cognitive performance in PD at early stage and over time. Logistic regression analyses were used to determine the genetic associations with the rapidity of cognitive decline in PD. Results SDMT performed better in detecting mild cognitive impairment at baseline (AUC = 0.763), and SDMT was the only tool showing a steady cognitive decline during longitudinal observation. Multigenetic factors significantly associated with cognitive impairment at early stage of the disease (AUC = 0.950) with IP6K2 rs12497850 more evident, and a significantly faster decline (AUC = 0.831) within 5 years after motor onset, particularly in those carrying FGF20 rs591323. Conclusion SDMT is a preferable cognitive assessment tool for PD and genetic factors synergistically contribute to the cognitive dysfunction in PD.
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Affiliation(s)
- Ling-Xiao Cao
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wee Lee Kong
- Pharmacology Department, School of Biomedical Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Piu Chan
- Department of Neurobiology, Neurology and Geriatrics, National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Wei Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Margaret J. Morris
- Pharmacology Department, School of Biomedical Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Yue Huang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Pharmacology Department, School of Biomedical Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
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22
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Galvez V, Romero-Rebollar C, Estudillo-Guerra MA, Fernandez-Ruiz J. Resting-state networks and their relationship with MoCA performance in PD patients. Brain Imaging Behav 2024; 18:612-621. [PMID: 38332386 DOI: 10.1007/s11682-024-00860-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
Although mild cognitive impairment is a common non-motor symptom experienced by individuals with Parkinson's Disease, the changes in intrinsic resting-state networks associated with its onset in Parkinson's remain underexamined. To address the issue, our study sought to examine resting-state network alterations and their association with total performance in the Montreal Cognitive Assessment and its cognitive domains in Parkinson's by means of functional magnetic resonance imaging of 29 Parkinson's patients with normal cognition, 25 Parkinson's patients with mild cognitive impairment, and 13 healthy controls. To contrast the Parkinson's groups with each other and the controls, the images were used to estimate the Z-score coefficient between the regions of interest from the default mode network, the salience network and the central executive network. Our first finding was that default mode and salience network connectivity decreased significantly in Parkinson's patients regardless of their cognitive status. Additionally, default mode network nodes had a negative and salience network nodes a positive correlation with the global assessment in Parkinson's with normal cognition; this inverse relationship of both networks to total score was not found in the group with cognitive impairment. Finally, a positive correlation was found between executive scores and anterior and posterior cortical network connectivity and, in the group with cognitive impairment, between language scores and salience network connectivity. Our results suggest that specific resting-state networks of Parkinson's patients with cognitive impairment differ from those of Parkinson's patients with normal cognition, supporting the evidence that cognitive impairment in Parkinson's Disease displays a differentiated neurodegenerative pattern.
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Affiliation(s)
- Victor Galvez
- Laboratorio de Neurociencias Cognitivas y Desarrollo, Escuela de Psicología, Universidad Panamericana, Ciudad de México, México.
| | - César Romero-Rebollar
- Escuela de Pedagogía, Universidad Panamericana, Ciudad de México, México
- Universidad Tecnológica de México-UNITEC MÉXICO-Campus en línea, Ciudad de México, México
| | - M Anayali Estudillo-Guerra
- Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Juan Fernandez-Ruiz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
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23
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Kantola M, Ilves O, Honkanen S, Hakonen H, Yli-Ikkelä R, Köyhäjoki A, Anttila MR, Rintala A, Korpi H, Sjögren T, Karvanen J, Aartolahti E. The Effects of Virtual Reality Training on Cognition in Older Adults: A Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Controlled Trials. J Aging Phys Act 2024; 32:321-349. [PMID: 38242114 DOI: 10.1123/japa.2023-0217] [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: 06/22/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 01/21/2024]
Abstract
The aim of this systematic review, meta-analysis, and meta-regression was to examine the effects of virtual reality-based training on global cognition and executive function compared with conventional training or information-based treatment in older adults, regardless of cognitive level. A systematic literature search was conducted using four databases. A total of 31 randomized controlled trials were identified. Pooled effect sizes were calculated, the risk of bias was assessed, and evidence was graded. The primary analyses showed a small but statistically significant effect of virtual reality-based training compared with control on global cognition (Hedges' g 0.42, 95% confidence interval [0.17, 0.68], I2 = 70.1%, n = 876, 20 randomized controlled trials, low evidence) and executive function (Hedges' g 0.35, 95% confidence interval [0.06, 0.65], I2 = 68.4%, n = 810, 16 randomized controlled trials, very low evidence). Meta-regression yielded inconclusive results. Virtual reality-based training may be more effective than control in improving cognition in older adults; however, more high-quality studies are needed.
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Affiliation(s)
- Mirjami Kantola
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Outi Ilves
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Sports and Rehabilitation, South-Eastern Finland University of Applied Sciences, Savonlinna, Finland
| | - Sari Honkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Harto Hakonen
- Jamk University of Applied Sciences, LIKES, Jyväskylä, Finland
| | - Riku Yli-Ikkelä
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anna Köyhäjoki
- Central Ostrobothnia Well-Being Service County "Soite", Kokkola, Finland
| | - Marjo-Riitta Anttila
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Aki Rintala
- Physical Activity and Functional Capacity Research Group, Faculty of Health Care and Social Services, LAB University of Applied Sciences, Lahti, Finland
| | - Hilkka Korpi
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Social and Healthcare Unit, Vaasa University of Applied Sciences, Vaasa, Finland
- Well-being and Culture Unit, Oulu University of Applied Sciences, Oulu, Finland
| | - Tuulikki Sjögren
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juha Karvanen
- Faculty of Mathematics and Science, University of Jyväskylä, Jyväskylä, Finland
| | - Eeva Aartolahti
- Institute of Rehabilitation, Jamk University of Applied Sciences, Jyväskylä, Finland
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24
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Qu M, Gao B, Jiang Y, Li Y, Pei C, Xie L, Zhang Y, Song Q, Miao Y. Atrophy patterns in hippocampus and amygdala subregions of depressed patients with Parkinson's disease. Brain Imaging Behav 2024; 18:475-484. [PMID: 38170304 PMCID: PMC11222218 DOI: 10.1007/s11682-023-00844-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
We aimed to explore the subregional atrophy patterns of the amygdala and hippocampus in Parkinson's disease (PD) with depression and their correlation with the severity of the depressive symptom. MRI scans were obtained for 34 depressed PD patients (DPD), 22 nondepressed PD patients (NDPD), and 28 healthy controls (HC). Amygdala and hippocampal subregions were automatically segmented, and the intergroup volume difference was compared. The relationships between the volumes of the subregions and depression severity were investigated. Logistic analysis and Receiver operator characteristic curve were used to find independent predictors of DPD. Compared with the HC group, atrophy of the bilateral lateral nucleus, left accessory basal nucleus, right cortical nucleus, right central nucleus, and right medial nucleus subregions of the amygdala were visible in the DPD group, while the right lateral nucleus subregion of the amygdala was smaller in the DPD group than in the NDPD group. The DPD group showed significant atrophy in the left molecular layer, left GC-DG, left CA3, and left CA4 subregions compared with the HC group for hippocampal subregion volumes. Also, the right lateral nuclei volume and disease duration were independent predictors of DPD. To sum up, DPD patients showed atrophy in multiple amygdala subregions and left asymmetric hippocampal subregions. The decreased amygdala and hippocampal subregion volumes were correlated with the severity of depressive symptoms. The volume of right lateral nuclei and disease duration could be used as a biomarker to detect DPD.
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Affiliation(s)
- Mingrui Qu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Bingbing Gao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Yuhan Jiang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Yuan Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Chenhui Pei
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | | | - Yukun Zhang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Yanwei Miao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian, 116011, China.
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25
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Contreras-Ruston F, Castillo-Allendes A, Saavedra-Garrido J, Ochoa-Muñoz AF, Hunter EJ, Kotz SA, Navarra J. Voice self-assessment in individuals with Parkinson's Disease as compared to general voice disorders. Parkinsonism Relat Disord 2024; 123:106944. [PMID: 38552350 DOI: 10.1016/j.parkreldis.2024.106944] [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] [Received: 08/09/2023] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Individuals with Parkinson's Disease (IwPD) often fail to adjust their voice in different situations, without awareness of this limitation. Clinicians use self-report questionnaires that are typically designed for individuals with General Voice Disorders (GVD) in the vocal assessment of IwPD. However, these instruments may not consider that IwPD have a reduced self-perception of their vocal deficits. This study aimed to compare self-reported vocal symptoms and voice loudness between IwPD and GVD. METHODS 28 IwPD and 26 with GVD completed the Voice Symptom Scale (VoiSS) questionnaire to evaluate their voice self-perception. Vocal loudness (dB) was also assessed. Univariate and multivariate analyses were used to compare the outcomes from these measures between the two groups. Principal Component Analysis and Hierarchical Clustering Analysis were applied to explore data patterns related to voice symptoms. RESULTS IwPD reported significantly fewer vocal symptoms than those with GVD in all VoiSS questionnaire domains. Multivariate principal component analysis found no significant correlations between VoiSS scores and participant similarities in voice measures. Despite experiencing hypophonia, IwPD scored lower in all VoiSS domains but still fell in the healthy voice range. Hierarchical Clustering Analysis grouped participants into three distinct categories, primarily based on age, vocal loudness, and VoiSS domain scores, distinguishing between PD and GVD individuals. CONCLUSIONS IwPD reported fewer vocal symptoms than GVD. The voice self-assessment seems to be unreliable to assess vocal symptoms in IwPD, at least regarding loudness. New self-report instruments tailored to PD individuals are needed due to their particular voice characteristics.
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Affiliation(s)
- Francisco Contreras-Ruston
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain; Faculty of Psychology and Neuroscience, Department of Neuropsychology & Psychopharmacology, Maastricht University, 6229 ER, Maastricht, the Netherlands; Speech-Language Pathology and Audiology Department - Universidad de Valparaíso, San Felipe, Chile.
| | - Adrián Castillo-Allendes
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA; Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, USA
| | - Jorge Saavedra-Garrido
- Institute of Statistics, University of Valparaíso, Faculty of Science, Valparaíso, Chile; Department of Meteorology, University of Valparaíso, Valparaíso, Chile
| | - Andrés Felipe Ochoa-Muñoz
- Institute of Statistics, University of Valparaíso, Faculty of Science, Valparaíso, Chile; School of Statistics, Universidad del Valle, Cali, Colombia
| | - Eric J Hunter
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, USA
| | - Sonja A Kotz
- Faculty of Psychology and Neuroscience, Department of Neuropsychology & Psychopharmacology, Maastricht University, 6229 ER, Maastricht, the Netherlands
| | - Jordi Navarra
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
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26
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Fei Y, Niu S, Xi X, Tang W, Zhao Y, Zhang G, Yu X, Li C, Li X, Liu Y, Li Y, Yin Y, Cui Y, Li X. Physical frailty intensifies the positive association of oral frailty with poor global cognitive function and executive function among older adults especially for females: a cross-sectional study. BMC Geriatr 2024; 24:468. [PMID: 38811863 PMCID: PMC11134949 DOI: 10.1186/s12877-024-05056-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/08/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Oral frailty is reported to increase the risk of new onset of mild cognitive impairment. Whereas, the association of oral frailty with cognition among older adults in both physical frail and non-physical frail status has not been sufficiently explored, and whether there are sex differences in the association is unclear. This study investigated the association of oral frailty and physical frailty with global cognitive function and executive function among older adults, as well as the sex differences in such association. METHODS This cross-sectional study included 307 participants aged ≥ 60 years old from communities between June 2023 and August 2023, in Nanjing, China. Global cognitive function and executive function were assessed by using the Montreal Cognitive Assessment (MoCA) and Trail Making Tests A (TMT-A), respectively. Oral frailty was identified by the combination of natural tooth, Oral Frailty Index-8 (OFI-8), and oral diadochokinesis. Physical frailty was measured by using Fried phenotype model which contained 5 criteria: unintentional weight loss, weakness, exhaustion, slowness, and low physical activity. Multiple linear regression analyses for overall participants and stratified by sex and presence or absence of physical frailty were performed, respectively, to examine the association between oral frailty and cognitive functions. RESULTS The median age of participants was 70 years old. The study included 158 (51.5%) females, 53 (17.3%) individuals with physical frailty, and 65 (21.2%) participants with oral frailty. After adjustment, the association between oral frailty and global cognitive function was observed in the physical frailty group (B = -2.67, 95% Confidence Interval [CI]: -5.27 to -0.07, p = 0.045) and the females with physical frailty (B = -4, 95% CI: -7.41 to -0.58, p = 0.024). Oral frailty was associated with executive function in overall participants (B = 0.12, 95% CI: 0.01 to 0.22, p = 0.037), physical frailty group (B = 23.68, 95% CI: 1.37 to 45.99, p = 0.038). In the adjusted models, oral frailty was significantly associated with executive function in all females (B = 0.21, 95% CI: 0.05 to 0.36, p = 0.009), in females without physical frailty (B = 0.19, 95% CI: 0.02 to 0.36, p = 0.027), and in females with physical frailty (B = 48.69, 95% CI: 7.17 to 90.21, p = 0.024). CONCLUSIONS Physical frailty intensifies the positive association of oral frailty with poor global cognitive function and executive function among older adults, particularly among females. It is ponderable to consider sex differences and facilitate the management of physical frailty when it comes to promoting cognitive health based on the perspective of oral health among older adults.
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Affiliation(s)
- Yang Fei
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Shuzhen Niu
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Xueru Xi
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Wenping Tang
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Yue Zhao
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Ge Zhang
- Department of Geriatrics (Geriatric Neurology), the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, China
| | - Xiaohong Yu
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Cheng Li
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Xinru Li
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Ying Liu
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Yaxin Li
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
| | - Yueheng Yin
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China.
| | - Yan Cui
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China.
| | - Xianwen Li
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, China
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Asimakidou E, Xiromerisiou G, Sidiropoulos C. Motor and Non-motor Outcomes of Deep Brain Stimulation across the Genetic Panorama of Parkinson's Disease: A Multi-Scale Meta-Analysis. Mov Disord Clin Pract 2024; 11:465-477. [PMID: 38318989 PMCID: PMC11078493 DOI: 10.1002/mdc3.13994] [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: 10/03/2023] [Revised: 01/12/2024] [Accepted: 01/21/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND In the era of modern medicine, where high-throughput sequencing techniques are readily available, it is desirable to elucidate the role of genetic background in patients with Parkinson's Disease (PD) undergoing Deep Brain Stimulation (DBS). Genetic stratification of PD patients undergoing DBS may assist in patient selection and prediction of clinical outcomes and complement existing selection procedures such as levodopa challenge testing. OBJECTIVE To capture a broad spectrum of motor and non-motor DBS outcomes in genetic PD patients with data from the recently updated literature. METHODS A multi-scale meta-analysis with 380 genetic PD cases was conducted using the Cochrane Review Manager, JASP software and R. RESULTS This meta-analysis revealed that overall, patients with genetic PD are good candidates for DBS but the outcomes might differ depending on the presence of specific mutations. PRKN carriers benefited the most regarding motor function, daily dose medication and motor complications. However, GBA carriers appeared to be more prone to cognitive decline after subthalamic nucleus DBS accompanied by a low quality of life with variable severity depending on genetic variants and concomitant alterations in other genes. Apart from GBA, cognitive worsening was also observed in SNCA carriers. Pre-operative levodopa responsiveness and a younger age of onset are associated with a favorable motor outcome. CONCLUSION A personalized approach with a variant-based risk stratification within the emerging field of surgicogenomics is needed. Integration of polygenic risk scores in clinical-decision making should be encouraged.
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Castelli MB, Alonso-Recio L, Carvajal F, Serrano JM. Does the Montreal Cognitive Assessment (MoCA) identify cognitive impairment profiles in Parkinson's disease? An exploratory study. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:238-247. [PMID: 34894908 DOI: 10.1080/23279095.2021.2011727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
An important proportion of patients with Parkinson's Disease (PD) present signs of cognitive impairment, although this is heterogeneous. In an attempt to classify this, the dual syndrome hypothesis distinguishes between two profiles: one defined by attentional and executive problems with damage in anterior cerebral regions, and another with mnesic and visuospatial alterations, with damage in posterior cerebral regions. The Montreal Cognitive Assessment (MoCA) is one of the recommended screening tools, and one of the most used, to assess cognitive impairment in PD. However, its ability to specifically identify these two profiles of cognitive impairment has not been studied. The aim of this study was, therefore, to analyze the capacity of the MoCA to detect cognitive impairment, and also to identify anterior and posterior profiles defined by the dual syndrome hypothesis. For this purpose, 59 patients with idiopathic PD were studied with the MoCA and a neuropsychological battery of tests covering all cognitive domains. Results of logistic regression analysis with ROC (Receiver Operating Characteristic) curves showed that MoCA detected cognitive impairment and identified patients with a profile of anterior/attentional and executive deficit, with acceptable sensibility and specificity. However, it did not identify patients with a posterior/mnesic-visuospatial impairment. We discuss the reasons for the lack of sensitivity of MoCA in this profile, and other possible implications of these results with regards the usefulness of this tool to assess cognitive impairment in PD.
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Affiliation(s)
- María Belén Castelli
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Laura Alonso-Recio
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Madrid, Spain
| | - Fernando Carvajal
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan Manuel Serrano
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
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29
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Fu Y, Wei Q, Wang Z, Zhao Q, Shi W. Effects of dexmedetomidine on postoperative pain and early cognitive impairment in older male patients undergoing laparoscopic cholecystectomy. Exp Ther Med 2024; 27:189. [PMID: 38533435 PMCID: PMC10964730 DOI: 10.3892/etm.2024.12477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/16/2024] [Indexed: 03/28/2024] Open
Abstract
The primary aim of the present study was to investigate the effect of dexmedetomidine (DEX) on postoperative pain and early cognitive impairment in old male patients, who underwent laparoscopic cholecystectomy (LC). A total of 97 old patients, subjected to LC at the 980 Hospital of the Joint Service Support Force of the People's Liberation Army of China, were randomly divided into two groups, namely the DEX and normal saline groups. Patients in the DEX group received an intravenous infusion of 0.8 µg/kg DEX within 10 min following general anesthesia, followed by a maintenance infusion of 0.5 µg/(kg/h). Furthermore, patients in the normal saline group were treated with an equivalent volume of normal saline. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) tests at 6 h, 1, 2 and 3 days, postoperatively. The incidence of postoperative cognitive dysfunction (POCD) and postoperative adverse events were recorded for both groups. In addition, the Visual Analogue Scale (VAS) pain score was utilized to assess the pain level of all patients, while the Quality of Recovery-15 (QoR-15) scale was employed to analyze the postoperative recovery results. Therefore, the MoCA score was higher in the DEX group compared with the normal saline group at 6 h and day 1 postoperatively. Additionally, the MMSE score was higher at 6 h postoperatively in the DEX group compared with the normal saline group. Correspondingly, the incidence of POCD was lower in the DEX group compared with the normal saline group at 6 h and day 1, after LC (P<0.05). VAS score in resting state for patients in the DEX group was significantly lower compared with the normal-saline group (P<0.05). Furthermore, the QoR-15 scale score in patients in the DEX group was notably increased compared with the normal saline group on the first and second days after the operation (P<0.05). Overall, the present study verified that the continuous infusion of DEX at a rate of 0.5 µg/(kg/h) during LC could effectively reduce the incidence of early POCD and alleviate postoperative pain in old male patients, thus facilitating postoperative recovery.
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Affiliation(s)
- Yanlong Fu
- Department of Hepatobiliary Surgery, The 980 Hospital of The Joint Service Support Force of The People's Liberation Army of China, Shijiazhuang, Hebei 050000, P.R. China
| | - Qiang Wei
- Department of Hepatobiliary Surgery, The 980 Hospital of The Joint Service Support Force of The People's Liberation Army of China, Shijiazhuang, Hebei 050000, P.R. China
| | - Zhenliang Wang
- Department of Hepatobiliary Surgery, The 980 Hospital of The Joint Service Support Force of The People's Liberation Army of China, Shijiazhuang, Hebei 050000, P.R. China
| | - Qingtao Zhao
- Department of Hepatobiliary Surgery, The 980 Hospital of The Joint Service Support Force of The People's Liberation Army of China, Shijiazhuang, Hebei 050000, P.R. China
| | - Wenxin Shi
- Department of Hepatobiliary Surgery, The 980 Hospital of The Joint Service Support Force of The People's Liberation Army of China, Shijiazhuang, Hebei 050000, P.R. China
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Yeager BE, Twedt HP, Bruss J, Schultz J, Narayanan NS. Cortical and subcortical functional connectivity and cognitive impairment in Parkinson's disease. Neuroimage Clin 2024; 42:103610. [PMID: 38677099 PMCID: PMC11066685 DOI: 10.1016/j.nicl.2024.103610] [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: 04/17/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024]
Abstract
Parkinson's disease (PD) is a neurodegenerative disease with cognitive as well as motor impairments. While much is known about the brain networks leading to motor impairments in PD, less is known about the brain networks contributing to cognitive impairments. Here, we leveraged resting-state functional magnetic resonance imaging (rs-fMRI) data from the Parkinson's Progression Marker Initiative (PPMI) to examine network dysfunction in PD patients with cognitive impairment. We focus on canonical cortical networks linked to cognition, including the salience network (SAL), frontoparietal network (FPN), and default mode network (DMN), as well as a subcortical basal ganglia network (BGN). We used the Montreal Cognitive Assessment (MoCA) as a continuous index of coarse cognitive function in PD. In 82 PD patients, we found that lower MoCA scores were linked with lower intra-network connectivity of the FPN. We also found that lower MoCA scores were linked with lower inter-network connectivity between the SAL and the BGN, the SAL and the DMN, as well as the FPN and the DMN. These data elucidate the relationship of cortical and subcortical functional connectivity with cognitive impairments in PD.
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Affiliation(s)
- Brooke E Yeager
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City 52242, USA.
| | - Hunter P Twedt
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City 52242, USA.
| | - Joel Bruss
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City 52242, USA; Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City 52242, USA.
| | - Jordan Schultz
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City 52242, USA.
| | - Nandakumar S Narayanan
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City 52242, USA.
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Roeben B, Liepelt-Scarfone I, Lerche S, Zimmermann M, Wurster I, Sünkel U, Schulte C, Deuschle C, Eschweiler GW, Maetzler W, Gasser T, Berg D, Brockmann K. Longitudinal cognitive decline characterizes the profile of non-PD-manifest GBA1 mutation carriers. NPJ Parkinsons Dis 2024; 10:88. [PMID: 38649346 PMCID: PMC11035543 DOI: 10.1038/s41531-024-00706-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
With disease-modifying treatment for Parkinson's disease (PD) associated with variants in the glucocerebrosidase gene (GBA1) under way, the challenge to design clinical trials with non-PD-manifest GBA mutation carriers (GBA1NMC) comes within close reach. To delineate trajectories of motor and non-motor markers as well as serum neurofilament light (sNfL) levels and to evaluate clinical endpoints as outcomes for clinical trials in GBA1NMC, longitudinal data of 56 GBA1NMC carriers and 112 age- and sex-matched GBA1 wildtype participants (GBA1wildtype) with up to 9 years of follow-up was analyzed using linear mixed-effects models (LMEM) and Kaplan-Meier survival analysis of clinical endpoints for motor and cognitive function. GBA1NMC showed worse performance in Pegboard, 20 m fast walking, global cognition as well as in executive and memory function at baseline. Longitudinally, LMEM revealed a higher annual increase of the MDS-UPDRS III bradykinesia subscore in GBA1NMC compared to GBA1wildtype, but comparable trajectories of all other motor and non-motor markers as well as sNfL. Kaplan-Meier survival analysis showed a significantly earlier progression to clinical endpoints of cognitive decline in GBA1NMC. Incidence of PD was significantly higher in GBA1NMC. In conclusion, our study extends data on GBA1NMC indicating early cognitive decline as a potentially characteristic feature. Comprehensive longitudinal assessments of cognitive function are crucial to delineate the evolution of early changes in GBA1NMC enabling a more accurate stratification and allow for a more precise definition of trial design and sample size.
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Grants
- Dr. Roeben was supported by the Clinician Scientist program of the Medical Faculty of the University of Tübingen (grant #478-0-0).
- Janssen Research and Development (Janssen R&D)
- Michael J. Fox Foundation for Parkinson’s Research (Michael J. Fox Foundation)
- European Commission (EC)
- EC | Horizon 2020 Framework Programme (EU Framework Programme for Research and Innovation H2020)
- Novartis
- International Parkinson Fonds (Germany) GmbH (IPD) German Ministry for Education and Research (BMBF)
- Dr. Zimmermann was supported by the Clinician Scientist program of the Medical Faculty of the University of Tübingen (grant #481-0-0).
- Dr. Wurster received funding from the Michael J. Fox Foundation in form of the Edmond J. Safra Fellowship in Movement Disorders.
- German Ministry for Education and Research (BMBF), German Research Council (DFG), German Innovationsfonds
- Robert Bosch Stiftung (Robert Bosch Foundation)
- Dr. Maetzler receives or received funding from the European Union, the German Federal Ministry of Education of Research, German Research Council, Michael J. Fox Foundation, Robert Bosch Foundation, Neuroalliance, Lundbeck, Sivantos and Janssen.
- Dr. Gasser receives research support from Novartis, the European Union, BMBF (the Federal Ministry of Education and Research), and Helmholtz Association.
- Janssen Pharmaceuticals (Janssen Pharmaceuticals, Inc.)
- Teva Pharmaceutical Industries (Teva Pharmaceutical Industries Ltd.)
- Abbott | Abbott Pharmaceuticals
- Boehringer Ingelheim (Boehringer Ingelheim Pharmaceuticals)
- UCB | UCB US
- Deutsches Zentrum für Neurodegenerative Erkrankungen (German Center for Neurodegenerative Diseases)
- Dr. Berg has received funding for travel or speaker honoraria from Lundbeck Inc., Novartis, UCB/ SCHWARZ PHARMA, Merck Serono, Biogen, Zambon, AbbVie, and BIALLtd.; and has received research support from Janssen, Teva Pharmaceutical Industries Ltd., Solvay Pharmaceuticals, Inc./Abbott, Boehringer, UCB, Michael J Fox Foundation, BMBF, dPV (German Parkinson’s disease association), Neuroallianz, DZNE, Center of Integrative Neurosciences and the Damp Foundation.
- Dr. Brockmann has received research grants from the University of Tuebingen (Clinician Scientist), the German Society of Parkinson’s disease (dpv), the Michael J. Fox Foundation (MJFF), the German Centre for Neurodegenerative Diseases (DZNE, MIGAP) and the German Federal Ministry of Education and Research (BMBF) in the frame of ERACoSysMed2 (FKZ 031L0137B).
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Affiliation(s)
- Benjamin Roeben
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany.
| | - Inga Liepelt-Scarfone
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
- IB-Hochschule, Stuttgart, Germany
| | - Stefanie Lerche
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Milan Zimmermann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Isabel Wurster
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Ulrike Sünkel
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwer Str. 14, 72076, Tübingen, Germany
| | - Claudia Schulte
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Christian Deuschle
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Gerhard W Eschweiler
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwer Str. 14, 72076, Tübingen, Germany
- Geriatric Center at the University Hospital of Tübingen, Calwer Str. 14, 72076, Tübingen, Germany
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, and Kiel University, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Thomas Gasser
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Daniela Berg
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, and Kiel University, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Kathrin Brockmann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
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B.T B, Chen JM. Performance Assessment of ChatGPT versus Bard in Detecting Alzheimer's Dementia. Diagnostics (Basel) 2024; 14:817. [PMID: 38667463 PMCID: PMC11048951 DOI: 10.3390/diagnostics14080817] [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: 03/06/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Large language models (LLMs) find increasing applications in many fields. Here, three LLM chatbots (ChatGPT-3.5, ChatGPT-4, and Bard) are assessed in their current form, as publicly available, for their ability to recognize Alzheimer's dementia (AD) and Cognitively Normal (CN) individuals using textual input derived from spontaneous speech recordings. A zero-shot learning approach is used at two levels of independent queries, with the second query (chain-of-thought prompting) eliciting more detailed information than the first. Each LLM chatbot's performance is evaluated on the prediction generated in terms of accuracy, sensitivity, specificity, precision, and F1 score. LLM chatbots generated a three-class outcome ("AD", "CN", or "Unsure"). When positively identifying AD, Bard produced the highest true-positives (89% recall) and highest F1 score (71%), but tended to misidentify CN as AD, with high confidence (low "Unsure" rates); for positively identifying CN, GPT-4 resulted in the highest true-negatives at 56% and highest F1 score (62%), adopting a diplomatic stance (moderate "Unsure" rates). Overall, the three LLM chatbots can identify AD vs. CN, surpassing chance-levels, but do not currently satisfy the requirements for clinical application.
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Affiliation(s)
- Balamurali B.T
- Science, Mathematics & Technology (SMT), Singapore University of Technology & Design, 8 Somapah Rd, Singapore 487372, Singapore
| | - Jer-Ming Chen
- Science, Mathematics & Technology (SMT), Singapore University of Technology & Design, 8 Somapah Rd, Singapore 487372, Singapore
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Summers D, Spencer K, Okasaki C, Huber JE. An Examination of Cognitive Heterogeneity in Parkinson Disease: The Dual-Syndrome Hypothesis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1127-1135. [PMID: 38446552 DOI: 10.1044/2024_jslhr-23-00621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE Cognitive impairment is one of the most debilitating nonmotor symptoms in Parkinson disease (PD), and its presentation is heterogeneous. One proposed model to explain cognitive variability in PD is the dual-syndrome hypothesis. This hypothesis delineates two cognitive profiles, a "fronto-striatal" profile and a "posterior cortical" profile according to symptom presentation, associated motor phenotype, and risk for dementia. The current study examined the dual-syndrome hypothesis in individuals with idiopathic PD to evaluate the existence of these profiles, determine the association with the motor phenotype (tremor dominant vs. postural instability/gait disorder), and assess the relative risk for dementia. METHOD A retrospective examination was conducted using data from the Parkinson's Progression Markers Initiative database at baseline (within 2 years of diagnosis) and 5 years after baseline. Descriptive categorizations, cluster analyses, generalized linear mixed models, and logistic regressions were used to address the research questions. RESULTS There was emerging evidence of cognitive profiles; however, these were not fully supported by cluster analyses. Baseline cognitive profile was associated with later motor phenotype, and as predicted, dementia risk was greatest in persons with baseline posterior cortical impairments. CONCLUSION The current results provide mixed support for the dual-syndrome hypothesis, with some evidence that the posterior cortical cognitive profile is associated with postural instability and gait disorder as well as greater dementia risk.
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Affiliation(s)
- Dale Summers
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Kristie Spencer
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Connie Okasaki
- Quantitative Ecology and Resource Management, University of Washington, Seattle
| | - Jessica E Huber
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
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Baek K, Kim YM, Na HK, Lee J, Shin DH, Heo SJ, Chung SJ, Kim K, Lee PH, Sohn YH, Yoon J, Kim YJ. Comparing Montreal Cognitive Assessment Performance in Parkinson's Disease Patients: Age- and Education-Adjusted Cutoffs vs. Machine Learning. J Mov Disord 2024; 17:171-180. [PMID: 38346940 PMCID: PMC11082615 DOI: 10.14802/jmd.23271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE The Montreal Cognitive Assessment (MoCA) is recommended for general cognitive evaluation in Parkinson's disease (PD) patients. However, age- and education-adjusted cutoffs specifically for PD have not been developed or systematically validated across PD cohorts with diverse education levels. METHODS In this retrospective analysis, we utilized data from 1,293 Korean patients with PD whose cognitive diagnoses were determined through comprehensive neuropsychological assessments. Age- and education-adjusted cutoffs were formulated based on 1,202 patients with PD. To identify the optimal machine learning model, clinical parameters and MoCA domain scores from 416 patients with PD were used. Comparative analyses between machine learning. METHODS and different cutoff criteria were conducted on an additional 91 consecutive patients with PD. RESULTS The cutoffs for cognitive impairment decrease with increasing age within the same education level. Similarly, lower education levels within the same age group correspond to lower cutoffs. For individuals aged 60-80 years, cutoffs were set as follows: 25 or 24 years for those with more than 12 years of education, 23 or 22 years for 10-12 years, and 21 or 20 years for 7-9 years. Comparisons between age- and education-adjusted cutoffs and the machine learning method showed comparable accuracies. The cutoff method resulted in a higher sensitivity (0.8627), whereas machine learning yielded higher specificity (0.8250). CONCLUSION Both the age- and education-adjusted cutoff. METHODS and machine learning. METHODS demonstrated high effectiveness in detecting cognitive impairment in PD patients. This study highlights the necessity of tailored cutoffs and suggests the potential of machine learning to improve cognitive assessment in PD patients.
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Affiliation(s)
- Kyeongmin Baek
- Department of Computer Engineering, Hallym University, Chuncheon, Korea
| | - Young Min Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Han Kyu Na
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
- Department of Neurology, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Junki Lee
- Department of Computer Engineering, Hallym University, Chuncheon, Korea
| | - Dong Ho Shin
- Massachusetts College of Pharmacy & Health Sciences, Boston, USA
| | - Seok-Jae Heo
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
- YONSEI BEYOND LAB, Yongin, Korea
| | - Kiyong Kim
- Department of Electronic Engineering, Kyonggi University, Suwon, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
- Department of Neurology, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Young H. Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
- Department of Neurology, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Jeehee Yoon
- Department of Computer Engineering, Hallym University, Chuncheon, Korea
| | - Yun Joong Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
- YONSEI BEYOND LAB, Yongin, Korea
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Wang R, Lian T, He M, Guo P, Yu S, Zuo L, Hu Y, Zhang W. Clinical features and neurobiochemical mechanisms of olfactory dysfunction in patients with Parkinson disease. J Neurol 2024; 271:1959-1972. [PMID: 38151574 DOI: 10.1007/s00415-023-12122-1] [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: 08/31/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/29/2023]
Abstract
This study aimed to investigate clinical features, influencing factors and neurobiochemical mechanisms of olfactory dysfunction (OD) in Parkinson disease (PD). Total 39 patients were divided into the PD with OD (PD-OD) and PD with no OD (PD-nOD) groups according to overall olfactory function, including threshold, discrimination and identification, assessed by Sniffin' Sticks test. Motor function and non-motor symptoms were rated by multiple scales. Dopamine, acetylcholine, norepinephrine and 5-hydroxytryptamine levels in cerebrospinal fluid (CSF) were measured. We found that the PD-OD group showed significantly lower score of Montreal Cognitive Assessment Scale, higher scores of rapid eye movement sleep behavior disorder (RBD) Screening Questionnaire and Epworth Sleepiness Scale than the PD-nOD group (p < 0.05). RBD Screening Questionnaire score was independently associated with the scores of overall olfactory function and discrimination (p < 0.05). Dopamine and acetylcholine levels in CSF from the PD-OD group was significantly lower than that from the PD-nOD group (p < 0.05). Dopamine and acetylcholine levels in CSF were significantly and positively correlated with the scores of overall olfactory function, threshold, discrimination and identification in PD patients (p < 0.05). RBD Screening Questionnaire score was significantly and negatively correlated with acetylcholine level in CSF in PD patients with poor olfactory detection (p < 0.05). This investigation reveals that PD-OD is associated with cognitive impairment, probable RBD and excessive daytime sleepiness. PD-OD is correlated with the decreased levels of dopamine and acetylcholine in CSF. RBD is an independent influencing factor of overall olfactory function and discrimination, and the decreased acetylcholine level in CSF may be the common neurobiochemical basis of RBD and OD in PD patients.
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Grants
- 2016YFC1306000 National Key Research and Development Program of China
- 2016YFC1306300 National Key Research and Development Program of China
- 81970992 National Natural Science Foundation of China
- 81571229 National Natural Science Foundation of China
- 81071015 National Natural Science Foundation of China
- 30770745 National Natural Science Foundation of China
- 82201639 National Natural Science Foundation of China
- 2022-2-2048 Capital's Funds for Health Improvement and Research (CFH)
- kz201610025030 Key Technology R&D Program of Beijing Municipal Education Commission
- 4161004 Key Project of Natural Science Foundation of Beijing, China
- 7082032 Natural Science Foundation of Beijing, China
- JJ2018-48 Project of Scientific and Technological Development of Traditional Chinese Medicine in Beijing
- Z121107001012161 Capital Clinical Characteristic Application Research
- 2009-3-26 High Level Technical Personnel Training Project of Beijing Health System, China
- BIBD-PXM2013_014226_07_000084 Project of Beijing Institute for Brain Disorders
- 20071D0300400076 Excellent Personnel Training Project of Beijing, China
- IDHT20140514 Project of Construction of Innovative Teams and Teacher Career Development for Universities and Colleges Under Beijing Municipality
- JING-15-2 Beijing Healthcare Research Project, China
- 2015-JL-PT-X04 Basic-Clinical Research Cooperation Funding of Capital Medical University, China
- 10JL49 Basic-Clinical Research Cooperation Funding of Capital Medical University, China
- 14JL15 Basic-Clinical Research Cooperation Funding of Capital Medical University, China
- PYZ2018077 Natural Science Foundation of Capital Medical University, Beijing, China
- 2019-028 Science and Technology Development Fund of Beijing Rehabilitation Hospital, Capital Medical University
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Affiliation(s)
- Ruidan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Tenghong Lian
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Mingyue He
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Peng Guo
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Shuyang Yu
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Lijun Zuo
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Yang Hu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Wei Zhang
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- Center of Parkinson's Disease, Beijing Institute for Brain Disorders, Beijing, 100053, China.
- Beijing Key Laboratory on Parkinson Disease, Beijing Institute for Brain Disorders, Beijing, 10053, China.
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Beaulieu-Jones BK, Frau F, Bozzi S, Chandross KJ, Peterschmitt MJ, Cohen C, Coulovrat C, Kumar D, Kruger MJ, Lipnick SL, Fitzsimmons L, Kohane IS, Scherzer CR. Disease progression strikingly differs in research and real-world Parkinson's populations. NPJ Parkinsons Dis 2024; 10:58. [PMID: 38480700 PMCID: PMC10937726 DOI: 10.1038/s41531-024-00667-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
Characterization of Parkinson's disease (PD) progression using real-world evidence could guide clinical trial design and identify subpopulations. Efforts to curate research populations, the increasing availability of real-world data, and advances in natural language processing, particularly large language models, allow for a more granular comparison of populations than previously possible. This study includes two research populations and two real-world data-derived (RWD) populations. The research populations are the Harvard Biomarkers Study (HBS, N = 935), a longitudinal biomarkers cohort study with in-person structured study visits; and Fox Insights (N = 36,660), an online self-survey-based research study of the Michael J. Fox Foundation. Real-world cohorts are the Optum Integrated Claims-electronic health records (N = 157,475), representing wide-scale linked medical and claims data and de-identified data from Mass General Brigham (MGB, N = 22,949), an academic hospital system. Structured, de-identified electronic health records data at MGB are supplemented using a manually validated natural language processing with a large language model to extract measurements of PD progression. Motor and cognitive progression scores change more rapidly in MGB than HBS (median survival until H&Y 3: 5.6 years vs. >10, p < 0.001; mini-mental state exam median decline 0.28 vs. 0.11, p < 0.001; and clinically recognized cognitive decline, p = 0.001). In real-world populations, patients are diagnosed more than eleven years later (RWD mean of 72.2 vs. research mean of 60.4, p < 0.001). After diagnosis, in real-world cohorts, treatment with PD medications has initiated an average of 2.3 years later (95% CI: [2.1-2.4]; p < 0.001). This study provides a detailed characterization of Parkinson's progression in diverse populations. It delineates systemic divergences in the patient populations enrolled in research settings vs. patients in the real-world. These divergences are likely due to a combination of selection bias and real population differences, but exact attribution of the causes is challenging. This study emphasizes a need to utilize multiple data sources and to diligently consider potential biases when planning, choosing data sources, and performing downstream tasks and analyses.
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Affiliation(s)
- Brett K Beaulieu-Jones
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA.
- APDA Center for Advanced Parkinson Research of Harvard Medical School and Brigham and Women's Hospital, Boston, MA, 02115, USA.
- Precision Neurology Program of Brigham & Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
- Department of Medicine, University of Chicago, Chicago, IL, 60615, USA.
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA.
| | | | - Sylvie Bozzi
- Sanofi Health Economics and Value Assessment, Sanofi, Paris, France
| | | | | | | | | | - Dinesh Kumar
- Sanofi Translational Sciences, Framingham, MA, 01701, USA
| | - Mark J Kruger
- Sanofi Genzyme, Clinical Development Neurology, Cambridge, MA, USA
| | - Scott L Lipnick
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA
| | - Lane Fitzsimmons
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA
| | - Isaac S Kohane
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA
| | - Clemens R Scherzer
- APDA Center for Advanced Parkinson Research of Harvard Medical School and Brigham and Women's Hospital, Boston, MA, 02115, USA.
- Precision Neurology Program of Brigham & Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA.
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Lau HY, Lin YH, Lin KC, Li YC, Yao G, Lin CY, Wu YH. Reliability of the Montreal Cognitive Assessment in people with stroke. Int J Rehabil Res 2024; 47:46-51. [PMID: 38323890 DOI: 10.1097/mrr.0000000000000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
This study examined the relative and absolute reliability of the Taiwanese version of the MoCA (MoCA-T) in people with stroke. The study recruited 114 individuals who were at least 3 months after the onset of a first-ever unilateral stroke. The MoCA-T was administered twice, at a 6-week interval, to all participants. The relative reliability was assessed using the intraclass correlation coefficient (ICC), and the absolute reliability was assessed using standard error of measurement (SEM), the smallest real difference (SRD), the SRD percentage, and the Bland-Altman method. The ICC analysis showed the MoCA-T was highly reliable (ICC = 0.85). The absolute reliability was between an acceptable and excellent level, where the SEM and the SRD at the 95% confidence interval were 1.38 and 3.83, respectively. The Bland-Altman analyses showed no systematic bias between repeated measurements. The range of the 95% limits of agreement was narrow, indicating a high level of stability over time. These findings suggest that the MoCA-T has high agreement between repeated measurements without systematic bias. The threshold to detect real change stands between an acceptable and excellent level. The MoCA-T is a reliable tool for cognitive screening in stroke rehabilitation.
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Affiliation(s)
- Hiu-Ying Lau
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei
| | - Yi-Hung Lin
- Department of Education, National Kaohsiung Normal University, Kaohsiung
| | - Keh-Chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei
- Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei
| | - Yi-Chun Li
- Department of Occupational Therapy, College of Medicine, I-Shou University, Kaohsiung
| | - Grace Yao
- Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Chih-Yu Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei
| | - Yi-Hsuan Wu
- Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei
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Severiano E Sousa C, Alarcão J, Pavão Martins I, Ferreira JJ. Cognitive testing in late-stage Parkinson's disease: A critical appraisal of available instruments. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:191-202. [PMID: 36027603 DOI: 10.1080/23279095.2022.2114355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE For patients with Parkinson's disease (PD), cognitive impairment is one of the most disabling non-motor symptoms, particularly in the late disease stages (LSPD). Without a common cognitive assessment battery, it is difficult to estimate its prevalence and limits comparisons across studies. In addition, some instruments traditionally used in PD may not be adequate for use in LSPD. We sought to identify instruments used to assess cognition in LSPD and to investigate their global characteristics and psychometric properties to recommend a cognitive battery for the LSPD population. METHOD We conducted a literature search of EMBASE and MEDLINE for articles reporting the use of cognitive tests in LSPD. The global characteristics and psychometric properties of the four most used cognitive tests in each cognitive domain were verified to recommend a cognitive assessment battery. RESULTS Of 60 included studies, 71.7% used screening scales to assess cognition. Of the 53 reported instruments, the Montreal Cognitive Assessment, the Digit Span, the Trail Making Test, the Semantic Fluency test, the Rey Auditory Verbal Learning Test, the Brief Visuospatial Memory Test-Revised, the Boston Naming Test, the Judgment of Line Orientation, and the Clock Drawing Test corresponded best overall to the requirements considered important for selecting instruments in LSPD. CONCLUSION Screening scales are frequently used to assess cognition in LSPD. We recommend a cognitive assessment battery that considers the special characteristics of the LSPD population, including being quick and easy to use, with minimized motor demands, and covering all relevant cognitive domains.
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Affiliation(s)
- Catarina Severiano E Sousa
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisbon, Portugal
| | - Joana Alarcão
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, Centro de Estudos de Medicina Baseada na Evidência, Universidade de Lisboa, Lisbon, Portugal
| | - Isabel Pavão Martins
- Faculdade de Medicina, Centro de Estudos Egas Moniz, Universidade de Lisboa, Lisbon, Portugal
- Laboratório de Estudos da Linguagem, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisbon, Portugal
- CNS-Campus Neurológico, Torres Vedras, Portugal
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Amin RM, Phillips JJ, Humbert AT, Cholerton BA, Short VD, Smith MJ, Zabetian CP, Mata IF, Kelly VE. Associations between baseline cognitive status and motor outcomes after treadmill training in people with Parkinson's disease: a pilot study. Disabil Rehabil 2024; 46:1082-1091. [PMID: 37010072 PMCID: PMC10545807 DOI: 10.1080/09638288.2023.2189318] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/27/2023] [Accepted: 03/05/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE To determine the effect of baseline cognition on gait outcomes after a treadmill training program for people with Parkinson's disease (PD). METHODS This pilot clinical trial involved people with PD who were classified as having no cognitive impairment (PD-NCI) or mild cognitive impairment (PD-MCI). Baseline executive function and memory were assessed. The intervention was a 10-week gait training program (twice-weekly treadmill sessions), with structured speed and distance progression and verbal cues for gait quality. Response to intervention was assessed by gait speed measured after week 2 (short-term) and week 10 (long-term). RESULTS Participants (n = 19; 12 PD-NCI, 7 PD-MCI) had a mean (standard deviation) age of 66.5 (6.3) years, disease duration of 8.8 (6.3) years, and MDS-UPDRS III score of 21.3 (10.7). Gait speed increased at short-term and long-term assessments. The response did not differ between PD-NCI and PD-MCI groups; however, better baseline memory performance and milder PD motor severity were independently associated with greater improvements in gait speed in unadjusted and adjusted models. CONCLUSIONS These findings suggest that memory impairments and more severe motor involvement can influence the response to gait rehabilitation in PD and highlight the need for treatments optimized for people with greater cognitive and motor impairment.IMPLICATIONS FOR REHABILITATIONCognitive deficits in Parkinson's disease (PD) could impact motor learning and gait rehabilitation, yet little is known about the effects of cognitive impairments on the response to rehabilitation in people with PD.This study demonstrates that the response to gait rehabilitation did not differ between people with PD who had no cognitive impairment and those with mild cognitive impairment.Across all participants, better baseline memory was associated with greater improvements in gait speed.Rehabilitation professionals should be mindful of PD severity, as those with more substantial memory and motor impairments may require additional dosing or support to maximize gait training benefits.
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Affiliation(s)
- Raima M. Amin
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
| | | | - Andrew T. Humbert
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Brenna A. Cholerton
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Valerie D. Short
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Melissa J. Smith
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Cyrus P. Zabetian
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Ignacio F. Mata
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
- Lerner Research Institute, Genomic Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Valerie E. Kelly
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Wang Q, Wang H, Zhao X, Han C, Liu C, Li Z, Du T, Sui Y, Zhang X, Zhang J, Xiao Y, Cai G, Meng F. Transcriptome sequencing of circular RNA reveals the involvement of hsa-SCMH1_0001 in the pathogenesis of Parkinson's disease. CNS Neurosci Ther 2024; 30:e14435. [PMID: 37664885 PMCID: PMC10916443 DOI: 10.1111/cns.14435] [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: 03/03/2022] [Revised: 08/01/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disease. Exosomes are endosome-derived extracellular vesicles that can take part in intercellular communication. Circular RNAs (circRNAs) are noncoding RNAs characterized by covalently closed-loop structures, which perform a crucial function in many diseases. AIM To clarify the expression and function of exosomal circRNSs of PD patients and look for circRNAs that might be related to the pathogenesis of PD. MATERIALS AND METHODS We examined circRNA and mRNA expression profiles in peripheral exosomes from PD patients (n = 23) and healthy controls (n = 15) using next-generation sequencing (NGS) technology, functional annotation, and quantitative polymerase chain reaction. Correlation analysis was performed between the expression levels of the circRNAs and the clinical characteristics of PD patients. The binding miRNAs and target genes were predicted using TargetScanHuman, miRDB, and miRTarBase. The predicted target genes were compared with the differentially expressed mRNAs in sequencing results. RESULTS According to the NGS, 62 upregulated and 37 downregulated circRNAs in the PD group were screened out. Correlation analysis revealed that hsa-SCMH1_0001 has strong clinical relevance. We identified 17 potential binding miRNAs of hsa-SCMH1_0001 with 149 potential target genes. ARID1A and C1orf115 belong to the intersection of the predicted target genes and the differentially expressed mRNAs obtained by sequencing. CONCLUSION This study suggested that hsa-SCMH1_0001 and its target genes ARID1A and C1orf115 are downregulated in PD patients and may be involved in the occurrence of PD.
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Affiliation(s)
- Qiao Wang
- Department of Functional Neurosurgery, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeurostimulationBeijingChina
- National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesBeijing HospitalBeijingChina
| | - Huizhi Wang
- Department of Functional Neurosurgery, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeurostimulationBeijingChina
| | - Xuemin Zhao
- Department of Neurophysiology, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
| | - Chunlei Han
- Beijing Key Laboratory of NeurostimulationBeijingChina
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Chong Liu
- Department of Functional Neurosurgery, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeurostimulationBeijingChina
| | - Zhibao Li
- Department of Functional Neurosurgery, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeurostimulationBeijingChina
| | - Tingting Du
- Department of Functional Neurosurgery, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeurostimulationBeijingChina
| | - Yunpeng Sui
- Department of Functional Neurosurgery, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeurostimulationBeijingChina
| | - Xin Zhang
- Department of Functional Neurosurgery, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeurostimulationBeijingChina
| | - Jianguo Zhang
- Department of Functional Neurosurgery, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeurostimulationBeijingChina
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Yilei Xiao
- Department of NeurosurgeryLiaocheng People's HospitalLiaochengChina
| | - Guoen Cai
- Department of NeurologyFujian Medical University Union HospitalFuzhouChina
- Fujian Key Laboratory of Molecular Neurology, Institute of Clinical Neurology, Institute of NeuroscienceFujian Medical UniversityFuzhouChina
| | - Fangang Meng
- Department of Functional Neurosurgery, Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina
- Beijing Key Laboratory of NeurostimulationBeijingChina
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- Chinese Institute for Brain ResearchBeijingChina
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Beaulieu-Jones BK, Frau F, Bozzi S, Chandross KJ, Peterschmitt MJ, Cohen C, Coulovrat C, Kumar D, Kruger MJ, Lipnick SL, Fitzsimmons L, Kohane IS, Scherzer CR. Disease progression strikingly differs in research and real-world Parkinson's populations. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.17.24302981. [PMID: 38405736 PMCID: PMC10889035 DOI: 10.1101/2024.02.17.24302981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Characterization of Parkinson's disease (PD) progression using real-world evidence could guide clinical trial design and identify subpopulations. Efforts to curate research populations, the increasing availability of real-world data and recent advances in natural language processing, particularly large language models, allow for a more granular comparison of populations and the methods of data collection describing these populations than previously possible. This study includes two research populations and two real-world data derived (RWD) populations. The research populations are the Harvard Biomarkers Study (HBS, N = 935), a longitudinal biomarkers cohort study with in-person structured study visits; and Fox Insights (N = 36,660), an online self-survey-based research study of the Michael J. Fox Foundation. Real-world cohorts are the Optum Integrated Claims-electronic health records (N = 157,475), representing wide-scale linked medical and claims data and de-identified data from Mass General Brigham (MGB, N = 22,949), an academic hospital system. Structured, de-identified electronic health records data at MGB are supplemented using natural language processing with a large language model to extract measurements of PD progression. This extraction process is manually validated for accuracy. Motor and cognitive progression scores change more rapidly in MGB than HBS (median survival until H&Y 3: 5.6 years vs. >10, p<0.001; mini-mental state exam median decline 0.28 vs. 0.11, p<0.001; and clinically recognized cognitive decline, p=0.001). In the real-world populations, patients are diagnosed more than eleven years later (RWD mean of 72.2 vs. research mean of 60.4, p<0.001). After diagnosis, in real-world cohorts, treatment with PD medications is initiated 2.3 years later on average (95% CI: [2.1-2.4]; p<0.001). This study provides a detailed characterization of Parkinson's progression in diverse populations. It delineates systemic divergences in the patient populations enrolled in research settings vs. patients in the real world. These divergences are likely due to a combination of selection bias and real population differences, but exact attribution of the causes is challenging using existing data. This study emphasizes a need to utilize multiple data sources and to diligently consider potential biases when planning, choosing data sources, and performing downstream tasks and analyses.
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Affiliation(s)
- Brett K Beaulieu-Jones
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA
- APDA Center for Advanced Parkinson Research of Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA
- Precision Neurology Program of Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Department of Medicine, University of Chicago, Chicago, IL 60615 USA
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase MD, 20815
| | | | - Sylvie Bozzi
- Sanofi Health Economics and Value Assessment, Sanofi, Paris, France
| | | | | | | | | | - Dinesh Kumar
- Sanofi Translational Sciences, Framingham, 01701 USA
| | - Mark J Kruger
- Sanofi Genzyme, Clinical Development Neurology, Cambridge, MA, United States
| | - Scott L Lipnick
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA
| | - Lane Fitzsimmons
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA
| | - Isaac S Kohane
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA
| | - Clemens R Scherzer
- APDA Center for Advanced Parkinson Research of Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA
- Precision Neurology Program of Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase MD, 20815
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Saffari SE, Soo SA, Mohammadi R, Ng KP, Greene W, Kandiah N. Modelling the Distribution of Cognitive Outcomes for Early-Stage Neurocognitive Disorders: A Model Comparison Approach. Biomedicines 2024; 12:393. [PMID: 38397995 PMCID: PMC10886528 DOI: 10.3390/biomedicines12020393] [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: 12/13/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Cognitive assessments for patients with neurocognitive disorders are mostly measured by the Montreal Cognitive Assessment (MoCA) and Visual Cognitive Assessment Test (VCAT) as screening tools. These cognitive scores are usually left-skewed and the results of the association analysis might not be robust. This study aims to study the distribution of the cognitive outcomes and to discuss potential solutions. Materials and Methods: In this retrospective cohort study of individuals with subjective cognitive decline or mild cognitive impairment, the inverse-transformed cognitive outcomes are modelled using different statistical distributions. The robustness of the proposed models are checked under different scenarios: with intercept-only, models with covariates, and with and without bootstrapping. Results: The main results were based on the VCAT score and validated via the MoCA score. The findings suggested that the inverse transformation method improved the modelling the cognitive scores compared to the conventional methods using the original cognitive scores. The association of the baseline characteristics (age, gender, and years of education) and the cognitive outcomes were reported as estimates and 95% confidence intervals. Bootstrap methods improved the estimate precision and the bootstrapped standard errors of the estimates were more robust. Cognitive outcomes were widely analysed using linear regression models with the default normal distribution as a conventional method. We compared the results of our suggested models with the normal distribution under various scenarios. Goodness-of-fit measurements were compared between the proposed models and conventional methods. Conclusions: The findings support the use of the inverse transformation method to model the cognitive outcomes instead of the original cognitive scores for early-stage neurocognitive disorders where the cognitive outcomes are left-skewed.
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Affiliation(s)
- Seyed Ehsan Saffari
- Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore;
- Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore;
| | - See Ann Soo
- Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore; (S.A.S.); (N.K.)
| | - Raziyeh Mohammadi
- Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore;
| | - Kok Pin Ng
- Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore;
- Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
| | - William Greene
- Stern School of Business (Emeritus), New York University, New York, NY 10012, USA;
| | - Negaenderan Kandiah
- Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore; (S.A.S.); (N.K.)
- Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
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Rezakhani S, Amiri M, Hassani A, Esmaeilpour K, Sheibani V. Anodal HD-tDCS on the dominant anterior temporal lobe and dorsolateral prefrontal cortex: clinical results in patients with mild cognitive impairment. Alzheimers Res Ther 2024; 16:27. [PMID: 38310304 PMCID: PMC10837991 DOI: 10.1186/s13195-023-01370-y] [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: 03/09/2023] [Accepted: 12/10/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVES Mild cognitive impairment (MCI) is a neurocognitive disorder in which the cognitive and mental abilities of humans are declined. Transcranial direct-current stimulation (tDCS) is an emerging noninvasive brain stimulation technique aimed at neuromodulation. In this study, we investigate whether high-definition anodal tDCS stimulation (anodal HD-tDCS) in MCI patients in two different brain regions will be effective in improving cognitive function. METHODS This study was done as a randomized, double-blind clinical trial. Sixty MCI patients (clinically diagnosed by expert neurologists) were randomly divided into three groups. Two groups received 2-mA anodal HD-tDCS for 20 min for 2 weeks (5 consecutive days in each week, 10 days in total). In the first group (twenty patients), the left dorsolateral prefrontal cortex (left DLPFC) was targeted. In the second group (twenty patients), the target zone was the dominant anterior temporal lobe (DATL). The third group (twenty patients) formed the Sham group. The Montreal Cognitive Assessment (MoCA) and Quality of Life in Alzheimer's Disease (QoLAD) were considered as the outcome measures. RESULTS MCI patients obtained the highest MoCA mean scores in both left DLPFC and DATL groups versus the study baseline 2 weeks after the intervention. In addition, the MoCA mean scores of MCI patients were greater in both intervention groups compared to the Sham group up to 3 months post-stimulation (p-value ≤ 0.05). However, as we moved away from the first stimulation day, a decreasing trend in the MoCA mean scores was observed. Moreover, in the left DLPFC and DATL groups, higher QoLAD mean scores were observed 3-month post-stimulation, highlighting the effectiveness of anodal HD-tDCS in improving the quality of life in MCI patients. CONCLUSION In this research, it was shown that applying anodal HD-tDCS at left DLPFC and DATL brain regains for two successive weeks improves cognitive function in MCI patients (by obtaining higher values of MoCA scores) up to 3 months after the intervention compared to the Sham group. This illustrates the positive effects of HD-tDCS, as a non-pharmacological intervention, for improving cognitive function and quality of life in MCI patients. SIGNIFICANCE Two weeks after anodal HD-tDCS of the DLPFC and DATL brain regions, the MCI patients achieved the highest MoCA mean scores compared to the Sham group across all measurement intervals.
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Affiliation(s)
- Soheila Rezakhani
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahmood Amiri
- Medical Technology Research Center, Institute of Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Atefe Hassani
- Medical Technology Research Center, Institute of Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Khadijeh Esmaeilpour
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Sheibani
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
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Donahue EK, Foreman RP, Duran JJ, Jakowec MW, O'Neill J, Petkus AJ, Holschneider DP, Choupan J, Van Horn JD, Venkadesh S, Bayram E, Litvan I, Schiehser DM, Petzinger GM. Increased perivascular space volume in white matter and basal ganglia is associated with cognition in Parkinson's Disease. Brain Imaging Behav 2024; 18:57-65. [PMID: 37855955 PMCID: PMC10844402 DOI: 10.1007/s11682-023-00811-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
Perivascular spaces (PVS), fluid-filled compartments surrounding brain vasculature, are an essential component of the glymphatic system responsible for transport of waste and nutrients. Glymphatic system impairment may underlie cognitive deficits in Parkinson's disease (PD). Studies have focused on the role of basal ganglia PVS with cognition in PD, but the role of white matter PVS is unknown. This study examined the relationship of white matter and basal ganglia PVS with domain-specific and global cognition in individuals with PD. Fifty individuals with PD underwent 3T T1w magnetic resonance imaging (MRI) to determine PVS volume fraction, defined as PVS volume normalized to total regional volume, within (i) centrum semiovale, (ii) prefrontal white matter (medial orbitofrontal, rostral middle frontal, superior frontal), and (iii) basal ganglia. A neuropsychological battery included assessment of global cognitive function (Montreal Cognitive Assessment, and global cognitive composite score), and cognitive-specific domains (executive function, memory, visuospatial function, attention, and language). Higher white matter rostral middle frontal PVS was associated with lower scores in both global cognitive and visuospatial function. In the basal ganglia higher PVS was associated with lower scores for memory with a trend towards lower global cognitive composite score. While previous reports have shown that greater amount of PVS in the basal ganglia is associated with decline in global cognition in PD, our findings suggest that increased white matter PVS volume may also underlie changes in cognition.
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Affiliation(s)
- Erin Kaye Donahue
- Department of Neurology, Keck School of Medicine, University of Southern California, 1333 San Pablo St, MCA-243, Los Angeles, CA, 90033, USA
| | - Ryan Patrick Foreman
- Department of Neurology, Keck School of Medicine, University of Southern California, 1333 San Pablo St, MCA-243, Los Angeles, CA, 90033, USA
| | - Jared Joshua Duran
- Department of Neurology, Keck School of Medicine, University of Southern California, 1333 San Pablo St, MCA-243, Los Angeles, CA, 90033, USA
| | - Michael Walter Jakowec
- Department of Neurology, Keck School of Medicine, University of Southern California, 1333 San Pablo St, MCA-243, Los Angeles, CA, 90033, USA
| | - Joseph O'Neill
- Division of Child Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, 90024, USA
| | - Andrew J Petkus
- Department of Neurology, Keck School of Medicine, University of Southern California, 1333 San Pablo St, MCA-243, Los Angeles, CA, 90033, USA
| | - Daniel P Holschneider
- Department of Neurology, Keck School of Medicine, University of Southern California, 1333 San Pablo St, MCA-243, Los Angeles, CA, 90033, USA
- Department of Psychiatry & the Behavioral Sciences, University of Southern California, Los Angeles, CA, 90033, USA
| | - Jeiran Choupan
- Laboratory of NeuroImaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - John Darrell Van Horn
- Department of Psychology, University of Virginia, Charlottesville, VA, 22904, USA
- School of Data Science, University of Virginia, Charlottesville, VA, 22904, USA
| | - Siva Venkadesh
- Department of Psychology, University of Virginia, Charlottesville, VA, 22904, USA
| | - Ece Bayram
- Parkinson and Other Movement Disorder Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, 92093, USA
| | - Irene Litvan
- Parkinson and Other Movement Disorder Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, 92093, USA
| | - Dawn M Schiehser
- Veterans Administration San Diego Healthcare System (VASDHS), San Diego, CA, 92161, USA
- Department of Psychiatry, University of California, San Diego, CA, 92093, USA
| | - Giselle Maria Petzinger
- Department of Neurology, Keck School of Medicine, University of Southern California, 1333 San Pablo St, MCA-243, Los Angeles, CA, 90033, USA.
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Hanff AM, Pauly C, Pauly L, Rauschenberger A, Leist AK, Krüger R, Zeegers MP, McCrum C. Determinants of patient-reported functional mobility in people with Parkinson's disease: A systematic review. Gait Posture 2024; 108:97-109. [PMID: 38029483 DOI: 10.1016/j.gaitpost.2023.11.013] [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] [Received: 01/29/2023] [Revised: 08/27/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Information on determinants of patient-reported functional mobility is lacking but would inform the planning of healthcare, resources and strategies to promote functional mobility in people with Parkinson's disease (PD). RESEARCH QUESTION To identify the determinants of patient-reported functional mobility of people with PD. METHODS Eligible: Randomized Controlled Trials, cohort, case-control, or cross-sectional analyses in people PD without date or setting restrictions, published in English, German, or French. Excluded: instruments with under 50 % of items measuring mobility. On August 9th 2023 we last searched Medline, CINAHL and PsychInfo. We assessed risk of bias using the mixed-methods appraisal tool. Results were synthesized by tabulating the determinants by outcomes and study designs. RESULTS Eleven studies published 2012-2023 were included (most in Swedish outpatient settings). Samples ranged from 9 to 255 participants. Follow-up varied from 1.5 to 36 months with attrition of 15-42 %. Heterogenic study designs complicated results synthesis. However, determinants related to environment seem to associate the strongest with patient-reported functional mobility, although determinants related to body structures and functions were most investigated. We identified disease duration, the ability to drive, caregiving, sex, age, cognitive impairment, postural instability and social participation as determinants of patient-reported functional mobility. DISCUSSION Methodological quality of the studies was limited. No study reported an a priori power calculation. Three studies controlled for confounders. The included studies lack representativeness of the population of people living with PD. Standardized sets of outcomes could enable more systematic research synthesis. CONCLUSIONS Future research should focus on activities, participation and environmental factors and improve methodological quality.
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Affiliation(s)
- Anne-Marie Hanff
- Transversal Translational Medicine, Luxembourg Institute of Health, Strassen, Luxembourg; Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands.
| | - Claire Pauly
- Translational Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Strassen, Luxembourg.
| | - Laure Pauly
- Transversal Translational Medicine, Luxembourg Institute of Health, Strassen, Luxembourg; Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Translational Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Strassen, Luxembourg.
| | - Armin Rauschenberger
- Biomedical Data Science, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Anja K Leist
- Department of Social Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Rejko Krüger
- Transversal Translational Medicine, Luxembourg Institute of Health, Strassen, Luxembourg; Translational Neuroscience, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Strassen, Luxembourg.
| | - Maurice P Zeegers
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Epidemiology, NUTRIM School of Nutrition and Translational Research in Metabolism, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
| | - Christopher McCrum
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Rehabilitation Sciences, Neurorehabilitation Research Group, KU Leuven, Leuven, Belgium.
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46
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Zhang P, Huang P, Li Y, Du J, Luo N, He Y, Liu J, He G, Cui S, Zhang W, Li G, Shen X, Jun L, Chen S. Relationships Between Rapid Eye Movement Sleep Behavior Disorder and Parkinson's Disease: Indication from Gut Microbiota Alterations. Aging Dis 2024; 15:357-368. [PMID: 37307829 PMCID: PMC10796088 DOI: 10.14336/ad.2023.0518] [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: 01/18/2023] [Accepted: 05/18/2023] [Indexed: 06/14/2023] Open
Abstract
Rapid eye movement sleep behavior disorder (RBD) has a close relationship with Parkinson's disease (PD) and was even regarded as the most reliable hallmark of prodromal PD. RBD might have similar changes in gut dysbiosis to PD, but the relationship between RBD and PD in gut microbial alterations is rarely studied. In this study, we aim to investigate whether there were consistent changes between RBD and PD in gut microbiota, and found some specific biomarkers in RBD that might indicate phenoconversion to PD. Alpha-diversity showed no remarkable difference and beta-diversity showed significant differences based on the unweighted (R = 0.035, P = 0.037) and weighted (R = 0.0045, P = 0.008) UniFrac analysis among idiopathic RBD (iRBD), PD with RBD, PD without RBD and normal controls (NC). Enterotype distribution indicated iRBD, PD with RBD and PD without RBD were Ruminococcus-dominant while NC were Bacteroides-dominant. 7 genera (4 increased: Aerococcus, Eubacterium, Gordonibacter and Stenotrophomonas, 3 decreased: Butyricicoccus, Faecalibacterium and Haemophilus) were consistently changed in iRBD and PD with RBD. Among them, 4 genera (Aerococcus, Eubacterium, Butyricicoccus, Faecalibacterium) remained distinctive in the comparison between PD with RBD and PD without RBD. Through clinical correlation analysis, Butyricicoccus and Faecalibacterium were found negatively correlated with the severity of RBD (RBD-HK). Functional analysis showed iRBD had similarly increased staurosporine biosynthesis to PD with RBD. Our study indicates that RBD had similar gut microbial changes to PD. Decreased Butyricicoccus and Faecalibacterium might be potential hallmarks of phenoconversion of RBD to PD.
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Affiliation(s)
- Pingchen Zhang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Pei Huang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Yuanyuan Li
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Juanjuan Du
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Ningdi Luo
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Yixi He
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Jin Liu
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Guiying He
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Shishuang Cui
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Weishan Zhang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Gen Li
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Xin Shen
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Liu Jun
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Shengdi Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
- Lab for Translational Research of Neurodegenerative Diseases, Shanghai Institute for Advanced Immunochemical Studies (SIAIS), Shanghai Tech University, Shanghai 201210, China
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47
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Firouzi M, Baetens K, Swinnen E, Baeken C, Van Overwalle F, Deroost N. Does transcranial direct current stimulation of the primary motor cortex improve implicit motor sequence learning in Parkinson's disease? J Neurosci Res 2024; 102:e25311. [PMID: 38400585 DOI: 10.1002/jnr.25311] [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: 05/10/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
Implicit motor sequence learning (IMSL) is a cognitive function that is known to be associated with impaired motor function in Parkinson's disease (PD). We previously reported positive effects of transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) on IMSL in 11 individuals with PD with mild cognitive impairments (MCI), with the largest effects occurring during reacquisition. In the present study, we included 35 individuals with PD, with (n = 15) and without MCI (n = 20), and 35 age- and sex-matched controls without PD, with (n = 13) and without MCI (n = 22). We used mixed-effects models to analyze anodal M1 tDCS effects on acquisition (during tDCS), short-term (five minutes post-tDCS) and long-term reacquisition (one-week post-tDCS) of general and sequence-specific learning skills, as measured by the serial reaction time task. At long-term reacquisition, anodal tDCS resulted in smaller general learning effects compared to sham, only in the PD group, p = .018, possibly due to floor effects. Anodal tDCS facilitated the acquisition of sequence-specific learning (M = 54.26 ms) compared to sham (M = 38.98 ms), p = .003, regardless of group (PD/controls). Further analyses revealed that this positive effect was the largest in the PD-MCI group (anodal: M = 69.07 ms; sham: M = 24.33 ms), p < .001. Although the observed effect did not exceed the stimulation period, this single-session tDCS study confirms the potential of tDCS to enhance IMSL, with the largest effects observed in patients with lower cognitive status. These findings add to the body of evidence that anodal tDCS can beneficially modulate the abnormal basal ganglia network activity that occurs in PD.
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Affiliation(s)
- Mahyar Firouzi
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Jette, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
| | - Kris Baetens
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
| | - Eva Swinnen
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Jette, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
| | - Chris Baeken
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
- Department of Psychiatry and Medical Psychology, Ghent University, University Hospital Ghent (UZ Ghent), Ghent, Belgium
- Department of Psychiatry, Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, University Hospital Brussel (UZ Brussel), Brussels, Belgium
| | - Frank Van Overwalle
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
| | - Natacha Deroost
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
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48
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Jun MH, Ku B, Kim K, Lee KH, Kim JU. A screening method for mild cognitive impairment in elderly individuals combining bioimpedance and MMSE. Front Aging Neurosci 2024; 16:1307204. [PMID: 38327500 PMCID: PMC10847325 DOI: 10.3389/fnagi.2024.1307204] [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: 10/04/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
We investigated a screening method for mild cognitive impairment (MCI) that combined bioimpedance features and the Korean Mini-Mental State Examination (K-MMSE) score. Data were collected from 539 subjects aged 60 years or older at the Gwangju Alzheimer's & Related Dementias (GARD) Cohort Research Center, A total of 470 participants were used for the analysis, including 318 normal controls and 152 MCI participants. We measured bioimpedance, K-MMSE, and the Seoul Neuropsychological Screening Battery (SNSB-II). We developed a multiple linear regression model to predict MCI by combining bioimpedance variables and K-MMSE total score and compared the model's accuracy with SNSB-II domain scores by the area under the receiver operating characteristic curve (AUROC). We additionally compared the model performance with several machine learning models such as extreme gradient boosting, random forest, support vector machine, and elastic net. To test the model performances, the dataset was divided into a training set (70%) and a test set (30%). The AUROC values of SNSB-II scores were 0.803 in both sexes, 0.840 for males, and 0.770 for females. In the combined model, the AUROC values were 0.790 (0.773) for males (and females), which were significantly higher than those from the model including MMSE scores alone (0.723 for males and 0.622 for females) or bioimpedance variables alone (0.640 for males and 0.615 for females). Furthermore, the accuracies of the combined model were comparable to those of machine learning models. The bioimpedance-MMSE combined model effectively distinguished the MCI participants and suggests a technique for rapid and improved screening of the elderly population at risk of cognitive impairment.
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Affiliation(s)
- Min-Ho Jun
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
| | - Boncho Ku
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Kahye Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
| | - Kun Ho Lee
- Gwangju Alzheimer’s Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, Republic of Korea
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Jaeuk U. Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
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49
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Brockmann K, Lerche S, Baiardi S, Rossi M, Wurster I, Quadalti C, Roeben B, Mammana A, Zimmermann M, Hauser AK, Deuschle C, Schulte C, Liepelt-Scarfone I, Gasser T, Parchi P. CSF α-synuclein seed amplification kinetic profiles are associated with cognitive decline in Parkinson's disease. NPJ Parkinsons Dis 2024; 10:24. [PMID: 38242875 PMCID: PMC10799016 DOI: 10.1038/s41531-023-00627-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/20/2023] [Indexed: 01/21/2024] Open
Abstract
Seed amplification assays have been implemented in Parkinson's disease to reveal disease-specific misfolded alpha-synuclein aggregates in biospecimens. While the assays' qualitative dichotomous seeding response is valuable to stratify and enrich cohorts for alpha-synuclein pathology in general, more quantitative parameters that are associated with clinical dynamics of disease progression and that might potentially serve as exploratory outcome measures in clinical trials targeting alpha-synuclein would add important information. To evaluate whether the seeding kinetic parameters time required to reach the seeding threshold (LAG phase), the peak of fluorescence response (Imax), and the area under the curve (AUC) are associated with clinical trajectories, we analyzed LAG, Imax, and AUC in relation to the development of cognitive decline in a longitudinal cohort of 199 people with Parkinson's disease with positive CSF alpha-synuclein seeding status. Patients were stratified into tertiles based on their individual CSF alpha-synuclein seeding kinetic properties. The effect of the kinetic parameters on longitudinal development of cognitive impairment defined by MoCA ≤25 was analyzed by Cox-Regression. Patients with a higher number of positive seeding replicates and tertile groups of shorter LAG, higher Imax, and higher AUC showed a higher prevalence of and a shorter duration until cognitive impairment longitudinally (3, 6, and 3 years earlier with p ≤ 0.001, respectively). Results remained similar in separate subgroup analyses of patients with and without GBA mutation. We conclude that a more prominent alpha-synuclein seeding kinetic profile translates into a more rapid development of cognitive decline.
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Affiliation(s)
- Kathrin Brockmann
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany.
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany.
- Department of Pharmacy and Biotechnology, University of Bologna, 40126, Bologna, Italy.
| | - Stefanie Lerche
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Simone Baiardi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy
| | - Marcello Rossi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139, Bologna, Italy
| | - Isabel Wurster
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
- Edmond J. Safra Fellow in Movement Disorders, Tuebingen, Germany
| | - Corinne Quadalti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139, Bologna, Italy
- Department of Pharmacy and Biotechnology, University of Bologna, 40126, Bologna, Italy
| | - Benjamin Roeben
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Angela Mammana
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139, Bologna, Italy
| | - Milan Zimmermann
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Ann-Kathrin Hauser
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Christian Deuschle
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Claudia Schulte
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Inga Liepelt-Scarfone
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Thomas Gasser
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Piero Parchi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy
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50
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Bhatia P, Bickle M, Agrawal AA, Truss B, Nikolaidi A, Brockmann K, Reinhardt L, Vogel S, Szegoe EM, Pal A, Hermann A, Mikicic I, Yun M, Falkenburger B, Sterneckert J. Axonal Lysosomal Assays for Characterizing the Effects of LRRK2 G2019S. BIOLOGY 2024; 13:58. [PMID: 38275734 PMCID: PMC10813644 DOI: 10.3390/biology13010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
The degeneration of axon terminals before the soma, referred to as "dying back", is a feature of Parkinson's disease (PD). Axonal assays are needed to model early PD pathogenesis as well as identify protective therapeutics. We hypothesized that defects in axon lysosomal trafficking as well as injury repair might be important contributing factors to "dying back" pathology in PD. Since primary human PD neurons are inaccessible, we developed assays to quantify axonal trafficking and injury repair using induced pluripotent stem cell (iPSC)-derived neurons with LRRK2 G2019S, which is one of the most common known PD mutations, and isogenic controls. We observed a subtle axonal trafficking phenotype that was partially rescued by a LRRK2 inhibitor. Mutant LRRK2 neurons showed increased phosphorylated Rab10-positive lysosomes, and lysosomal membrane damage increased LRRK2-dependent Rab10 phosphorylation. Neurons with mutant LRRK2 showed a transient increase in lysosomes at axotomy injury sites. This was a pilot study that used two patient-derived lines to develop its methodology; we observed subtle phenotypes that might correlate with heterogeneity in LRRK2-PD patients. Further analysis using additional iPSC lines is needed. Therefore, our axonal lysosomal assays can potentially be used to characterize early PD pathogenesis and test possible therapeutics.
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Affiliation(s)
- Priyanka Bhatia
- Center for Regenerative Therapies TU Dresden (CRTD), Technische Universität Dresden, 01307 Dresden, Germany; (P.B.)
| | - Marc Bickle
- Roche Institute of Human Biology, 4070 Basel, Switzerland
| | - Amay A. Agrawal
- Center for Regenerative Therapies TU Dresden (CRTD), Technische Universität Dresden, 01307 Dresden, Germany; (P.B.)
| | - Buster Truss
- Center for Regenerative Therapies TU Dresden (CRTD), Technische Universität Dresden, 01307 Dresden, Germany; (P.B.)
| | - Aikaterina Nikolaidi
- Center for Regenerative Therapies TU Dresden (CRTD), Technische Universität Dresden, 01307 Dresden, Germany; (P.B.)
| | - Kathrin Brockmann
- German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
- Department of Neurodegenerative Diseases, Center of Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Lydia Reinhardt
- Center for Regenerative Therapies TU Dresden (CRTD), Technische Universität Dresden, 01307 Dresden, Germany; (P.B.)
| | - Stefanie Vogel
- Center for Regenerative Therapies TU Dresden (CRTD), Technische Universität Dresden, 01307 Dresden, Germany; (P.B.)
| | - Eva M. Szegoe
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany
| | - Arun Pal
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany
| | - Andreas Hermann
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany
- Translational Neurodegeneration Section “Albrecht Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, 18147 Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, University of Rostock, 18147 Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, 18147 Rostock, Germany
| | - Ivan Mikicic
- Center for Regenerative Therapies TU Dresden (CRTD), Technische Universität Dresden, 01307 Dresden, Germany; (P.B.)
| | - Maximina Yun
- Center for Regenerative Therapies TU Dresden (CRTD), Technische Universität Dresden, 01307 Dresden, Germany; (P.B.)
- Max Planck Institute of Molecular Cellular Biology and Genetics, 01307 Dresden, Germany
- Physics of Life Excellence Cluster, 01307 Dresden, Germany
| | - Björn Falkenburger
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany
| | - Jared Sterneckert
- Center for Regenerative Therapies TU Dresden (CRTD), Technische Universität Dresden, 01307 Dresden, Germany; (P.B.)
- Medical Faculty Carl Gustav Carus of TU Dresden, 01307 Dresden, Germany
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