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Zhuang XM, Kuo LW, Lin SY, Yang JJ, Tu MC, Hsu YH. Prospective Memory and Regional Functional Connectivity in Subcortical Ischemic Vascular Disease. Front Aging Neurosci 2021; 13:686040. [PMID: 34489671 PMCID: PMC8417716 DOI: 10.3389/fnagi.2021.686040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/22/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives: Patients with subcortical ischemic vascular disease (SIVD) often have prominent frontal dysfunction. However, it remains unclear how SIVD affects prospective memory (PM), which strongly relies on the frontoparietal network. The present study aimed to investigate PM performance in patients with early stage SIVD as compared to those with Alzheimer's disease (AD) and to older adults with normal cognition, and to explore the neural correlates of PM deficits. Method: Patients with very-mild to mild dementia due to SIVD or AD and normal controls (NC) aged above 60 years were recruited. Seventy-three participants (20 SIVD, 22 AD, and 31 NC) underwent structural magnetic resonance imaging (MRI), cognitive screening tests, and a computerized PM test. Sixty-five of these participants (19 SIVD, 20 AD, and 26 NC) also received resting-state functional MRI. Results: The group with SIVD had significantly fewer PM hits than the control group on both time-based and non-focal event-based PM tasks. Among patients in the very early stage, only those with SIVD but not AD performed significantly worse than the controls. Correlational analyses showed that non-focal event-based PM in SIVD was positively correlated with regional homogeneity in bilateral superior and middle frontal gyri, while time-based PM was not significantly associated with regional homogeneity in any of the regions of interest within the dorsal frontoparietal regions. Conclusions: The findings of this study highlight the vulnerability of non-focal event-based PM to the disruption of regional functional connectivity in bilateral superior and middle frontal gyri in patients with SIVD.
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Affiliation(s)
- Xuan-Miao Zhuang
- Department of Psychology, National Chung Cheng University, Chiayi, Taiwan
| | - Li-Wei Kuo
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, Taiwan.,Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shih-Yen Lin
- Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan
| | - Jir-Jei Yang
- Department of Medical Imaging, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Min-Chien Tu
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,Department of Neurology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yen-Hsuan Hsu
- Department of Psychology, National Chung Cheng University, Chiayi, Taiwan.,Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, Chiayi, Taiwan
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White Matter Hyperintensities Contribute to Language Deficits in Primary Progressive Aphasia. Cogn Behav Neurol 2020; 33:179-191. [PMID: 32889950 DOI: 10.1097/wnn.0000000000000237] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the contribution of white matter hyperintensities (WMH) to language deficits while accounting for cortical atrophy in individuals with primary progressive aphasia (PPA). METHOD Forty-three individuals with PPA completed neuropsychological assessments of nonverbal semantics, naming, and sentence repetition plus T2-weighted and fluid-attenuated inversion recovery scans. Using three visual scales, we rated WMH and cerebral ventricle size for both scan types. We used Spearman correlations to evaluate associations between the scales and scans. To test whether visual ratings-particularly of WMH-are associated with language, we compared a base model (including gray matter component scores obtained via principal component analysis, age, and days between assessment and MRI as independent variables) with full models (ie, the base model plus visual ratings) for each language variable. RESULTS Visual ratings were significantly associated within and between scans and were significantly correlated with age but not with other vascular risk factors. Only the T2 scan ratings were associated with language abilities. Specifically, controlling for other variables, poorer naming was significantly related to larger ventricles (P = 0.033) and greater global (P = 0.033) and periventricular (P = 0.049) WMH. High global WMH (P = 0.034) were also correlated with worse sentence repetition skills. CONCLUSION Visual ratings of global brain health were associated with language deficits in PPA independent of cortical atrophy and age. While WMH are not unique to PPA, measuring WMH in conjunction with cortical atrophy may elucidate more accurate brain structure-behavior relationships in PPA than cortical atrophy measures alone.
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Maillard P, Fletcher E, Singh B, Martinez O, Johnson DK, Olichney JM, Farias ST, DeCarli C. Cerebral white matter free water: A sensitive biomarker of cognition and function. Neurology 2019; 92:e2221-e2231. [PMID: 30952798 PMCID: PMC6537135 DOI: 10.1212/wnl.0000000000007449] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 01/08/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To determine whether free water (FW) content, initially developed to correct metrics derived from diffusion tensor imaging and recently found to be strongly associated with vascular risk factors, may constitute a sensitive biomarker of white matter (WM) microstructural differences associated with cognitive performance but remains unknown. METHODS Five hundred thirty-six cognitively diverse individuals, aged 77 ± 8 years, received yearly comprehensive clinical evaluations and a baseline MRI examination of whom 224 underwent follow-up MRI. WM microstructural measures, including FW, fractional anisotropy, and mean diffusivity corrected for FW and WM hyperintensity burden were computed within WM voxels of each individual. Baseline and change in MRI metrics were then used as independent variables to explain baseline and change in episodic memory (EM), executive function (EF), and Clinical Dementia Rating (CDR) scores using linear, logistic, and Cox proportional-hazards regressions. RESULTS Higher baseline FW and WM hyperintensity were associated with lower baseline EM and EF, higher baseline CDR, accelerated EF and EM decline, and higher probability to transition to a more severe CDR stage (p values <0.01). Annual change in FW was also found to be associated with concomitant change in cognitive and functional performance (p values <0.01). CONCLUSIONS This study finds cross-sectional and longitudinal associations between FW content and trajectory of cognitive and functional performance in a large sample of cognitively diverse individuals. It supports the need to investigate the pathophysiologic process that manifests increased FW, potentially leading to more severe WM territory injury and promoting cognitive and functional decline.
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Affiliation(s)
- Pauline Maillard
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis.
| | - Evan Fletcher
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - Baljeet Singh
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - Oliver Martinez
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - David K Johnson
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - John M Olichney
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - Sarah T Farias
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
| | - Charles DeCarli
- From the Imaging of Dementia and Aging Laboratory and Center for Neurosciences (P.M., E.F., B.S., O.M., C.D.), Davis, CA; and Department of Neurology (D.K.J., J.M.O., S.T.F., C.D.), University of California, Davis
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Asselin A, Potvin O, Bouchard LO, Brisson M, Duchesne S. Validation of an Magnetic Resonance Imaging Acquisition and Review Protocol for Alzheimer's Disease and Related Disorders. Can Assoc Radiol J 2019; 70:172-180. [DOI: 10.1016/j.carj.2018.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 09/04/2018] [Accepted: 10/08/2018] [Indexed: 10/27/2022] Open
Abstract
Purpose Magnetic resonance imaging (MRI) of the brain allows for the identification of structural lesions typical of Alzheimer's disease (AD), the main cause of dementia. However, to have a clinical impact, it is imperative that acquisition and reporting of this MRI-based evidence be standardized, ensuring the highest possible reliability and reproducibility. Our objective was to validate a systematic radiological MRI acquisition and review process in the context of AD. Methods We included 100 individuals with a suspicion of dementia due to AD for whom MRI were acquired using our proposed protocol of clinically achievable acquisitions and used a unified reading grid to gather semi-quantitative evidence guiding diagnostic. MRIs were read by 3 raters with different experience levels. Interrater reliability was measured using Cohen's kappa statistic. Results Interrater reliability average for lesions occupying space, hemorrhage, or ischemia, was respectively 0.754, 0.715, and 0.501. Average reliability of white matter hyperintensity burden (Fazekas), global cortical atrophy, and temporal lobe atrophy (Scheltens) scales was 0.687, 0.473, and 0.621 (right)/0.599 (left), respectively. The kappas for regional cortical atrophy (frontal, parietal, occipital, temporal, and posterior cingulum) varied from 0.281–0.678. The average MRI reading time varied between 1.43-5.22 minutes. Conclusions The presence of space occupying lesions, hemorrhagic or ischemic phenomena, and radiological scales have a good interrater reproducibility in MRI. Coupled with standardized acquisitions, such a protocol should be used when evaluating possible dementias, especially those due to probable AD.
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Affiliation(s)
| | | | | | - Mélanie Brisson
- Centre hospitalier universitaire de Québec, Quebec City, Canada
- Radiology Department, Université Laval, Quebec City, Canada
| | - Simon Duchesne
- CERVO Brain Research Centre, Quebec City, Canada
- Radiology Department, Université Laval, Quebec City, Canada
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Pereira N, Gonçalves APB, Goulart M, Tarrasconi MA, Kochhann R, Fonseca RP. Age-related differences in conversational discourse abilities A comparative study. Dement Neuropsychol 2019; 13:53-71. [PMID: 31073380 PMCID: PMC6497023 DOI: 10.1590/1980-57642018dn13-010006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/10/2018] [Indexed: 11/24/2022] Open
Abstract
Conversational discourse (CD) is among the most complex tasks in everyday life and relies on multiple cognitive domains (communicative and executive abilities). Alterations in discourse comprehension and production are often present in pathological aging. However, there is still a need to identify changes in healthy aging. OBJECTIVE This study aimed to compare young and older adults for the frequency of impaired communicative behaviors on a CD task. Performance was scored according to the Complementary Procedure of Conversational Discourse Analysis (CPCDA), developed based on the CD task from the Montreal Communication Evaluation Battery. METHODS A total of 95 participants (54 young-adults and 41 older adults) were evaluated. The frequency of communicative behaviors was compared between groups using MANCOVA and Chi-square tests. RESULTS Young adults showed fewer impairments in expression, pragmatics, cohesion, coherence, comprehension and emotional prosody. Older adults showed higher levels of verbal initiative and had fewer word finding difficulties. Communicative behaviors associated with planning and self-monitoring (e.g. repetition of information and syllabic false starts) appear to be common in the speech of healthy individuals in general. CONCLUSION Studies which evaluate both discursive and cognitive skills are required to identify age-related changes. This would allow for the development of screening tools for CD assessment and preventive programs.
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Affiliation(s)
- Natalie Pereira
- Doctoral student, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ana Paula Bresolin Gonçalves
- Psychology undergraduate student, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mariana Goulart
- Psychology undergraduate student, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marina Amarante Tarrasconi
- Psychology undergraduate student, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Renata Kochhann
- PhD, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rochele Paz Fonseca
- PhD, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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