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Riverol M, Ríos-Rivera MM, Imaz-Aguayo L, Solis-Barquero SM, Arrondo C, Montoya-Murillo G, Villino-Rodríguez R, García-Eulate R, Domínguez P, Fernández-Seara MA. Structural neuroimaging changes associated with subjective cognitive decline from a clinical sample. Neuroimage Clin 2024; 42:103615. [PMID: 38749146 PMCID: PMC11109886 DOI: 10.1016/j.nicl.2024.103615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Alzheimer's disease (AD) is characterized by progressive deterioration of cognitive functions. Some individuals with subjective cognitive decline (SCD) are in the early phase of the disease and subsequently progress through the AD continuum. Although neuroimaging biomarkers could be used for the accurate and early diagnosis of preclinical AD, the findings in SCD samples have been heterogeneous. This study established the morphological differences in brain magnetic resonance imaging (MRI) findings between individuals with SCD and those without cognitive impairment based on a clinical sample of patients defined according to SCD-Initiative recommendations. Moreover, we investigated baseline structural changes in the brains of participants who remained stable or progressed to mild cognitive impairment or dementia. METHODS This study included 309 participants with SCD and 43 healthy controls (HCs) with high-quality brain MRI at baseline. Among the 99 subjects in the SCD group who were followed clinically, 32 progressed (SCDp) and 67 remained stable (SCDnp). A voxel-wise statistical comparison of gray and white matter (WM) volume was performed between the HC and SCD groups and between the HC, SCDp, and SCDnp groups. XTRACT ATLAS was used to define the anatomical location of WM tract damage. Region-of-interest (ROI) analyses were performed to determine brain volumetric differences. White matter lesion (WML) burden was established in each group. RESULTS Voxel-based morphometry (VBM) analysis revealed that the SCD group exhibited gray matter atrophy in the middle frontal gyri, superior orbital gyri, superior frontal gyri, right rectal gyrus, whole occipital lobule, and both thalami and precunei. Meanwhile, ROI analysis revealed decreased volume in the left rectal gyrus, bilateral medial orbital gyri, middle frontal gyri, superior frontal gyri, calcarine fissure, and left thalamus. The SCDp group exhibited greater hippocampal atrophy (p < 0.001) than the SCDnp and HC groups on ROI analyses. On VBM analysis, however, the SCDp group exhibited increased hippocampal atrophy only when compared to the SCDnp group (p < 0.001). The SCD group demonstrated lower WM volume in the uncinate fasciculus, cingulum, inferior fronto-occipital fasciculus, anterior thalamic radiation, and callosum forceps than the HC group. However, no significant differences in WML number (p = 0.345) or volume (p = 0.156) were observed between the SCD and HC groups. CONCLUSIONS The SCD group showed brain atrophy mainly in the frontal and occipital lobes. However, only the SCDp group demonstrated atrophy in the medial temporal lobe at baseline. Structural damage in the brain regions was anatomically connected, which may contribute to early memory decline.
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Affiliation(s)
- Mario Riverol
- Department of Neurology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona 31008, Navarra, Spain.
| | - Mirla M Ríos-Rivera
- Department of Neurology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain; School of Medicine, Universidad Autónoma de Chiriquí, David 4001, Chiriquí, Panama
| | - Laura Imaz-Aguayo
- Department of Neurology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain
| | | | - Carlota Arrondo
- Department of Neurology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain
| | | | | | - Reyes García-Eulate
- Department of Radiology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain
| | - Pablo Domínguez
- Department of Radiology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona 31008, Navarra, Spain
| | - Maria A Fernández-Seara
- Department of Radiology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona 31008, Navarra, Spain
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Lichtenberg PA, Rorai V, Flores EV, Tarraf W. The WALLET Study: Financial Decision Making and Key Financial Behaviors Associated with Excess Spending. Clin Gerontol 2024:1-12. [PMID: 38695303 DOI: 10.1080/07317115.2024.2348049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/22/2024] [Indexed: 05/24/2024]
Abstract
OBJECTIVES The Wealth Accumulation and Losses in Later life Early Cognitive Transitions (WALLET) study data was used to examine correlates with excess spending in older adults who do and do not have early memory loss. METHODS The WALLET study collected detailed financial information from participants' primary checking account statements (n = 150). Information on participant sociodemographic, health, and disability status, memory functioning, financial decision-making, and financial literacy was also collected. Participants either had no memory problems or early memory loss. Bivariate and multiple regression analyses were conducted. RESULTS The early memory loss group had significantly higher excess spending than those with no memory loss. Financial decision-making and higher-risk financial behaviors were also linked to higher excess spending. Early memory loss was no longer statistically significant after accounting for financial stressors and resources. CONCLUSIONS The multidimensional nature of financial capacity assessment has long been known. The WALLET study data is unique, however, in that it demonstrates the links between excess spending with decision-making, early memory loss, and a set of specific financial behaviors. CLINICAL IMPLICATIONS Real-world assessments of financial management and financial decision-making yield important information about how older adults are managing money and making key financial decisions. Checking account reviews can be used to determine excess spending.
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Affiliation(s)
- Peter A Lichtenberg
- Distinguished Department of Psychology, Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Vanessa Rorai
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Emily V Flores
- Research Assistant, Department of Psychology and Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, Michigan, USA
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Ku YT, Chiu PY, Hua MS, Liao YC, Chang HT. Development of a Revised Version of Subjective Memory Complaints Questionnaire in Taiwan: A Preliminary Study. Arch Clin Neuropsychol 2024; 39:78-91. [PMID: 37337458 DOI: 10.1093/arclin/acad045] [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] [Accepted: 05/18/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVES Research has suggested that subjective memory complaints (SMC) are predictive of cognitive decline in cases of Alzheimer's disease; however, multidimensional characteristics of SMC make it difficult to formulate causal links. The Subjective Memory Complaints Questionnaire (SMCQ) has proven effective in capturing the nature of SMC. In this study, we developed a revised version of SMCQ (SMCQ-R) with corresponding normative data for application in Taiwan. METHODS This study recruited 100 cognitively normal participants (> 45 years) stratified according to demographic characteristics. Assessments were performed to evaluate test-retest reliability, criterion-related validity, and construct validity of SMCQ-R. SMCQ-R scores of 20 matched patients with mild cognitive impairment (MCI) were also compared with those of normal participants to test construct validity. RESULTS Reliability of SMCQ-R was satisfactory (0.81-0.95). Factor analysis revealed a three-factor structure: everyday memory problems (EMP), recent severe memory problems (RSMP), and long-term memory problems (LTMP). EMP and RSMP scores were negatively associated with objective cognitive function (r = -.20 to .39). Depressive symptoms were positively associated with all factors (r = .23-.33). Age was positively associated with total (b = 0.09, p < .05) and EMP scores (b = 0.06, p < .01). MCI patients obtained higher scores (p < .05) on all subscales. SMCQ-R scores discriminated between normal and MCI individuals (area under the curve = 0.77). This study established a norm based on scores adjusted to control for effects of age. CONCLUSIONS SMCQ-R has sound psychometric properties and could potentially be used as a tool to assess SMC in clinical settings.
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Affiliation(s)
- Yi-Ting Ku
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Pai-Yi Chiu
- Department of Neurology, Show Chwan Memorial Hospital, Changhua City, Taiwan
- Department of Applied Mathematics, College of Science, Tunghai University, Taichung, Taiwan
| | - Mau-Sun Hua
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Yu-Chi Liao
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
- Clinical Psychology Center, Asia University, Taichung, Taiwan
| | - Hsin-Te Chang
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
- Department of Psychology, College of Science, Chung Yuan Christian University, Taoyuan, Taiwan
- Research Assistance Center, Show Chwan Memorial Hospital, Changhua City, Taiwan
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Gerlach AR, Karim HT, Lee S, Kolobaric A, Tudorascu DL, Butters MA, Andreescu C. White Noise-Is Anxiety in Late-Life Associated With White Matter Hyperintensity Burden? Am J Geriatr Psychiatry 2024; 32:83-97. [PMID: 37718134 PMCID: PMC10843002 DOI: 10.1016/j.jagp.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/28/2023] [Accepted: 08/24/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE We investigated the relationship between anxiety phenotypes (global anxiety, worry, and rumination) and white matter hyperintensities (WMH), with special consideration for the roles of age and executive function (EF). Our hypotheses were 1) anxiety phenotypes would be associated with WMH and 2) EF would moderate this relationship. DESIGN Cross-sectional. SETTING Participants were recruited from the local community (Pittsburgh, PA). PARTICIPANTS We recruited 110 older adults (age ≥ 50) with varying worry severity and clinical comorbidity. INTERVENTIONS Not applicable. MEASUREMENTS Demographics (age, sex, race, education), clinical measures (cumulative illness burden, global anxiety, worry, and rumination), EF, and WMH quantified with magnetic resonance imaging. RESULTS Lower global anxiety and worry severity were significantly correlated with higher WMH volume, though the global anxiety relationship was not significant after controlling for age. Rumination as not associated with WMH burden. EF was not correlated with either global anxiety, worry, rumination, or WMH. However, in those with advanced age and/or greater WMH burden, there was an association between worry and EF as well as EF and WMH. CONCLUSION Longitudinal studies are needed in order to clarify the complex interactions between anxiety phenotypes, WMH, and EF.
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Affiliation(s)
- Andrew R Gerlach
- Department of Psychiatry (ARG, HTK, DLT, MAB, CA), University of Pittsburgh, Pittsburgh, PA
| | - Helmet T Karim
- Department of Psychiatry (ARG, HTK, DLT, MAB, CA), University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering (HTK), University of Pittsburgh, Pittsburgh, PA
| | - Soyoung Lee
- Department of Psychiatry (SL), Brigham and Women's Hospital, Boston, MA; Department of Psychiatry (SL), Harvard Medical School, Boston, MA
| | | | - Dana L Tudorascu
- Department of Psychiatry (ARG, HTK, DLT, MAB, CA), University of Pittsburgh, Pittsburgh, PA; Department of Biostatistics (DLT), University of Pittsburgh, Pittsburgh, PA
| | - Meryl A Butters
- Department of Psychiatry (ARG, HTK, DLT, MAB, CA), University of Pittsburgh, Pittsburgh, PA
| | - Carmen Andreescu
- Department of Psychiatry (ARG, HTK, DLT, MAB, CA), University of Pittsburgh, Pittsburgh, PA.
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Cheng CH, Hung CC, Chao YP, Nouchi R, Wang PN. Subjective cognitive decline exhibits alterations of resting-state phase-amplitude coupling in precuneus. Clin Neurophysiol 2023; 156:281-289. [PMID: 37722986 DOI: 10.1016/j.clinph.2023.08.015] [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: 01/13/2023] [Revised: 07/26/2023] [Accepted: 08/16/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE Subjective cognitive decline (SCD) is associated with increased risks for progressing to Alzheimer's disease (AD). This study aimed to investigate phase-amplitude coupling (PAC) in individuals with SCD and healthy controls (HCs) in the baseline year and determined the predictability of cognitive changes in the clinical follow-up. METHODS Resting-state magnetoencephalographic signals in 29 HCs and 23 SCD subjects were recorded in the baseline year. The parahippocampal gyrus, posterior cingulate cortex and precuneus were selected as regions of interest (ROIs). Based on the grand-averaged comodulograms, delta-beta, delta-gamma and theta-gamma PAC values were extracted from each ROI. RESULTS Compared with the HCs, the SCD group showed decreased theta-gamma PAC in the precuneus. Theta-gamma PAC of the left precuneus was associated with SCD severity and performance of immediate recall in the baseline year. The SCD group was followed for 3 years and divided into SCD-Stable and SCD-Decline groups based on scores of Mini-Mental State Examination. No significant differences in PAC of the baseline year were found between SCD-Stable and SCD-Decline groups. CONCLUSIONS The SCD group demonstrated reduced theta-gamma PAC in the precuneus. SIGNIFICANCE Subjective perception of cognitive decline is reflected by objective alterations of brain function.
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Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Chun-Che Hung
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan
| | - Yi-Ping Chao
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan; Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Rui Nouchi
- Department of Cognitive Health Science, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Pei-Ning Wang
- Division of General Neurology, Department of Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Neurology, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Bednorz A, Religa D. Utility of the Comprehensive Trail Making Test in the Assessment of Mild Cognitive Impairment in Older Patients. Geriatrics (Basel) 2023; 8:108. [PMID: 37987468 PMCID: PMC10660718 DOI: 10.3390/geriatrics8060108] [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: 09/04/2023] [Revised: 10/18/2023] [Accepted: 10/28/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION The purpose of this study is to determine the usefulness of the CTMT (Comprehensive Trail Making Test) in diagnosing mild cognitive impairment in older patients. The test is used to assess executive functions, of which impairment is already observed in the early stages of the neurodegenerative process. MATERIALS AND METHODS The study includes 98 patients of a geriatric ward assigned to 2 groups of 49 patients each: patients diagnosed with a mild cognitive impairment and patients without a cognitive impairment, constituting the control group (group K). A set of screening tests was used in the initial study: the MMSE (Mini-Mental State Examination), MoCA (Montreal Cognitive Assessment), and CDT (Clock Drawing Test), GDS (Geriatric Depression Scale). The second study included the performance of the CTMT; the performance indicator was the time of performance. RESULTS Statistically significant differences are obtained between patients with mild cognitive impairments and those in cognitive normality in the performance of the CTMT test (p < 0.01). Patients with MCIs took longer to complete all trails of the test. To identify cognitive impairment, cutoff points were proposed for the CTMT total score and the other test trails. The CTMT overall score and CTMT 5 scored the highest AUCs (CTMT overall score = 0.77, CTMT Trail 5 = 0.80). CONCLUSIONS The Comprehensive Trail Making Test may be useful in diagnosing mild cognitive impairment as a complementary screening tool.
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Affiliation(s)
- Adam Bednorz
- John Paul II Geriatric Hospital, 40-353 Katowice, Poland;
- Institute of Psychology, Humanitas Academy, 41-200 Sosnowiec, Poland
| | - Dorota Religa
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, 141 86 Huddinge, Sweden
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Arola A, Laakso HM, Heinonen H, Pitkänen J, Ahlström M, Lempiäinen J, Paajanen T, Virkkala J, Koikkalainen J, Lötjönen J, Korvenoja A, Melkas S, Jokinen H. Subjective vs informant-reported cognitive complaints have differential clinical significance in covert cerebral small vessel disease. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100182. [PMID: 37745893 PMCID: PMC10514088 DOI: 10.1016/j.cccb.2023.100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/30/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
Objective Subjective cognitive complaints are common in patients with cerebral small vessel disease (cSVD), yet their relationship with informant evaluations, objective cognitive functions and severity of brain changes are poorly understood. We studied the associations of subjective and informant reports with findings from comprehensive neuropsychological assessment and brain MRI. Method In the Helsinki SVD Study, 152 older adults with varying degrees of white matter hyperintensities (WMH) but without stroke or dementia were classified as having normal cognition or mild cognitive impairment (MCI) based on neuropsychological criteria. The measures also included continuous domain scores for memory and executive functions. Cognitive complaints were evaluated with the subjective and informant versions of the Prospective and Retrospective Memory Questionnaire (PRMQ) and Dysexecutive Questionnaire (DEX); functional abilities with the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL); and depressive symptoms with the Geriatric Depression Scale (GDS-15). Results Subjective cognitive complaints correlated significantly with informant reports (r=0.40-0.50, p<0.001). After controlling for demographics, subjective and informant DEX and PRMQ were not related to MCI, memory or executive functions. Instead, subjective DEX and PRMQ significantly associated with GDS-15 and informant DEX and PRMQ with WMH volume and A-IADL. Conclusions Neither subjective nor informant-reported cognitive complaints associated with objective cognitive performance. Informant-evaluations were related to functional impairment and more severe WMH, whereas subjective complaints only associated with mild depressive symptoms. These findings suggest that awareness of cognitive impairment may be limited in early-stage cSVD and highlight the value of informant assessments in the identification of patients with functional impairment.
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Affiliation(s)
- Anne Arola
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hanna M. Laakso
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Heidi Heinonen
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Johanna Pitkänen
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Matti Ahlström
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Juha Lempiäinen
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Teemu Paajanen
- Work ability and working careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jussi Virkkala
- Department of Neurophysiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha Koikkalainen
- Combinostics Ltd, Tampere, Finland
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jyrki Lötjönen
- Combinostics Ltd, Tampere, Finland
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo, Finland
| | - Antti Korvenoja
- Medical Imaging Center, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Susanna Melkas
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hanna Jokinen
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Goldstein FC, Okafor M, Yang Z, Thomas T, Saleh S, Hajjar I. Subjective cognitive complaints in White and African American older adults: associations with demographic, mood, cognitive, and neuroimaging features. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:957-970. [PMID: 37602758 PMCID: PMC10843657 DOI: 10.1080/13825585.2023.2249181] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 07/03/2023] [Indexed: 08/22/2023]
Abstract
Subjective cognitive complaints (SCC) in cognitively intact older adults have been investigated as a clinically important symptom that may portend the onset of a neurodegenerative disorder such as Alzheimer's disease. Few studies have concurrently incorporated demographic features, depressive symptoms, neuropsychological status, and neuroimaging correlates of SCC and evaluated whether these differ in White and African American older adults. In the current study, 131 (77 White, 54 African American) healthy participants ≥50 years old completed the Cognitive Function Instrument (CFI) to assess SCC, and they underwent objective cognitive testing, assessment of mood, and brain magnetic resonance imaging. Pearson Product Moment correlations were performed to evaluate associations of the CFI self-ratings with the above measures for the combined group and separately for White and African American participants. SCC were associated with greater depressive symptoms in both White and African American participants in adjusted models controlling for overall cognitive status, education, and hypertension. Greater white matter hyperintensities, lower cortical thickness, older age, and slower set shifting speed were associated with increased SCC in White participants. Although the correlations were not significant for African Americans, the strength of the associations were comparable to White participants. Hippocampal volume was not associated with either total SCC or items specific to memory functioning in the entire group. Longitudinal studies are needed to further evaluate the clinical significance of these associations with risk of conversion to mild cognitive impairment and dementia.
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Affiliation(s)
| | - Maureen Okafor
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Zhiyi Yang
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Tiffany Thomas
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Sabria Saleh
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Ihab Hajjar
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
- Department of Neurology, University of Texas Southwestern, Dallas Texas
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Kuang Q, Huang M, Lei Y, Wu L, Jin C, Dai J, Zhou F. Clinical and cognitive correlates tractography analysis in patients with white matter hyperintensity of vascular origin. Front Neurosci 2023; 17:1187979. [PMID: 37397447 PMCID: PMC10311635 DOI: 10.3389/fnins.2023.1187979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Purpose White matter hyperintensity lesions (WMHL) in the brain are a consequence of cerebral small vessel disease and microstructural damage. Patients with WMHL have diverse clinical features, and hypertension, advanced age, obesity, and cognitive decline are often observed. However, whether these clinical features are linked to interrupted structural connectivity in the brain requires further investigation. This study therefore explores the white matter pathways associated with WMHL, with the objective of identifying neural correlates for clinical features in patients with WMHL. Methods Diffusion magnetic resonance imaging (MRI) and several clinical features (MoCA scores, hypertension scores, body mass index (BMI), duration of hypertension, total white matter lesion loads, and education.) highly related to WMHL were obtained in 16 patients with WMHL and 20 health controls. We used diffusion MRI connectometry to explore the relationship between clinical features and specific white matter tracts using DSI software. Results The results showed that the anterior splenium of the corpus callosum, the inferior longitudinal fasciculus, the anterior corpus callosum and the middle cerebellar peduncle were significantly correlated with hypertension scores (false discovery rate (FDR) = 0.044). The anterior splenium of the corpus callosum, the left thalamoparietal tract, the inferior longitudinal fasciculus, and the left cerebellar were significantly correlated with MoCA scores (FDR = 0.016). The anterior splenium of corpus callosum, inferior fronto-occipital fasciculus, cingulum fasciculus, and fornix/fimbria were significantly correlated with body mass index (FDR = 0.001). Conclusion Our findings show that hypertension score, MoCA score, and BMI are important clinical features in patients with WMHL, hypertension degree and higher BMI are associated with whiter matter local disconnection in patients with WMHL, and may contribute to understanding the cognitive impairments observed in patients with WMHL.
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Affiliation(s)
- Qinmei Kuang
- Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Clinical Research Center for Medical Imaging in Jiangxi Province, Nanchang, China
| | - Muhua Huang
- Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Clinical Research Center for Medical Imaging in Jiangxi Province, Nanchang, China
| | - Yumeng Lei
- Department of Radiology, Nanchang First Hospital, Nanchang, Jiangxi, China
| | - Lin Wu
- Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Clinical Research Center for Medical Imaging in Jiangxi Province, Nanchang, China
| | - Chen Jin
- Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Clinical Research Center for Medical Imaging in Jiangxi Province, Nanchang, China
| | - Jiankun Dai
- GE Healthcare, MR Research China, Beijing, China
| | - Fuqing Zhou
- Department of Radiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Clinical Research Center for Medical Imaging in Jiangxi Province, Nanchang, China
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10
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Rothstein A, Zhang Y, Briggs AQ, Bernard MA, Shao Y, Favilla C, Sloane K, Witsch J, Masurkar AV. Impact of white matter hyperintensities on subjective cognitive decline phenotype in a diverse cohort of cognitively normal older adults. Int J Geriatr Psychiatry 2023; 38:e5948. [PMID: 37291739 DOI: 10.1002/gps.5948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/20/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Subjective cognitive decline (SCD) is a preclinical stage of AD. White matter hyperintensities (WMH), an MRI marker of cerebral small vessel disease, associate with AD biomarkers and progression. The impact of WMH on SCD phenotype is unclear. METHODS/DESIGN A retrospective, cross-sectional analysis was conducted on a diverse cohort with SCD evaluated at the NYU Alzheimer's Disease Research Center between January 2017 and November 2021 (n = 234). The cohort was dichotomized into none-to-mild (n = 202) and moderate-to-severe (n = 32) WMH. Differences in SCD and neurocognitive assessments were evaluated via Wilcoxon or Fisher exact tests, with p-values adjusted for demographics using multivariable logistic regression. RESULTS Moderate-to-severe WMH participants reported more difficulty with decision making on the Cognitive Change Index (1.5 SD 0.7 vs. 1.2 SD 0.5, p = 0.0187) and worse short-term memory (2.2 SD 0.4 vs. 1.9 SD 0.3, p = 0.0049) and higher SCD burden (9.5 SD 1.6 vs. 8.7 SD 1.7, p = 0.0411) on the Brief Cognitive Rating Scale. Moderate-to-severe WMH participants scored lower on the Mini-Mental State Examination (28.0 SD 1.6 vs. 28.5 SD 1.9, p = 0.0491), and on delayed paragraph (7.2 SD 2.0 vs. 8.8 SD 2.9, p = 0.0222) and designs recall (4.5 SD 2.3 vs. 6.1 SD 2.5, p = 0.0373) of the Guild Memory Test. CONCLUSIONS In SCD, WMH impact overall symptom severity, specifically in executive and memory domains, as well as objective performance on global and domain-specific tests in verbal memory and visual working/associative memory.
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Affiliation(s)
- Aaron Rothstein
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yian Zhang
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Anthony Q Briggs
- Center for Cognitive Neurology, Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Mark A Bernard
- Center for Cognitive Neurology, Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Yongzhao Shao
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Christopher Favilla
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kelly Sloane
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jens Witsch
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Arjun V Masurkar
- Center for Cognitive Neurology, Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Neuroscience Institute, NYU Grossman School of Medicine, New York, New York, USA
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11
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Bryant AM, Kerr ZY, Walton SR, Barr WB, Guskiewicz KM, McCrea MA, Brett BL. Investigating the association between subjective and objective performance-based cognitive function among former collegiate football players. Clin Neuropsychol 2023; 37:595-616. [PMID: 35670306 PMCID: PMC9726994 DOI: 10.1080/13854046.2022.2083021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/22/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Studies have observed variable associations of prior contact sport participation with subjective and objective measures of cognitive function. This study directly investigated the association between subjective self-report and objective performance-based cognition among former collegiate football players, as well as its relationship to self-reported concussion history. METHODS Former collegiate football players (N = 57; mean age = 37.9 years [SD = 1.49]) retired from sport 15-years prior were enrolled. Linear regression models examined associations between subjective cognition (Quality of Life in Neurological Disorders Cognitive Functioning-Short Form), and performance on a neuropsychological battery. Domain specific (executive function) metrics of subjective (Behavior Rating Inventory of Executive Function-Adult) and objective cognition were also exclusively examined. Associations between self-reported concussion history with subjective and objective measures were tested. Potential influential factors (sleep quality and distress) were included as covariates. RESULTS Subjective cognition was not significantly associated with any objective measures of cognitive functioning (p's > .05). Greater self-reported concussion history was inversely associated with subjective cognition (B = -2.49, p = .004), but not objective performance-based cognition (p's > .05). Distress was significantly related to all metrics of subjective cognition (p's < .001) as well as performance on delayed recall and verbal fluency (p's < .05). Sleep quality was only significantly related to timed visuospatial sequencing (p = .033). CONCLUSIONS Reliance on self-reported measures of cognitive functioning alone is insufficient when assessing cognition in former contact sport athletes. Assessment of other factors known to influence subjective cognitive complaints should also be examined in determining the presence of cognitive deficits.
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Affiliation(s)
- Andrew M. Bryant
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Zachary Y. Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Samuel R. Walton
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | | | - Kevin M. Guskiewicz
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Michael A. McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Benjamin L. Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
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Morrison C, Dadar M, Villeneuve S, Ducharme S, Collins DL. White matter hyperintensity load varies depending on subjective cognitive decline criteria. GeroScience 2023; 45:17-28. [PMID: 36401741 PMCID: PMC9886741 DOI: 10.1007/s11357-022-00684-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/27/2022] [Indexed: 11/21/2022] Open
Abstract
Increased age and cognitive impairment is associated with an increase in cerebrovascular pathology often measured as white matter hyperintensities (WMHs) on MRI. Whether WMH burden differs between cognitively unimpaired older adults with subjective cognitive decline (SCD +) and without subjective cognitive decline (SCD -) remains conflicting, and could be related to the methods used to identify SCD. Our goal was to examine if four common SCD classification methods are associated with different WMH accumulation patterns between SCD + and SCD - . A total of 535 cognitively unimpaired older adults with 1353 time points from the Alzheimer's Disease Neuroimaging Initiative were included in this study. SCD was operationalized using four different methods: Cognitive Change Index (CCI), Everyday Cognition Scale (ECog), ECog + Worry, and Worry. Linear mixed-effects models were used to investigate the associations between SCD and overall and regional WMH burden. Overall temporal WMH burden differences were only observed with the Worry questionnaire. Higher WMH burden change over time was observed in SCD + compared to SCD - in the temporal and parietal regions using the CCI (temporal, p = .01; parietal p = .02) and ECog (temporal, p = .02; parietal p = .01). For both the ECog + Worry and Worry questionnaire, change in WMH burden over time was increased in SCD + compared to SCD - for overall, frontal, temporal, and parietal WMH burden (p < .05). These results show that WMH burden differs between SCD + and SCD - depending on the questionnaire and the approach (regional/global) used to measure WMHs. The various methods used to define SCD may reflect different types of underlying pathologies.
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Affiliation(s)
- Cassandra Morrison
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.
| | - Mahsa Dadar
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Sylvia Villeneuve
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Simon Ducharme
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
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13
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Wiegersma AM, Boots A, Roseboom TJ, de Rooij SR. Exposure to the Dutch Famine in Early Gestation and Cognitive Function and Decline in Older Age. Nutrients 2023; 15:nu15020293. [PMID: 36678168 PMCID: PMC9867093 DOI: 10.3390/nu15020293] [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: 10/13/2022] [Revised: 11/30/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
People exposed to the 1944-1945 Dutch famine in early gestation performed worse on a selective attention task at age 58 and reported more cognitive problems at age 72. We here hypothesized that undernutrition in early gestation is associated with poorer cognitive functioning in older age and a higher rate of cognitive decline. We tested this hypothesis in the Dutch famine birth cohort in men and women combined and separately. We assessed cognitive function using a Stroop-like, trail-making and 15-word task (at ages 68 and 74) and the Montreal cognitive assessment as well as self-perceived cognitive problems (at age 74) in 73 men (n = 34) and women (n = 39). We compared cognitive function and decline (change in cognitive function between age 68 and 74) between those exposed in early gestation and those not exposed (born before or conceived after the famine). Although in both men and women cognitive function declined from age 68 to 74, cognitive task scores and the rate of decline did not differ between those exposed or unexposed to famine. At age 74, men exposed to famine in early gestation more often reported cognitive problems, although this was not statistically different from unexposed men (OR 3.1 [95%CI 0.7 to 13.0]). We did not find evidence of increased cognitive decline after prenatal undernutrition. Selective participation and mortality may have hampered our ability to detect potential true effects. The self-perceived cognitive problems among men who had been exposed to famine in early gestation might be an indication of future dementia risk.
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Affiliation(s)
- Aline Marileen Wiegersma
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, 1007 MB Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands
- Correspondence:
| | - Amber Boots
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, 1007 MB Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands
| | - Tessa J. Roseboom
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, 1007 MB Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands
- Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Susanne R. de Rooij
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, 1007 MB Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, 1105 AZ Amsterdam, The Netherlands
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Cerebrovascular damage in subjective cognitive decline: A systematic review and meta-analysis. Ageing Res Rev 2022; 82:101757. [PMID: 36240992 DOI: 10.1016/j.arr.2022.101757] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) has been postulated as an early marker of Alzheimer's Disease (AD) but it can also be associated to other non-AD pathologies such as Vascular Dementia (VaD). Nevertheless, there is scarce data about SCD as a potential harbinger of cerebrovascular pathology. Thus, we conducted a systematic review and meta-analysis on the association between SCD and cerebrovascular damage measured by neuroimaging markers. METHOD This study was performed following the PRISMA guidelines. The search was conducted in 3 databases (PubMed, Scopus and Web of Science) from origin to December 8th, 2021. Primary studies including cognitively unimpaired adults with SCD and neuroimaging markers of cerebrovascular damage (i.e., white matter signal abnormalities, WMSA) were selected. Qualitative synthesis and meta-analysis of studies with a case-control design was performed. RESULTS Of 241 articles identified, 21 research articles were selected. Eight case-control studies were included for the meta-analysis. A significant overall effect-size was observed for the mean WMSA burden in SCD relative to controls, where the WMSA burden was higher in SCD. CONCLUSION Our findings show the potential usefulness of SCD as a harbinger of cerebrovascular disease in cognitively healthy individuals. Further research is needed in order to elucidate the role of SCD as a preclinical marker of vascular cognitive impairment.
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15
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Arrondo P, Elía-Zudaire Ó, Martí-Andrés G, Fernández-Seara MA, Riverol M. Grey matter changes on brain MRI in subjective cognitive decline: a systematic review. Alzheimers Res Ther 2022; 14:98. [PMID: 35869559 PMCID: PMC9306106 DOI: 10.1186/s13195-022-01031-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/15/2022] [Indexed: 11/25/2022]
Abstract
Introduction People with subjective cognitive decline (SCD) report cognitive deterioration. However, their performance in neuropsychological evaluation falls within the normal range. The present study aims to analyse whether structural magnetic resonance imaging (MRI) reveals grey matter changes in the SCD population compared with healthy normal controls (HC). Methods Parallel systematic searches in PubMed and Web of Science databases were conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Quality assessment was completed using the Newcastle-Ottawa Scale (NOS). Results Fifty-one MRI studies were included. Thirty-five studies used a region of interest (ROI) analysis, 15 used a voxel-based morphometry (VBM) analysis and 10 studies used a cortical thickness (CTh) analysis. Ten studies combined both, VBM or CTh analysis with ROI analysis. Conclusions Medial temporal structures, like the hippocampus or the entorhinal cortex (EC), seemed to present grey matter reduction in SCD compared with HC, but the samples and results are heterogeneous. Larger sample sizes could help to better determine if these grey matter changes are consistent in SCD subjects. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01031-6.
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16
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White matter hyperintensity distribution differences in aging and neurodegenerative disease cohorts. Neuroimage Clin 2022; 36:103204. [PMID: 36155321 PMCID: PMC9668605 DOI: 10.1016/j.nicl.2022.103204] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION White matter hyperintensities (WMHs) are common magnetic resonance imaging (MRI) findings in the aging population in general, as well as in patients with neurodegenerative diseases. They are known to exacerbate the cognitive deficits and worsen the clinical outcomes in the patients. However, it is not well-understood whether there are disease-specific differences in prevalence and distribution of WMHs in different neurodegenerative disorders. METHODS Data included 976 participants with cross-sectional T1-weighted and fluid attenuated inversion recovery (FLAIR) MRIs from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) cohort of the Canadian Consortium on Neurodegeneration in Aging (CCNA) with eleven distinct diagnostic groups: cognitively intact elderly (CIE), subjective cognitive impairment (SCI), mild cognitive impairment (MCI), vascular MCI (V-MCI), Alzheimer's dementia (AD), vascular AD (V-AD), frontotemporal dementia (FTD), Lewy body dementia (LBD), cognitively intact elderly with Parkinson's disease (PD-CIE), cognitively impaired Parkinson's disease (PD-CI), and mixed dementias. WMHs were segmented using a previously validated automated technique. WMH volumes in each lobe and hemisphere were compared against matched CIE individuals, as well as each other, and between men and women. RESULTS All cognitively impaired diagnostic groups had significantly greater overall WMH volumes than the CIE group. Vascular groups (i.e. V-MCI, V-AD, and mixed dementia) had significantly greater WMH volumes than all other groups, except for FTD, which also had significantly greater WMH volumes than all non-vascular groups. Women tended to have lower WMH burden than men in most groups and regions, controlling for age. The left frontal lobe tended to have a lower WMH burden than the right in all groups. In contrast, the right occipital lobe tended to have greater WMH volumes than the left. CONCLUSIONS There were distinct differences in WMH prevalence and distribution across diagnostic groups, sexes, and in terms of asymmetry. WMH burden was significantly greater in all neurodegenerative dementia groups, likely encompassing areas exclusively impacted by neurodegeneration as well as areas related to cerebrovascular disease pathology.
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Doi T, Nakakubo S, Tsutsumimoto K, Kurita S, Kiuchi Y, Nishimoto K, Shimada H. The association of white matter hyperintensities with motoric cognitive risk syndrome. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100150. [PMID: 36324398 PMCID: PMC9616382 DOI: 10.1016/j.cccb.2022.100150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 06/06/2022] [Accepted: 07/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The motoric cognitive risk syndrome (MCR) was characterized by slow gait and subjective cognitive complaints. MCR was associated with brain structural changes. However, the association between white matter hyperintensities (WMH) and MCR was unclear and the aim of this study was to examine this association. MATERIAL AND METHODS The study participants were 1227 older adults (mean age: 72.0 ± 6.0 yrs, women: 52.6%). We collected magnetic resonance imaging (MRI) data to assess WMH. To assess MCR, data on gait speed and subjective cognitive complaints were collected. Demographical and medical data was collected as covariates. RESULTS Among participants, the proportion of MCR was 5.0% (n = 61) and severe WMH was 16.8% (n = 206). From logistic regression analysis, severe WMH associated with MCR even when adjusted for covariates (odds ratio 2.18 [95% confidential interval 1.15-4.16], p = 0.017). This association was observed in subgroups stratified by the participants' characteristics: higher age, not having fall history, not obesity, not being physical inactivity and not having depressive symptom. CONCLUSIONS Our findings revealed that vascular pathophysiological changes in the brain were associated with MCR. The association was pronounced by several factors. Further evaluation was required to clarify pathophysiology of MCR.
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Affiliation(s)
- Takehiko Doi
- Corresponding author at: Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511, Japan.
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18
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Chen R, Cai G, Xu S, Sun Q, Luo J, Wang Y, Li M, Lin H, Liu J. Body mass index related to executive function and hippocampal subregion volume in subjective cognitive decline. Front Aging Neurosci 2022; 14:905035. [PMID: 36062154 PMCID: PMC9428252 DOI: 10.3389/fnagi.2022.905035] [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: 03/26/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
Abstract
Objective This study aims to explore whether body mass index (BMI) level affects the executive function and hippocampal subregion volume of subjective cognitive decline (SCD). Materials and methods A total of 111 participants were included in the analysis, including SCD (38 of normal BMI, 27 of overweight and obesity) and normal cognitive control (NC) (29 of normal BMI, 17 of overweight and obesity). All subjects underwent the Chinese version of the Stroop Color-Word Test (SCWT) to measure the executive function and a high-resolution 3D T1 structural image acquisition. Two-way ANOVA was used to examine the differences in executive function and gray matter volume in hippocampal subregions under different BMI levels between the SCD and NC. Result The subdimensions of executive function in which different BMI levels interact with SCD and NC include inhibition control function [SCWT C-B reaction time(s): F (1,104) = 5.732, p = 0.018], and the hippocampal subregion volume of CA1 [F (1,99) = 8.607, p = 0.004], hippocampal tail [F (1,99) = 4.077, p = 0.046], and molecular layer [F (1,99) = 6.309, p = 0.014]. After correction by Bonferroni method, the population × BMI interaction only had a significant effect on the CA1 (p = 0.004). Further analysis found that the SCWT C-B reaction time of SCD was significantly longer than NC no matter whether it is at the normal BMI level [F (1,104) = 4.325, p = 0.040] or the high BMI level [F (1,104) = 21.530, p < 0.001], and the inhibitory control function of SCD was worse than that of NC. In the normal BMI group, gray matter volume in the hippocampal subregion (CA1) of SCD was significantly smaller than that of NC [F (1,99) = 4.938, p = 0.029]. For patients with SCD, the high BMI group had worse inhibitory control function [F (1,104) = 13.499, p < 0.001] and greater CA1 volume compared with the normal BMI group [F (1,99) = 7.619, p = 0.007]. Conclusion The BMI level is related to the inhibition control function and the gray matter volume of CA1 subregion in SCD. Overweight seems to increase the gray matter volume of CA1 in the elderly with SCD, but it is not enough to compensate for the damage to executive function caused by the disease. These data provide new insights into the relationship between BMI level and executive function of SCD from the perspective of imaging.
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Affiliation(s)
- Ruilin Chen
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Guiyan Cai
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shurui Xu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Qianqian Sun
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jia Luo
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yajun Wang
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ming Li
- Affiliated Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hui Lin
- Department of Physical Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiao Liu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, China
- Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation, Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Möllers T, Stocker H, Perna L, Rujescu D, Holleczek B, Schöttker B, Brenner H. Subjective short-term memory difficulties at ages 50-75 predict dementia risk in a community-based cohort followed over 17 years. Age Ageing 2022; 51:6607610. [PMID: 35697354 DOI: 10.1093/ageing/afac113] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Subjective cognitive decline (SCD) is an established precursor of dementia. However, the relationship between SCD and dementia has been mostly studied among people aged 65+. We aimed to assess the association between subjective memory difficulties at ages 50-75 with all-cause dementia and dementia-subtypes in a community-based cohort with long-term follow-up. METHODS 6,190 individuals (51% female) aged 50-75 years (median age, 62) attending a general health examination (by a total of 684 general practitioners) in Saarland, Germany, in 2000-2002 were recruited for a community-based cohort study. Subjective difficulties regarding short-term and long-term memory were assessed at baseline with two simple yes/no questions. Associations with dementia (-subtypes) diagnoses during 17 years of follow-up were estimated by Cox proportional hazards models. RESULTS 492 participants were diagnosed with dementia during 17 years of follow-up. Participants with short-term memory difficulties were at higher risk to receive incident all-cause dementia and vascular dementia diagnoses both within 0-9 years (age and sex adjusted hazard ratios (aHR), 1.80 and 2.00, respectively) and within 0-17 years (aHR 1.55 and 1.78, respectively) from recruitment (P < 0.05 in all cases). For clinical Alzheimer's disease, a significant association was only seen within the initial 6 years. There were no associations of long-term memory difficulties with any type of dementia. CONCLUSIONS Subjective difficulties in short-term memory predict both intermediate and long-term risk of vascular and all-cause dementia even among late middle-age adults. These results underline the importance of cardiovascular disease prevention efforts well before old age for maintaining cognitive health.
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Affiliation(s)
- Tobias Möllers
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.,Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Hannah Stocker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.,Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Laura Perna
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.,Department of Translational Research in Psychiatry - Max Planck Institute of Psychiatry, München, Germany
| | - Dan Rujescu
- Department of Psychiatry and Psychotherapy, Division of General Psychiatry, Medical University Vienna, Vienna, Austria
| | | | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.,Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.,Network Aging Research, Heidelberg University, Heidelberg, Germany
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Dhana A, DeCarli C, Dhana K, Desai P, Krueger K, Evans DA, Rajan KB. Association of Subjective Memory Complaints With White Matter Hyperintensities and Cognitive Decline Among Older Adults in Chicago, Illinois. JAMA Netw Open 2022; 5:e227512. [PMID: 35426922 PMCID: PMC9012965 DOI: 10.1001/jamanetworkopen.2022.7512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/28/2022] [Indexed: 11/26/2022] Open
Abstract
Importance Subjective memory complaints (SMCs) are associated with a faster cognitive decline; whether this association is also associated with structural brain alterations, such as white matter hyperintensity (WMH) volumes, requires investigation. Objective To evaluate the association of SMCs with WMH volumes and cognitive decline and investigate the role of WMH volumes in the association between SMCs and cognitive decline. Design, Setting, and Participants The Chicago Health and Aging Project, a population-based cohort study, enrolled adults aged 65 years or older. Data collection occurred in 3-year cycles from 1993 until 2012. Our study comprised 975 participants with magnetic resonance imaging assessments, of which 900 participants had data on SMCs and covariates, and 713 participants provided 2 or more cognitive assessments during the follow-up. Statistical analyses were conducted from May to October 2021. Exposures SMCs were obtained from self-reported questionnaire data during clinical evaluations, and the cycle, when reported, constituted the baseline of our study. Based on the frequency and severity of concerns, we categorized participants into 3 groups, (1) no concerns, (2) moderate concerns, and (3) very worried. Main Outcomes and Measures Volumetric magnetic resonance imaging measures of WMH volume and neuropsychological testing assessments of global cognition. Linear regression analysis was used to investigate the association between SMCs and WMH volumes in a multivariable model adjusted for age, sex, race and ethnicity, education, APOE4 status, and total intracranial volume. The association of SMCs with cognitive decline was investigated using linear mixed-effects models for age, sex, race and ethnicity, education, APOE4 status, follow-up time, and each variable in interaction with time to estimate the annual longitudinal change in cognitive function. Results Of the 900 participants with data on SMCs, covariates, and WMH volumes, 553 (61.4%) were women, 539 (59.9%) were African American, and the mean (SD) age was 79.5 (6.2) years. SMCs were associated with a larger WMH volume and faster cognitive decline. Compared with participants with no concerns, participants who were very worried had higher WMH volumes (β = 0.833; 95% CI, 0.203-1.463) and 174% faster cognitive decline (β = -0.049; 95% CI, -0.076 to -0.022). The association between SMCs and cognitive decline remained statistically significant among individuals with large WMH volumes (ie, within the fourth quartile). Within the fourth quartile of WMH volumes, participants who were very worried had 428% faster cognitive decline (β = -0.077; 95% CI, -0.144 to -0.011) compared with participants with no concerns. Conclusions and Relevance This cohort study suggests that SMCs, frequently reported by older individuals, are an important sign of cognitive impairment, especially among people with abnormalities in brain structure, such as larger WMH volumes.
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Affiliation(s)
- Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Sacramento
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Kristin Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
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21
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Boutzoukas EM, O'Shea A, Kraft JN, Hardcastle C, Evangelista ND, Hausman HK, Albizu A, Van Etten EJ, Bharadwaj PK, Smith SG, Song H, Porges EC, Hishaw A, DeKosky ST, Wu SS, Marsiske M, Alexander GE, Cohen R, Woods AJ. Higher white matter hyperintensity load adversely affects pre-post proximal cognitive training performance in healthy older adults. GeroScience 2022; 44:1441-1455. [PMID: 35278154 PMCID: PMC9213634 DOI: 10.1007/s11357-022-00538-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022] Open
Abstract
Cognitive training has shown promise for improving cognition in older adults. Age-related neuroanatomical changes may affect cognitive training outcomes. White matter hyperintensities are one common brain change in aging reflecting decreased white matter integrity. The current study assessed (1) proximal cognitive training performance following a 3-month randomized control trial and (2) the contribution of baseline whole-brain white matter hyperintensity load, or total lesion volume (TLV), on pre-post proximal training change. Sixty-two healthy older adults were randomized to either adaptive cognitive training or educational training control interventions. Repeated-measures analysis of covariance revealed two-way group × time interactions such that those assigned cognitive training demonstrated greater improvement on proximal composite (total training composite) and sub-composite (processing speed training composite, working memory training composite) measures compared to education training counterparts. Multiple linear regression showed higher baseline TLV associated with lower pre-post change on processing speed training sub-composite (β = -0.19, p = 0.04), but not other composite measures. These findings demonstrate the utility of cognitive training for improving post-intervention proximal performance in older adults. Additionally, pre-post proximal processing speed training change appears to be particularly sensitive to white matter hyperintensity load versus working memory training change. These data suggest that TLV may serve as an important factor for consideration when planning processing speed-based cognitive training interventions for remediation of cognitive decline in older adults.
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Affiliation(s)
- Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Cheshire Hardcastle
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Emily J Van Etten
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Samantha G Smith
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Hyun Song
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Eric C Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Alex Hishaw
- Department Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, USA.,Department of Neurology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Steven T DeKosky
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Samuel S Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Gene E Alexander
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA.,Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA. .,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA. .,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA.
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22
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Wiegersma AM, Boots A, Roseboom TJ, de Rooij SR. Prenatal exposure to the Dutch famine is associated with more self-perceived cognitive problems at 72 years of age. BMC Geriatr 2022; 22:176. [PMID: 35236291 PMCID: PMC8892724 DOI: 10.1186/s12877-022-02820-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/02/2022] [Indexed: 11/19/2022] Open
Abstract
Background Undernutrition during critical periods of neurodevelopment can hinder the developing brain with lasting negative consequences for brain size, structure and function. In this study, we describe self-perceived cognitive problems of men and women who were born around the time of the Dutch famine of 1944–45. Methods We compared self-perceived cognitive problems between men and women who had been exposed to the 1944–45 Dutch famine in late, mid or early gestation and those who were born before or conceived after the famine (and had thus not been exposed prenatally). We included 595 participants aged 71–74 years. Results Women who had been exposed to famine in late gestation more often reported cognitive problems compared to those who had not been exposed (OR 2.2 [95% CI 1.1–4.4]), whereas for men, this was the case for those exposed in early gestation (OR 2.3 [0.9–5.5]). Furthermore, men and women exposed in early gestation more often reported consulting a healthcare practitioner for cognitive problems in the past 12 months (OR 3.2 [1.3–8.1]). Especially men exposed in early gestation reported having consulted a healthcare practitioner more often than unexposed men (OR 4.4 [1.2–16.0]). Conclusions These findings suggest that prenatal undernutrition does not only have lasting effects on brain size, but also on its function, with more self-perceived cognitive problems at older age, which also require more medical attention. Also, the effects of undernutrition depend on sex and its timing during gestation. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02820-2.
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Affiliation(s)
- Aline Marileen Wiegersma
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
| | - Amber Boots
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Tessa J Roseboom
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.,Department of Obstetrics and Gynaecology, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
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23
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Jiménez-Sánchez L, Hamilton OKL, Clancy U, Backhouse EV, Stewart CR, Stringer MS, Doubal FN, Wardlaw JM. Sex Differences in Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis. Front Neurol 2021; 12:756887. [PMID: 34777227 PMCID: PMC8581736 DOI: 10.3389/fneur.2021.756887] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/04/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Cerebral small vessel disease (SVD) is a common cause of stroke, mild cognitive impairment, dementia and physical impairments. Differences in SVD incidence or severity between males and females are unknown. We assessed sex differences in SVD by assessing the male-to-female ratio (M:F) of recruited participants and incidence of SVD, risk factor presence, distribution, and severity of SVD features. Methods: We assessed four recent systematic reviews on SVD and performed a supplementary search of MEDLINE to identify studies reporting M:F ratio in covert, stroke, or cognitive SVD presentations (registered protocol: CRD42020193995). We meta-analyzed differences in sex ratios across time, countries, SVD severity and presentations, age and risk factors for SVD. Results: Amongst 123 relevant studies (n = 36,910 participants) including 53 community-based, 67 hospital-based and three mixed studies published between 1989 and 2020, more males were recruited in hospital-based than in community-based studies [M:F = 1.16 (0.70) vs. M:F = 0.79 (0.35), respectively; p < 0.001]. More males had moderate to severe SVD [M:F = 1.08 (0.81) vs. M:F = 0.82 (0.47) in healthy to mild SVD; p < 0.001], and stroke presentations where M:F was 1.67 (0.53). M:F did not differ for recent (2015-2020) vs. pre-2015 publications, by geographical region, or age. There were insufficient sex-stratified data to explore M:F and risk factors for SVD. Conclusions: Our results highlight differences in male-to-female ratios in SVD severity and amongst those presenting with stroke that have important clinical and translational implications. Future SVD research should report participant demographics, risk factors and outcomes separately for males and females. Systematic Review Registration: [PROSPERO], identifier [CRD42020193995].
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Affiliation(s)
- Lorena Jiménez-Sánchez
- Translational Neuroscience PhD Programme, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Olivia K. L. Hamilton
- Translational Neuroscience PhD Programme, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
| | - Una Clancy
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Ellen V. Backhouse
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Catriona R. Stewart
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Michael S. Stringer
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Fergus N. Doubal
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Joanna M. Wardlaw
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, United Kingdom
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24
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Jung Y, Viviano RP, van Rooden S, van der Grond J, Rombouts SARB, Damoiseaux JS. White Matter Hyperintensities and Apolipoprotein E Affect the Association Between Mean Arterial Pressure and Objective and Subjective Cognitive Functioning in Older Adults. J Alzheimers Dis 2021; 84:1337-1350. [PMID: 34657884 DOI: 10.3233/jad-210695] [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: 11/15/2022]
Abstract
BACKGROUND White matter hyperintensities (WMH) show a robust relationship with arterial pressure as well as objective and subjective cognitive functioning. In addition, APOE ɛ4 carriership may influence how arterial pressure affects cognitive functioning. OBJECTIVE To determine the role of region-specific WMH burden and APOE ɛ4 carriership on the relationship between mean arterial pressure (MAP) and cognitive function as well as subjective cognitive decline (SCD). METHODS The sample consisted of 87 cognitively unimpaired middle-aged to older adults aged 50-85. We measured WMH volume for the whole brain, anterior thalamic radiation (ATR), forceps minor, and superior longitudinal fasciculus (SLF). We examined whether WMH burden mediated the relationship between MAP and cognition (i.e., TMT-A score for processing speed; Stroop performance for executive function) as well as SCD (i.e., Frequency of Forgetting (FoF)), and whether APOE ɛ4 carriership moderated that mediation. RESULTS WMH burden within SLF mediated the effect of MAP on Stroop performance. Both whole brain and ATR WMH burden mediated the effect of MAP on FoF score. In the MAP-WMH-Stroop relationship, the mediation effect of SLF WMH and the effect of MAP on SLF WMH were significant only in APOE ɛ4 carriers. In the MAP-WMH-FoF relationship, the effect of MAP on whole brain WMH burden was significant only in ɛ4 carriers. CONCLUSION WMH burden and APOE genotype explain the link between blood pressure and cognitive function and may enable a more accurate assessment of the effect of high blood pressure on cognitive decline and risk for dementia.
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Affiliation(s)
- Youjin Jung
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Raymond P Viviano
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Sanneke van Rooden
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands.,Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Jessica S Damoiseaux
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Institute of Gerontology, Wayne State University, Detroit, MI, USA
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25
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Ramos H, Moreno L, Gil M, García-Lluch G, Sendra-Lillo J, Alacreu M. Pharmacists' Knowledge of Factors Associated with Dementia: The A-to-Z Dementia Knowledge List. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9934. [PMID: 34639242 PMCID: PMC8508463 DOI: 10.3390/ijerph18199934] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 12/24/2022]
Abstract
Dementia is a neurodegenerative disease with no cure that can begin up to 20 years before its diagnosis. A key priority in patients with dementia is the identification of early modifiable factors that can slow the progression of the disease. Community pharmacies are suitable points for cognitive-impairment screening because of their proximity to patients. Therefore, the continuous training of professionals working in pharmacies directly impacts the public health of the population. The main purpose of this study was to assess community pharmacists' knowledge of dementia-related factors. Thus, we conducted a cross-sectional study of 361 pharmacists via an online questionnaire that quizzed their knowledge of a list of dementia-related factors, which we later arranged into the A-to-Z Dementia Knowledge List. We found that younger participants had a better knowledge of risk factors associated with dementia. The risk factors most often identified were a family history of dementia followed by social isolation. More than 40% of the respondents did not identify herpes labialis, sleep more than 9 h per day, and poor hearing as risk factors. A higher percentage of respondents were better able to identify protective factors than risk factors. The least known protective factors were internet use, avoidance of pollution, and the use of anti-inflammatory drugs. Pharmacists' knowledge of dementia-related factors should be renewed with the aim of enhancing their unique placement to easily implement cognitive-impairment screening.
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Affiliation(s)
- Hernán Ramos
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain; (H.R.); (L.M.); (M.G.); (G.G.-L.); (J.S.-L.)
- Muy Ilustre Colegio Oficial de Farmacéuticos, 46003 Valencia, Spain
| | - Lucrecia Moreno
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain; (H.R.); (L.M.); (M.G.); (G.G.-L.); (J.S.-L.)
- Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
| | - María Gil
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain; (H.R.); (L.M.); (M.G.); (G.G.-L.); (J.S.-L.)
- Muy Ilustre Colegio Oficial de Farmacéuticos, 46003 Valencia, Spain
| | - Gemma García-Lluch
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain; (H.R.); (L.M.); (M.G.); (G.G.-L.); (J.S.-L.)
| | - José Sendra-Lillo
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain; (H.R.); (L.M.); (M.G.); (G.G.-L.); (J.S.-L.)
- Muy Ilustre Colegio Oficial de Farmacéuticos, 46003 Valencia, Spain
| | - Mónica Alacreu
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain; (H.R.); (L.M.); (M.G.); (G.G.-L.); (J.S.-L.)
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
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26
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Fogel H, Levy-Lamdan O, Zifman N, Hiller T, Efrati S, Suzin G, Hack DC, Dolev I, Tanne D. Brain Network Integrity Changes in Subjective Cognitive Decline: A Possible Physiological Biomarker of Dementia. Front Neurol 2021; 12:699014. [PMID: 34526957 PMCID: PMC8435601 DOI: 10.3389/fneur.2021.699014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/07/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The current study seeks to illustrate potential early and objective neurophysiological biomarkers of neurodegenerative cognitive decline by evaluating features of brain network physiological performance and structure utilizing different modalities. Methods: This study included 17 clinically healthy individuals with self-reported cognitive decline (Subjective Cognitive Decline group, SCD, no objective finding of cognitive decline), 12 individuals diagnosed with amnestic Mild Cognitive Impairment (aMCI), 11 individuals diagnosed with Dementia, and 15 healthy subjects. All subjects underwent computerized cognitive performance testing, MRI scans including T1 for gray matter (GM) volume quantification, DTI for quantification of white matter (WM) microstructure fractional anisotropy (FA) and mean diffusivity (MD), and brain network function evaluation using DELPHI (TMS-EEG) measures of connectivity, excitability, and plasticity. Results: Both DELPHI analysis of network function and DTI analysis detected a significant decrease in connectivity, excitability, and WM integrity in the SCD group compared to healthy control (HC) subjects; a significant decrease was also noted for aMCI and Dementia groups compared to HC. In contrast, no significant decrease was observed in GM volume in the SCD group compared to healthy norms, a significant GM volume decrease was observed only in objectively cognitively impaired aMCI subjects and in dementia subjects. Conclusions: This study results suggest that objective direct measures of brain network physiology and WM integrity may provide early-stage biomarkers of neurodegenerative-related changes in subjects that have not yet displayed any other objective measurable cognitive or GM volume deficits which may facilitate early preventive care for neurodegenerative decline and dementia.
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Affiliation(s)
| | | | - Noa Zifman
- QuantalX Neuroscience, Beer-Yaacov, Israel
| | - Tal Hiller
- QuantalX Neuroscience, Beer-Yaacov, Israel
| | - Shai Efrati
- Sagol Center for Hyperbaric Medicine and Research, Shamir Medical Center, Zerifin, Israel.,Sackler School of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Gil Suzin
- Sagol Center for Hyperbaric Medicine and Research, Shamir Medical Center, Zerifin, Israel
| | - Dallas C Hack
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States
| | | | - David Tanne
- Sackler School of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.,Stroke and Cognition Institute, Rambam Healthcare Campus, Haifa, Israel
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27
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Ortega G, Espinosa A, Alegret M, Monté-Rubio GC, Sotolongo-Grau O, Sanabria A, Tartari JP, Rodríguez-Gómez O, Marquié M, Vivas A, Gómez-Chiari M, Alarcón-Martín E, Pérez-Cordón A, Roberto N, Hernández I, Rosende-Roca M, Vargas L, Mauleón A, Abdelnour C, Esteban De Antonio E, López-Cuevas R, Alonso-Lana S, Moreno-Grau S, de Rojas I, Orellana A, Montrreal L, Tárraga L, Ruiz A, Boada M, Valero S. Combination of white matter hyperintensities and Aβ burden is related to cognitive composites domain scores in subjective cognitive decline: the FACEHBI cohort. Alzheimers Res Ther 2021; 13:141. [PMID: 34404456 PMCID: PMC8371791 DOI: 10.1186/s13195-021-00877-6] [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: 03/02/2021] [Accepted: 07/13/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND To explore whether the combination of white matter hyperintensities (WMHs) and amyloid-beta (Aβ) deposition is associated with worse cognitive performance on cognitive composites (CCs) domain scores in individuals with subjective cognitive decline (SCD). METHODS Two hundred participants from the FACEHBI cohort underwent structural magnetic resonance imaging (MRI), 18F-florbetaben positron emission tomography (FBB-PET), and neuropsychological assessment. WMHs were addressed through the Fazekas scale, the Age-Related White Matter Changes (ARWMC) scale, and the FreeSurfer pipeline. Eight CCs domain scores were created using the principal component analysis (PCA). Age, sex, education, and apolipoprotein E (APOE) were used as adjusting variables. RESULTS Adjusted multiple linear regression models showed that FreeSurfer (B - .245; 95% CI - .1.676, - .393, p = .016) and β burden (SUVR) (B - .180; 95% CI - 2.140, - .292; p = .070) were associated with face-name associative memory CCs domain score, although the latest one was not statistically significant after correction for multiple testing (p = .070). There was non-significant interaction of these two factors on this same CCs domain score (p = .54). However, its cumulative effects on face-name associative performance indicated that those individuals with either higher WMH load or higher Aβ burden showed the worst performance on the face-name associative memory CCs domain score. CONCLUSIONS Our results suggest that increased WMH load and increased Aβ are independently associated with poorer episodic memory performance in SCD individuals, indicating a cumulative effect of the combination of these two pathological conditions in promoting lower cognitive performance, an aspect that could help in terms of treatment and prevention.
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Affiliation(s)
- G Ortega
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain.
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
| | - A Espinosa
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Alegret
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - G C Monté-Rubio
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - O Sotolongo-Grau
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Sanabria
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - J P Tartari
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - O Rodríguez-Gómez
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Marquié
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Vivas
- Departament de Diagnòstic Per La Imatge, Clínica Corachan, Barcelona, Spain
| | - M Gómez-Chiari
- Departament de Diagnòstic Per La Imatge, Clínica Corachan, Barcelona, Spain
| | - E Alarcón-Martín
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Pérez-Cordón
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - N Roberto
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - I Hernández
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Rosende-Roca
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - L Vargas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Mauleón
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - C Abdelnour
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - E Esteban De Antonio
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - R López-Cuevas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - S Alonso-Lana
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - S Moreno-Grau
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - I de Rojas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Orellana
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - L Montrreal
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - L Tárraga
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Ruiz
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Boada
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - S Valero
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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Scarth M, Rissanen I, Scholten RJPM, Geerlings MI. Biomarkers of Alzheimer's Disease and Cerebrovascular Lesions and Clinical Progression in Patients with Subjective Cognitive Decline: A Systematic Review. J Alzheimers Dis 2021; 83:1089-1111. [PMID: 34397412 DOI: 10.3233/jad-210218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Early identification of Alzheimer's disease (AD) may be extremely beneficial for delaying disease progression. Subjective cognitive decline (SCD) may be an early indicator of AD pathology. Not all individuals with SCD will eventually develop AD, making it critical to identify biomarkers during the SCD stage which indicate likely clinical progression. OBJECTIVE The present review aims to summarize available data on structural MRI and cerebrospinal fluid (CSF) biomarkers and their association with clinical progression to mild cognitive impairment (MCI) or AD in people with SCD. METHODS Database searches were conducted using Embase and PubMed until June 2020. Longitudinal studies assessing biomarkers in individuals with SCD and assessing clinical progression to MCI/AD were included. Two assessors performed data extraction and assessed the risk of bias in the included studies. Data were synthesized narratively. RESULTS An initial search identified 1,065 papers; after screening and review 14 studies were included. Sample size of the included studies ranged from 28-674, mean age was 60.0-68.6 years, and 10.2%-52%of participants converted to MCI/AD. Lower levels of CSF Aβ 42 were consistently associated with clinical progression. Combination measures identifying an AD-like profile of Aβ 42 and tau levels were strongly associated with clinical progression. Biomarkers identified with structural MRI were less conclusive, as some studies found significant associations while others did not. CONCLUSION Biomarkers may be able to predict clinical progression in those with cognitive complaints. Aβ 42, or combinations of Aβ 42 and tau may be useful biomarkers in identifying individuals with SCD who will progress to MCI/AD.
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Affiliation(s)
- Morgan Scarth
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Ina Rissanen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Rob J P M Scholten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
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Lam S, Lipton RB, Harvey DJ, Zammit AR, Ezzati A. White matter hyperintensities and cognition across different Alzheimer's biomarker profiles. J Am Geriatr Soc 2021; 69:1906-1915. [PMID: 33891712 DOI: 10.1111/jgs.17173] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/15/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVES To examine the association between white matter hyperintensities (WMH) and cognitive domains such as memory and executive function (EF) across different clinical and biomarker categories of Alzheimer's disease (AD). DESIGN Cross-sectional study. SETTING Alzheimer's Disease Neuroimaging Initiative. PARTICIPANTS A total of 216 cognitively normal (CN) participants and 407 participants with mild cognitive impairment (MCI) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) at baseline. MEASUREMENTS Based on the 2018 research framework, participants were classified using AT(N) (amyloid-β deposition [A], pathologic tau [T], and neurodegeneration [(N)]) biomarkers into one of three categories: biomarker negative [A - T- (N)-], amyloid negative but other biomarker positive [A - T ± (N)+ or A - T + (N)±] or amyloid positive [A + T ± (N)±]. Linear regression models were then used to examine the association between WMH and memory composite scores and EF composite scores. RESULTS Higher WMH burden was associated with worse EF in both CN and MCI subgroups while a significant association between WMH and memory was only found in the MCI subgroup. Furthermore, WMH was associated with EF in the group with A - T ± (N)+ or A - T + (N)± biomarker category, but not for A - T - (N)- (normal biomarker) and A + T ± (N) ± (AD pathology). The association between higher WMH and worse memory was independent of amyloid levels in individuals with MCI with evidence of AD pathology. CONCLUSION Vascular disease, as indexed by WMH, independent of AD pathology affects cognitive function in both CN and MCI subgroups. Future studies using the AT(N) research framework should consider white matter lesions as a key biomarker contributing to the clinical presentation of AD.
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Affiliation(s)
- Sharon Lam
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Neurology, Montefiore Medical Center, Bronx, New York, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Danielle J Harvey
- Department of Public Health Sciences, University of California-Davis, Davis, California, USA
| | - Andrea R Zammit
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Ali Ezzati
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Neurology, Montefiore Medical Center, Bronx, New York, USA
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30
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Kavroulakis E, Simos NJ, Maris TG, Zaganas I, Panagiotakis S, Papadaki E. Evidence of Age-Related Hemodynamic and Functional Connectivity Impairment: A Resting State fMRI Study. Front Neurol 2021; 12:633500. [PMID: 33833727 PMCID: PMC8021915 DOI: 10.3389/fneur.2021.633500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To assess age-related changes in intrinsic functional brain connectivity and hemodynamics during adulthood in the context of the retrogenesis hypothesis, which states that the rate of age-related changes is higher in late-myelinating (prefrontal, lateral-posterior temporal) cerebrocortical areas as compared to early myelinating (parietal, occipital) regions. In addition, to examine the dependence of age-related changes upon concurrent subclinical depression symptoms which are common even in healthy aging. Methods: Sixty-four healthy adults (28 men) aged 23-79 years (mean 45.0, SD = 18.8 years) were examined. Resting-state functional MRI (rs-fMRI) time series were used to compute voxel-wise intrinsic connectivity contrast (ICC) maps reflecting the strength of functional connectivity between each voxel and the rest of the brain. We further used Time Shift Analysis (TSA) to estimate voxel-wise hemodynamic lead or lag for each of 22 ROIs from the automated anatomical atlas (AAL). Results: Adjusted for depression symptoms, gender and education level, reduced ICC with age was found primarily in frontal, temporal regions, and putamen, whereas the opposite trend was noted in inferior occipital cortices (p < 0.002). With the same covariates, increased hemodynamic lead with advancing age was found in superior frontal cortex and thalamus, with the opposite trend in inferior occipital cortex (p < 0.002). There was also evidence of reduced coupling between voxel-wise intrinsic connectivity and hemodynamics in the inferior parietal cortex. Conclusion: Age-related intrinsic connectivity reductions and hemodynamic changes were demonstrated in several regions-most of them part of DMN and salience networks-while impaired neurovascular coupling was, also, found in parietal regions. Age-related reductions in intrinsic connectivity were greater in anterior as compared to posterior cortices, in line with implications derived from the retrogenesis hypothesis. These effects were affected by self-reported depression symptoms, which also increased with age.
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Affiliation(s)
- Eleftherios Kavroulakis
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece
| | - Nicholas J Simos
- Department of Electrical and Computer Engineering, Technical University of Crete, Chania, Greece.,Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Greece
| | - Thomas G Maris
- Department of Medical Physics, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece
| | - Ioannis Zaganas
- Department of Neurology, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece
| | - Simeon Panagiotakis
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Greece
| | - Efrosini Papadaki
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece.,Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Greece
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31
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Sabbagh M, Miller J, Jones S, Ritter A, Shi J, DeCourt B, Wint D. Does Informant-Based Reporting of Cognitive Decline Correlate with Age-Adjusted Hippocampal Volume in Mild Cognitive Impairment and Alzheimer's Disease? J Alzheimers Dis Rep 2021; 5:207-211. [PMID: 33981957 PMCID: PMC8075551 DOI: 10.3233/adr-200260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Informant-based measures are effective screening tools for cognitive impairment. The Alzheimer's Questionnaire (AQ) is a subjective, informant-based measure that detects amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) with high sensitivity and specificity and has been shown to predict amyloid burden. OBJECTIVE To determine whether informant-based report of cognitive decline correlates with hippocampal volume changes in MCI and AD. METHODS Retrospective chart review of 139 clinically referred patients with clinical diagnoses of aMCI or mild dementia due to AD was conducted. Diagnostic status (clinical diagnosis made by a neurologist), NeuroQuant measured MRI brain with percentile rank hippocampal volume, Montreal Cognitive Assessment (MoCA) total, AQ-Total score, and demographic variables were extracted from medical records. Spearman correlation was used to assess the relationship between hippocampal volume and AQ-Total. The AQ was used to assign diagnostic status. Thus, the relationship between the AQ and diagnostic status was excluded. RESULTS The sample include 88 female and 51 male participants. The mean age was 74.37±9.45, mean MOCA was 22.65±4.18, mean education was 14.80±3.35, and mean AQ score was 10.54±5.22. Hippocampal volume and the AQ correlation was r = -0.33 [95%CI -0.47 to -0.17], p < 0.0001. CONCLUSION In a mixed-clinical sample of patients presenting to an outpatient memory disorders center, higher endorseme-nts of functional impairments by caregivers were significantly associated with smaller hippocampal volumes. When used in conjunction with other available measures, these findings further support the role of the AQ in clinical decision-making and demonstrate an additional relationship between clinical measures and volumetric MRI.
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Affiliation(s)
- Marwan Sabbagh
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Justin Miller
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Stephen Jones
- Department of Neuroradiology, Cleveland Clinic, Cleveland, OH, USA
| | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Jiong Shi
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Boris DeCourt
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Dylan Wint
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
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32
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Clancy U, Gilmartin D, Jochems ACC, Knox L, Doubal FN, Wardlaw JM. Neuropsychiatric symptoms associated with cerebral small vessel disease: a systematic review and meta-analysis. Lancet Psychiatry 2021; 8:225-236. [PMID: 33539776 DOI: 10.1016/s2215-0366(20)30431-4] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/09/2020] [Accepted: 09/23/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Cerebral small vessel disease, a common cause of vascular dementia, is often considered clinically silent before dementia or stroke become apparent. However, some individuals have subtle symptoms associated with acute MRI lesions. We aimed to determine whether neuropsychiatric and cognitive symptoms vary according to small vessel disease burden. METHODS In this systematic review and meta-analysis, we searched MEDLINE, EMBASE, and PsycINFO for articles published in any language from database inception to Jan 24, 2020. We searched for studies assessing anxiety, apathy, delirium, emotional lability, fatigue, personality change, psychosis, dementia-related behavioural symptoms or cognitive symptoms (including subjective memory complaints), and radiological features of cerebral small vessel disease. We extracted reported odds ratios (OR), standardised mean differences (SMD), and correlations, stratified outcomes by disease severity or symptom presence or absence, and pooled data using random-effects meta-analyses, reporting adjusted findings when possible. We assessed the bias on included studies using the Risk of Bias for Non-randomized Studies tool. This study is registered with PROSPERO, CRD42018096673. FINDINGS Of 7119 papers identified, 81 studies including 79 cohorts in total were eligible for inclusion (n=21 730 participants, mean age 69·2 years). Of these 81 studies, 45 (8120 participants) reported effect estimates. We found associations between worse white matter hyperintensity (WMH) severity and apathy (OR 1·41, 95% CI 1·05-1·89) and the adjusted SMD in apathy score between WMH severities was 0·38 (95% CI 0·15-0·61). Worse WMH severity was also associated with delirium (adjusted OR 2·9, 95% CI 1·12-7·55) and fatigue (unadjusted OR 1·63, 95% CI 1·20-2·22). WMHs were not consistently associated with subjective memory complaints (OR 1·34, 95% CI 0·61-2·94) and unadjusted SMD for WMH severity between these groups was 0·08 (95% CI -0·31 to 0·47). Anxiety, dementia-related behaviours, emotional lability, and psychosis were too varied or sparse for meta-analysis; these factors were reviewed narratively. Overall heterogeneity varied from 0% to 79%. Only five studies had a low risk of bias across all domains. INTERPRETATION Apathy, fatigue, and delirium associated independently with worse WMH, whereas subjective cognitive complaints did not. The association of anxiety, dementia-related behaviours, emotional lability, and psychosis with cerebral small vessel disease require further investigation. These symptoms should be assessed longitudinally to improve early clinical detection of small vessel disease and enable prevention trials to happen early in the disease course, long before cognition declines. FUNDING Chief Scientist Office of the Scottish Government, UK Dementia Research Institute, Fondation Leducq, Stroke Association Garfield-Weston Foundation, Alzheimer's Society, and National Health Service Research Scotland.
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Affiliation(s)
- Una Clancy
- Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Daniel Gilmartin
- Department of Geriatric Medicine, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Angela C C Jochems
- Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Lucy Knox
- Department of Medicine, Borders General Hospital, NHS Borders, Melrose, UK
| | - Fergus N Doubal
- Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
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33
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Valdés Hernández MDC, Grimsley-Moore T, Chappell FM, Thrippleton MJ, Armitage PA, Sakka E, Makin S, Wardlaw JM. Post-stroke Cognition at 1 and 3 Years Is Influenced by the Location of White Matter Hyperintensities in Patients With Lacunar Stroke. Front Neurol 2021; 12:634460. [PMID: 33732208 PMCID: PMC7956970 DOI: 10.3389/fneur.2021.634460] [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: 11/27/2020] [Accepted: 02/05/2021] [Indexed: 12/22/2022] Open
Abstract
Lacunar strokes are a common type of ischemic stroke. They are known to have long-term cognitive deficits, but the influencing factors are still largely unknown. We investigated if the location of the index lacunar stroke or regional WMH and their change at 1 year could predict the cognitive performance at 1 and 3 years post-stroke in lacunar stroke patients. We used lacunar lesion location and WMH-segmented data from 118 patients, mean age 64.9 who had a brain MRI scan soon after presenting with symptoms, of which 88 had a repeated scan 12 months later. Premorbid intelligence (National Adult Reading Test) and current intelligence [Addenbrooke's Cognitive Exam-Revised (ACE-R)] were measured at 1, 12, and 36 months after the stroke. ANCOVA analyses adjusting for baseline cognition/premorbid intelligence, vascular risk factors, age, sex and total baseline WMH volume found that the recent small subcortical infarcts (RSSI) in the internal/external capsule/lentiform nucleus and centrum semiovale did not predict cognitive scores at 12 and 36 months. However, RSSI location moderated voxel-based associations of WMH change from baseline to 1 year with cognitive scores at 1 and 3 years. WMH increase in the external capsule, intersection between the anterior limb of the internal and external capsules, and optical radiation, was associated with worsening of ACE-R scores 1 and 3 years post-stroke after accounting for the location of the index infarct, age and baseline cognition.
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Affiliation(s)
- Maria Del C Valdés Hernández
- Centre for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, Edinburgh, United Kingdom
| | - Tara Grimsley-Moore
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Francesca M Chappell
- Centre for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, Edinburgh, United Kingdom
| | - Michael J Thrippleton
- Centre for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, Edinburgh, United Kingdom
| | - Paul A Armitage
- Academic Unit of Radiology, University of Sheffield, Sheffield, United Kingdom
| | - Eleni Sakka
- Centre for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, Edinburgh, United Kingdom
| | - Stephen Makin
- Centre for Rural Health, University of Aberdeen, Aberdeen, United Kingdom
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, Edinburgh, United Kingdom
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34
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Andreassen S, Lindland EMS, Solheim AM, Beyer MK, Ljøstad U, Mygland Å, Lorentzen ÅR, Reiso H, Harbo HF, Løhaugen GCC, Eikeland R. Cognitive function, fatigue and Fazekas score in patients with acute neuroborreliosis. Ticks Tick Borne Dis 2021; 12:101678. [PMID: 33529985 DOI: 10.1016/j.ttbdis.2021.101678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/14/2022]
Abstract
Long-term cognitive problems and fatigue after adequately treated neuroborreliosis has caused uncertainty and debate among patients and health care workers for years. Despite several studies, the prevalence, cause and severity of such complaints are still not clarified. More knowledge about cognitive function, fatigue and MRI findings in the acute phase of neuroborreliosis could possibly contribute to clarification. In the current study, we therefore aimed to address this. Patients with well-characterized acute neuroborreliosis (n = 72) and a matched control group (n = 68) were screened with eight subtests from three different neuropsychological test batteries assessing attention, working memory and processing speed, and with Fatigue Severity Scale. Fazekas score was used to grade white matter hyperintensities on MRI. We found no differences in mean scores on the neuropsychological tests between the groups. The patient group reported significantly higher level of fatigue (Fatigue Severity Scale: 4.8 vs. 2.9, p < .001). There was no significant difference in Fazekas score between the groups. Neuroborreliosis does not seem to affect cognitive functions in the acute state of the disease, while fatigue is common.
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Affiliation(s)
- Silje Andreassen
- Department of Pediatrics, Sørlandet Hospital Arendal, Postbox 416, 4604, Kristiansand, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Elisabeth Margrete Stokke Lindland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Radiology, Sørlandet Hospital, Arendal, Norway; Division of Radiology and Nuclear Medicine Oslo University Hospital, Oslo, Norway
| | - Anne Marit Solheim
- Department of Neurology, Sørlandet Hospital, Kristiansand, Norway; Department of Clinical Medicine, University of Bergen, Norway
| | - Mona Kristiansen Beyer
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Radiology and Nuclear Medicine Oslo University Hospital, Oslo, Norway
| | - Unn Ljøstad
- Department of Neurology, Sørlandet Hospital, Kristiansand, Norway; Department of Clinical Medicine, University of Bergen, Norway
| | - Åse Mygland
- Department of Neurology, Sørlandet Hospital, Kristiansand, Norway; Department of Clinical Medicine, University of Bergen, Norway; Department of Habilitation, Sørlandet Hospital, Norway
| | - Åslaug Rudjord Lorentzen
- Department of Neurology, Sørlandet Hospital, Kristiansand, Norway; The Norwegian National Advisory Unit on Tick-borne Diseases, Norway
| | - Harald Reiso
- The Norwegian National Advisory Unit on Tick-borne Diseases, Norway
| | - Hanne Flinstad Harbo
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Neurology, Oslo University Hospital, Norway
| | | | - Randi Eikeland
- Department of Pediatrics, Sørlandet Hospital Arendal, Postbox 416, 4604, Kristiansand, Norway; The Norwegian National Advisory Unit on Tick-borne Diseases, Norway
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Yang Y, Zha X, Zhang X, Ke J, Hu S, Wang X, Su Y, Hu C. Dynamics and Concordance Abnormalities Among Indices of Intrinsic Brain Activity in Individuals With Subjective Cognitive Decline: A Temporal Dynamics Resting-State Functional Magnetic Resonance Imaging Analysis. Front Aging Neurosci 2021; 12:584863. [PMID: 33568986 PMCID: PMC7868384 DOI: 10.3389/fnagi.2020.584863] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 12/03/2020] [Indexed: 11/13/2022] Open
Abstract
Individuals with subjective cognitive decline (SCD) are more likely to develop into Alzheimer disease (AD) in the future. Resting-state functional magnetic resonance imaging (rs-fMRI) studies have shown alterations of intrinsic brain activity (IBA) in SCD individuals. However, rs-fMRI studies to date have mainly focused on static characteristics of IBA, with few studies reporting dynamics- and concordance-related changes in IBA indices in SCD individuals. To investigate these aberrant changes, a temporal dynamic analysis of rs-fMRI data was conducted on 94 SCD individuals (71.07 ± 6.18 years, 60 female), 75 (74.36 ± 8.42 years, 35 female) mild cognitive impairment (MCI) patients, and 82 age-, gender-, and education-matched controls (NCs; 73.88 ± 7.40 years, 49 female) from the Alzheimer's Disease Neuroimaging Initiative database. The dynamics and concordance of the rs-fMRI indices were calculated. The results showed that SCD individuals had a lower amplitude of low-frequency fluctuations dynamics in bilateral hippocampus (HP)/parahippocampal gyrus (PHG)/fusiform gyrus (FG) and bilateral cerebellum, a lower fractional amplitude of low-frequency fluctuation dynamics in bilateral precuneus (PreCu) and paracentral lobule, and a lower regional homogeneity dynamics in bilateral cerebellum, vermis, and left FG compared with the other two groups, whereas those in MCI patients were higher (Gaussian random field-corrected, voxel-level P < 0.001, cluster-level P < 0.05). Furthermore, SCD individuals had higher concordance in bilateral HP/PHG/FG, temporal lobe, and left midcingulate cortex than NCs, but those in MCI were lower than those in NCs. No correlation between concordance values and neuropsychological scale scores was found. SCD individuals showed both dynamics and concordance-related alterations in IBA, which indicates a compensatory mechanism in SCD individuals. Temporal dynamics analysis offers a novel approach to capturing brain alterations in individuals with SCD.
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Affiliation(s)
- Yiwen Yang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Medical Imaging, Soochow University, Suzhou, China
| | - Xinyi Zha
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaodong Zhang
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - Jun Ke
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Medical Imaging, Soochow University, Suzhou, China
| | - Su Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Medical Imaging, Soochow University, Suzhou, China
| | - Ximing Wang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Medical Imaging, Soochow University, Suzhou, China
| | - Yunyan Su
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Medical Imaging, Soochow University, Suzhou, China
| | - Chunhong Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Medical Imaging, Soochow University, Suzhou, China
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Boutzoukas EM, O'Shea A, Albizu A, Evangelista ND, Hausman HK, Kraft JN, Van Etten EJ, Bharadwaj PK, Smith SG, Song H, Porges EC, Hishaw A, DeKosky ST, Wu SS, Marsiske M, Alexander GE, Cohen R, Woods AJ. Frontal White Matter Hyperintensities and Executive Functioning Performance in Older Adults. Front Aging Neurosci 2021; 13:672535. [PMID: 34262445 PMCID: PMC8273864 DOI: 10.3389/fnagi.2021.672535] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/31/2021] [Indexed: 11/27/2022] Open
Abstract
Frontal lobe structures decline faster than most other brain regions in older adults. Age-related change in the frontal lobe is associated with poorer executive function (e.g., working memory, switching/set-shifting, and inhibitory control). The effects and presence of frontal lobe white matter hyperintensities (WMH) on executive function in normal aging is relatively unknown. The current study assessed relationships between region-specific frontal WMH load and cognitive performance in healthy older adults using three executive function tasks from the NIH Toolbox (NIHTB) Cognition Battery. A cohort of 279 healthy older adults ages 65-88 completed NIHTB and 3T T1-weighted and FLAIR MRI. Lesion Segmentation Toolbox quantified WMH volume and generated lesion probability maps. Individual lesion maps were registered to the Desikan-Killiany atlas in FreeSurfer 6.0 to define regions of interest (ROI). Independent linear regressions assessed relationships between executive function performance and region-specific WMH in frontal lobe ROIs. All models included age, sex, education, estimated total intracranial volume, multi-site scanner differences, and cardiovascular disease risk using Framingham criteria as covariates. Poorer set-shifting performance was associated with greater WMH load in three frontal ROIs including bilateral superior frontal (left β = -0.18, FDR-p = 0.02; right β = -0.20, FDR-p = 0.01) and right medial orbitofrontal (β = -0.17, FDR-p = 0.02). Poorer inhibitory performance associated with higher WMH load in one frontal ROI, the right superior frontal (right β = -0.21, FDR-p = 0.01). There were no significant associations between working memory and WMH in frontal ROIs. Our study demonstrates that location and pattern of frontal WMH may be important to assess when examining age-related differences in cognitive functions involving switching/set-shifting and inhibition. On the other hand, working memory performance was not related to presence of frontal WMH in this sample. These data suggest that WMH may contribute selectively to age-related declines in executive function. Findings emerged beyond predictors known to be associated with WMH presence, including age and cardiovascular disease risk. The spread of WMH within the frontal lobes may play a key role in the neuropsychological profile of cognitive aging. Further research should explore whether early intervention on modifiable vascular factors or cognitive interventions targeted for executive abilities may help mitigate the effect of frontal WMH on executive function.
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Affiliation(s)
- Emanuel M. Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicole D. Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Hanna K. Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Jessica N. Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Emily J. Van Etten
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Pradyumna K. Bharadwaj
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Samantha G. Smith
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Hyun Song
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Eric C. Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Alex Hishaw
- Department Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
- Department of Neurology, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Steven T. DeKosky
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Samuel S. Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Gene E. Alexander
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Adam J. Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
- *Correspondence: Adam J. Woods
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Melazzini L, Vitali P, Olivieri E, Bolchini M, Zanardo M, Savoldi F, Di Leo G, Griffanti L, Baselli G, Sardanelli F, Codari M. White Matter Hyperintensities Quantification in Healthy Adults: A Systematic Review and Meta-Analysis. J Magn Reson Imaging 2020; 53:1732-1743. [PMID: 33345393 DOI: 10.1002/jmri.27479] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Although white matter hyperintensities (WMH) volumetric assessment is now customary in research studies, inconsistent WMH measures among homogenous populations may prevent the clinical usability of this biomarker. PURPOSE To determine whether a point estimate and reference standard for WMH volume in the healthy aging population could be determined. STUDY TYPE Systematic review and meta-analysis. POPULATION In all, 9716 adult subjects from 38 studies reporting WMH volume were retrieved following a systematic search on EMBASE. FIELD STRENGTH/SEQUENCE 1.0T, 1.5T, or 3.0T/fluid-attenuated inversion recovery (FLAIR) and/or proton density/T2 -weighted fast spin echo sequences or gradient echo T1 -weighted sequences. ASSESSMENT After a literature search, sample size, demographics, magnetic field strength, MRI sequences, level of automation in WMH assessment, study population, and WMH volume were extracted. STATISTICAL TESTS The pooled WMH volume with 95% confidence interval (CI) was calculated using the random-effect model. The I2 statistic was calculated as a measure of heterogeneity across studies. Meta-regression analysis of WMH volume on age was performed. RESULTS Of the 38 studies analyzed, 17 reported WMH volume as the mean and standard deviation (SD) and were included in the meta-analysis. Mean and SD of age was 66.11 ± 10.92 years (percentage of men 50.45% ± 21.48%). Heterogeneity was very high (I2 = 99%). The pooled WMH volume was 4.70 cm3 (95% CI: 3.88-5.53 cm3 ). At meta-regression analysis, WMH volume was positively associated with subjects' age (β = 0.358 cm3 per year, P < 0.05, R2 = 0.27). DATA CONCLUSION The lack of standardization in the definition of WMH together with the high technical variability in assessment may explain a large component of the observed heterogeneity. Currently, volumes of WMH in healthy subjects are not comparable between studies and an estimate and reference interval could not be determined. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Luca Melazzini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Paolo Vitali
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Emanuele Olivieri
- Medicine and Surgery Medical School, Università degli Studi di Milano, Milano, Italy
| | - Marco Bolchini
- Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy
| | - Moreno Zanardo
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Filippo Savoldi
- Postgraduate School in Radiology, Università degli Studi di Milano, Milano, Italy
| | - Giovanni Di Leo
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Ludovica Griffanti
- Department of Psychiatry, Wellcome Centre for Integrative Neuroimaging (WIN), University of Oxford, Oxford, UK
| | - Giuseppe Baselli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Marina Codari
- Department of Radiology, Stanford University School of Medicine, Stanford, California, USA
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Payoux P, Ranjeva JP. Contributions of PET and MRI imaging in the evaluation of CNS drugs in human neurodegenerative diseases. Therapie 2020; 76:121-126. [PMID: 33563477 DOI: 10.1016/j.therap.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/29/2020] [Indexed: 11/19/2022]
Abstract
This manuscript reviews the contributions of the neuroimaging methods including PET, conventional and advanced MRI methods to monitor the effect of new disease modifying drugs in neurodegenerative diseases. It now seems obvious that in many pathologies these two techniques are more and more complementary.
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Affiliation(s)
- Pierre Payoux
- Inserm, UPS, ToNIC, Nuclear Medicine Department, Toulouse NeuroImaging Center, University Hospital of Toulouse France, Université de Toulouse, 31000 Toulouse, France.
| | - Jean-Philippe Ranjeva
- CNRS, CRMBM, Aix-Marseille University, 13385 Marseille, France; CEMEREM, AP-HM, University Hospital Timone, 13385 Marseille, France
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Xue C, Sun H, Hu G, Qi W, Yue Y, Rao J, Yang W, Xiao C, Chen J. Disrupted Patterns of Rich-Club and Diverse-Club Organizations in Subjective Cognitive Decline and Amnestic Mild Cognitive Impairment. Front Neurosci 2020; 14:575652. [PMID: 33177982 PMCID: PMC7593791 DOI: 10.3389/fnins.2020.575652] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/25/2020] [Indexed: 01/06/2023] Open
Abstract
Background Subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI) were considered to be a continuum of Alzheimer’s disease (AD) spectrum. The abnormal topological architecture and rich-club organization in the brain functional network can reveal the pathology of the AD spectrum. However, few studies have explored the disrupted patterns of diverse club organizations and the combination of rich- and diverse-club organizations in SCD and aMCI. Methods We collected resting-state functional magnetic resonance imaging data of 19 SCDs, 29 aMCIs, and 28 healthy controls (HCs) from the Alzheimer’s Disease Neuroimaging Initiative. Graph theory analysis was used to analyze the network metrics and rich- and diverse-club organizations simultaneously. Results Compared with HC, the aMCI group showed altered small-world and network efficiency, whereas the SCD group remained relatively stable. The aMCI group showed reduced rich-club connectivity compared with the HC. In addition, the aMCI group showed significantly increased feeder connectivity and decreased local connectivity of the diverse club compared with the SCD group. The overlapping nodes of the rich club and diverse club showed a significant difference in nodal efficiency and shortest path length (Lp) between groups. Notably, the Lp values of overlapping nodes in the SCD and aMCI groups were significantly associated with episodic memory. Conclusion The present study demonstrates that the network properties of SCD and aMCI have varying degrees of damage. The combination of the rich club and the diverse club can provide a novel insight into the pathological mechanism of the AD spectrum. The altered patterns in overlapping nodes might be potential biomarkers in the diagnosis of the AD spectrum.
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Affiliation(s)
- Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Haiting Sun
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University (Air Force Medical University), Xi'an, China
| | - Guanjie Hu
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yingying Yue
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jiang Rao
- Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenjie Yang
- Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chaoyong Xiao
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China.,Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China
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Schlosser M, Demnitz-King H, Whitfield T, Wirth M, Marchant NL. Repetitive negative thinking is associated with subjective cognitive decline in older adults: a cross-sectional study. BMC Psychiatry 2020; 20:500. [PMID: 33036587 PMCID: PMC7547434 DOI: 10.1186/s12888-020-02884-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/19/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In the absence of a cure or effective treatment for dementia, attention has shifted towards identifying risk factors for prevention. Subjective Cognitive Decline (SCD) describes self-perceived worsening of cognition despite unimpaired performance on neuropsychological tests. SCD has been associated with an increased dementia risk and steeper memory decline. Repetitive negative thinking (RNT) is a transdiagnostic process that manifests across several mental health disorders associated with increased vulnerability to dementia. RNT has thus been proposed as a candidate marker of risk for dementia and, relatedly, could contribute to the manifestation of SCD. We aimed to investigate the relationship between SCD and RNT alongside other proposed psychological risk/protective factors for dementia and cognitive decline. METHODS In a cross-sectional online survey, 491 older adults (mean = 64.9 years, SD = 4.2; 63.1% female) completed measures of RNT, personality traits, purpose in life, worry, rumination, and meditation practice. SCD was assessed continuously via self-perceived cognitive function (Neuro-QoL) and categorically via endorsement (yes/no) of memory complaints. Regression models, using a stepwise backwards elimination, were built to assess associations between SCD, demographics, and all risk/protective factors. RESULTS A total of 24.2% of participants reported memory complaints. In the final prediction models, RNT was the only psychological variable associated with lower self-perceived cognitive function and with a higher likelihood of memory complaints. CONCLUSIONS This study empirically corroborates the theoretical relationship between SCD and RNT. Longitudinal studies are needed to establish whether RNT is a prodromal symptom or an independent risk factor, and whether RNT can be a promising construct for future research on SCD and dementia risk.
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Affiliation(s)
- Marco Schlosser
- Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor, Wing A, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. .,Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
| | - Harriet Demnitz-King
- grid.83440.3b0000000121901201Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor, Wing A, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Tim Whitfield
- grid.83440.3b0000000121901201Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor, Wing A, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Miranka Wirth
- German Center for Neurodegenerative Diseases (DZNE) Dresden, Dresden, Germany
| | - Natalie L. Marchant
- grid.83440.3b0000000121901201Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor, Wing A, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
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Wang X, Huang W, Su L, Xing Y, Jessen F, Sun Y, Shu N, Han Y. Neuroimaging advances regarding subjective cognitive decline in preclinical Alzheimer's disease. Mol Neurodegener 2020; 15:55. [PMID: 32962744 PMCID: PMC7507636 DOI: 10.1186/s13024-020-00395-3] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/07/2020] [Indexed: 12/15/2022] Open
Abstract
Subjective cognitive decline (SCD) is regarded as the first clinical manifestation in the Alzheimer’s disease (AD) continuum. Investigating populations with SCD is important for understanding the early pathological mechanisms of AD and identifying SCD-related biomarkers, which are critical for the early detection of AD. With the advent of advanced neuroimaging techniques, such as positron emission tomography (PET) and magnetic resonance imaging (MRI), accumulating evidence has revealed structural and functional brain alterations related to the symptoms of SCD. In this review, we summarize the main imaging features and key findings regarding SCD related to AD, from local and regional data to connectivity-based imaging measures, with the aim of delineating a multimodal imaging signature of SCD due to AD. Additionally, the interaction of SCD with other risk factors for dementia due to AD, such as age and the Apolipoprotein E (ApoE) ɛ4 status, has also been described. Finally, the possible explanations for the inconsistent and heterogeneous neuroimaging findings observed in individuals with SCD are discussed, along with future directions. Overall, the literature reveals a preferential vulnerability of AD signature regions in SCD in the context of AD, supporting the notion that individuals with SCD share a similar pattern of brain alterations with patients with mild cognitive impairment (MCI) and dementia due to AD. We conclude that these neuroimaging techniques, particularly multimodal neuroimaging techniques, have great potential for identifying the underlying pathological alterations associated with SCD. More longitudinal studies with larger sample sizes combined with more advanced imaging modeling approaches such as artificial intelligence are still warranted to establish their clinical utility.
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Affiliation(s)
- Xiaoqi Wang
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
| | - Weijie Huang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China.,Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
| | - Li Su
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Sino-Britain Centre for Cognition and Ageing Research, Southwest University, Chongqing, China
| | - Yue Xing
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, 50937, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Yu Sun
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China. .,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.
| | - Ni Shu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China. .,Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China. .,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China.
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China. .,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China. .,National Clinical Research Center for Geriatric Disorders, Beijing, China.
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Scarapicchia V, Garcia-Barrera M, MacDonald S, Gawryluk JR. Resting State BOLD Variability Is Linked to White Matter Vascular Burden in Healthy Aging but Not in Older Adults With Subjective Cognitive Decline. Front Hum Neurosci 2019; 13:429. [PMID: 31920589 PMCID: PMC6936515 DOI: 10.3389/fnhum.2019.00429] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/18/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Alzheimer's disease (AD) is the leading cause of dementia. A lack of curative treatments and a rapidly aging global population have amplified the need for early biomarkers of the disease process. Recent advances suggest that subjective cognitive decline (SCD) may be one of the earliest symptomatic markers of the AD cascade. Previous studies have identified changes in variability in the blood-oxygen-level-dependent (BOLD) signal in patients with AD, with a possible association between BOLD variability and cerebrovascular factors in the aging brain. The objective of the current study was to determine whether changes in BOLD variability can be identified in individuals with SCD, and whether this signal may be associated with markers of cerebrovascular integrity in SCD and older adults without memory complaints. Method: Data were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database from 19 participants with SCD and 19 similarly-aged controls. For each participant, a map of BOLD signal variability (SDBOLD) was computed as the standard deviation of the BOLD time-series at each voxel. Group comparisons were performed to examine differences in resting-state SDBOLD in SCD vs. healthy controls. Relationships were then examined between participant SDBOLD maps and neuroimaging markers of white matter vascular infarcts in each group separately. Results: Between-group comparisons showed no significant differences in whole-brain SDBOLD in individuals with SCD and controls. In the healthy aging group, higher white matter hyperintensity (WMH) burden was associated with greater SDBOLD in right temporal regions (p < 0.05), and lower scores on a measure of global executive functioning. These associations were not identified in individuals with SCD. Conclusion: The current study underscores previous evidence for a relationship between SDBOLD and white matter vascular infarcts in the healthy aging brain. The findings also provide evidence for a dissociable relationship between healthy aging and SCD, such that in healthy controls, increased WMH is associated with declines in executive function that is not observed in older adults who present with memory complaints. Further multimodal work is needed to better understand the contributions of vascular pathology to the BOLD signal, and its potential relationship with pathological aging.
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Affiliation(s)
- Vanessa Scarapicchia
- Department Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Mauricio Garcia-Barrera
- Department Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Stuart MacDonald
- Department Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Jodie R. Gawryluk
- Department Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
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Lowe AJ, Paquola C, Vos de Wael R, Girn M, Lariviere S, Tavakol S, Caldairou B, Royer J, Schrader DV, Bernasconi A, Bernasconi N, Spreng RN, Bernhardt BC. Targeting age-related differences in brain and cognition with multimodal imaging and connectome topography profiling. Hum Brain Mapp 2019; 40:5213-5230. [PMID: 31444896 PMCID: PMC6864903 DOI: 10.1002/hbm.24767] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/29/2019] [Accepted: 08/05/2019] [Indexed: 02/06/2023] Open
Abstract
Aging is characterized by accumulation of structural and metabolic changes in the brain. Recent studies suggest transmodal brain networks are especially sensitive to aging, which, we hypothesize, may be due to their apical position in the cortical hierarchy. Studying an open‐access healthy cohort (n = 102, age range = 30–89 years) with MRI and Aβ PET data, we estimated age‐related cortical thinning, hippocampal atrophy and Aβ deposition. In addition to carrying out surface‐based morphological and metabolic mapping experiments, we stratified effects along neocortical and hippocampal resting‐state functional connectome gradients derived from independent datasets. The cortical gradient depicts an axis of functional differentiation from sensory‐motor regions to transmodal regions, whereas the hippocampal gradient recapitulates its long‐axis. While age‐related thinning and increased Aβ deposition occurred across the entire cortical topography, increased Aβ deposition was especially pronounced toward higher‐order transmodal regions. Age‐related atrophy was greater toward the posterior end of the hippocampal long‐axis. No significant effect of age on Aβ deposition in the hippocampus was observed. Imaging markers correlated with behavioral measures of fluid intelligence and episodic memory in a topography‐specific manner, confirmed using both univariate as well as multivariate analyses. Our results strengthen existing evidence of structural and metabolic change in the aging brain and support the use of connectivity gradients as a compact framework to analyze and conceptualize brain‐based biomarkers of aging.
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Affiliation(s)
- Alexander J Lowe
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Casey Paquola
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Reinder Vos de Wael
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Manesh Girn
- Laboratory of Brain and Cognition, Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Sara Lariviere
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Shahin Tavakol
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Lab, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Dewi V Schrader
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Lab, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Lab, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - R Nathan Spreng
- Laboratory of Brain and Cognition, Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.,Department of Psychiatry and Psychology, McGill University, Montreal, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
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Papadaki E, Kavroulakis E, Kalaitzakis G, Karageorgou D, Makrakis D, Maris TG, Simos PG. Age‐related deep white matter changes in myelin and water content: A T
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relaxometry study. J Magn Reson Imaging 2019; 50:1393-1404. [DOI: 10.1002/jmri.26707] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/16/2019] [Accepted: 02/19/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
- Efrosini Papadaki
- Department of RadiologySchool of Medicine, University of Crete Heraklion, Crete Greece
- Institute of Computer ScienceFoundation of Research and Technology Heraklion Greece
| | | | - Georgios Kalaitzakis
- Department of Medical PhysicsSchool of Medicine, University of Crete Heraklion, Crete Greece
| | - Dimitra Karageorgou
- Department of RadiologySchool of Medicine, University of Crete Heraklion, Crete Greece
| | - Dimitrios Makrakis
- Department of RadiologySchool of Medicine, University of Crete Heraklion, Crete Greece
| | - Thomas G. Maris
- Institute of Computer ScienceFoundation of Research and Technology Heraklion Greece
- Department of Medical PhysicsSchool of Medicine, University of Crete Heraklion, Crete Greece
| | - Panagiotis G. Simos
- Institute of Computer ScienceFoundation of Research and Technology Heraklion Greece
- Department of PsychiatrySchool of Medicine, University of Crete Heraklion, Crete Greece
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