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Liampas I, Siokas V, Zoupa E, Kyriakoulopoulou P, Stamati P, Provatas A, Tsouris Z, Tsimourtou V, Lyketsos CG, Dardiotis E. Neuropsychiatric symptoms and white matter hyperintensities in older adults without dementia. Int Psychogeriatr 2024:1-13. [PMID: 38639110 DOI: 10.1017/s1041610224000607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
OBJECTIVE We aimed to examine associations between neuropsychiatric symptoms (NPS) and white matter hyperintensities (WMH) status in older adults without dementia under the hypothesis that WMH increased the odds of having NPS. DESIGN Longitudinal analysis of data acquired from the National Alzheimer's Coordinating Center Uniform Data Set. SETTINGS Data were derived from 46 National Institute on Aging - funded Alzheimer's Disease Research Centers. PARTICIPANTS NACC participants aged ≥50 years with available data on WMH severity with a diagnosis of mild cognitive impairment (MCI) or who were cognitively unimpaired (CU) were studied. Among 4617 CU participants, 376 had moderate and 54 extensive WMH. Among 3170 participants with MCI, 471 had moderate and 88 had extensive WMH. MEASUREMENTS Using Cardiovascular Health Study (CHS) scores, WMH were coded as no to mild (CHS score: 0-4), moderate (score: 5-6) or extensive (score: 7-8). NPS were quantified on the Neuropsychiatric Inventory Questionnaire. Binary logistic regression models estimated the odds of reporting each of 12 NPS by WMH status separately for individuals with MCI or who were CU. RESULTS Compared to CU individuals with no to mild WMH, the odds of having elation [9.87, (2.63-37.10)], disinhibition [4.42, (1.28-15.32)], agitation [3.51, (1.29-9.54)] or anxiety [2.74, (1.28-5.88)] were higher for the extensive WMH group, whereas the odds of having disinhibition were higher for the moderate WMH group [1.94, (1.05-3.61)]. In the MCI group, he odds of NPS did not vary by WMH status. CONCLUSIONS Extensive WMH were associated with higher odds of NPS in CU older adults but not in those with MCI.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Elli Zoupa
- Larisa Day Care Center of People with Alzheimer's Disease, Association for Regional Development and Mental Health (EPAPSY), Marousi, Greece
| | | | - Polyxeni Stamati
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Antonios Provatas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Zisis Tsouris
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Vana Tsimourtou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Constantine G Lyketsos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Rotblatt LJ, Aiken-Morgan AT, Marsiske M, Horgas AL, Thomas KR. Do Associations Between Vascular Risk and Mild Cognitive Impairment Vary by Race? J Aging Health 2023; 35:74S-83S. [PMID: 33497299 PMCID: PMC8310897 DOI: 10.1177/0898264320984357] [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] [Indexed: 12/14/2022]
Abstract
Objectives: Given prevalence differences of mild cognitive impairment (MCI) among Black and white older adults, this study aimed to examine whether overall vascular risk factor (VRF) burden and individual VRF associations with amnestic (aMCI) and nonamnestic (naMCI) MCI status varied by Black/white race. Methods: Participants included 2755 older adults without dementia from the ACTIVE study. Comprehensive neuropsychological criteria were used to classify cognitively normal, aMCI, and naMCI. VRFs were primarily defined using subjective report and medication data. Multinomial logistic regression was run predicting MCI subtype. Results: Greater overall VRF burden, high cholesterol, and obesity evinced greater odds of naMCI in Black participants than whites. Across participants, diabetes and hypertension were associated with increased odds of aMCI and naMCI, respectively. Discussion: Results may reflect known systemic inequities on dimensions of social determinants of health for Black older adults. Continued efforts toward examining underlying mechanisms contributing to these findings are critical.
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Affiliation(s)
- Lindsay J. Rotblatt
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | | | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Ann L. Horgas
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL
| | - Kelsey R. Thomas
- Veterans Affairs San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA
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3
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Reiter K, Butts AM, Janecek JK, Correro AN, Nencka A, Agarwal M, Franczak M, Glass Umfleet L. Relationship between cognitive reserve, brain volume, and neuropsychological performance in amnestic and nonamnestic MCI. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:940-956. [PMID: 36573001 DOI: 10.1080/13825585.2022.2161462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022]
Abstract
Cognitive Reserve (CR) is a theoretical construct that influences the onset and course of cognitive and structural changes that occur with aging and mild cognitive impairment (MCI). There is a paucity of research that examines the relationship of CR and brain volumes in amnestic (aMCI) and nonamnestic (naMCI) separately. This study is a retrospective chart review of MCI patients who underwent neuropsychological evaluation and brain MRI with NeuroReader™ (NR). NR is an FDA-cleared software that standardizes MRI volumes to a control sample. Classifications of aMCI and naMCI were based on Petersen criteria. CR was measured as education, occupation, and word reading. Data analysis included bivariate correlations between CR, neuropsychological test scores, and NR-brain volumes by MCI subtype. The Benjamini-Hochberg method corrected for multiple comparisons. The sample included 91 participants with aMCI and 41 with naMCI. Within naMCI, positive correlations were observed between CR and whole brain volume, total gray matter, bifrontal, left parietal, left occipital, and bilateral cerebellum. Within aMCI, no significant correlations were observed between CR and brain volumes. Positive correlations with CR were observed in language, attention, and visual learning in both aMCI and naMCI groups. The current study adds to the minimal literature on CR and naMCI. Results revealed that CR is associated with volumetrics in naMCI only, though cognitive findings were similar in both MCI groups. Possible explanations include heterogeneous disease pathologies, disease stage, or a differential influence of CR on volumetrics in MCI. Additional longitudinal and biomarker studies will better elucidate this relationship.
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Affiliation(s)
- K Reiter
- Cleveland Clinic, Neurological Institute, Cleveland, OH, USA
| | - A M Butts
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - J K Janecek
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - A N Correro
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Nencka
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Agarwal
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Franczak
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - L Glass Umfleet
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
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4
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Verghese J, De Sanctis P, Ayers E. Everyday function profiles in prodromal stages of MCI: Prospective cohort study. Alzheimers Dement 2023; 19:498-506. [PMID: 35472732 PMCID: PMC9596617 DOI: 10.1002/alz.12681] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/16/2022] [Accepted: 03/29/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The nature and course of limitations in everyday function in the early clinical stages of cognitive decline is not well known. METHODS We compared complex everyday functional profiles at baseline in 59 community-dwelling older individuals with normal cognitive performance who went on to develop incident mild cognitive impairment (MCI) ("pre-MCI") with 284 older individuals who remained cognitively normal over follow-up. RESULTS The mean number of limitations on complex everyday function at baseline was 3.1 ± 3.0 in the 59 pre-MCI cases and 2.0 ± 2.4 in the 284 normal controls (P = .003). Pre-MCI cases had limitations in traveling, entertaining, remembering appointments, and hobbies compared to normal controls. A progressive increase in mild limitations on complex everyday function preceded the incidence of MCI (mean change: pre-MCI 1.9 ± 3.6 vs normal controls 0.5 ± 2.7, P < .001). DISCUSSION Prodromal stages of MCI are associated with progressive mild limitations in complex activities of daily living.
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Affiliation(s)
- Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Pierfilippo De Sanctis
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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5
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Low S, Goh KS, Ng TP, Moh A, Ang SF, Wang J, Ang K, Tang WE, Lim Z, Subramaniam T, Sum CF, Lim SC. Association Between Use of Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors and Cognitive Function in a Longitudinal Study of Patients with Type 2 Diabetes. J Alzheimers Dis 2022; 87:635-642. [PMID: 35342091 DOI: 10.3233/jad-215678] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The association between sodium-glucose cotransporter-2 inhibitors (SGLT2i) use and cognitive function in type 2 diabetes remains unclear. OBJECTIVE Explore the association between SGLT2i and longitudinal changes in cognitive function in adults with type 2 diabetes (T2DM) and assessed the cognitive domains which were impacted by SGLT2i. METHODS We conducted a prospective cohort study of 476 patients aged 60.6±7.4 years with follow-up period up to 6.4 years. Data on SGLT2i use was derived from questionnaire and verified with clinical database. We used Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to assess cognition. The association between SGLT2i use and rate of RBANS score change was examined using multiple linear regression. RESULTS There were 138 patients (29.0%) on SGLT2i, including 84 (17.7%) for < 3 years and 54 (11.3%) for ≥3 years. SGLT2i use was positively associated with RBANS total score increase in language (coefficient 0.60; 95% CI 0.10-1.11; p = 0.019) in unadjusted analysis. This positive association persisted in fully adjusted model (coefficient 0.74; 95% CI 0.12 to 1.36; p = 0.019). SGLT2i use for ≥3 years was positively associated with RBANS score increase globally and in language domain in fully adjusted analysis with coefficients 0.54 (95% CI 0.13 to 0.95; p = 0.010) and 1.12 (95% CI 0.27 to 1.97; p = 0.010) respectively. CONCLUSION Our findings revealed a previously unobserved association between ≥3 years SGLT2i use and improved cognitive scores globally and in language domain and executive function. Future studies should investigate the role of SGLT2i in ameliorating cognitive decline.
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Affiliation(s)
- Serena Low
- Diabetes Centre, Admiralty Medical Centre, Singapore, Singapore.,Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Kiat Sern Goh
- Department of Geriatrics. Changi General Hospital, Singapore
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Angela Moh
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Su Fen Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Jiexun Wang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Keven Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Wern Ee Tang
- National Healthcare Group Polyclinics, Singapore, Singapore
| | - Ziliang Lim
- National Healthcare Group Polyclinics, Singapore, Singapore
| | | | - Chee Fang Sum
- Diabetes Centre, Admiralty Medical Centre, Singapore, Singapore
| | - Su Chi Lim
- Diabetes Centre, Admiralty Medical Centre, Singapore, Singapore.,Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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6
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OUP accepted manuscript. Arch Clin Neuropsychol 2022; 37:873-890. [DOI: 10.1093/arclin/acac026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 11/14/2022] Open
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7
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Rizzi L, Aventurato ÍK, Balthazar MLF. Neuroimaging Research on Dementia in Brazil in the Last Decade: Scientometric Analysis, Challenges, and Peculiarities. Front Neurol 2021; 12:640525. [PMID: 33790850 PMCID: PMC8005640 DOI: 10.3389/fneur.2021.640525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Abstract
The last years have evinced a remarkable growth in neuroimaging studies around the world. All these studies have contributed to a better understanding of the cerebral outcomes of dementia, even in the earliest phases. In low- and middle-income countries, studies involving structural and functional neuroimaging are challenging due to low investments and heterogeneous populations. Outstanding the importance of diagnosing mild cognitive impairment and dementia, the purpose of this paper is to offer an overview of neuroimaging dementia research in Brazil. The review includes a brief scientometric analysis of quantitative information about the development of this field over the past 10 years. Besides, discusses some peculiarities and challenges that have limited neuroimaging dementia research in this big and heterogeneous country of Latin America. We systematically reviewed existing neuroimaging literature with Brazilian authors that presented outcomes related to a dementia syndrome, published from 2010 to 2020. Briefly, the main neuroimaging methods used were morphometrics, followed by fMRI, and DTI. The major diseases analyzed were Alzheimer's disease, mild cognitive impairment, and vascular dementia, respectively. Moreover, research activity in Brazil has been restricted almost entirely to a few centers in the Southeast region, and funding could be the main driver for publications. There was relative stability concerning the number of publications per year, the citation impact has historically been below the world average, and the author's gender inequalities are not relevant in this specific field. Neuroimaging research in Brazil is far from being developed and widespread across the country. Fortunately, increasingly collaborations with foreign partnerships contribute to the impact of Brazil's domestic research. Although the challenges, neuroimaging researches performed in the native population regarding regional peculiarities and adversities are of pivotal importance.
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Affiliation(s)
- Liara Rizzi
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil
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8
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Iverson GL, Gardner AJ. Symptoms of traumatic encephalopathy syndrome are common in the US general population. Brain Commun 2021; 3:fcab001. [PMID: 33842882 PMCID: PMC8023423 DOI: 10.1093/braincomms/fcab001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/04/2020] [Accepted: 11/19/2020] [Indexed: 12/14/2022] Open
Abstract
There are no validated criteria for diagnosing chronic traumatic encephalopathy, or traumatic encephalopathy syndrome, in a living person. The purpose of this study is to examine symptom reporting resembling the research criteria for traumatic encephalopathy syndrome in men and women from the US general population. This is a retrospective analysis of publicly available data from a cross-sectional epidemiological study. The National Comorbidity Survey Replication was designed to examine the prevalence and correlates of mental disorders in the USA. The study included a nationally representative sample of 9282 adults (4139 men and 5143 women). An in-person interview and survey were conducted in the homes of men and women from the general population. The study was conducted with participants residing in New York City, Los Angeles, Chicago, Philadelphia, Detroit, San Francisco, Washington DC, Dallas/Fort Worth, Houston, Boston, Nassau-Suffolk NY, St. Louis, Pittsburgh, Baltimore, Minneapolis and Atlanta. Symptoms from the research criteria for the diagnosis of traumatic encephalopathy syndrome were applied to men and women in the general population and in sub-groups of people with health problems and mental health problems. A small percentage of the US general population met symptom criteria for traumatic encephalopathy syndrome (6.6–11.9%, depending on the definition applied). People with chronic pain were much more likely to meet criteria (i.e. 14.8–30.5%), and two out of three people who have experienced suicidality in the past year met symptom criteria for traumatic encephalopathy syndrome (65.2–72.2%). The majority of women with a mood disorder and chronic pain met criteria (62.7–89.8%). This is the largest study, to date, examining the aspects of the research criteria for the diagnosis of traumatic encephalopathy syndrome in the general population, and the first study to examine these criteria in women. This study has important clinical and public health implications. The potential rate for misdiagnosing traumatic encephalopathy syndrome in adults who are experiencing chronic pain, idiopathic mental health problems or both is high.
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Affiliation(s)
- Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Spaulding Research Institute, Charlestown, MA 02129, USA.,MassGeneral Hospital for Children Sports Concussion Program, Boston, MA 02114, USA.,Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA 02129, USA
| | - Andrew J Gardner
- Hunter New England Local Health District, Sports Concussion Program, Waratah, NSW 2298, Australia.,Priority Research Centre for Sentre for Stroke and Brain Injury, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
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Nicolini P, Mari D, Abbate C, Inglese S, Bertagnoli L, Tomasini E, Rossi PD, Lombardi F. Autonomic function in amnestic and non-amnestic mild cognitive impairment: spectral heart rate variability analysis provides evidence for a brain-heart axis. Sci Rep 2020; 10:11661. [PMID: 32669640 PMCID: PMC7363846 DOI: 10.1038/s41598-020-68131-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 06/15/2020] [Indexed: 12/27/2022] Open
Abstract
Mild cognitive impairment (MCI) is a heterogeneous syndrome with two main clinical subtypes, amnestic (aMCI) and non-amnestic (naMCI). The analysis of heart rate variability (HRV) is a tool to assess autonomic function. Cognitive and autonomic processes are linked via the central autonomic network. Autonomic dysfunction entails several adverse outcomes. However, very few studies have investigated autonomic function in MCI and none have considered MCI subtypes or the relationship of HRV indices with different cognitive domains and structural brain damage. We assessed autonomic function during an active orthostatic challenge in 253 oupatients aged ≥ 65, [n = 82 aMCI, n = 93 naMCI, n = 78 cognitively normal (CN), neuropsychologically tested] with power spectral analysis of HRV. We used visual rating scales to grade cerebrovascular burden and hippocampal/insular atrophy (HA/IA) on neuroimaging. Only aMCI showed a blunted response to orthostasis. Postural changes in normalised low frequency (LF) power and in the LF to high frequency ratio correlated with a memory test (positively) and HA/IA (negatively) in aMCI, and with attention/executive function tests (negatively) and cerebrovascular burden (positively) in naMCI. These results substantiate the view that the ANS is differentially impaired in aMCI and naMCI, consistently with the neuroanatomic substrate of Alzheimer's and small-vessel subcortical ischaemic disease.
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Affiliation(s)
- Paola Nicolini
- Cardiovascular Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy.
| | - Daniela Mari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Carlo Abbate
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Silvia Inglese
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Laura Bertagnoli
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Emanuele Tomasini
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Paolo D Rossi
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Federico Lombardi
- Cardiovascular Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Clinical and Community Sciences, University of Milan, Milan, Italy
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Wang S, Jiaerken Y, Yu X, Shen Z, Luo X, Hong H, Sun J, Xu X, Zhang R, Zhou Y, Lou M, Huang P, Zhang M. Understanding the association between psychomotor processing speed and white matter hyperintensity: A comprehensive multi-modality MR imaging study. Hum Brain Mapp 2019; 41:605-616. [PMID: 31675160 PMCID: PMC7267958 DOI: 10.1002/hbm.24826] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/22/2019] [Accepted: 10/02/2019] [Indexed: 01/01/2023] Open
Abstract
Cognitive processing speed is crucial for human cognition and declines with aging. White matter hyperintensity (WMH), a common sign of WM vascular damage in the elderly, is closely related to slower psychomotor processing speed. In this study, we investigated the association between WMH and psychomotor speed changes through a comprehensive assessment of brain structural and functional features. Multi-modal MRIs were acquired from 60 elderly adults. Psychomotor processing speeds were assessed using the Trail Making Test Part A (TMT-A). Linear regression analyses were performed to assess the associations between TMT-A and brain features, including WMH volumes in five cerebral regions, diffusivity parameters in the major WM tracts, regional gray matter volume, and brain activities across the whole brain. Hierarchical regression analysis was used to demonstrate the contribution of each index to slower psychomotor processing speed. Linear regression analysis demonstrated that WMH volume in the occipital lobe and fractional anisotropy of the forceps major, an occipital association tract, were associated with TMT-A. Besides, resting-state brain activities in the visual cortex connected to the forceps major were associated with TMT-A. Hierarchical regression showed fractional anisotropy of the forceps major and regional brain activities were significant predictors of TMT-A. The occurrence of WMH, combined with the disruption of passing-through fiber integrity and altered functional activities in areas connected by this fiber, are associated with a decline of psychomotor processing speed. While the causal relationship of this WMH-Tract-Function-Behavior link requires further investigation, this study enhances our understanding of these complex mechanisms.
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Affiliation(s)
- Shuyue Wang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yeerfan Jiaerken
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xinfeng Yu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhujing Shen
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Luo
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Hong
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jianzhong Sun
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ruiting Zhang
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Zhou
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Min Lou
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Jongsiriyanyong S, Limpawattana P. Mild Cognitive Impairment in Clinical Practice: A Review Article. Am J Alzheimers Dis Other Demen 2018; 33:500-507. [PMID: 30068225 PMCID: PMC10852498 DOI: 10.1177/1533317518791401] [Citation(s) in RCA: 186] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The spectrum of cognitive decline in the elderly ranges from what can be classified as normal cognitive decline with aging to subjective cognitive impairment to mild cognitive impairment (MCI) to dementia. This article reviewed the up-to-date evidence of MCI including the diagnostic criteria of MCI due to Alzheimer's disease, vascular cognitive impairment and MCI due to Parkinson disease, management and preventive intervention of MCI. There are various etiologies of MCI, and a large number of studies have been conducted to ascertain the practical modalities of preserving cognition in predementia stages. Lifestyle modification, such as aerobic exercise, is an approved modality to preserve cognitive ability and decrease the rate of progression to dementia, as well as being recommended for frailty prevention.
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Affiliation(s)
| | - Panita Limpawattana
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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12
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Suo C, Gates N, Fiatarone Singh M, Saigal N, Wilson GC, Meiklejohn J, Sachdev P, Brodaty H, Wen W, Singh N, Baune BT, Baker M, Foroughi N, Wang Y, Valenzuela MJ. Midlife managerial experience is linked to late life hippocampal morphology and function. Brain Imaging Behav 2017; 11:333-345. [PMID: 27848149 PMCID: PMC5408055 DOI: 10.1007/s11682-016-9649-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An active cognitive lifestyle has been suggested to have a protective role in the long-term maintenance of cognition. Amongst healthy older adults, more managerial or supervisory experiences in midlife are linked to a slower hippocampal atrophy rate in late life. Yet whether similar links exist in individuals with Mild Cognitive Impairment (MCI) is not known, nor whether these differences have any functional implications. 68 volunteers from the Sydney SMART Trial, diagnosed with non-amnestic MCI, were divided into high and low managerial experience (HME/LME) during their working life. All participants underwent neuropsychological testing, structural and resting-state functional MRI. Group comparisons were performed on hippocampal volume, morphology, hippocampal seed-based functional connectivity, memory and executive function and self-ratings of memory proficiency. HME was linked to better memory function (p = 0.024), mediated by larger hippocampal volume (p = 0.025). More specifically, deformation analysis found HME had relatively more volume in the CA1 sub-region of the hippocampus (p < 0.05). Paradoxically, this group rated their memory proficiency worse (p = 0.004), a result correlated with diminished functional connectivity between the right hippocampus and right prefrontal cortex (p < 0.001). Finally, hierarchical regression modelling substantiated this double dissociation.
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Affiliation(s)
- C Suo
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Science, Monash University, Clayton, Australia
| | - N Gates
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - M Fiatarone Singh
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences and Sydney Medical School, The University of Sydney, Lidcombe, Australia
- Hebrew SeniorLife, Boston, MA, USA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - N Saigal
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - G C Wilson
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - J Meiklejohn
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - P Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - H Brodaty
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - W Wen
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - N Singh
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - B T Baune
- Department of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - M Baker
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences and Sydney Medical School, The University of Sydney, Lidcombe, Australia
- School of Exercise Science, Australian Catholic University, Strathfield, NSW, Australia
| | - N Foroughi
- Clinical and Rehabilitation Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Y Wang
- Hebrew SeniorLife, Boston, MA, USA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
- Department of Medicine and the Diabetes Center, University of California, San Francisco, San Francisco, CA, USA
| | - Michael J Valenzuela
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
- Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia.
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
- Brain and Mind Centre, 100 Mallett St Camperdown, Sydney, NSW, 2050, Australia.
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Conti J, Sterr A, Brucki SMD, Conforto AB. Diversity of approaches in assessment of executive functions in stroke: limited evidence? eNeurologicalSci 2015; 1:12-20. [PMID: 26623442 PMCID: PMC4662603 DOI: 10.1016/j.ensci.2015.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Stroke is a leading cause of disability worldwide. Cognitive functions and, in particular, executive function, are commonly affected after stroke, leading to impairments in performance of daily activities, decrease in social participation and in quality of life. Appropriate assessment and understanding of executive dysfunction are important, firstly to develop better rehabilitation strategies for executive functions per se and secondly to consider executive function abilities on rehabilitation strategies in general. The purpose of this review was to identify the most widely used assessment tools of executive dysfunction for patients with stroke, and their psychometric properties. We systematically reviewed manuscripts published in English in databases from 1999 to 2015. We identified 35 publications. The most frequently used instruments were the Stroop, Digit Span and Trail making tests. Psychometric properties were described for the Executive Function Performance Test, Executive Clock Drawing Task, Chinese Frontal Assessment Battery and Virtual Action Planning — Supermarket, and two subtests of the Cambridge Cognitive Examination — Revised. There is a paucity of tools to reliably measure executive dysfunction after stroke, despite the fact that executive dysfunction is frequent. Identification of the best tools for executive dysfunction assessment is necessary to address important gaps in research and in clinical practice.
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Affiliation(s)
- Juliana Conti
- Neurostimulation Laboratory, Neurology Clinical Division. Hospital das Clínicas/Sao Paulo University
| | - Annette Sterr
- School of Psychology, University of Surrey, Guildford, UK and Visiting Professor, Neurostimulation Laboratory
| | | | - Adriana B Conforto
- Neurostimulation Laboratory, Neurology Clinical Division. Hospital das Clínicas/Sao Paulo University ; Hospital Israelita Albert Einstein, São Paulo, Brazil
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Sudo FK, Alves GS, Ericeira-Valente L, Alves CEO, Tiel C, Moreira DM, Laks J, Engelhardt E. Executive testing predicts functional loss in subjects with white matter lesions. Neurocase 2015; 21:679-87. [PMID: 25350127 DOI: 10.1080/13554794.2014.973884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In order to assess ecological validity of executive function (EF) tests and the impact of EF dysfunction on functional status in elderly subjects with moderate and severe subcortical white matter hyperintensities (WMHs), we made a correlation analysis between EF scores and two measures of Instrumental Activities of Daily Living (IADL). Trail-making test and CLOX correlated with the ability to perform IADL in subjects with severe WMH. EF tests might present low ecological validity for those with WMH below severe stage.
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Affiliation(s)
- Felipe Kenji Sudo
- a Center for Subjects with Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro (CDA/IPUB/UFRJ) , Rio de Janeiro , Brazil
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Yanhong O, Chandra M, Venkatesh D. Mild cognitive impairment in adult: A neuropsychological review. Ann Indian Acad Neurol 2014; 16:310-8. [PMID: 24101808 PMCID: PMC3788272 DOI: 10.4103/0972-2327.116907] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 05/29/2013] [Accepted: 07/07/2013] [Indexed: 12/31/2022] Open
Abstract
Mild cognitive impairment (MCI) is associated with an increased risk of developing dementia. This is clinically relevant overt dementia can be prevented if treatment strategies are devised for MCI. Neuropsychological deficits in this condition are very common and are important clinically for treatment and outcomes. We aimed to review various neuropsychological deficits in MCI. Further, we have presented the current evidence for nosological status, neuroanatomical basis, and clinical outcome of this heterogeneous construct. All published papers on the topic of neuropsychological deficits in MCI on Medline and other databases were reviewed. A wide range of memory and executive function deficits are common in MCI patients. However, several studies are limited by either improper designs or inadequate sample sizes. Several neuropsychological impairments like memory function and executive functions can be diagnosed in MCI. The evidence base for the exact neuroanatomical basis of MCI is not robust yet. However, given the wide range of outcomes, controversies and debates exist regarding the nosological significance of the deficits. Hence, more studies are needed to specifically locate the impairments and further delineate the construct of MCI.
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Affiliation(s)
- Ouyang Yanhong
- Hainan People's Hospital, First Aid Center EICU, Hainan, China
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