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Kim AJ, Senior J, Chu S, Mather M. Aging impairs reactive attentional control but not proactive distractor inhibition. J Exp Psychol Gen 2024; 153:1938-1959. [PMID: 38780565 PMCID: PMC11250690 DOI: 10.1037/xge0001602] [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: 05/25/2024]
Abstract
Older adults tend to be more prone to distraction compared with young adults, and this age-related deficit has been attributed to a deficiency in inhibitory processing. However, recent findings challenge the notion that aging leads to global impairments in inhibition. To reconcile these mixed findings, we investigated how aging modulates multiple mechanisms of attentional control by tracking the timing and direction of eye movements. When engaged in feature-search mode and proactive distractor suppression, older adults made fewer first fixations to the target but inhibited the task-irrelevant salient distractor as effectively as did young adults. However, when engaged in singleton-search mode and required to reactively disengage from the distractor, older adults made significantly more first saccades toward the task-irrelevant salient distractor and showed increased fixation times in orienting to the target, longer dwell times on incorrect saccades, and increased saccadic reaction times compared with young adults. Our findings reveal that aging differently impairs attentional control depending on whether visual search requires proactive distractor suppression or reactive distractor disengagement. Furthermore, our oculomotor measures reveal both age-related deficits and age equivalence in various mechanisms of attention, including goal-directed orienting, selection history, disengagement, and distractor inhibition. These findings help explain why conclusions of age-related declines or age equivalence in mechanisms of attentional control are task specific and reveal that older adults do not exhibit global impairments in mechanisms of inhibition. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Andy Jeesu Kim
- School of Gerontology, University of Southern California
| | - Joshua Senior
- School of Gerontology, University of Southern California
| | - Sonali Chu
- School of Gerontology, University of Southern California
| | - Mara Mather
- School of Gerontology, University of Southern California
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2
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Patterson EJ, Bounds AD, Wagner SK, Kadri-Langford R, Taylor R, Daly D. Oculomics: A Crusade Against the Four Horsemen of Chronic Disease. Ophthalmol Ther 2024; 13:1427-1451. [PMID: 38630354 PMCID: PMC11109082 DOI: 10.1007/s40123-024-00942-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/25/2024] [Indexed: 05/22/2024] Open
Abstract
Chronic, non-communicable diseases present a major barrier to living a long and healthy life. In many cases, early diagnosis can facilitate prevention, monitoring, and treatment efforts, improving patient outcomes. There is therefore a critical need to make screening techniques as accessible, unintimidating, and cost-effective as possible. The association between ocular biomarkers and systemic health and disease (oculomics) presents an attractive opportunity for detection of systemic diseases, as ophthalmic techniques are often relatively low-cost, fast, and non-invasive. In this review, we highlight the key associations between structural biomarkers in the eye and the four globally leading causes of morbidity and mortality: cardiovascular disease, cancer, neurodegenerative disease, and metabolic disease. We observe that neurodegenerative disease is a particularly promising target for oculomics, with biomarkers detected in multiple ocular structures. Cardiovascular disease biomarkers are present in the choroid, retinal vasculature, and retinal nerve fiber layer, and metabolic disease biomarkers are present in the eyelid, tear fluid, lens, and retinal vasculature. In contrast, only the tear fluid emerged as a promising ocular target for the detection of cancer. The retina is a rich source of oculomics data, the analysis of which has been enhanced by artificial intelligence-based tools. Although not all biomarkers are disease-specific, limiting their current diagnostic utility, future oculomics research will likely benefit from combining data from various structures to improve specificity, as well as active design, development, and optimization of instruments that target specific disease signatures, thus facilitating differential diagnoses.
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Affiliation(s)
| | | | - Siegfried K Wagner
- Moorfields Eye Hospital NHS Trust, 162 City Road, London, EC1V 2PD, UK
- UCL Institute of Ophthalmology, University College London, 11-43 Bath Street, London, EC1V 9EL, UK
| | | | - Robin Taylor
- Occuity, The Blade, Abbey Square, Reading, Berkshire, RG1 3BE, UK
| | - Dan Daly
- Occuity, The Blade, Abbey Square, Reading, Berkshire, RG1 3BE, UK
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Fink L, Simola J, Tavano A, Lange E, Wallot S, Laeng B. From pre-processing to advanced dynamic modeling of pupil data. Behav Res Methods 2024; 56:1376-1412. [PMID: 37351785 PMCID: PMC10991010 DOI: 10.3758/s13428-023-02098-1] [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] [Accepted: 02/20/2023] [Indexed: 06/24/2023]
Abstract
The pupil of the eye provides a rich source of information for cognitive scientists, as it can index a variety of bodily states (e.g., arousal, fatigue) and cognitive processes (e.g., attention, decision-making). As pupillometry becomes a more accessible and popular methodology, researchers have proposed a variety of techniques for analyzing pupil data. Here, we focus on time series-based, signal-to-signal approaches that enable one to relate dynamic changes in pupil size over time with dynamic changes in a stimulus time series, continuous behavioral outcome measures, or other participants' pupil traces. We first introduce pupillometry, its neural underpinnings, and the relation between pupil measurements and other oculomotor behaviors (e.g., blinks, saccades), to stress the importance of understanding what is being measured and what can be inferred from changes in pupillary activity. Next, we discuss possible pre-processing steps, and the contexts in which they may be necessary. Finally, we turn to signal-to-signal analytic techniques, including regression-based approaches, dynamic time-warping, phase clustering, detrended fluctuation analysis, and recurrence quantification analysis. Assumptions of these techniques, and examples of the scientific questions each can address, are outlined, with references to key papers and software packages. Additionally, we provide a detailed code tutorial that steps through the key examples and figures in this paper. Ultimately, we contend that the insights gained from pupillometry are constrained by the analysis techniques used, and that signal-to-signal approaches offer a means to generate novel scientific insights by taking into account understudied spectro-temporal relationships between the pupil signal and other signals of interest.
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Affiliation(s)
- Lauren Fink
- Department of Music, Max Planck Institute for Empirical Aesthetics, Grüneburgweg 14, 60322, Frankfurt am Main, Germany.
- Department of Psychology, Neuroscience & Behavior, McMaster University, 1280 Main St. West, Hamilton, Ontario, L8S 4L8, Canada.
| | - Jaana Simola
- Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
- Department of Education, University of Helsinki, Helsinki, Finland
| | - Alessandro Tavano
- Department of Cognitive Neuropsychology, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
| | - Elke Lange
- Department of Music, Max Planck Institute for Empirical Aesthetics, Grüneburgweg 14, 60322, Frankfurt am Main, Germany
| | - Sebastian Wallot
- Department of Literature, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
- Institute for Sustainability Education and Psychologyy, Leuphana University, Lüneburg, Germany
| | - Bruno Laeng
- Department of Psychology, University of Oslo, Oslo, Norway
- RITMO Centre for Interdisciplinary studies in Rhythm, Time, and Motion, University of Oslo, Oslo, Norway
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4
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Romagnoli M, Amore G, Avanzini P, Carelli V, La Morgia C. Chromatic pupillometry for evaluating melanopsin retinal ganglion cell function in Alzheimer's disease and other neurodegenerative disorders: a review. Front Psychol 2024; 14:1295129. [PMID: 38259552 PMCID: PMC10801184 DOI: 10.3389/fpsyg.2023.1295129] [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: 09/21/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
The evaluation of pupillary light reflex (PLR) by chromatic pupillometry may provide a unique insight into specific photoreceptor functions. Chromatic pupillometry refers to evaluating PLR to different wavelengths and intensities of light in order to differentiate outer/inner retinal photoreceptor contributions to the PLR. Different protocols have been tested and are now established to assess in-vivo PLR contribution mediated by melanopsin retinal ganglion cells (mRGCs). These intrinsically photosensitive photoreceptors modulate the non-image-forming functions of the eye, which are mainly the circadian photoentrainment and PLR, via projections to the hypothalamic suprachiasmatic and olivary pretectal nucleus, respectively. In this context, chromatic pupillometry has been used as an alternative and non-invasive tool to evaluate the mRGC system in several clinical settings, including hereditary optic neuropathies, glaucoma, and neurodegenerative disorders such as Parkinson's disease (PD), idiopathic/isolated rapid eye movement sleep behavior disorder (iRBD), and Alzheimer's disease (AD). The purpose of this article is to review the key steps of chromatic pupillometry protocols for studying in-vivo mRGC-system functionality and provide the main findings of this technique in the research setting on neurodegeneration. mRGC-dependent pupillary responses are short-wavelength sensitive, have a higher threshold of activation, and are much slower and sustained compared with rod- and cone-mediated responses, driving the tonic component of the PLR during exposure to high-irradiance and continuous light stimulus. Thus, mRGCs contribute mainly to the tonic component of the post-illumination pupil response (PIPR) to bright blue light flash that persists after light stimulation is switched off. Given the role of mRGCs in circadian photoentrainment, the use of chromatic pupillometry to perform a functional evaluation of mRGcs may be proposed as an early biomarker of mRGC-dysfunction in neurodegenerative disorders characterized by circadian and/or sleep dysfunction such as AD, PD, and its prodromal phase iRBD. The evaluation by chromatic pupillometry of mRGC-system functionality may lay the groundwork for a new, easily accessible biomarker that can be exploited also as the starting point for future longitudinal cohort studies aimed at stratifying the risk of conversion in these disorders.
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Affiliation(s)
- Martina Romagnoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy
| | - Giulia Amore
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | | | - Valerio Carelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Chiara La Morgia
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
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Kim J, Lee J, Jun SB, Sung JE. Pupillometry as a window to detect cognitive aging in the brain. Biomed Eng Lett 2024; 14:91-101. [PMID: 38186956 PMCID: PMC10770000 DOI: 10.1007/s13534-023-00315-6] [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: 06/02/2023] [Revised: 07/24/2023] [Accepted: 08/22/2023] [Indexed: 01/09/2024] Open
Abstract
This study investigated whether there are aging-related differences in pupil dilation (pupillometry) while the cognitive load is manipulated using digit- and word-span tasks. A group of 17 younger and 15 cognitively healthy older adults performed digit- and word-span tasks. Each task comprised three levels of cognitive loads with 10 trials for each level. For each task, the recall accuracy and the slope of pupil dilation were calculated and analyzed. The raw signal of measured pupil size was low-pass filtered and interpolated to eliminate blinking artifacts and spike noises. Two-way ANOVA was used for statistical analyses. For the recall accuracy, the significant group differences emerged as the span increases in digit-span (5- vs. 7-digit) and word-span (4- vs. 5-word) tasks, while the group differences were not significant on 3-digit- and 3-word-span tasks with lower cognitive load. In digit-span tasks, there was no aging-related difference in the slope of pupil dilation. However, in word-span tasks, the slope of pupil dilation differed significantly between two groups as cognitive load increased, indicating that older adults presented a higher pupil dilation slope than younger adults especially under the conditions with higher cognitive load. The current study found significant aging effects in the pupil dilations under the more cognitive demanding span tasks when the types of span tasks varied (e.g., digit vs. word). The manipulations successfully elicited differential aging effects, given that the aging effects became most salient under word-span tasks with greater cognitive load especially under the maximum length. Supplementary Information The online version contains supplementary material available at 10.1007/s13534-023-00315-6.
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Affiliation(s)
- Jiae Kim
- Department of Communication Disorders, Ewha Womans University, Seoul, Republic of Korea
| | - Jiyeon Lee
- Department of Electronic and Electrical Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - Sang Beom Jun
- Department of Electronic and Electrical Engineering, Ewha Womans University, Seoul, Republic of Korea
- Graduate Program in Smart Factory, Ewha Womans University, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, Republic of Korea
| | - Jee Eun Sung
- Department of Communication Disorders, Ewha Womans University, Seoul, Republic of Korea
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6
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Suh A, Ong J, Kamran SA, Waisberg E, Paladugu P, Zaman N, Sarker P, Tavakkoli A, Lee AG. Retina Oculomics in Neurodegenerative Disease. Ann Biomed Eng 2023; 51:2708-2721. [PMID: 37855949 DOI: 10.1007/s10439-023-03365-0] [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: 07/13/2023] [Accepted: 09/05/2023] [Indexed: 10/20/2023]
Abstract
Ophthalmic biomarkers have long played a critical role in diagnosing and managing ocular diseases. Oculomics has emerged as a field that utilizes ocular imaging biomarkers to provide insights into systemic diseases. Advances in diagnostic and imaging technologies including electroretinography, optical coherence tomography (OCT), confocal scanning laser ophthalmoscopy, fluorescence lifetime imaging ophthalmoscopy, and OCT angiography have revolutionized the ability to understand systemic diseases and even detect them earlier than clinical manifestations for earlier intervention. With the advent of increasingly large ophthalmic imaging datasets, machine learning models can be integrated into these ocular imaging biomarkers to provide further insights and prognostic predictions of neurodegenerative disease. In this manuscript, we review the use of ophthalmic imaging to provide insights into neurodegenerative diseases including Alzheimer Disease, Parkinson Disease, Amyotrophic Lateral Sclerosis, and Huntington Disease. We discuss recent advances in ophthalmic technology including eye-tracking technology and integration of artificial intelligence techniques to further provide insights into these neurodegenerative diseases. Ultimately, oculomics opens the opportunity to detect and monitor systemic diseases at a higher acuity. Thus, earlier detection of systemic diseases may allow for timely intervention for improving the quality of life in patients with neurodegenerative disease.
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Affiliation(s)
- Alex Suh
- Tulane University School of Medicine, New Orleans, LA, USA.
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Phani Paladugu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, 6560 Fannin St #450, Houston, TX, 77030, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA
- Departments of Ophthalmology, Neurology and Neurosurgery, Weill Cornell Medicine, New York, NY, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Alnawmasi MM, Khuu SK. Deficits in the pupillary response associated with abnormal visuospatial attention allocation in mild traumatic brain injury. J Clin Exp Neuropsychol 2023; 45:855-873. [PMID: 38368620 DOI: 10.1080/13803395.2024.2314727] [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: 02/21/2023] [Accepted: 11/25/2023] [Indexed: 02/20/2024]
Abstract
INTRODUCTION The ability to allocate visual attention is known to be impaired in patients with mild traumatic brain injury (mTBI). In the present study, we investigated a possible neural correlate of this cognitive deficit by examining the pupil response of patients with mTBI whilst performing a modified Posner visual search task. METHOD Two experiments were conducted in which the target location was either not cued (Experiment 1) or cued (Experiment 2). Additionally, in Experiment 2, the type of cue (endogenous vs exogenous cue) and cue validity were treated as independent variables. In both experiments, search efficiency was varied by changing shape similarity between target and distractor patterns. The reaction time required to judge whether the target was present or absent and pupil dilation metrics, particularly the pupil dilation latency (PDL) and amplitude (PDA), were measured. Thirteen patients with chronic mTBI and 21 age-, sex-, and IQ -matched controls participated in the study. RESULTS In Experiment 1, patients with mTBI displayed a similar PDA for both efficient and inefficient search conditions, while control participants had a significantly larger PDA in inefficient search conditions compared to efficient search conditions. As cognitive load is positively correlated with PDA, our findings suggest that mTBI patients were unable to apply more mental effort whilst performing visual search, particularly if the task is difficult when visual search is inefficient. In Experiment 2, when the target location was cued, patients with mTBI displayed no significant pupil dilation response to the target regardless of the efficiency of the search, nor whether the cue was valid or invalid. These results contrasted with control participants, who were additionally sensitive to the validity of the cue in which PDA was smaller for cue-valid conditions than invalid conditions, particularly for efficient search conditions. CONCLUSION Pupillometry provided further evidence of attention allocation deficits following mTBI.
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Affiliation(s)
- Mohammed M Alnawmasi
- Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Sieu K Khuu
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
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8
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García-Bermúdez MY, Vohra R, Freude K, van Wijngaarden P, Martin K, Thomsen MS, Aldana BI, Kolko M. Potential Retinal Biomarkers in Alzheimer's Disease. Int J Mol Sci 2023; 24:15834. [PMID: 37958816 PMCID: PMC10649108 DOI: 10.3390/ijms242115834] [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: 09/01/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Alzheimer's disease (AD) represents a major diagnostic challenge, as early detection is crucial for effective intervention. This review examines the diagnostic challenges facing current AD evaluations and explores the emerging field of retinal alterations as early indicators. Recognizing the potential of the retina as a noninvasive window to the brain, we emphasize the importance of identifying retinal biomarkers in the early stages of AD. However, the examination of AD is not without its challenges, as the similarities shared with other retinal diseases introduce complexity in the search for AD-specific markers. In this review, we address the relevance of using the retina for the early diagnosis of AD and the complex challenges associated with the search for AD-specific retinal biomarkers. We provide a comprehensive overview of the current landscape and highlight avenues for progress in AD diagnosis by retinal examination.
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Affiliation(s)
| | - Rupali Vohra
- Eye Translational Research Unit, Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Kristine Freude
- Group of Stem Cell Models and Embryology, Department of Veterinary and Animal Sciences, University of Copenhagen, 1870 Frederiksberg, Denmark
| | - Peter van Wijngaarden
- Center for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC 3002, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Keith Martin
- Center for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC 3002, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC 3010, Australia
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Maj Schneider Thomsen
- Neurobiology Research and Drug Delivery, Department of Health, Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Blanca Irene Aldana
- Neurometabolism Research Group, Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Miriam Kolko
- Eye Translational Research Unit, Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
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9
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Riley E, Cicero N, Swallow K, De Rosa E, Anderson A. Locus coeruleus neuromelanin accumulation and dissipation across the lifespan. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.17.562814. [PMID: 37905002 PMCID: PMC10614878 DOI: 10.1101/2023.10.17.562814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
The pigment neuromelanin, produced in the locus coeruleus (LC) as a byproduct of catecholamine synthesis, gives the "blue spot" its name, and both identifies LC neurons and is thought to play an important yet complex role in normal and pathological aging. Using neuromelanin-sensitive T1-weighted turbo spin echo MRI scans we characterized volume and neuromelanin signal intensity in the LC of 96 participants between the ages of 19 and 86. Although LC volume did not change significantly throughout the lifespan, LC neuromelanin signal intensity increased from early adulthood, peaked around age 60 and precipitously declined thereafter. Neuromelanin intensity was greater in the caudal relative to rostral extent and in women relative to men. With regard to function, rostral LC neuromelanin intensity was associated with fluid cognition in older adults (60+) only in those above the 50th percentile of cognitive ability for age. The gradual accumulation of LC neuromelanin across the lifespan, its sudden dissipation in later life, and relation to preserved cognitive function, is consistent with its complex role in normal and pathological aging.
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Affiliation(s)
| | | | | | - Eve De Rosa
- Department of Psychology, Cornell University
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Bell TR, Elman JA, Beck A, Fennema-Notestine C, Gustavson DE, Hagler DJ, Jak AJ, Lyons MJ, Puckett OK, Toomey R, Franz CE, Kremen WS. Rostral-middle locus coeruleus integrity and subjective cognitive decline in early old age. J Int Neuropsychol Soc 2023; 29:763-774. [PMID: 36524301 PMCID: PMC10272292 DOI: 10.1017/s1355617722000881] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Abnormal tau, a hallmark Alzheimer's disease (AD) pathology, may appear in the locus coeruleus (LC) decades before AD symptom onset. Reports of subjective cognitive decline are also often present prior to formal diagnosis. Yet, the relationship between LC structural integrity and subjective cognitive decline has remained unexplored. Here, we aimed to explore these potential associations. METHODS We examined 381 community-dwelling men (mean age = 67.58; SD = 2.62) in the Vietnam Era Twin Study of Aging who underwent LC-sensitive magnetic resonance imaging and completed the Everyday Cognition scale to measure subjective cognitive decline along with their selected informants. Mixed models examined the associations between rostral-middle and caudal LC integrity and subjective cognitive decline after adjusting for depressive symptoms, physical morbidities, and family. Models also adjusted for current objective cognitive performance and objective cognitive decline to explore attenuation. RESULTS For participant ratings, lower rostral-middle LC contrast to noise ratio (LCCNR) was associated with significantly greater subjective decline in memory, executive function, and visuospatial abilities. For informant ratings, lower rostral-middle LCCNR was associated with significantly greater subjective decline in memory only. Associations remained after adjusting for current objective cognition and objective cognitive decline in respective domains. CONCLUSIONS Lower rostral-middle LC integrity is associated with greater subjective cognitive decline. Although not explained by objective cognitive performance, such a relationship may explain increased AD risk in people with subjective cognitive decline as the LC is an important neural substrate important for higher order cognitive processing, attention, and arousal and one of the first sites of AD pathology.
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Affiliation(s)
- Tyler R. Bell
- Department of Psychiatry, University of California San Diego, San Diego, La Jolla, CA, 92093
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, 92093
| | - Jeremy A. Elman
- Department of Psychiatry, University of California San Diego, San Diego, La Jolla, CA, 92093
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, 92093
| | - Asad Beck
- Center for Neurotechnology, University of Washington, Seattle, WA, USA
| | - Christine Fennema-Notestine
- Department of Psychiatry, University of California San Diego, San Diego, La Jolla, CA, 92093
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, 92093
- Department of Radiology, University of California San Diego, San Diego, La Jolla, CA, 92093
| | - Daniel E. Gustavson
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO
| | - Donald J. Hagler
- Department of Psychiatry, University of California San Diego, San Diego, La Jolla, CA, 92093
- Department of Radiology, University of California San Diego, San Diego, La Jolla, CA, 92093
| | - Amy J. Jak
- Department of Psychiatry, University of California San Diego, San Diego, La Jolla, CA, 92093
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, 92093
| | - Michael J Lyons
- Department of Psychology, Boston University, Boston, MA, USA, 02215
| | - Olivia K. Puckett
- Department of Psychiatry, University of California San Diego, San Diego, La Jolla, CA, 92093
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, 92093
| | - Rosemary Toomey
- Department of Psychology, Boston University, Boston, MA, USA, 02215
| | - Carol E. Franz
- Department of Psychiatry, University of California San Diego, San Diego, La Jolla, CA, 92093
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, 92093
| | - William S. Kremen
- Department of Psychiatry, University of California San Diego, San Diego, La Jolla, CA, 92093
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, 92093
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11
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Williams ME, Elman JA, Bell TR, Dale AM, Eyler LT, Fennema-Notestine C, Franz CE, Gillespie NA, Hagler DJ, Lyons MJ, McEvoy LK, Neale MC, Panizzon MS, Reynolds CA, Sanderson-Cimino M, Kremen WS. Higher cortical thickness/volume in Alzheimer's-related regions: protective factor or risk factor? Neurobiol Aging 2023; 129:185-194. [PMID: 37343448 PMCID: PMC10676195 DOI: 10.1016/j.neurobiolaging.2023.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/18/2023] [Accepted: 05/03/2023] [Indexed: 06/23/2023]
Abstract
Some evidence suggests a biphasic pattern of changes in cortical thickness wherein higher, rather than lower, thickness is associated with very early Alzheimer's disease (AD) pathology. We examined whether integrating information from AD brain signatures based on mean diffusivity (MD) can aid in the interpretation of cortical thickness/volume as a risk factor for future AD-related changes. Participants were 572 men in the Vietnam Era Twin Study of Aging who were cognitively unimpaired at baseline (mean age = 56 years; range = 51-60). Individuals with both high thickness/volume signatures and high MD signatures at baseline had lower cortical thickness/volume in AD signature regions and lower episodic memory performance 12 years later compared to those with high thickness/volume and low MD signatures at baseline. Groups did not differ in level of young adult cognitive reserve. Our findings are in line with a biphasic model in which increased cortical thickness may precede future decline and establish the value of examining cortical MD alongside cortical thickness to identify subgroups with differential risk for poorer brain and cognitive outcomes.
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Affiliation(s)
- McKenna E Williams
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
| | - Jeremy A Elman
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Tyler R Bell
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Anders M Dale
- Department of Radiology, University of California San Diego, La Jolla, CA, USA; Department of Neuroscience, University of California San Diego, La Jolla, CA, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
| | - Christine Fennema-Notestine
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Carol E Franz
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Donald J Hagler
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Matthew S Panizzon
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California Riverside, Riverside, CA, USA
| | - Mark Sanderson-Cimino
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - William S Kremen
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
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12
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Barry C, Wang E. Racially fair pupillometry measurements for RGB smartphone cameras using the far red spectrum. Sci Rep 2023; 13:13841. [PMID: 37620445 PMCID: PMC10449795 DOI: 10.1038/s41598-023-40796-0] [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: 06/16/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
Pupillometry is a measurement of pupil dilation commonly performed as part of neurological assessments. Prior work have demonstrated the potential for pupillometry in screening or diagnosing a number of neurological disorders including Alzheimer's Disease, Schizophrenia, and Traumatic Brain Injury. Unfortunately, the expense and inaccessibility of specialized pupilometers that image in the near infrared spectrum limit the measurement to high resource clinics or institutions. Ideally, this measurement could be available via ubiquitous devices like smartphones or tablets with integrated visible spectrum imaging systems. In the visible spectrum of RGB cameras, the melanin in the iris absorbs light such that it is difficult to distinguish the pupil aperature that appears black. In this paper, we propose a novel pupillometry technique to enable smartphone RGB cameras to effectively differentiate the pupil from the iris. The proposed system utilizes a 630 nm long-pass filter to image in the far red (630-700 nm) spectrum, where the melanin in the iris reflects light to appear brighter in constrast to the dark pupil. Using a convolutional neural network, the proposed system measures pupil diameter as it dynamically changes in a frame by frame video. Comparing across 4 different smartphone models, the pupil-iris contrast of N = 12 participants increases by an average of 451% with the proposed system. In a validation study of N = 11 participants comparing the relative pupil change in the proposed system to a Neuroptics PLR-3000 Pupillometer during a pupillary light response test, the prototype system acheived a mean absolute error of 2.4%.
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Affiliation(s)
- Colin Barry
- Electrical and Computer Engineering Department, University of California San Diego, La Jolla, CA, USA.
- Design Lab, University of California San Diego, La Jolla, CA, USA.
| | - Edward Wang
- Electrical and Computer Engineering Department, University of California San Diego, La Jolla, CA, USA
- Design Lab, University of California San Diego, La Jolla, CA, USA
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13
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Sparks S, Pinto J, Hayes G, Spitschan M, Bulte DP. The impact of Alzheimer's disease risk factors on the pupillary light response. Front Neurosci 2023; 17:1248640. [PMID: 37650103 PMCID: PMC10463762 DOI: 10.3389/fnins.2023.1248640] [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: 06/27/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia, and its prevalence is increasing and is expected to continue to increase over the next few decades. Because of this, there is an urgent requirement to determine a way to diagnose the disease, and to target interventions to delay and ideally stop the onset of symptoms, specifically those impacting cognition and daily livelihood. The pupillary light response (PLR) is controlled by the sympathetic and parasympathetic branches of the autonomic nervous system, and impairments to the pupillary light response (PLR) have been related to AD. However, most of these studies that assess the PLR occur in patients who have already been diagnosed with AD, rather than those who are at a higher risk for the disease but without a diagnosis. Determining whether the PLR is similarly impaired in subjects before an AD diagnosis is made and before cognitive symptoms of the disease begin, is an important step before using the PLR as a diagnostic tool. Specifically, identifying whether the PLR is impaired in specific at-risk groups, considering both genetic and non-genetic risk factors, is imperative. It is possible that the PLR may be impaired in association with some risk factors but not others, potentially indicating different pathways to neurodegeneration that could be distinguished using PLR. In this work, we review the most common genetic and lifestyle-based risk factors for AD and identify established relationships between these risk factors and the PLR. The evidence here shows that many AD risk factors, including traumatic brain injury, ocular and intracranial hypertension, alcohol consumption, depression, and diabetes, are directly related to changes in the PLR. Other risk factors currently lack sufficient literature to make any conclusions relating directly to the PLR but have shown links to impairments in the parasympathetic nervous system; further research should be conducted in these risk factors and their relation to the PLR.
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Affiliation(s)
- Sierra Sparks
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Joana Pinto
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Genevieve Hayes
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Manuel Spitschan
- TUM Department of Sport and Health Sciences (TUM SG), Chronobiology and Health, Technical University of Munich, Munich, Germany
- TUM Institute for Advanced Study (TUM-IAS), Technical University of Munich, Garching, Germany
- Max Planck Institute for Biological Cybernetics, Translational Sensory and Circadian Neuroscience, Tübingen, Germany
| | - Daniel P. Bulte
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
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14
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Bell TR, Beck A, Gillespie NA, Reynolds CA, Elman JA, Williams ME, Gustavson DE, Lyons MJ, Neale MC, Kremen WS, Franz CE. A Traitlike Dimension of Subjective Memory Concern Over 30 Years Among Adult Male Twins. JAMA Psychiatry 2023; 80:718-727. [PMID: 37163244 PMCID: PMC10173101 DOI: 10.1001/jamapsychiatry.2023.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/06/2023] [Indexed: 05/11/2023]
Abstract
Importance Subjective memory concern has long been considered a state-related indicator of impending cognitive decline or dementia. The possibility that subjective memory concern may itself be a heritable trait is largely ignored, yet such an association would substantially confound its use in clinical or research settings. Objective To assess the heritability and traitlike dimensions of subjective memory concern and its clinical correlates. Design, Setting, and Participants This longitudinal twin cohort study was conducted from 1967 to 2019 among male adults with a mean (SD) age of 37.75 (2.52) years to follow-up at mean ages of 56.15 (2.72), 61.50 (2.43), and 67.35 (2.57) years (hereafter, 38, 56, 62, and 67 years, respectively) in the Vietnam Era Twin Study of Aging. The study included a national community-dwelling sample with health, education, and lifestyle characteristics comparable to a general sample of US men in this age cohort. Participants were monozygotic and dizygotic twins randomly recruited from the Vietnam Era Twin Registry. Data were analyzed from May 2021 to December 2022. Main Outcomes and Measures Measures included subjective memory concern at 4 time points; objective memory, depressive symptoms, and anxiety at the last 3 time points; negative emotionality (trait neuroticism) at age 56 years; polygenic risk scores (PRSs) for neuroticism, depression, and Alzheimer disease; APOE genotype; and parental history of dementia. Primary outcomes were heritability and correlations between subjective memory concern and other measures. Results The sample included 1555 male adults examined at age 38 years, 520 at age 56 years (due to late introduction of subjective memory concern questions), 1199 at age 62 years, and 1192 at age 67 years. Phenotypically, subjective memory concerns were relatively stable over time. At age 56 years, subjective memory concern had larger correlations with depressive symptoms (r, 0.32; 95% CI, 0.21 to 0.42), anxiety (r, 0.36; 95% CI, 0.18 to 0.51), and neuroticism (r, 0.34; 95% CI, 0.26 to 0.41) than with objective memory (r, -0.24; 95% CI, -0.33 to -0.13). Phenotypic results were similar at ages 62 and 67 years. A best-fitting autoregressive twin model indicated that genetic influences on subjective memory concern accumulated and persisted over time (h2 = 0.26-0.34 from age 38-67 years). At age 56 years, genetic influences for subjective memory concern were moderately correlated with genetic influences for anxiety (r, 0.36; 95% CI, 0.18 to 0.51), negative emotionality (r, 0.51; 95% CI, 0.44-0.57), and depressive symptoms (r, 0.20; 95% CI, 0.10 to 0.29) as well as objective memory (r, -0.22; 95% CI, -0.30 to -0.14). Similar genetic correlations were seen at ages 62 and 67 years. The neuroticism PRS was associated with subjective memory concern at age 38 years (r, 0.10; 95% CI, 0.03. to 0.18) and age 67 years (r, 0.09; 95% CI, 0.01 to 0.16). Subjective memory concern was not associated with any Alzheimer disease risk measures. Conclusions and Relevance This cohort study found stable genetic influences underlying subjective memory concern dating back to age 38 years. Subjective memory concern had larger correlations with affect-related measures than with memory-related measures. Improving the utility of subjective memory concern as an indicator of impending cognitive decline and dementia may depend on isolating its statelike component from its traitlike component.
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Affiliation(s)
- Tyler R. Bell
- Center for Behavior Genetics of Aging, Department of Psychiatry, University of California, San Diego, La Jolla
| | - Asad Beck
- Graduate Program in Neuroscience, University of Washington, Seattle
| | - Nathan A. Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond
| | | | - Jeremy A. Elman
- Center for Behavior Genetics of Aging, Department of Psychiatry, University of California, San Diego, La Jolla
| | - McKenna E. Williams
- Center for Behavior Genetics of Aging, Department of Psychiatry, University of California, San Diego, La Jolla
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego
| | | | - Michael J. Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Michael C. Neale
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond
| | - William S. Kremen
- Center for Behavior Genetics of Aging, Department of Psychiatry, University of California, San Diego, La Jolla
| | - Carol E. Franz
- Center for Behavior Genetics of Aging, Department of Psychiatry, University of California, San Diego, La Jolla
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15
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Yamazaki Y, Suwabe K, Nagano-Saito A, Saotome K, Kuwamizu R, Hiraga T, Torma F, Suzuki K, Sankai Y, Yassa MA, Soya H. A possible contribution of the locus coeruleus to arousal enhancement with mild exercise: evidence from pupillometry and neuromelanin imaging. Cereb Cortex Commun 2023; 4:tgad010. [PMID: 37323937 PMCID: PMC10267300 DOI: 10.1093/texcom/tgad010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/12/2023] [Accepted: 05/13/2023] [Indexed: 06/17/2023] Open
Abstract
Acute mild exercise has been observed to facilitate executive function and memory. A possible underlying mechanism of this is the upregulation of the ascending arousal system, including the catecholaminergic system originating from the locus coeruleus (LC). Prior work indicates that pupil diameter, as an indirect marker of the ascending arousal system, including the LC, increases even with very light-intensity exercise. However, it remains unclear whether the LC directly contributes to exercise-induced pupil-linked arousal. Here, we examined the involvement of the LC in the change in pupil dilation induced by very light-intensity exercise using pupillometry and neuromelanin imaging to assess the LC integrity. A sample of 21 young males performed 10 min of very light-intensity exercise, and we measured changes in the pupil diameters and psychological arousal levels induced by the exercise. Neuromelanin-weighted magnetic resonance imaging scans were also obtained. We observed that pupil diameter and psychological arousal levels increased during very light-intensity exercise, which is consistent with previous findings. Notably, the LC contrast, a marker of LC integrity, predicted the magnitude of pupil dilation and psychological arousal enhancement with exercise. These relationships suggest that the LC-catecholaminergic system is a potential a mechanism for pupil-linked arousal induced by very light-intensity exercise.
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Affiliation(s)
- Yudai Yamazaki
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tannoudai, Tsukuba, Ibaraki 305-8574, Japan
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8574, Japan
| | - Kazuya Suwabe
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8574, Japan
- Faculty of Health and Sport Sciences, Ryutsu Keizai University, 120 Ryugasaki, Ibaraki 301-0844, Japan
- Center for Cybernics Research, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8573, Japan
| | - Atsuko Nagano-Saito
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tannoudai, Tsukuba, Ibaraki 305-8574, Japan
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8574, Japan
- Department of Radiology, Ushiku Aiwa General Hospital, 896 Inoko-cho, Ushiku, Ibaraki 300-1296, Japan
| | - Kousaku Saotome
- Center for Cybernics Research, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8573, Japan
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
| | - Ryuta Kuwamizu
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tannoudai, Tsukuba, Ibaraki 305-8574, Japan
- Graduate School of Letters, Kyoto University, Sakyo-ku, Kyoto 606-8501, Japan
| | - Taichi Hiraga
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tannoudai, Tsukuba, Ibaraki 305-8574, Japan
| | - Ferenc Torma
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tannoudai, Tsukuba, Ibaraki 305-8574, Japan
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8574, Japan
| | - Kenji Suzuki
- Center for Cybernics Research, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8573, Japan
| | - Yoshiyuki Sankai
- Center for Cybernics Research, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8573, Japan
| | - Michael A Yassa
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8574, Japan
- Department of Neurobiology and Behavior, University of California, Irvine, CA 92679-3800, United States
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA 92679-3800, United States
| | - Hideaki Soya
- Corresponding author: Laboratory of Exercise Biochemistry and Neuroendocrinology; Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8574, Japan.
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16
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Hussain A, Sheikh Z, Subramanian M. The Eye as a Diagnostic Tool for Alzheimer’s Disease. Life (Basel) 2023; 13:life13030726. [PMID: 36983883 PMCID: PMC10052959 DOI: 10.3390/life13030726] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/23/2023] [Accepted: 03/04/2023] [Indexed: 03/10/2023] Open
Abstract
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder impacting cognition, function, and behavior in the elderly population. While there are currently no disease-modifying agents capable of curing AD, early diagnosis and management in the preclinical stage can significantly improve patient morbidity and life expectancy. Currently, the diagnosis of Alzheimer’s disease is a clinical one, often supplemented by invasive and expensive biomarker testing. Over the last decade, significant advancements have been made in our understanding of AD and the role of ocular tissue as a potential biomarker. Ocular biomarkers hold the potential to provide noninvasive and easily accessible diagnostic and monitoring capabilities. This review summarizes current research for detecting biomarkers of Alzheimer’s disease in ocular tissue.
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17
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Devos H, Gustafson KM, Liao K, Ahmadnezhad P, Kuhlmann E, Estes BJ, Martin LE, Mahnken JD, Brooks WM, Burns JM. Effect of Cognitive Reserve on Physiological Measures of Cognitive Workload in Older Adults with Cognitive Impairments. J Alzheimers Dis 2023; 92:141-151. [PMID: 36710677 PMCID: PMC10023364 DOI: 10.3233/jad-220890] [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: 01/25/2023]
Abstract
BACKGROUND Cognitive reserve may protect against cognitive decline. OBJECTIVE This cross-sectional study investigated the association between cognitive reserve and physiological measures of cognitive workload in older adults with cognitive impairment. METHODS 29 older adults with cognitive impairment (age: 75±6, 11 (38%) women, MoCA: 20±7) and 19 with normal cognition (age: 74±6; 11 (58%) women; MoCA: 28±2) completed a working memory test of increasing task demand (0-, 1-, 2-back). Cognitive workload was indexed using amplitude and latency of the P3 event-related potential (ERP) at electrode sites Fz, Cz, and Pz, and changes in pupillary size, converted to an index of cognitive activity (ICA). The Cognitive Reserve Index questionnaire (CRIq) evaluated Education, Work Activity, and Leisure Time as a proxy of cognitive reserve. Linear mixed models evaluated the main effects of cognitive status, CRIq, and the interaction effect of CRIq by cognitive status on ERP and ICA. RESULTS The interaction effect of CRIq total score by cognitive status on P3 ERP and ICA was not significant. However, higher CRIq total scores were associated with lower ICA (p = 0.03). The interaction effects of CRIq subscores showed that Work Activity affected P3 amplitude (p = 0.03) and ICA (p = 0.03) differently between older adults with and without cognitive impairments. Similarly, Education affected ICA (p = 0.02) differently between the two groups. No associations were observed between CRIq and P3 latency. CONCLUSION Specific components of cognitive reserve affect cognitive workload and neural efficiency differently in older adults with and without cognitive impairments.
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Affiliation(s)
- Hannes Devos
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kathleen M Gustafson
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.,Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ke Liao
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Pedram Ahmadnezhad
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Emily Kuhlmann
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Bradley J Estes
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Laura E Martin
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jonathan D Mahnken
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - William M Brooks
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.,Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jeffrey M Burns
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
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18
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Tokushige SI, Matsumoto H, Matsuda SI, Inomata-Terada S, Kotsuki N, Hamada M, Tsuji S, Ugawa Y, Terao Y. Early detection of cognitive decline in Alzheimer's disease using eye tracking. Front Aging Neurosci 2023; 15:1123456. [PMID: 37025964 PMCID: PMC10070704 DOI: 10.3389/fnagi.2023.1123456] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/06/2023] [Indexed: 04/08/2023] Open
Abstract
Background Patients with Alzheimer's disease (AD) are known to exhibit visuospatial processing impairment, as reflected in eye movements from the early stages of the disease. We investigated whether the pattern of gaze exploration during visual tasks could be useful for detecting cognitive decline at the earliest stage. Methods Sixteen AD patients (age: 79.1 ± 7.9 years, Mini Mental State Examination [MMSE] score: 17.7 ± 5.3, mean ± standard deviation) and 16 control subjects (age: 79.4 ± 4.6, MMSE score: 26.9 ± 2.4) participated. In the visual memory task, subjects memorized presented line drawings for later recall. In the visual search tasks, they searched for a target Landolt ring of specific orientation (serial search task) or color (pop-out task) embedded among arrays of distractors. Using video-oculography, saccade parameters, patterns of gaze exploration, and pupil size change during task performance were recorded and compared between AD and control subjects. Results In the visual memory task, the number of informative regions of interest (ROIs) fixated was significantly reduced in AD patients compared to control subjects. In the visual search task, AD patients took a significantly longer time and more saccades to detect the target in the serial but not in pop-out search. In both tasks, there was no significant difference in the saccade frequency and amplitude between groups. On-task pupil modulation during the serial search task was decreased in AD. The number of ROIs fixated in the visual memory task and search time and saccade numbers in the serial search task differentiated both groups of subjects with high sensitivity, whereas saccade parameters of pupil size modulation were effective in confirming normal cognition from cognitive decline with high specificity. Discussion Reduced fixation on informative ROIs reflected impaired attentional allocation. Increased search time and saccade numbers in the visual search task indicated inefficient visual processing. Decreased on-task pupil size during visual search suggested decreased pupil modulation with cognitive load in AD patients, reflecting impaired function of the locus coeruleus. When patients perform the combination of these tasks to visualize multiple aspects of visuospatial processing, cognitive decline can be detected at an early stage with high sensitivity and specificity and its progression be evaluated.
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Affiliation(s)
- Shin-ichi Tokushige
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Neurology, Kyorin University, Tokyo, Japan
| | | | | | | | - Naoki Kotsuki
- Department of Neurology, Kyorin University, Tokyo, Japan
| | - Masashi Hamada
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shoji Tsuji
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute of Medical Genomics, International University of Health and Welfare, Chiba, Japan
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan
| | - Yasuo Terao
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Medical Physiology, Kyorin University, Tokyo, Japan
- *Correspondence: Yasuo Terao,
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19
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Zeeman M, Figeys M, Brimmo T, Burnstad C, Hao J, Kim ES. Task-Evoked Pupillary Response as a Potential Biomarker of Dementia and Mild Cognitive Impairment: A Scoping Review. Am J Alzheimers Dis Other Demen 2023; 38:15333175231160010. [PMID: 36896819 PMCID: PMC10580717 DOI: 10.1177/15333175231160010] [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] [Indexed: 03/11/2023]
Abstract
Pupil dilation functions as a proxy for cognitive effort and can be measured through automated pupillometry. The aim of this scoping review is to examine how individuals with cognitive impairment differ in task-evoked pupillary responses relative to cognitively healthy individuals. A systematic literature search across six databases was conducted to identify studies examining changes in pupillary responses evoked by cognitive tasks comparing patients with dementia to healthy controls. Eight articles met inclusion criteria and were included for review. Differences in task-evoked pupillary response between cognitively impaired and cognitively healthy participants were observed across studies. Pupil dilation is decreased in patients with Alzheimer's Disease compared to controls, with no difference observed in patients with mild cognitive impairment. A mild, non-significant trend towards reduced pupil dilation in patients with either Parkinson's Disease or Dementia with Lewy Bodies suggests a similar but less pronounced effect than in AD patients. Further research is required to examine the utility of task-evoked pupillary responses as a potential biomarker indexing cognitive decline in individuals transitioning to mild cognitive impairment and/or dementia.
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Affiliation(s)
- Michael Zeeman
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Mathieu Figeys
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Tolani Brimmo
- Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Cleo Burnstad
- Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Jasmine Hao
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Esther S Kim
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Canada
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20
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Caligiore D, Giocondo F, Silvetti M. The Neurodegenerative Elderly Syndrome (NES) hypothesis: Alzheimer and Parkinson are two faces of the same disease. IBRO Neurosci Rep 2022; 13:330-343. [PMID: 36247524 PMCID: PMC9554826 DOI: 10.1016/j.ibneur.2022.09.007] [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: 03/14/2022] [Revised: 09/07/2022] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
Increasing evidence suggests that Alzheimer's disease (AD) and Parkinson's disease (PD) share monoamine and alpha-synuclein (αSyn) dysfunctions, often beginning years before clinical manifestations onset. The triggers for these impairments and the causes leading these early neurodegenerative processes to become AD or PD remain unclear. We address these issues by proposing a radically new perspective to frame AD and PD: they are different manifestations of one only disease we call "Neurodegenerative Elderly Syndrome (NES)". NES goes through three phases. The seeding stage, which starts years before clinical signs, and where the part of the brain-body affected by the initial αSyn and monoamine dysfunctions, influences the future possible progression of NES towards PD or AD. The compensatory stage, where the clinical symptoms are still silent thanks to compensatory mechanisms keeping monoamine concentrations homeostasis. The bifurcation stage, where NES becomes AD or PD. We present recent literature supporting NES and discuss how this hypothesis could radically change the comprehension of AD and PD comorbidities and the design of novel system-level diagnostic and therapeutic actions.
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Affiliation(s)
- Daniele Caligiore
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via San Martino della Battaglia 44, Rome 00185, Italy
- AI2Life s.r.l., Innovative Start-Up, ISTC-CNR Spin-Off, Via Sebino 32, Rome 00199, Italy
| | - Flora Giocondo
- Laboratory of Embodied Natural and Artificial Intelligence, Institute of Cognitive Sciences and Technologies, National Research Council (LENAI-ISTC-CNR), Via San Martino della Battaglia 44, Rome 00185, Italy
| | - Massimo Silvetti
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via San Martino della Battaglia 44, Rome 00185, Italy
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21
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Imaoka Y, Flury A, Hauri L, de Bruin ED. Effects of different virtual reality technology driven dual-tasking paradigms on posture and saccadic eye movements in healthy older adults. Sci Rep 2022; 12:18059. [PMID: 36302813 PMCID: PMC9613688 DOI: 10.1038/s41598-022-21346-6] [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: 06/09/2021] [Accepted: 09/26/2022] [Indexed: 01/24/2023] Open
Abstract
Postural sway and eye movements are potential biomarkers for dementia screening. Assessing the two movements comprehensively could improve the understanding of complicated syndrome for more accurate screening. The purpose of this research is to evaluate the effects of comprehensive assessment in healthy older adults (OA), using a novel concurrent comprehensive assessment system consisting of stabilometer and virtual reality headset. 20 healthy OA (70.4 ± 4.9 years) were recruited. Using a cross-sectional study design, this study investigated the effects of various dual-tasking paradigms with integrated tasks of visuospatial memory (VM), spatial orientation (SO), and visual challenge on posture and saccades. Dual-task paradigms with VM and SO affected the saccadic eye movements significantly. Two highly intensive tests of anti-saccade with VM task and pro-saccade with SO task also influenced postural sway significantly. Strong associations were seen between postural sway and eye movements for the conditions where the two movements theoretically shared common neural pathways in the brain, and vice versa. This study suggests that assessing posture and saccades with the integrated tasks comprehensively and simultaneously could be useful to explain different functions of the brain. The results warrant a cross-sectional study in OA with and without dementia to explore differences between these groups.
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Affiliation(s)
- Yu Imaoka
- grid.5801.c0000 0001 2156 2780Motor Control and Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Andri Flury
- grid.5801.c0000 0001 2156 2780Motor Control and Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Laura Hauri
- grid.5801.c0000 0001 2156 2780Motor Control and Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Eling D. de Bruin
- grid.5801.c0000 0001 2156 2780Motor Control and Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8093 Zurich, Switzerland ,grid.4714.60000 0004 1937 0626Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, 141 83 Stockholm, Sweden ,grid.510272.3School of Health Professions, Eastern Switzerland University of Applied Sciences, 9001 St. Gallen, Switzerland
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22
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Sun X, Sun X, Wang Q, Wang X, Feng L, Yang Y, Jing Y, Yang C, Zhang S. Biosensors toward behavior detection in diagnosis of alzheimer’s disease. Front Bioeng Biotechnol 2022; 10:1031833. [PMID: 36338126 PMCID: PMC9626796 DOI: 10.3389/fbioe.2022.1031833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022] Open
Abstract
In recent years, a huge number of individuals all over the world, elderly people, in particular, have been suffering from Alzheimer’s disease (AD), which has had a significant negative impact on their quality of life. To intervene early in the progression of the disease, accurate, convenient, and low-cost detection technologies are gaining increased attention. As a result of their multiple merits in the detection and assessment of AD, biosensors are being frequently utilized in this field. Behavioral detection is a prospective way to diagnose AD at an early stage, which is a more objective and quantitative approach than conventional neuropsychological scales. Furthermore, it provides a safer and more comfortable environment than those invasive methods (such as blood and cerebrospinal fluid tests) and is more economical than neuroimaging tests. Behavior detection is gaining increasing attention in AD diagnosis. In this review, cutting-edge biosensor-based devices for AD diagnosis together with their measurement parameters and diagnostic effectiveness have been discussed in four application subtopics: body movement behavior detection, eye movement behavior detection, speech behavior detection, and multi-behavior detection. Finally, the characteristics of behavior detection sensors in various application scenarios are summarized and the prospects of their application in AD diagnostics are presented as well.
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Affiliation(s)
- Xiaotong Sun
- Ningbo Innovation Center, School of Mechanical Engineering, Zhejiang University, Ningbo, China
- Faculty of Science and Engineering, University of Nottingham Ningbo, Ningbo, China
| | - Xu Sun
- Faculty of Science and Engineering, University of Nottingham Ningbo, Ningbo, China
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, University of Nottingham Ningbo, Ningbo, China
- *Correspondence: Sheng Zhang, ; Xu Sun,
| | - Qingfeng Wang
- Nottingham University Business School China, University of Nottingham Ningbo China, Ningbo, Zhejiang, China
| | - Xiang Wang
- Ningbo Innovation Center, School of Mechanical Engineering, Zhejiang University, Ningbo, China
- Faculty of Science and Engineering, University of Nottingham Ningbo, Ningbo, China
| | - Luying Feng
- Ningbo Innovation Center, School of Mechanical Engineering, Zhejiang University, Ningbo, China
| | - Yifan Yang
- Ningbo Innovation Center, School of Mechanical Engineering, Zhejiang University, Ningbo, China
- Faculty of Science and Engineering, University of Nottingham Ningbo, Ningbo, China
| | - Ying Jing
- Business School, NingboTech University, Ningbo, China
| | - Canjun Yang
- Ningbo Innovation Center, School of Mechanical Engineering, Zhejiang University, Ningbo, China
| | - Sheng Zhang
- Ningbo Innovation Center, School of Mechanical Engineering, Zhejiang University, Ningbo, China
- Faculty of Science and Engineering, University of Nottingham Ningbo, Ningbo, China
- *Correspondence: Sheng Zhang, ; Xu Sun,
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23
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Zeng H, Jiang Y, Beer-Hammer S, Yu X. Awake Mouse fMRI and Pupillary Recordings in the Ultra-High Magnetic Field. Front Neurosci 2022; 16:886709. [PMID: 35903811 PMCID: PMC9318598 DOI: 10.3389/fnins.2022.886709] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/09/2022] [Indexed: 11/23/2022] Open
Abstract
Awake rodent fMRI is becoming a promising non-invasive brain imaging module when investigating large-scale brain function given behavioral tasks. Previous studies have either applied sedatives during scanning or pre-treatment of anesthetics, e.g., isoflurane, to reduce the motion of animals, which could confound the brain function of "awake" states in rodents. Here, we have established a long training awake mouse fMRI-pupillometry paradigm/setup without the initial use of anesthesia. To validate the awake mouse fMRI platform, evoked BOLD-fMRI was performed to identify brain activation in the visual cortex, dorsal lateral geniculate nuclei, and superior colliculus. Furthermore, pupil signal fluctuation was investigated during scanning, showing a less dilated pupil after 5-8 weeks of intermittent training. Thus, using the awake mouse fMRI with real-time pupillometry provides a longitudinal functional mapping tool to study fully conscious mice.
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Affiliation(s)
- Hang Zeng
- High-Field Magnetic Resonance Department, Max Planck Institute for Biological Cybernetics, Tuebingen, Germany
- Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tuebingen, Tuebingen, Germany
| | - Yuanyuan Jiang
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, United States
| | - Sandra Beer-Hammer
- Department of Pharmacology, Experimental Therapy, and Toxicology, Interfaculty Center of Pharmacogenomics and Drug Research (ICePhA), University of Tüebingen, Tübingen, Germany
| | - Xin Yu
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, United States
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24
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Moderate Alcohol Use Is Associated with Reduced Cardiovascular Risk in Middle-Aged Men Independent of Health, Behavior, Psychosocial, and Earlier Life Factors. Nutrients 2022; 14:nu14112183. [PMID: 35683983 PMCID: PMC9182350 DOI: 10.3390/nu14112183] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/21/2022] [Accepted: 05/21/2022] [Indexed: 02/04/2023] Open
Abstract
We examined whether the often-reported protective association of alcohol with cardiovascular disease (CVD) risk could arise from confounding. Our sample comprised 908 men (56−67 years), free of prevalent CVD. Participants were categorized into 6 groups: never drinkers, former drinkers, and very light (1−4 drinks in past 14 days), light (5−14 drinks), moderate (15−28 drinks), and at-risk (>28 drinks) drinkers. Generalized linear mixed effect models examined the associations of alcohol use with three established CVD risk scores: The Framingham Risk Score (FRS); the atherosclerotic CVD (ASCVD) risk score; and the Metabolic Syndrome (MetS) Severity score, adjusting for group differences in demographics, body size, and health-related behaviors. In separate models we additionally adjusted for several groups of potentially explanatory factors including socioeconomic status, social support, physical and mental health status, childhood factors, and prior history of alcohol misuse. Results showed lower CVD risk among light and moderate alcohol drinkers, relative to very light drinkers, for all CVD risk scores, independent of demographics, body size, and health-related behaviors. Alcohol-CVD risk associations were robust to further adjustment for several groups of potential explanatory factors. Study limitations include the all-male sample with limited racial and ethnic diversity, and the inability to adjust for sugar consumption and for patterns of alcohol consumption. Although this observational study does not address causation, results show that middle-aged men who consume alcohol in moderation have lower CVD risk and better cardiometabolic health than men who consume little or no alcohol, independent of a variety of health, behavioral, psychosocial, and earlier life factors.
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25
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Alvarenga AB, Oliveira HR, Miller SP, Silva FF, Brito LF. Genetic Modeling and Genomic Analyses of Yearling Temperament in American Angus Cattle and Its Relationship With Productive Efficiency and Resilience Traits. Front Genet 2022; 13:794625. [PMID: 35444687 PMCID: PMC9014094 DOI: 10.3389/fgene.2022.794625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Cattle temperament has been considered by farmers as a key breeding goal due to its relevance for cattlemen's safety, animal welfare, resilience, and longevity and its association with many economically important traits (e.g., production and meat quality). The definition of proper statistical models, accurate variance component estimates, and knowledge on the genetic background of the indicator trait evaluated are of great importance for accurately predicting the genetic merit of breeding animals. Therefore, 266,029 American Angus cattle with yearling temperament records (1-6 score) were used to evaluate statistical models and estimate variance components; investigate the association of sex and farm management with temperament; assess the weighted correlation of estimated breeding values for temperament and productive, reproductive efficiency and resilience traits; and perform a weighted single-step genome-wide association analysis using 69,559 animals genotyped for 54,609 single-nucleotide polymorphisms. Sex and extrinsic factors were significantly associated with temperament, including conception type, age of dam, birth season, and additional animal-human interactions. Similar results were observed among models including only the direct additive genetic effect and when adding other maternal effects. Estimated heritability of temperament was equal to 0.39 on the liability scale. Favorable genetic correlations were observed between temperament and other relevant traits, including growth, feed efficiency, meat quality, and reproductive traits. The highest approximated genetic correlations were observed between temperament and growth traits (weaning weight, 0.28; yearling weight, 0.28). Altogether, we identified 11 genomic regions, located across nine chromosomes including BTAX, explaining 3.33% of the total additive genetic variance. The candidate genes identified were enriched in pathways related to vision, which could be associated with reception of stimulus and/or cognitive abilities. This study encompasses large and diverse phenotypic, genomic, and pedigree datasets of US Angus cattle. Yearling temperament is a highly heritable and polygenic trait that can be improved through genetic selection. Direct selection for temperament is not expected to result in unfavorable responses on other relevant traits due to the favorable or low genetic correlations observed. In summary, this study contributes to a better understanding of the impact of maternal effects, extrinsic factors, and various genomic regions associated with yearling temperament in North American Angus cattle.
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Affiliation(s)
- Amanda B Alvarenga
- Department of Animal Sciences, Purdue University, West Lafayette, IN, United States
| | - Hinayah R Oliveira
- Department of Animal Sciences, Purdue University, West Lafayette, IN, United States.,Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada
| | - Stephen P Miller
- American Angus Association, Angus Genetics Inc., St Joseph, MO, United States
| | - Fabyano F Silva
- Department of Animal Sciences, Federal University of Vicosa, Viçosa, Brazil
| | - Luiz F Brito
- Department of Animal Sciences, Purdue University, West Lafayette, IN, United States
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26
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David M, Malhotra PA. New approaches for the quantification and targeting of noradrenergic dysfunction in Alzheimer's disease. Ann Clin Transl Neurol 2022; 9:582-596. [PMID: 35293158 PMCID: PMC8994981 DOI: 10.1002/acn3.51539] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 12/14/2022] Open
Abstract
There is clear, early noradrenergic dysfunction in Alzheimer's disease. This is likely secondary to pathological tau deposition in the locus coeruleus, the pontine nucleus that produces and releases noradrenaline, prior to involvement of cortical brain regions. Disruption of noradrenergic pathways affects cognition, especially attention, impacting memory and broader functioning. Additionally, it leads to autonomic and neuropsychiatric symptoms. Despite the strong evidence of noradrenergic involvement in Alzheimer's, there are no clear trial data supporting the clinical use of any noradrenergic treatments. Several approaches have been tried, including proof-of-principle studies and (mostly small scale) randomised controlled trials. Treatments have included pharmacotherapies as well as stimulation. The lack of clear positive findings is likely secondary to limitations in gauging locus coeruleus integrity and dysfunction at an individual level. However, the recent development of several novel biomarkers holds potential and should allow quantification of dysfunction. This may then inform inclusion criteria and stratification for future trials. Imaging approaches have improved greatly following the development of neuromelanin-sensitive sequences, enabling the use of structural MRI to estimate locus coeruleus integrity. Additionally, functional MRI scanning has the potential to quantify network dysfunction. As well as neuroimaging, EEG, fluid biomarkers and pupillometry techniques may prove useful in assessing noradrenergic tone. Here, we review the development of these biomarkers and how they might augment clinical studies, particularly randomised trials, through identification of patients most likely to benefit from treatment. We outline the biomarkers with most potential, and how they may transform symptomatic therapy for people living with Alzheimer's disease.
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Affiliation(s)
- Michael David
- Imperial College London and the University of SurreyUK Dementia Research Institute Care Research and Technology CentreSir Michael Uren Hub, 86 Wood LaneLondonW12 0BZUK
- Imperial College London, Brain SciencesSouth KensingtonLondonSW7 2AZUK
- Imperial College Healthcare NHS Trust, Clinical NeurosciencesCharing Cross HospitalLondonW2 1NYUK
| | - Paresh A. Malhotra
- Imperial College London and the University of SurreyUK Dementia Research Institute Care Research and Technology CentreSir Michael Uren Hub, 86 Wood LaneLondonW12 0BZUK
- Imperial College London, Brain SciencesSouth KensingtonLondonSW7 2AZUK
- Imperial College Healthcare NHS Trust, Clinical NeurosciencesCharing Cross HospitalLondonW2 1NYUK
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27
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Steinhauer SR, Bradley MM, Siegle GJ, Roecklein KA, Dix A. Publication guidelines and recommendations for pupillary measurement in psychophysiological studies. Psychophysiology 2022; 59:e14035. [PMID: 35318693 PMCID: PMC9272460 DOI: 10.1111/psyp.14035] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/11/2022] [Indexed: 11/27/2022]
Abstract
A variety of psychological and physical phenomena elicit variations in the diameter of pupil of the eye. Changes in pupil size are mediated by the relative activation of the sphincter pupillae muscle (decrease pupil diameter) and the dilator pupillae muscle (increase pupil diameter), innervated by the parasympathetic and sympathetic branches, respectively, of the autonomic nervous system. The current guidelines are intended to inform and guide psychophysiological research involving pupil measurement by (1) summarizing important aspects concerning the physiology of the pupil, (2) providing methodological and data-analytic guidelines and recommendations, and (3) briefly reviewing psychological phenomena that modulate pupillary reactivity. Because of the increased ease and tractability of pupil measurement, the goal of these guidelines is to promote accurate recording, analysis, and reporting of pupillary data in psychophysiological research.
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Affiliation(s)
- Stuart R. Steinhauer
- Veterans Affairs Pittsburgh Healthcare System, VISN 4 MIRECC, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Greg J. Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Annika Dix
- Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
- Centre for Tactile Internet with Human-in-the-Loop (CeTI), Technische Universität Dresden, Dresden, Germany
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28
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El Haj M, Chapelet G, Moustafa AA, Boutoleau-Bretonnière C. Pupil size as an indicator of cognitive activity in mild Alzheimer's disease. EXCLI JOURNAL 2022; 21:307-316. [PMID: 35382454 PMCID: PMC8977451 DOI: 10.17179/excli2021-4568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 12/07/2021] [Indexed: 12/15/2022]
Abstract
It is well established that pupil activity indexes cognitive processing. For instance, research has consistently demonstrated that the pupil reacts to working memory span task performance. However, little is known about pupil reaction to cognitive processing in Alzheimer's Disease (AD). We thus investigated whether span tasks can modulate pupil size in patients with AD. We invited 24 patients with AD and 24 healthy older adults to perform backward and forward spans, as well as to count aloud in a control condition, while their pupil activity was recorded with eye tracking glasses. In patients with AD, analysis demonstrated larger pupil size during backward spans (M = 2.12, SD = .39) than during forward spans (M = 1.98, SD = .36) [t(23) = 3.22, p = .004], larger pupil size during forward spans than during counting (M = 1.67, SD = .33) [t(23) = 4.75, p < .001], as well as larger pupil size during backward spans than during counting [t(23) = 10.60, p < .001]. In control participants, analysis demonstrated larger pupil size during backward spans (M = 3.36, SD = .49) than during forward spans (M = 2.85, SD = .68) [t(23) = 5.82, p < .001], larger pupil size during forward spans than during counting (M = 2.09, SD = .62) [t(23) = 5.42, < .001], as well as larger pupil size during backward spans than during counting [t(23) = 9.70, p < .001]. Results also demonstrated a significant interaction effect between groups and conditions [F(2,92) = 16.63, p < .001]; in other words, patients with AD have shown fewer variations on the pupil size across the conditions compared to the control participants. The larger pupil size during backward spans, compared with forward spans or counting, can be attributed to the high cognitive load of backward spans. The modulation of pupil size, as observed across backward/forward spans and counting, can possibly be attributed to sympathetic/adrenergic and parasympathetic/cholinergic activities. Our study demonstrates the value of pupillometry as a potential biomarker of cognitive processing in AD.
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Affiliation(s)
- Mohamad El Haj
- Nantes Université, Univ. Angers, Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), F-44000 Nantes, France,Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France,Institut Universitaire de France, Paris, France,*To whom correspondence should be addressed: Mohamad El Haj, Faculté de Psychologie, LPPL – Laboratoire de Psychologie des Pays de la Loire, Université de Nantes, Chemin de la Censive du Tertre, BP 81227, 44312 Nantes Cedex 3, France, E-mail:
| | - Guillaume Chapelet
- CHU Nantes, Clinical Gerontology Department, Bd Jacques Monod, F44093, Nantes, France,Université de Nantes, Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Nantes, France
| | - Ahmed A. Moustafa
- School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, Queensland, Australia,Department of Human Anatomy and Physiology, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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29
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Chapman LR, Hallowell B. The Unfolding of Cognitive Effort During Sentence Processing: Pupillometric Evidence From People With and Without Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4900-4917. [PMID: 34763522 PMCID: PMC9150667 DOI: 10.1044/2021_jslhr-21-00129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/18/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE Arousal and cognitive effort are relevant yet often overlooked components of attention during language processing. Pupillometry can be used to provide a psychophysiological index of arousal and cognitive effort. Given that much is unknown regarding the relationship between cognition and language deficits seen in people with aphasia (PWA), pupillometry may be uniquely suited to explore those relationships. The purpose of this study was to examine arousal and the time course of the allocation of cognitive effort related to sentence processing in people with and without aphasia. METHOD Nineteen PWA and age- and education-matched control participants listened to relatively easy (subject-relative) and relatively difficult (object-relative) sentences and were required to answer occasional comprehension questions. Tonic and phasic pupillary responses were used to index arousal and the unfolding of cognitive effort, respectively, while sentences were processed. Group differences in tonic and phasic responses were examined. RESULTS Group differences were observed for both tonic and phasic responses. PWA exhibited greater overall arousal throughout the task compared with controls, as evidenced by larger tonic pupil responses. Controls exhibited more effort (greater phasic responses) for difficult compared with easy sentences; PWA did not. Group differences in phasic responses were apparent during end-of-sentence and postsentence time windows. CONCLUSIONS Results indicate that the attentional state of PWA in this study was not consistently supportive of adequate task engagement. PWA in our sample may have relatively limited attentional capacity or may have challenges with allocating existing capacity in ways that support adequate task engagement and performance. This work adds to the body of evidence supporting the validity of pupillometric tasks for the study of aphasia and contributes to a better understanding of the nature of language deficits in aphasia. Supplemental Material https://doi.org/10.23641/asha.16959376.
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Affiliation(s)
- Laura Roche Chapman
- Department of Communication Sciences and Disorders, Appalachian State University, Boone, NC
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30
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Jang H, Soroski T, Rizzo M, Barral O, Harisinghani A, Newton-Mason S, Granby S, Stutz da Cunha Vasco TM, Lewis C, Tutt P, Carenini G, Conati C, Field TS. Classification of Alzheimer's Disease Leveraging Multi-task Machine Learning Analysis of Speech and Eye-Movement Data. Front Hum Neurosci 2021; 15:716670. [PMID: 34616282 PMCID: PMC8488259 DOI: 10.3389/fnhum.2021.716670] [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: 05/29/2021] [Accepted: 08/13/2021] [Indexed: 11/13/2022] Open
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative condition that results in impaired performance in multiple cognitive domains. Preclinical changes in eye movements and language can occur with the disease, and progress alongside worsening cognition. In this article, we present the results from a machine learning analysis of a novel multimodal dataset for AD classification. The cohort includes data from two novel tasks not previously assessed in classification models for AD (pupil fixation and description of a pleasant past experience), as well as two established tasks (picture description and paragraph reading). Our dataset includes language and eye movement data from 79 memory clinic patients with diagnoses of mild-moderate AD, mild cognitive impairment (MCI), or subjective memory complaints (SMC), and 83 older adult controls. The analysis of the individual novel tasks showed similar classification accuracy when compared to established tasks, demonstrating their discriminative ability for memory clinic patients. Fusing the multimodal data across tasks yielded the highest overall AUC of 0.83 ± 0.01, indicating that the data from novel tasks are complementary to established tasks.
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Affiliation(s)
- Hyeju Jang
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - Thomas Soroski
- Vancouver Stroke Program and Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Matteo Rizzo
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - Oswald Barral
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - Anuj Harisinghani
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - Sally Newton-Mason
- Vancouver Stroke Program and Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Saffrin Granby
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | | | - Caitlin Lewis
- Vancouver Stroke Program and Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Pavan Tutt
- Vancouver Stroke Program and Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Giuseppe Carenini
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - Cristina Conati
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - Thalia S Field
- Vancouver Stroke Program and Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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31
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Majeed A, Marwick B, Yu H, Fadavi H, Tavakoli M. Ophthalmic Biomarkers for Alzheimer's Disease: A Review. Front Aging Neurosci 2021; 13:720167. [PMID: 34566623 PMCID: PMC8461312 DOI: 10.3389/fnagi.2021.720167] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022] Open
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by neuronal loss, extracellular amyloid-β (Aβ) plaques, and intracellular neurofibrillary tau tangles. A diagnosis is currently made from the presenting symptoms, and the only definitive diagnosis can be done post-mortem. Over recent years, significant advances have been made in using ocular biomarkers to diagnose various neurodegenerative diseases, including AD. As the eye is an extension of the central nervous system (CNS), reviewing changes in the eye's biology could lead to developing a series of non-invasive, differential diagnostic tests for AD that could be further applied to other diseases. Significant changes have been identified in the retinal nerve fiber layer (RNFL), cornea, ocular vasculature, and retina. In the present paper, we review current research and assess some ocular biomarkers' accuracy and reliability that could potentially be used for diagnostic purposes. Additionally, we review the various imaging techniques used in the measurement of these biomarkers.
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Affiliation(s)
- Ayesha Majeed
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Ben Marwick
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Haoqing Yu
- Medical School, University of Exeter, Exeter, United Kingdom
| | | | - Mitra Tavakoli
- Medical School, University of Exeter, Exeter, United Kingdom
- Exeter Centre of Excellence for Diabetes Research, University of Exeter, Exeter, United Kingdom
- National Institute for Health Research, Exeter Clinical Research Facility, Exeter, United Kingdom
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32
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Caligiore D, Silvetti M, D'Amelio M, Puglisi-Allegra S, Baldassarre G. Computational Modeling of Catecholamines Dysfunction in Alzheimer's Disease at Pre-Plaque Stage. J Alzheimers Dis 2021; 77:275-290. [PMID: 32741822 PMCID: PMC7592658 DOI: 10.3233/jad-200276] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Alzheimer’s disease (AD) etiopathogenesis remains partially unexplained. The main conceptual framework used to study AD is the Amyloid Cascade Hypothesis, although the failure of recent clinical experimentation seems to reduce its potential in AD research. Objective: A possible explanation for the failure of clinical trials is that they are set too late in AD progression. Recent studies suggest that the ventral tegmental area (VTA) degeneration could be one of the first events occurring in AD progression (pre-plaque stage). Methods: Here we investigate this hypothesis through a computational model and computer simulations validated with behavioral and neural data from patients. Results: We show that VTA degeneration might lead to system-level adjustments of catecholamine release, triggering a sequence of events leading to relevant clinical and pathological signs of AD. These changes consist first in a midfrontal-driven compensatory hyperactivation of both VTA and locus coeruleus (norepinephrine) followed, with the progression of the VTA impairment, by a downregulation of catecholamine release. These processes could then trigger the neural degeneration at the cortical and hippocampal levels, due to the chronic loss of the neuroprotective role of norepinephrine. Conclusion: Our novel hypothesis might contribute to the formulation of a wider system-level view of AD which might help to devise early diagnostic and therapeutic interventions.
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Affiliation(s)
- Daniele Caligiore
- Computational and Translational Neuroscience Laboratory (CTNLab), Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Massimo Silvetti
- Computational and Translational Neuroscience Laboratory (CTNLab), Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Marcello D'Amelio
- Unit of Molecular Neurosciences, Department of Medicine, University Campus-Biomedico, Rome, Italy.,IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Gianluca Baldassarre
- Laboratory of Computational Embodied Neuroscience (LOCEN), Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
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Wong MNK, Lai DWL, Chan HHL, Lam BYH. Neural and Retinal Characteristics in Relation to Working Memory in Older Adults with Mild Cognitive Impairment. Curr Alzheimer Res 2021; 18:185-195. [PMID: 34102976 DOI: 10.2174/1567205018666210608114044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/10/2021] [Accepted: 04/18/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study investigated the relationship between neural activities and retinal structures associated with working memory (WM) in older adults with mild cognitive impairment (MCI). METHODS Eleven older adults with MCI and 29 healthy controls (60 to 73 years old) were tested. All participants underwent an event-related potential (ERP) recording while performing the two-back memory task. The Optical coherence tomography angiography (OCT-A) was administered to examine the perfusion and vessel density in the retina. RESULTS Results showed that WM performance in the MCI group was negatively associated with ERP latencies in central parietal regions (CP6 and CP8) (ps< 0.05). The left nasal vessel and perfusion densities were negatively correlated with the latencies in these two central parietal regions and positively related to WM performance only in the MCI group (ps< 0.05). CONCLUSION The findings on WM, central parietal brain activity, and left nasal vessel and perfusion densities in the retina help us gain a better understanding of the neural and retinal underpinnings of WM in relation to MCI.
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Affiliation(s)
- Mabel N K Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| | - Daniel W L Lai
- Faculty of Social Sciences, Hong Kong Baptist University, 224 Waterloo Rd, Kowloon Tong, Hong Kong
| | - Henry H-L Chan
- School of Optometry, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| | - Bess Y-H Lam
- Department of Psychiatry, The University of Hong Kong, Pok Fu Lam, Hong Kong
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Fernández G, Parra MA. Oculomotor Behaviors and Integrative Memory Functions in the Alzheimer's Clinical Syndrome. J Alzheimers Dis 2021; 82:1033-1044. [PMID: 34151787 DOI: 10.3233/jad-201189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Biological information drawn from eye-tracking metrics is providing evidence regarding drivers of cognitive decline in Alzheimer's disease. In particular, pupil size has proved useful to investigate cognitive performance during online activities. OBJECTIVE To investigate the oculomotor correlates of impaired performance of patients with mild Alzheimer's Clinical Syndrome (ACS) on a recently developed memory paradigm, namely the Short-Term Memory Binding Test (STMBT). METHODS We assessed a sample of eighteen healthy controls (HC) and eighteen patients with a diagnosis of mild ACS with the STMBT while we recorded their oculomotor behaviors using pupillometry and eye-tracking. RESULTS As expected, a group (healthy controls versus ACS) by condition (Unbound Colours versus Bound Colours) interaction was found whereby behavioral group differences were paramount in the Bound Colours condition. Healthy controls' pupils dilated significantly more in the Bound Colours than in the Unbound Colours condition, a discrepancy not observed in ACS patients. Furthermore, ROC analysis revealed the abnormal pupil behaviors distinguished ACS patients from healthy controls with values of sensitivity and specify of 100%, thus outperforming both recognition scores and gaze duration. CONCLUSION The biological correlates of Short-Term Memory Binding impairments appear to involve a network much wider than we have thought to date, which expands across cortical and subcortical structures. We discuss these findings focusing on their implications for our understanding of neurocognitive phenotypes in the preclinical stages of Alzheimer's disease and potential development of cognitive biomarkers that can support ongoing initiatives to prevent dementia.
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Affiliation(s)
- Gerardo Fernández
- Chief Scientific Officer, ViewMind Inc., New York, NY, USA.,Axis Neurociencias, Bahía Blanca, Argentina.,Instituto de Investigaciones en Ingeniería Eléctrica (IIIE) (UNS-CONICET), Bahía Blanca, Buenos Aires, Argentina
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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35
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Williams ME, Elman JA, McEvoy LK, Andreassen OA, Dale AM, Eglit GML, Eyler LT, Fennema-Notestine C, Franz CE, Gillespie NA, Hagler DJ, Hatton SN, Hauger RL, Jak AJ, Logue MW, Lyons MJ, McKenzie RE, Neale MC, Panizzon MS, Puckett OK, Reynolds CA, Sanderson-Cimino M, Toomey R, Tu XM, Whitsel N, Xian H, Kremen WS. 12-year prediction of mild cognitive impairment aided by Alzheimer's brain signatures at mean age 56. Brain Commun 2021; 3:fcab167. [PMID: 34396116 PMCID: PMC8361427 DOI: 10.1093/braincomms/fcab167] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/26/2021] [Accepted: 05/10/2021] [Indexed: 01/22/2023] Open
Abstract
Neuroimaging signatures based on composite scores of cortical thickness and hippocampal volume predict progression from mild cognitive impairment to Alzheimer's disease. However, little is known about the ability of these signatures among cognitively normal adults to predict progression to mild cognitive impairment. Towards that end, a signature sensitive to microstructural changes that may predate macrostructural atrophy should be useful. We hypothesized that: (i) a validated MRI-derived Alzheimer's disease signature based on cortical thickness and hippocampal volume in cognitively normal middle-aged adults would predict progression to mild cognitive impairment; and (ii) a novel grey matter mean diffusivity signature would be a better predictor than the thickness/volume signature. This cohort study was part of the Vietnam Era Twin Study of Aging. Concurrent analyses compared cognitively normal and mild cognitive impairment groups at each of three study waves (ns = 246-367). Predictive analyses included 169 cognitively normal men at baseline (age = 56.1, range = 51-60). Our previously published thickness/volume signature derived from independent data, a novel mean diffusivity signature using the same regions and weights as the thickness/volume signature, age, and an Alzheimer's disease polygenic risk score were used to predict incident mild cognitive impairment an average of 12 years after baseline (follow-up age = 67.2, range = 61-71). Additional analyses adjusted for predicted brain age difference scores (chronological age minus predicted brain age) to determine if signatures were Alzheimer-related and not simply ageing-related. In concurrent analyses, individuals with mild cognitive impairment had higher (worse) mean diffusivity signature scores than cognitively normal participants, but thickness/volume signature scores did not differ between groups. In predictive analyses, age and polygenic risk score yielded an area under the curve of 0.74 (sensitivity = 80.00%; specificity = 65.10%). Prediction was significantly improved with addition of the mean diffusivity signature (area under the curve = 0.83; sensitivity = 85.00%; specificity = 77.85%; P = 0.007), but not with addition of the thickness/volume signature. A model including both signatures did not improve prediction over a model with only the mean diffusivity signature. Results held up after adjusting for predicted brain age difference scores. The novel mean diffusivity signature was limited by being yoked to the thickness/volume signature weightings. An independently derived mean diffusivity signature may thus provide even stronger prediction. The young age of the sample at baseline is particularly notable. Given that the brain signatures were examined when participants were only in their 50 s, our results suggest a promising step towards improving very early identification of Alzheimer's disease risk and the potential value of mean diffusivity and/or multimodal brain signatures.
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Affiliation(s)
- McKenna E Williams
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Jeremy A Elman
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Linda K McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo 0316, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo 0372, Norway
| | - Anders M Dale
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
- Department of Neuroscience, University of California San Diego, La Jolla, CA 92093, USA
| | - Graham M L Eglit
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, CA 92093, USA
| | - Christine Fennema-Notestine
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Carol E Franz
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Donald J Hagler
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Sean N Hatton
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Neuroscience, University of California San Diego, La Jolla, CA 92093, USA
| | - Richard L Hauger
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA 92093, USA
| | - Amy J Jak
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- VA San Diego Healthcare System, San Diego, CA 92093, USA
| | - Mark W Logue
- National Center for PTSD: Behavioral Science Division, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Psychiatry and the Biomedical Genetics Section, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02212, USA
| | - Ruth E McKenzie
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
- School of Education and Social Policy, Merrimack College, North Andover, MA 01845, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Matthew S Panizzon
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Olivia K Puckett
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California Riverside, Riverside, CA 92521, USA
| | - Mark Sanderson-Cimino
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Rosemary Toomey
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02212, USA
| | - Xin M Tu
- Family Medicine and Public Health, University of California San Diego, La Jolla, CA 92093, USA
| | - Nathan Whitsel
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Hong Xian
- Department of Biostatistics, St. Louis University, St. Louis, MO 63103, USA
| | - William S Kremen
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA 92093, USA
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Walz JA, Mani R, Alnawmasi MM, Khuu SK. Visuospatial Attention Allocation as an Indicator of Cognitive Deficit in Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Front Hum Neurosci 2021; 15:675376. [PMID: 34354575 PMCID: PMC8329082 DOI: 10.3389/fnhum.2021.675376] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/23/2021] [Indexed: 01/02/2023] Open
Abstract
Traumatic Brain Injury (TBI) is defined by changes in brain function resulting from external forces acting on the brain and is typically characterized by a host of physiological and functional changes such as cognitive deficits including attention problems. In the present study, we focused on the effect of TBI on the ability to allocate attention in vision (i.e., the use of endogenous and exogenous visual cues) by systematically reviewing previous literature on the topic. We conducted quantitative synthesis of 16 selected studies of visual attention following TBI, calculating 80 effect size estimates. The combined effect size was large (g = 0.79, p < 0.0001) with medium heterogeneity (I2 = 68.39%). Subgroup analyses revealed an increase in deficit with moderate-to-severe and severe TBI as compared to mild TBI [F(2, 76) = 24.14, p < 0.0001]. Task type was another key source of variability and subgroup analyses indicated that higher order attention processes were severely affected by TBI [F(2, 77) = 5.66, p = 0.0051). Meta-regression analyses revealed significant improvement in visual attention deficit with time [p(mild) = 0.031, p(moderate-to-severe) = 0.002, p(severe) < 0.0001]. Taken together, these results demonstrate that visual attention is affected by TBI and that regular assessment of visual attention, using a systematic attention allocation task, may provide a useful clinical measure of cognitive impairment and change after TBI.
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Affiliation(s)
- Jacinta A Walz
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
| | - Revathy Mani
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
| | - Mohammed M Alnawmasi
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
| | - Sieu K Khuu
- School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia
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Xiao S, Li Y, Liu M, Li Y. Electrophysiological Studies of Cognitive Reappraisal Success and Failure in aMCI. Brain Sci 2021; 11:brainsci11070855. [PMID: 34198957 PMCID: PMC8301780 DOI: 10.3390/brainsci11070855] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/08/2021] [Accepted: 06/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Although successful reappraisal relies on cognitive resources, how cognitive impairment affects brain processes related to cognitive reappraisal is not yet clear. METHODS Forty-four amnestic mild cognitive impairment (aMCI) subjects and 72 healthy elderly controls (HECs) were divided into the MCI-Failure (n = 23), MCI-Success (n = 21), HEC-Failure (n = 26), and HEC-Success (n = 46) groups according to changes in self-reported affect using reappraisal. All participants viewed 30 negative and 30 neutral images preceded by straightforward descriptions of these images and 30 negative images preceded by more neutral descriptions. RESULTS Reappraisal failure was found to be more common in people with MCI. Reappraisal failure is associated with altered neurophysiological indices of negative-reappraisal stimuli processing that are reflected in smaller theta responsivity to negative-reappraisal stimuli between 350-550 ms. The MCI-Success group showed enhanced LPP for negative-reappraisal stimuli from 1200 to 3500 ms, reflecting compensatory effort to complete the reappraisal task, while subjects in other groups showed reduced LPP for negative-reappraisal stimuli from 550 to 1200 ms. CONCLUSIONS These findings deepen our understanding of how cognitive decline impacts reappraisal and informs early diagnosis and interventions for MCI.
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Affiliation(s)
- Shasha Xiao
- School of Communication and Information Engineering, Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai 200444, China;
| | - Yingjie Li
- School of Communication and Information Engineering, Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai 200444, China;
- Correspondence: (Y.L.); (Y.L.)
| | - Meng Liu
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, China;
| | - Yunxia Li
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, China;
- Correspondence: (Y.L.); (Y.L.)
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Zandi B, Lode M, Herzog A, Sakas G, Khanh TQ. PupilEXT: Flexible Open-Source Platform for High-Resolution Pupillometry in Vision Research. Front Neurosci 2021; 15:676220. [PMID: 34220432 PMCID: PMC8249868 DOI: 10.3389/fnins.2021.676220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022] Open
Abstract
The human pupil behavior has gained increased attention due to the discovery of the intrinsically photosensitive retinal ganglion cells and the afferent pupil control path's role as a biomarker for cognitive processes. Diameter changes in the range of 10-2 mm are of interest, requiring reliable and characterized measurement equipment to accurately detect neurocognitive effects on the pupil. Mostly commercial solutions are used as measurement devices in pupillometry which is associated with high investments. Moreover, commercial systems rely on closed software, restricting conclusions about the used pupil-tracking algorithms. Here, we developed an open-source pupillometry platform consisting of hardware and software competitive with high-end commercial stereo eye-tracking systems. Our goal was to make a professional remote pupil measurement pipeline for laboratory conditions accessible for everyone. This work's core outcome is an integrated cross-platform (macOS, Windows and Linux) pupillometry software called PupilEXT, featuring a user-friendly graphical interface covering the relevant requirements of professional pupil response research. We offer a selection of six state-of-the-art open-source pupil detection algorithms (Starburst, Swirski, ExCuSe, ElSe, PuRe and PuReST) to perform the pupil measurement. A developed 120-fps pupillometry demo system was able to achieve a calibration accuracy of 0.003 mm and an averaged temporal pupil measurement detection accuracy of 0.0059 mm in stereo mode. The PupilEXT software has extended features in pupil detection, measurement validation, image acquisition, data acquisition, offline pupil measurement, camera calibration, stereo vision, data visualization and system independence, all combined in a single open-source interface, available at https://github.com/openPupil/Open-PupilEXT.
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Affiliation(s)
- Babak Zandi
- Laboratory of Lighting Technology, Department of Electrical Engineering and Information Technology, Technical University of Darmstadt, Darmstadt, Germany
| | - Moritz Lode
- Laboratory of Lighting Technology, Department of Electrical Engineering and Information Technology, Technical University of Darmstadt, Darmstadt, Germany
| | - Alexander Herzog
- Laboratory of Lighting Technology, Department of Electrical Engineering and Information Technology, Technical University of Darmstadt, Darmstadt, Germany
| | - Georgios Sakas
- Interactive Graphic Systems, Department of Computer Science, Technical University of Darmstadt, Darmstadt, Germany
| | - Tran Quoc Khanh
- Laboratory of Lighting Technology, Department of Electrical Engineering and Information Technology, Technical University of Darmstadt, Darmstadt, Germany
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Kelly L, Seifi M, Ma R, Mitchell SJ, Rudolph U, Viola KL, Klein WL, Lambert JJ, Swinny JD. Identification of intraneuronal amyloid beta oligomers in locus coeruleus neurons of Alzheimer's patients and their potential impact on inhibitory neurotransmitter receptors and neuronal excitability. Neuropathol Appl Neurobiol 2021; 47:488-505. [PMID: 33119191 DOI: 10.1111/nan.12674] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 12/22/2022]
Abstract
AIMS Amyloid β-oligomers (AβO) are potent modulators of Alzheimer's pathology, yet their impact on one of the earliest brain regions to exhibit signs of the condition, the locus coeruleus (LC), remains to be determined. Of particular importance is whether AβO impact the spontaneous excitability of LC neurons. This parameter determines brain-wide noradrenaline (NA) release, and thus NA-mediated brain functions, including cognition, emotion and immune function, which are all compromised in Alzheimer's patients. Therefore, the aim of the study was to determine the expression profile of AβO in the LC of Alzheimer's patients and to probe their potential impact on the molecular and functional correlates of LC excitability, using a mouse model of increased Aβ production (APP-PSEN1). METHODS AND RESULTS Immunohistochemistry and confocal microscopy, using AβO-specific antibodies, confirmed LC AβO expression both intraneuronally and extracellularly in both Alzheimer's and APP-PSEN1 samples. Patch clamp electrophysiology recordings revealed that APP-PSEN1 LC neuronal hyperexcitability accompanied this AβO expression profile, arising from a diminished inhibitory effect of GABA due to impaired expression and function of the GABA-A receptor (GABAA R) α3 subunit. This altered LC α3-GABAA R expression profile overlapped with AβO expression in samples from both APP-PSEN1 mice and Alzheimer's patients. Finally, strychnine-sensitive glycine receptors (GlyRs) remained resilient to Aβ-induced changes and their activation reversed LC hyperexcitability. CONCLUSIONS The data suggest a close association between AβO and α3-GABAA Rs in the LC of Alzheimer's patients, and their potential to dysregulate LC activity, thereby contributing to the spectrum of pathology of the LC-NA system in this condition.
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Affiliation(s)
- Louise Kelly
- School of Pharmacy & Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Mohsen Seifi
- School of Pharmacy & Biomedical Sciences, University of Portsmouth, Portsmouth, UK
- Leicester School of Pharmacy, De Montfort University, Leicester, UK
| | - Ruolin Ma
- School of Pharmacy & Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Scott J Mitchell
- Neuroscience, Division of Systems Medicine, Ninewells Hospital & Medical School, Dundee University, Dundee, UK
| | - Uwe Rudolph
- Department of Comparative Biosciences, College of Veterinary Medicine, and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kirsten L Viola
- Department of Neurobiology and Physiology, Northwestern University, Evanston, IL, USA
| | - William L Klein
- Department of Neurobiology and Physiology, Northwestern University, Evanston, IL, USA
| | - Jeremy J Lambert
- Neuroscience, Division of Systems Medicine, Ninewells Hospital & Medical School, Dundee University, Dundee, UK
| | - Jerome D Swinny
- School of Pharmacy & Biomedical Sciences, University of Portsmouth, Portsmouth, UK
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Jiménez EC, Sierra-Marcos A, Romeo A, Hashemi A, Leonovych O, Bustos Valenzuela P, Solé Puig M, Supèr H. Altered Vergence Eye Movements and Pupil Response of Patients with Alzheimer's Disease and Mild Cognitive Impairment During an Oddball Task. J Alzheimers Dis 2021; 82:421-433. [PMID: 34024820 DOI: 10.3233/jad-201301] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is characterized by progressive deterioration of cognitive functions and may be preceded by mild cognitive impairment (MCI). Evidence shows changes in pupil and vergence responses related to cognitive processing of visual information. OBJECTIVE Here we test the hypothesis that MCI and AD are associated with specific patterns in vergence and pupil responses. METHODS We employed a visual oddball task. In the distractor condition (80%of the trials), a blue stimulus was presented whereas in the target condition (20%of trials) it was red. Participants (23 Controls, 33 MCI patients, and 18 AD patients) were instructed to press a button when a target appeared. RESULTS Participants briefly converged their eyes 200 ms after stimulus presentation. In controls, this transient peak response was followed by a delay response to targets but not to distractor stimuli. In the patient groups, delay responses to distractors were noticed. Consequently, the differential vergence response was strong in the control group, weak in the MCI group, and absent in the AD group. Pupils started to dilate 500-600 ms after the appearance of a target but slightly contracted after the presentation of a distractor. This differential pupil response was strongest in the AD group. CONCLUSION Our findings support the idea of a role of vergence and pupil responses in attention and reveal altered responses in MCI and AD patients. Further studies should assess the value of vergence and pupil measurements as an objective support tool for early diagnosis of AD.
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Affiliation(s)
- Elizabeth Carolina Jiménez
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.,University of Guadalajara, Jalisco, México
| | - Alba Sierra-Marcos
- Department of Neurology and Neurophysiology, Hospital Sanitas CIMA, Barcelona, Spain
| | - August Romeo
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Amin Hashemi
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Oleksii Leonovych
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.,Braingaze SL, Mataró, Spain
| | - Patricia Bustos Valenzuela
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Maria Solé Puig
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Hans Supèr
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences of the University of Barcelona (UBNeuro), Barcelona, Spain.,Braingaze SL, Mataró, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
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Jonell P, Moëll B, Håkansson K, Henter GE, Kucherenko T, Mikheeva O, Hagman G, Holleman J, Kivipelto M, Kjellström H, Gustafson J, Beskow J. Multimodal Capture of Patient Behaviour for Improved Detection of Early Dementia: Clinical Feasibility and Preliminary Results. FRONTIERS IN COMPUTER SCIENCE 2021. [DOI: 10.3389/fcomp.2021.642633] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Non-invasive automatic screening for Alzheimer’s disease has the potential to improve diagnostic accuracy while lowering healthcare costs. Previous research has shown that patterns in speech, language, gaze, and drawing can help detect early signs of cognitive decline. In this paper, we describe a highly multimodal system for unobtrusively capturing data during real clinical interviews conducted as part of cognitive assessments for Alzheimer’s disease. The system uses nine different sensor devices (smartphones, a tablet, an eye tracker, a microphone array, and a wristband) to record interaction data during a specialist’s first clinical interview with a patient, and is currently in use at Karolinska University Hospital in Stockholm, Sweden. Furthermore, complementary information in the form of brain imaging, psychological tests, speech therapist assessment, and clinical meta-data is also available for each patient. We detail our data-collection and analysis procedure and present preliminary findings that relate measures extracted from the multimodal recordings to clinical assessments and established biomarkers, based on data from 25 patients gathered thus far. Our findings demonstrate feasibility for our proposed methodology and indicate that the collected data can be used to improve clinical assessments of early dementia.
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Zandi B, Khanh TQ. Deep learning-based pupil model predicts time and spectral dependent light responses. Sci Rep 2021; 11:841. [PMID: 33436693 PMCID: PMC7803766 DOI: 10.1038/s41598-020-79908-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/11/2020] [Indexed: 01/29/2023] Open
Abstract
Although research has made significant findings in the neurophysiological process behind the pupillary light reflex, the temporal prediction of the pupil diameter triggered by polychromatic or chromatic stimulus spectra is still not possible. State of the art pupil models rested in estimating a static diameter at the equilibrium-state for spectra along the Planckian locus. Neither the temporal receptor-weighting nor the spectral-dependent adaptation behaviour of the afferent pupil control path is mapped in such functions. Here we propose a deep learning-driven concept of a pupil model, which reconstructs the pupil's time course either from photometric and colourimetric or receptor-based stimulus quantities. By merging feed-forward neural networks with a biomechanical differential equation, we predict the temporal pupil light response with a mean absolute error below 0.1 mm from polychromatic (2007 [Formula: see text] 1 K, 4983 [Formula: see text] 3 K, 10,138 [Formula: see text] 22 K) and chromatic spectra (450 nm, 530 nm, 610 nm, 660 nm) at 100.01 ± 0.25 cd/m2. This non-parametric and self-learning concept could open the door to a generalized description of the pupil behaviour.
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Affiliation(s)
- Babak Zandi
- Department of Electrical Engineering and Information Technology, Laboratory of Lighting Technology, Technical University of Darmstadt, 64289, Darmstadt, Germany.
| | - Tran Quoc Khanh
- Department of Electrical Engineering and Information Technology, Laboratory of Lighting Technology, Technical University of Darmstadt, 64289, Darmstadt, Germany
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Devos H, Gustafson K, Ahmadnezhad P, Liao K, Mahnken JD, Brooks WM, Burns JM. Psychometric Properties of NASA-TLX and Index of Cognitive Activity as Measures of Cognitive Workload in Older Adults. Brain Sci 2020; 10:E994. [PMID: 33339224 PMCID: PMC7766152 DOI: 10.3390/brainsci10120994] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/01/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022] Open
Abstract
Cognitive workload is increasingly recognized as an important determinant of performance in cognitive tests and daily life activities. Cognitive workload is a measure of physical and mental effort allocation to a task, which can be determined through self-report or physiological measures. However, the reliability and validity of these measures have not been established in older adults with a wide range of cognitive ability. The aim of this study was to establish the test-retest reliability of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Index of Cognitive Activity (ICA), extracted from pupillary size. The convergent validity of these measures against event-related potentials (ERPs) was also investigated. A total of 38 individuals with scores on the Montreal Cognitive Assessment ranging between 17 and 30 completed a working memory test (n-back) with three levels of difficulty at baseline and at a two-week follow-up. The intraclass correlation coefficients (ICC) values of the NASA-TLX ranged between 0.71 and 0.81, demonstrating good to excellent reliability. The mean ICA scores showed fair to good reliability, with ICCs ranging between 0.56 and 0.73. The mean ICA and NASA-TLX scores showed significant and moderate correlations (Pearson's r ranging between 0.30 and 0.33) with the third positive peak of the ERP at the midline channels. We conclude that ICA and NASA-TLX are reliable measures of cognitive workload in older adults. Further research is needed in dissecting the subjective and objective constructs of cognitive workload.
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Affiliation(s)
- Hannes Devos
- Laboratory for Advanced Rehabilitation Research in Simulation, Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Kathleen Gustafson
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (K.G.); (W.M.B.); (J.M.B.)
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Pedram Ahmadnezhad
- Laboratory for Advanced Rehabilitation Research in Simulation, Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Ke Liao
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Jonathan D. Mahnken
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - William M. Brooks
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (K.G.); (W.M.B.); (J.M.B.)
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Jeffrey M. Burns
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (K.G.); (W.M.B.); (J.M.B.)
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
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Huo Z, Rana BK, Elman JA, Dong R, Engelman CD, Johnson SC, Lyons MJ, Franz CE, Kremen WS, Zhao J. Metabolic Profiling of Cognitive Aging in Midlife. Front Aging Neurosci 2020; 12:555850. [PMID: 33250761 PMCID: PMC7674168 DOI: 10.3389/fnagi.2020.555850] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 10/16/2020] [Indexed: 01/08/2023] Open
Abstract
Alzheimer's dementia (AD) begins many years before its clinical symptoms. Metabolic dysfunction represents a core feature of AD and cognitive impairment, but few metabolomic studies have focused on cognitive aging in midlife. Using an untargeted metabolomics approach, we identified metabolic predictors of cognitive aging in midlife using fasting plasma sample from 30 middle-aged (mean age 57.2), male-male twin pairs enrolled in the Vietnam Era Twin Study of Aging (VETSA). For all twin pairs, one twin developed incident MCI, whereas his co-twin brother remained to be cognitively normal during an average 5.5-year follow-up. Linear mixed model was used to identify metabolites predictive of MCI conversion or cognitive change over time, adjusting for traditional risk factors. Results from twins were replicated in an independent cohort of middle-aged adults (mean age 59.1) in the Wisconsin Registry for Alzheimer's Prevention (WRAP). Results in twins showed that higher baseline levels of four plasma metabolites, including sphingomyelin (d18:1/20:1 and d18:2/20:0), sphingomyelin (d18:1/22:1, d18:2/22:0, and d16:1/24:1), DAG (18:2/20:4), and hydroxy-CMPF, were significantly associated with a slower decrease in one or more domains of cognitive function. The association of sphingomyelin (d18:1/20:1 and d18:2/20:0) was replicated in WRAP. Our results support that metabolic perturbation occurs many years before cognitive impairment and plasma metabolites may serve as early biomarkers for prediction or monitoring of cognitive aging and AD in midlife.
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Affiliation(s)
- Zhiguang Huo
- Department of Biostatistics, University of Florida, Gainesville, FL, United States
| | - Brinda K. Rana
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Jeremy A. Elman
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Ruocheng Dong
- Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Corinne D. Engelman
- Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Michael J. Lyons
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, United States
| | - Carol E. Franz
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - William S. Kremen
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| | - Jinying Zhao
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
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Del Cerro I, Martínez-Zalacaín I, Guinea-Izquierdo A, Gascón-Bayarri J, Viñas-Diez V, Urretavizcaya M, Naval-Baudin P, Aguilera C, Reñé-Ramírez R, Ferrer I, Menchón JM, Soria V, Soriano-Mas C. Locus coeruleus connectivity alterations in late-life major depressive disorder during a visual oddball task. NEUROIMAGE-CLINICAL 2020; 28:102482. [PMID: 33371943 PMCID: PMC7649653 DOI: 10.1016/j.nicl.2020.102482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/25/2020] [Accepted: 10/19/2020] [Indexed: 11/05/2022]
Abstract
Patients with late-life MDD show lower global LC connectivity in an oddball task. Lower LC connectivity was observed with the ACC, fusiform gyrus and cerebellum. LC-ACC connectivity correlated with two different measures of depression severity.
The Locus Coeruleus (LC) is the major source of noradrenergic neurotransmission. Structural alterations in the LC have been observed in neurodegenerative disorders and at-risk individuals, although functional connectivity studies between the LC and other brain areas have not been yet performed in these populations. Patients with late-life major depressive disorder (MDD) are indeed at increased risk for neurodegenerative disorders, and here we investigated LC connectivity in late-life MDD in comparison to individuals with amnestic type mild cognitive impairment (aMCI) and healthy controls (HCs). We assessed 20 patients with late-life MDD, 16 patients with aMCI, and 26 HCs, who underwent a functional magnetic resonance scan while performing a visual oddball task. We assessed task-related modulations of LC connectivity (i.e., Psychophysiological Interactions, PPI) with other brain areas. A T1-weighted fast spin-echo sequence for LC localization was also obtained. Patients with late-life MDD showed lower global connectivity during target detection in a cluster encompassing the right caudal LC. Specifically, we observed lower LC connectivity with the left anterior cingulate cortex (ACC), the right fusiform gyrus, and different cerebellar clusters. Moreover, alterations in LC-ACC connectivity correlated negatively with depression severity (i.e., Geriatric Depression Scale and number of recurrences). Reduced connectivity of the LC during oddball performance seems to specifically characterize patients with late-life MDD, but not other populations of aged individuals with cognitive alterations. Such alteration is associated with different measures of disease severity, such as the current presence of symptoms and the burden of disease (number of recurrences).
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Affiliation(s)
- Inés Del Cerro
- Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; Network Center for Biomedical Research on Mental Health (CIBERSAM), Carlos III Health Institute (ISCIII), Barcelona, Spain
| | - Ignacio Martínez-Zalacaín
- Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Andrés Guinea-Izquierdo
- Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Jordi Gascón-Bayarri
- Dementia Diagnostic and Treatment Unit, Department of Neurology, Bellvitge University Hospital, Barcelona, Spain
| | - Vanesa Viñas-Diez
- Dementia Diagnostic and Treatment Unit, Department of Neurology, Bellvitge University Hospital, Barcelona, Spain
| | - Mikel Urretavizcaya
- Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; Network Center for Biomedical Research on Mental Health (CIBERSAM), Carlos III Health Institute (ISCIII), Barcelona, Spain
| | - Pablo Naval-Baudin
- Imaging Diagnostic Institute (IDI), Neuroradiology Unit, Bellvitge University Hospital, Barcelona, Spain
| | - Carlos Aguilera
- Imaging Diagnostic Institute (IDI), Neuroradiology Unit, Bellvitge University Hospital, Barcelona, Spain
| | - Ramón Reñé-Ramírez
- Dementia Diagnostic and Treatment Unit, Department of Neurology, Bellvitge University Hospital, Barcelona, Spain
| | - Isidre Ferrer
- Department of Pathology and Experimental Therapeutics, Institute of Neurosciences, University of Barcelona, Barcelona, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Pathologic Anatomy, Bellvitge University Hospital, Barcelona, Spain; Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Barcelona, Spain
| | - José M Menchón
- Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; Network Center for Biomedical Research on Mental Health (CIBERSAM), Carlos III Health Institute (ISCIII), Barcelona, Spain
| | - Virginia Soria
- Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; Network Center for Biomedical Research on Mental Health (CIBERSAM), Carlos III Health Institute (ISCIII), Barcelona, Spain.
| | - Carles Soriano-Mas
- Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Network Center for Biomedical Research on Mental Health (CIBERSAM), Carlos III Health Institute (ISCIII), Barcelona, Spain; Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Kelberman M, Keilholz S, Weinshenker D. What's That (Blue) Spot on my MRI? Multimodal Neuroimaging of the Locus Coeruleus in Neurodegenerative Disease. Front Neurosci 2020; 14:583421. [PMID: 33122996 PMCID: PMC7573566 DOI: 10.3389/fnins.2020.583421] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/16/2020] [Indexed: 01/04/2023] Open
Abstract
The locus coeruleus (LC) has long been underappreciated for its role in the pathophysiology of Alzheimer’s disease (AD), Parkinson’s disease (PD), and other neurodegenerative disorders. While AD and PD are distinct in clinical presentation, both are characterized by prodromal protein aggregation in the LC, late-stage degeneration of the LC, and comorbid conditions indicative of LC dysfunction. Many of these early studies were limited to post-mortem histological techniques due to the LC’s small size and location deep in the brainstem. Thus, there is a growing interest in utilizing in vivo imaging of the LC as a predictor of preclinical neurodegenerative processes and biomarker of disease progression. Simultaneously, neuroimaging in animal models of neurodegenerative disease holds promise for identifying early alterations to LC circuits, but has thus far been underutilized. While still in its infancy, a handful of studies have reported effects of single gene mutations and pathology on LC function in disease using various neuroimaging techniques. Furthermore, combining imaging and optogenetics or chemogenetics allows for interrogation of network connectivity in response to changes in LC activity. The purpose of this article is twofold: (1) to review what magnetic resonance imaging (MRI) and positron emission tomography (PET) have revealed about LC dysfunction in neurodegenerative disease and its potential as a biomarker in humans, and (2) to explore how animal models can be used to test hypotheses derived from clinical data and establish a mechanistic framework to inform LC-focused therapeutic interventions to alleviate symptoms and impede disease progression.
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Affiliation(s)
- Michael Kelberman
- Department of Human Genetics, Emory University, Atlanta, GA, United States
| | - Shella Keilholz
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, United States
| | - David Weinshenker
- Department of Human Genetics, Emory University, Atlanta, GA, United States
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Nam U, Lee K, Ko H, Lee JY, Lee EC. Analyzing Facial and Eye Movements to Screen for Alzheimer's Disease. SENSORS 2020; 20:s20185349. [PMID: 32961984 PMCID: PMC7570590 DOI: 10.3390/s20185349] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 01/09/2023]
Abstract
Brain disease can be screened using eye movements. Degenerative brain disorders change eye movement because they affect not only memory and cognition but also the cranial nervous system involved in eye movement. We compared the facial and eye movement patterns of patients with mild Alzheimer’s disease and cognitively normal people to analyze the neurological signs of dementia. After detecting the facial landmarks, the coordinate values for the movements were extracted. We used Spearman’s correlation coefficient to examine associations between horizontal and vertical facial and eye movements. We analyzed the correlation between facial and eye movements without using special eye-tracking equipment or complex conditions in order to measure the behavioral aspect of the natural human gaze. As a result, we found differences between patients with Alzheimer’s disease and cognitively normal people. Patients suffering from Alzheimer’s disease tended to move their face and eyes simultaneously in the vertical direction, whereas the cognitively normal people did not, as confirmed by a Mann–Whitney–Wilcoxon test. Our findings suggest that objective and accurate measurement of facial and eye movements can be used to screen such patients quickly. The use of camera-based testing for the early detection of patients showing signs of neurodegeneration can have a significant impact on the public care of dementia.
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Affiliation(s)
- Uiseo Nam
- Department of Computer Science, Graduate School, Sangmyung University, Seoul 03016, Korea; (U.N.); (K.L.)
| | - Kunyoung Lee
- Department of Computer Science, Graduate School, Sangmyung University, Seoul 03016, Korea; (U.N.); (K.L.)
| | - Hyunwoong Ko
- Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul 08826, Korea;
| | - Jun-Young Lee
- Department of Psychiatry, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul 03080, Korea
- Correspondence: (J.-Y.L.); (E.C.L.); Tel.: +82-2-781-7553
| | - Eui Chul Lee
- Department of Human-Centered Artificial Intelligence, Sangmyung University, Seoul 03016, Korea
- Correspondence: (J.-Y.L.); (E.C.L.); Tel.: +82-2-781-7553
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Wu SZ, Masurkar AV, Balcer LJ. Afferent and Efferent Visual Markers of Alzheimer's Disease: A Review and Update in Early Stage Disease. Front Aging Neurosci 2020; 12:572337. [PMID: 33061906 PMCID: PMC7518395 DOI: 10.3389/fnagi.2020.572337] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/20/2020] [Indexed: 01/06/2023] Open
Abstract
Vision, which requires extensive neural involvement, is often impaired in Alzheimer's disease (AD). Over the last few decades, accumulating evidence has shown that various visual functions and structures are compromised in Alzheimer's dementia and when measured can detect those with dementia from those with normal aging. These visual changes involve both the afferent and efferent parts of the visual system, which correspond to the sensory and eye movement aspects of vision, respectively. There are fewer, but a growing number of studies, that focus on the detection of predementia stages. Visual biomarkers that detect these stages are paramount in the development of successful disease-modifying therapies by identifying appropriate research participants and in identifying those who would receive future therapies. This review provides a summary and update on common afferent and efferent visual markers of AD with a focus on mild cognitive impairment (MCI) and preclinical disease detection. We further propose future directions in this area. Given the ease of performing visual tests, the accessibility of the eye, and advances in ocular technology, visual measures have the potential to be effective, practical, and non-invasive biomarkers of AD.
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Affiliation(s)
- Shirley Z. Wu
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, United States
| | - Arjun V. Masurkar
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States
| | - Laura J. Balcer
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
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Mirzaei N, Shi H, Oviatt M, Doustar J, Rentsendorj A, Fuchs DT, Sheyn J, Black KL, Koronyo Y, Koronyo-Hamaoui M. Alzheimer's Retinopathy: Seeing Disease in the Eyes. Front Neurosci 2020; 14:921. [PMID: 33041751 PMCID: PMC7523471 DOI: 10.3389/fnins.2020.00921] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/10/2020] [Indexed: 01/18/2023] Open
Abstract
The neurosensory retina emerges as a prominent site of Alzheimer's disease (AD) pathology. As a CNS extension of the brain, the neuro retina is easily accessible for noninvasive, high-resolution imaging. Studies have shown that along with cognitive decline, patients with mild cognitive impairment (MCI) and AD often suffer from visual impairments, abnormal electroretinogram patterns, and circadian rhythm disturbances that can, at least in part, be attributed to retinal damage. Over a decade ago, our group identified the main pathological hallmark of AD, amyloid β-protein (Aβ) plaques, in the retina of patients including early-stage clinical cases. Subsequent histological, biochemical and in vivo retinal imaging studies in animal models and in humans corroborated these findings and further revealed other signs of AD neuropathology in the retina. Among these signs, hyperphosphorylated tau, neuronal degeneration, retinal thinning, vascular abnormalities and gliosis were documented. Further, linear correlations between the severity of retinal and brain Aβ concentrations and plaque pathology were described. More recently, extensive retinal pericyte loss along with vascular platelet-derived growth factor receptor-β deficiency were discovered in postmortem retinas of MCI and AD patients. This progressive loss was closely associated with increased retinal vascular amyloidosis and predicted cerebral amyloid angiopathy scores. These studies brought excitement to the field of retinal exploration in AD. Indeed, many questions still remain open, such as queries related to the temporal progression of AD-related pathology in the retina compared to the brain, the relations between retinal and cerebral changes and whether retinal signs can predict cognitive decline. The extent to which AD affects the retina, including the susceptibility of certain topographical regions and cell types, is currently under intense investigation. Advances in retinal amyloid imaging, hyperspectral imaging, optical coherence tomography, and OCT-angiography encourage the use of such modalities to achieve more accurate, patient- and user-friendly, noninvasive detection and monitoring of AD. In this review, we summarize the current status in the field while addressing the many unknowns regarding Alzheimer's retinopathy.
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Affiliation(s)
- Nazanin Mirzaei
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Haoshen Shi
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Mia Oviatt
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Jonah Doustar
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Altan Rentsendorj
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Dieu-Trang Fuchs
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Julia Sheyn
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Keith L. Black
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Yosef Koronyo
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
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Piano M, Nilforooshan R, Evans S. Binocular Vision, Visual Function, and Pupil Dynamics in People Living With Dementia and Their Relation to the Rate of Cognitive Decline and Structural Changes Within the Brain: Protocol for an Observational Study. JMIR Res Protoc 2020; 9:e16089. [PMID: 32773379 PMCID: PMC7445601 DOI: 10.2196/16089] [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: 09/02/2019] [Revised: 04/24/2020] [Accepted: 05/12/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Visual impairment is a common comorbidity in people living with dementia. Addressing sources of visual difficulties can have a significant impact on the quality of life for people living with dementia and their caregivers. Depth perception problems are purportedly common in dementia and also contribute to falls, visuomotor task difficulties, and poorer psychosocial well-being. However, depth perception and binocular vision are rarely assessed in dementia research. Sleep fragmentation is also common for people living with dementia, and binocular cooperation for depth perception can be affected by fatigue. Pupillary responses under cognitive load also have the potential to be a risk marker for cognitive decline in people living with dementia and can be combined with the above measures for a comprehensive evaluation of clinical visual changes in people living with dementia and their relation to changes in cognitive status, sleep quality, and cortical structure or function. OBJECTIVE This study aims to characterize the nature of clinical visual changes and altered task-evoked pupillary responses that may occur in people living with dementia and evaluate whether these responses relate to changes in cognitive status (standardized Mini Mental State Examination [MMSE] score), Pittsburgh sleep quality index, and cortical structure or function. METHODS This proposed exploratory observational study will enroll ≤210 people with recently diagnosed dementia (within the last 24 months). The following parameters will be assessed on 3 occasions, 4 months apart (plus or minus 2 weeks): visual function (visual acuity and contrast sensitivity), binocular function (motor fusion and stereopsis), task-evoked pupillary responses (minimum and maximum pupil size, time to maximum dilation, and dilation velocity), cognitive status (MMSE score), and sleep quality (Pittsburgh Sleep Quality Index). A subset of patients (n=30) with Alzheimer disease will undergo structural and functional magnetic resonance imaging at first and third visits, completing a 10-day consensus sleep diary to monitor sleep quality, verified by sleep actimetry. RESULTS This research was funded in February 2018 and received National Health Service Research Ethics Committee approval in September 2018. The data collection period was from October 1, 2018, to November 30, 2019. A total of 24 participants were recruited for the study. The data analysis is complete, with results expected to be published before the end of 2020. CONCLUSIONS Findings will demonstrate how often people with dementia experience binocular vision problems. If frequent, diagnosing and treating them could improve quality of life by reducing the risk of falls and fine visuomotor task impairment and by relieving psychosocial anxiety. This research will also demonstrate whether changes in depth perception, pupillary responses, and quality of vision relate to changes in memory or sleep quality and brain structure or function. If related, these quick and noninvasive eye tests help monitor dementia. This would help justify whether binocular vision and pupillary response testing should be included in dementia-friendly eye-testing guidelines. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/16089.
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Affiliation(s)
- Marianne Piano
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Australia
- National Vision Research Institute, Australian College of Optometry, Melbourne, Australia
| | | | - Simon Evans
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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