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Pei YF, Li XD, Liu QY, Zhang CW, Wang YH, Chen MR, Chen HS. A nomogram for predicting cerebral white matter lesions in elderly men. Front Neurol 2024; 15:1343654. [PMID: 38751887 PMCID: PMC11094237 DOI: 10.3389/fneur.2024.1343654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
Objective This study aimed to develop a nomogram tool to predict cerebral white matter lesions (WMLs) in elderly men. Methods Based on a retrospective cohort from January 2017 to December 2019, a multivariate logistic analysis was performed to construct a nomogram for predicting WMLs. The nomogram was further validated using a follow-up cohort between January 2020 and December 2022. The calibration curve, receiver operating characteristics (ROC) curves, and the decision curves analysis (DCA) were used to evaluate discrimination and calibration of this nomogram. Result A total of 436 male patients were enrolled in this study, and all 436 patients were used as the training cohort and 163 follow-up patients as the validation cohort. A multivariate logistic analysis showed that age, cystatin C, uric acid, total cholesterol, platelet, and the use of antiplatelet drugs were independently associated with WMLs. Based on these variables, a nomogram was developed. The nomogram displayed excellent predictive power with the area under the ROC curve of 0.951 [95% confidence interval (CI), 0.929-0.972] in the training cohort and 0.915 (95% CI, 0.864-0.966) in the validation cohort. The calibration of the nomogram was also good, as indicated by the Hosmer-Lemeshow test with p-value of 0.594 in the training cohort and 0.178 in the validation cohort. The DCA showed that the nomogram holds good clinical application value. Conclusion We have developed and validated a novel nomogram tool for identifying elderly men at high risk of WMLs, which exhibits excellent predictive power, discrimination, and calibration.
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Affiliation(s)
| | | | | | | | | | | | - Hui-Sheng Chen
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China
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Van Etten EJ, Bharadwaj PK, Grilli MD, Raichlen DA, Hishaw GA, Huentelman MJ, Trouard TP, Alexander GE. Impact of age and apolipoprotein E ε4 status on regional white matter hyperintensity volume and cognition in healthy aging. J Int Neuropsychol Soc 2024:1-11. [PMID: 38515367 DOI: 10.1017/s1355617724000122] [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] [Indexed: 03/23/2024]
Abstract
OBJECTIVE White matter hyperintensity (WMH) volume is a neuroimaging marker of lesion load related to small vessel disease that has been associated with cognitive aging and Alzheimer's disease (AD) risk. METHOD The present study sought to examine whether regional WMH volume mediates the relationship between APOE ε4 status, a strong genetic risk factor for AD, and cognition and if this association is moderated by age group differences within a sample of 187 healthy older adults (APOE ε4 status [carrier/non-carrier] = 56/131). RESULTS After we controlled for sex, education, and vascular risk factors, ANCOVA analyses revealed significant age group by APOE ε4 status interactions for right parietal and left temporal WMH volumes. Within the young-old group (50-69 years), ε4 carriers had greater right parietal and left temporal WMH volumes than non-carriers. However, in the old-old group (70-89 years), right parietal and left temporal WMH volumes were comparable across APOE ε4 groups. Further, within ε4 non-carriers, old-old adults had greater right parietal and left temporal WMH volumes than young-old adults, but there were no significant differences across age groups in ε4 carriers. Follow-up moderated mediation analyses revealed that, in the young-old, but not the old-old group, there were significant indirect effects of ε4 status on memory and executive functions through left temporal WMH volume. CONCLUSIONS These findings suggest that, among healthy young-old adults, increased left temporal WMH volume, in the context of the ε4 allele, may represent an early marker of cognitive aging with the potential to lead to greater risk for AD.
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Affiliation(s)
- Emily J Van Etten
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Matthew D Grilli
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Neurology, University of Arizona, Tucson, AZ, USA
| | - David A Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA
| | - Georg A Hishaw
- Department of Neurology, University of Arizona, Tucson, AZ, USA
| | - Matthew J Huentelman
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Theodore P Trouard
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Gene E Alexander
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
- Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
- Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
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Van Etten EJ, Bharadwaj PK, Grilli MD, Raichlen DA, Hishaw GA, Huentelman MJ, Trouard TP, Alexander GE. Regional covariance of white matter hyperintensity volume patterns associated with hippocampal volume in healthy aging. Front Aging Neurosci 2024; 16:1349449. [PMID: 38524117 PMCID: PMC10957632 DOI: 10.3389/fnagi.2024.1349449] [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: 12/04/2023] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Hippocampal volume is particularly sensitive to the accumulation of total brain white matter hyperintensity volume (WMH) in aging, but how the regional distribution of WMH volume differentially impacts the hippocampus has been less studied. In a cohort of 194 healthy older adults ages 50-89, we used a multivariate statistical method, the Scaled Subprofile Model (SSM), to (1) identify patterns of regional WMH differences related to left and right hippocampal volumes, (2) examine associations between the multimodal neuroimaging covariance patterns and demographic characteristics, and (3) investigate the relation of the patterns to subjective and objective memory in healthy aging. We established network covariance patterns of regional WMH volume differences associated with greater left and right hippocampal volumes, which were characterized by reductions in left temporal and right parietal WMH volumes and relative increases in bilateral occipital WMH volumes. Additionally, we observed lower expression of these hippocampal-related regional WMH patterns were significantly associated with increasing age and greater subjective memory complaints, but not objective memory performance in this healthy older adult cohort. Our findings indicate that, in cognitively healthy older adults, left and right hippocampal volume reductions were associated with differences in the regional distribution of WMH volumes, which were exacerbated by advancing age and related to greater subjective memory complaints. Multivariate network analyses, like SSM, may help elucidate important early effects of regional WMH volume on brain and cognitive aging in healthy older adults.
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Affiliation(s)
- Emily J. Van Etten
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Pradyumna K. Bharadwaj
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Matthew D. Grilli
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - David A. Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, CA, United States
- Department of Anthropology, University of Southern California, Los Angeles, CA, United States
| | - Georg A. Hishaw
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - Matthew J. Huentelman
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
| | - Theodore P. Trouard
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States
| | - Gene E. Alexander
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
- Arizona Alzheimer’s Consortium, Phoenix, AZ, United States
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
- Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, United States
- Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, United States
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Sah RP, Vidya CS, Pereira P, Jayaram S, Yadav AK, Sujatha P. Elevated Homocysteine Level and Brain Atrophy Changes as Markers to Screen the Alzheimer Disease: Case Series. Ann Geriatr Med Res 2024; 28:116-120. [PMID: 38105011 PMCID: PMC10982442 DOI: 10.4235/agmr.23.0135] [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: 08/19/2023] [Revised: 11/09/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023] Open
Abstract
Alzheimer disease (AD) is the most common cause of dementia worldwide. Its clinical manifestations include a progressive loss of memory and other cognitive domains, as well as brain atrophy. An elevated homocysteine level (>15 µmol/L), known as hyperhomocysteinemia, is also an attributing risk factor for AD, vascular pathologies, and brain atrophy. Neuroimaging studies including T2-weighted magnetic resonance imaging scans revealed white matter hyperintensities in the periventricular and deep white matter, enlarged ventricles, widened sulci, and decreased white matter mass, which are features of aging, as well as cerebrovascular changes. This case series investigated changes in biochemical marker levels including serum homocysteine, folate, and vitamin B12, and the degree of atrophic variations in cortical-subcortical white matter in AD. The present study hypothesized that serum homocysteine levels might be used as a surrogate marker to screen for AD at an earlier stage.
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Affiliation(s)
- Ram Prakash Sah
- Department of Anatomy, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
| | - C. S. Vidya
- Department of Anatomy, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
| | - Pratibha Pereira
- Department of Geriatric Medicine, JSS Hospital, JSS Academy of Higher Education and Research, Mysore, India
| | - Shubha Jayaram
- Department of Biochemistry, Mysore Medical College and Research Institute, Mysore, India
| | - Anshu Kumar Yadav
- Department of Biochemistry and Medical Genetics, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
| | - P. Sujatha
- Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
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Graciani AL, Gutierre MU, Coppi AA, Arida RM, Gutierre RC. MYELIN, AGING, AND PHYSICAL EXERCISE. Neurobiol Aging 2023; 127:70-81. [PMID: 37116408 DOI: 10.1016/j.neurobiolaging.2023.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023]
Abstract
Myelin sheath is a structure in neurons fabricated by oligodendrocytes and Schwann cells responsible for increasing the efficiency of neural synapsis, impulse transmission, and providing metabolic support to the axon. They present morpho-functional changes during health aging as deformities of the sheath and its fragmentation, causing an increased load on microglial phagocytosis, with Alzheimer's disease aggravating. Physical exercise has been studied as a possible protective agent for the nervous system, offering benefits to neuroplasticity. In this regard, studies in animal models for Alzheimer's and depression reported the efficiency of physical exercise in protecting against myelin degeneration. A reduction of myelin damage during aging has also been observed in healthy humans. Physical activity promotes oligodendrocyte proliferation and myelin preservation during old age, although some controversies remain. In this review, we will address how effective physical exercise can be as a protective agent of the myelin sheath against the effects of aging in physiological and pathological conditions.
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Song H, Bharadwaj PK, Raichlen DA, Habeck CG, Huentelman MJ, Hishaw GA, Trouard TP, Alexander GE. Association of homocysteine-related subcortical brain atrophy with white matter lesion volume and cognition in healthy aging. Neurobiol Aging 2023; 121:129-138. [PMID: 36436304 PMCID: PMC10002471 DOI: 10.1016/j.neurobiolaging.2022.10.011] [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: 10/19/2021] [Revised: 10/16/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
Homocysteine (Hcy) is a vascular risk factor associated with cognitive impairment and cerebrovascular disease but has also been implicated in Alzheimer's disease (AD). Using multivariate Scaled Subprofile Model (SSM) analysis, we sought to identify a network pattern in structural neuroimaging reflecting the regionally distributed association of plasma Hcy with subcortical gray matter (SGM) volumes and its relation to other health risk factors and cognition in 160 healthy older adults, ages 50-89. We identified an SSM Hcy-SGM pattern that was characterized by bilateral hippocampal and nucleus accumbens volume reductions with relative volume increases in bilateral caudate, pallidum, and putamen. Greater Hcy-SGM pattern expression was associated with greater white matter hyperintensity (WMH) volume, older age, and male sex, but not with other vascular and AD-related risk factors. Mediation analyses revealed that age predicted WMH volume, which predicted Hcy-SGM pattern expression, which, in turn, predicted cognitive processing speed performance. These findings suggest that the multivariate SSM Hcy-SGM pattern may be indicative of cognitive aging, reflecting a potential link between vascular health and cognitive dysfunction in healthy older adults.
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Affiliation(s)
- Hyun Song
- Department of Psychology, University of Arizona, Tucson, AZ, USA; Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology, University of Arizona, Tucson, AZ, USA; Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - David A Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA
| | - Christian G Habeck
- Cognitive Neuroscience Division, Department of Neurology and Taub Institute, Columbia University, New York, NY, USA
| | - Matthew J Huentelman
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA; Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Georg A Hishaw
- Department of Neurology, University of Arizona, Tucson, AZ, USA
| | - Theodore P Trouard
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA; Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Gene E Alexander
- Department of Psychology, University of Arizona, Tucson, AZ, USA; Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA; Department of Psychiatry, University of Arizona, Tucson, AZ, USA; Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, University of Arizona, Tucson, AZ, USA.
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Guo W, Shi J. White matter hyperintensities volume and cognition: A meta-analysis. Front Aging Neurosci 2022; 14:949763. [PMID: 36118701 PMCID: PMC9476945 DOI: 10.3389/fnagi.2022.949763] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Cerebral small vessel disease (CSVD) is prevalent in the elderly and leads to an increased risk of cognitive impairment and dementia. The volume of white matter hyperintensities (WMHs) increases with age, which affects cognition. Objective To explore the relationship between WMH volume and cognitive decline in patients with CSVD. Methods We performed a systematic search of PubMed, Embase, and the Web of Science databases from their respective creation dates to the 5 May 2022 to identify all the clinical studies on either mild cognitive impairment (MCI) or dementia in regards to WMH volume in CSVD. Results White matter hyperintensities was associated with the risk of both the MCI and dementia, with a 35% increased risk [relative risk (RR) = 1.35; (95% CI: 1.01–1.81)] of progression from cognitively unimpaired (CU) to MCI (six studies, n = 2,278) and a 49% increased risk [RR = 1.49; (95% CI: 1.21–1.84)] of progression to dementia (six studies, n = 6,330). In a subgroup analysis, a follow-up period of over 5 years increased the risk of MCI by 40% [RR = 1.40; (95% CI: 1.07–1.82)] and dementia by 48% [RR = 1.48; (95% CI: 1.15–1.92)]. Conclusion White matter hyperintensities was found to be substantially correlated with the risk of cognitive impairment. Furthermore, cognitive decline was found to be a chronic process, such that WMH predicted the rate of cognitive decline in CSVD beyond 5 years. The cognitive decline observed in patients with WMH may, therefore, be minimized by early intervention.
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Makino K, Lee S, Bae S, Harada K, Chiba I, Katayama O, Tomida K, Morikawa M, Yamashiro Y, Sudo M, Takayanagi N, Shimada H. Light intensity physical activity is beneficially associated with brain volume in older adults with high cardiovascular risk. Front Cardiovasc Med 2022; 9:882562. [PMID: 35911542 PMCID: PMC9326229 DOI: 10.3389/fcvm.2022.882562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundOlder people with high cardiovascular risk, including those without cardiovascular diseases, are an at-risk population for dementia. Regular physical activity is generally recommended to maintain brain health; however, the optimal intensity of physical activity for maintaining brain volume in older adults with cardiovascular risk remains unclear. We examined the associations between intensity-specific physical activity and brain volume stratified by absolute cardiovascular risk level in older adults without cardiovascular diseases.Methods and resultsThis cross-sectional study involved 725 community-dwelling older Japanese adults without cardiovascular diseases. We estimated absolute cardiovascular risk using the World Health Organization risk estimation charts, which include variables such as age, sex, diabetes mellitus, smoking, systolic blood pressure, and total cholesterol, and stratified cardiovascular risk level into three risk categories: low (≤ 9%), moderate (10–14%), and high (≥15%). We measured daily physical activity using a triaxial accelerometer, and calculated the average time spent in moderate-to-vigorous intensity physical activity (MVPA) and light intensity physical activity (LPA). We performed brain T1-weighted magnetic resonance imaging and calculated the volume of the cortical gray matter, subcortical gray matter, and cerebral white matter, using the FreeSurfer software. In the overall sample, multivariable linear regression analysis showed that greater MVPA was significantly associated with greater volume of the cortical gray matter and cerebral white matter, and greater LPA was significantly associated with greater volume of the cerebral white matter. Additionally, in the analysis of the sample stratified by absolute cardiovascular risk level, cerebral white matter volume was significantly associated with both MVPA and LPA in the high cardiovascular risk group.ConclusionsThe association between physical activity and brain volume differed according to cardiovascular risk level in community-dwelling older adults. In a population at high cardiovascular risk, maintaining or increasing LPA might be a practical and achievable strategy for healthy brain aging.
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Affiliation(s)
- Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
- *Correspondence: Keitaro Makino
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ippei Chiba
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | | | - Motoki Sudo
- Tokyo Research Laboratories, Kao Corporation, Tokyo, Japan
| | | | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Cao Z, Mai Y, Fang W, Lei M, Luo Y, Zhao L, Liao W, Yu Q, Xu J, Ruan Y, Xiao S, Mok VCT, Shi L, Liu J. The Correlation Between White Matter Hyperintensity Burden and Regional Brain Volumetry in Patients With Alzheimer's Disease. Front Hum Neurosci 2022; 16:760360. [PMID: 35774484 PMCID: PMC9237397 DOI: 10.3389/fnhum.2022.760360] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background White matter hyperintensities (WMHs) and regional brain lobe atrophy coexist in the brain of patients with Alzheimer's disease (AD), but the association between them in patients with AD still lacks comprehensive investigation and solid imaging data support. Objective We explored whether WMHs can promote the pathological process of AD by aggravating atrophy in specific brain regions and tried to explain the regional specificity of these relationships. Methods A sample of 240 adults including 180 normal controls (NCs) and 80 cases with AD were drawn from the ADNI database. T1-weighted magnetic resonance imaging (MRI) and T2-weighted fluid-attenuated MRI of the participants were downloaded and were analyzed using AccuBrain® to generate the quantitative ratio of WMHs (WMHr, WMH volumes corrected by intracranial volume) and regional brain atrophy. We also divided WMHr into periventricular WMHr (PVWMHr) and deep WMHr (DWMHr) for the purpose of this study. The Cholinergic Pathways Hyperintensities Scale (CHIPS) scores were conducted by two evaluators. Independent t-test, Mann–Whitney U test, or χ2 test were used to compare the demographic characteristics, and Spearman correlation coefficient values were used to determine the association between WMHs and different regions of brain atrophy. Results Positive association between WMHr and quantitative medial temporal lobe atrophy (QMTA) (rs = 0.281, p = 0.011), temporal lobe atrophy (rs = 0.285, p = 0.011), and insular atrophy (rs = 0.406, p < 0.001) was found in the AD group before Bonferroni correction. PVWMHr contributed to these correlations. By separately analyzing the relationship between PVWMHr and brain atrophy, we found that there were still positive correlations after correction in QMTA (rs = 0.325, p = 0.003), temporal lobe atrophy (rs = 0.298, p = 0.007), and insular atrophy (rs = 0.429, p < 0.001) in AD group. Conclusion WMH severity tends to be associated with regional brain atrophy in patients with AD, especially with medial temporal lobe, temporal lobe, and insular lobe atrophy. PVWMHs were devoted to these correlations.
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Affiliation(s)
- Zhiyu Cao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yingren Mai
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wenli Fang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ming Lei
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yishan Luo
- BrainNow Research Institute, Shenzhen, China
| | - Lei Zhao
- BrainNow Research Institute, Shenzhen, China
| | - Wang Liao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qun Yu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiaxin Xu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuting Ruan
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Songhua Xiao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Vincent C. T. Mok
- BrainNow Research Institute, Shenzhen, China
- Division of Neurology, Department of Medicine and Therapeutics, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Lin Shi
- BrainNow Research Institute, Shenzhen, China
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Lin Shi
| | - Jun Liu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Jun Liu
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Five years of exercise intervention at different intensities and development of white matter hyperintensities in community dwelling older adults, a Generation 100 sub-study. Aging (Albany NY) 2022; 14:596-622. [PMID: 35042832 PMCID: PMC8833118 DOI: 10.18632/aging.203843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Abstract
We investigated if a five-year supervised exercise intervention with moderate-intensity continuous training (MICT) or high-intensity interval training (HIIT) versus control; physical activity according to national guidelines, attenuated the growth of white matter hyperintensities (WMH). We hypothesized that supervised exercise, in particular HIIT, reduced WMH growth. Older adults from the general population participating in the RCT Generation 100 Study were scanned at 3T MRI at baseline (age 70–77), and after 1-, 3- and 5-years. At each follow-up, cardiorespiratory fitness was measured with ergospirometry, and physical activity plus clinical data collected. Manually delineated total WMH, periventricular (PWMH), deep (DWMH), and automated total white matter hypointensity volumes were obtained. No group by time interactions were present in linear mixed model analyses with the different WMH measurements as outcomes. In the combined exercise (MICT&HIIT) group, a significant group by time interaction was uncovered for PWMH volume, with a larger increase in the MICT&HIIT group. Cardiorespiratory fitness at the follow-ups or change in cardiorespiratory fitness over time were not associated with any WMH measure. Contrary to our hypothesis, taking part in MICT or HIIT over a five-year period did not attenuate WMH growth compared to being in a control group following national physical activity guidelines.
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Umegaki H, Sakurai T, Arai H. Active Life for Brain Health: A Narrative Review of the Mechanism Underlying the Protective Effects of Physical Activity on the Brain. Front Aging Neurosci 2021; 13:761674. [PMID: 34916925 PMCID: PMC8670095 DOI: 10.3389/fnagi.2021.761674] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/08/2021] [Indexed: 12/16/2022] Open
Abstract
A growing body of evidence clearly indicates the beneficial effects of physical activity (PA) on cognition. The importance of PA is now being reevaluated due to the increase in sedentary behavior in older adults during the COVID-19 pandemic. Although many studies in humans have revealed that PA helps to preserve brain health, the underlying mechanisms have not yet been fully elucidated. In this review, which mainly focuses on studies in humans, we comprehensively summarize the mechanisms underlying the beneficial effects of PA or exercise on brain health, particularly cognition. The most intensively studied mechanisms of the beneficial effects of PA involve an increase in brain-derived neurotrophic factor (BDNF) and preservation of brain volume, especially that of the hippocampus. Nonetheless, the mutual associations between these two factors remain unclear. For example, although BDNF presumably affects brain volume by inhibiting neuronal death and/or increasing neurogenesis, human data on this issue are scarce. It also remains to be determined whether PA modulates amyloid and tau metabolism. However, recent advances in blood-based biomarkers are expected to help elucidate the beneficial effects of PA on the brain. Clinical data suggest that PA functionally modulates cognition independently of neurodegeneration, and the mechanisms involved include modulation of functional connectivity, neuronal compensation, neuronal resource allocation, and neuronal efficiency. However, these mechanisms are as yet not fully understood. A clear understanding of the mechanisms involved could help motivate inactive persons to change their behavior. More accumulation of evidence in this field is awaited.
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Affiliation(s)
- Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
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Hotz I, Deschwanden PF, Mérillat S, Liem F, Kollias S, Jäncke L. Associations of subclinical cerebral small vessel disease and processing speed in non-demented subjects: A 7-year study. Neuroimage Clin 2021; 32:102884. [PMID: 34911190 PMCID: PMC8633374 DOI: 10.1016/j.nicl.2021.102884] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/26/2021] [Accepted: 11/16/2021] [Indexed: 12/22/2022]
Abstract
Markers of cerebral small vessel disease (CSVD) have previously been associated with age-related cognitive decline. Using longitudinal data of cognitively healthy, older adults (N = 216, mean age at baseline = 70.9 years), we investigated baseline status and change in white matter hyperintensities (WMH) (total, periventricular, deep), normal appearing white matter (NAWM), brain parenchyma volume (BPV) and processing speed over seven years as well as the impact of different covariates by applying latent growth curve (LGC) models. Generally, we revealed a complex pattern of associations between the different CSVD markers. More specifically, we observed that changes of deep WMH (dWMH), as compared to periventricular WMH (pWMH), were more strongly related to the changes of other CSVD markers and also to baseline processing speed performance. Further, the number of lacunes rather than their volume reflected the severity of CSVD. With respect to the studied covariates, we revealed that higher education had a protective effect on subsequent total WMH, pWMH, lacunar number, NAWM volume, and processing speed performance. The indication of antihypertensive drugs was associated with lower lacunar number and volume at baseline and the indication of antihypercholesterolemic drugs came along with higher processing speed performance at baseline. In summary, our results confirm previous findings, and extend them by providing information on true within-person changes, relationships between the different CSVD markers and brain-behavior associations. The moderate to strong associations between changes of the different CSVD markers indicate a common pathological relationship and, thus, support multidimensional treatment strategies.
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Affiliation(s)
- Isabel Hotz
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland; University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
| | - Pascal Frédéric Deschwanden
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Susan Mérillat
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Franziskus Liem
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Spyridon Kollias
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland; University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
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Fang M, Strand K, Zhang J, Totillo M, Signorile JF, Galvin JE, Wang J, Jiang H. Retinal vessel density correlates with cognitive function in older adults. Exp Gerontol 2021; 152:111433. [PMID: 34091000 DOI: 10.1016/j.exger.2021.111433] [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] [Received: 02/05/2021] [Revised: 05/09/2021] [Accepted: 05/28/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE We examined the associations between retinal microvascular density, cognition, and physical fitness in healthy older adults with no reported cognitive decline. METHODS Twenty cognitively normal older adults (age: 70.3 ± 4.6 years) were recruited. Both eyes of each subject were imaged using optical coherence tomography angiography. The vessel densities of the retinal vascular network (RVN), superficial vascular plexus (SVP), and deep vascular plexus (DVP) were measured. Cognitive function was assessed using the Mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA), while physical performance was evaluated using the total work during the YMCA cycle ergometer test (TW-YMCA). Spearman correlations (rs) were computed between measures of retinal microvascular density, cognitive function, and physical performance. RESULTS The MoCA was significantly correlated to vessel density of SVD (rs = 0.53, P = 0.02) but not RVN (rs = 0.39, P = 0.09) and DVP (rs = 0.02, P = 0.93). MoCA was not correlated with TW-YMCA (rs = 0.05, P = 0.83). Retinal microvascular densities were not related to TW-YMCA (rs = -0.05-0.18, P > 0.05). Additionally, MMSE was not related the retinal vessel densities (rs = -0.10-0.21, P > 0.05) and TW-YMCA (rs = -0.19, P = 0.41). CONCLUSIONS This is the first study to reveal the association between retinal vessel density and cognition as measured with MoCA in healthy older adults with no reported cognitive decline.
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Affiliation(s)
- Min Fang
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Jinan University, Shenzhen, China; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Keri Strand
- Department of Kinesiology and Sports Sciences, University of Miami, FL, USA
| | - Juan Zhang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Matthew Totillo
- Department of Kinesiology and Sports Sciences, University of Miami, FL, USA
| | - Joseph F Signorile
- Department of Kinesiology and Sports Sciences, University of Miami, FL, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jianhua Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hong Jiang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
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Van Etten EJ, Bharadwaj PK, Hishaw GA, Huentelman MJ, Trouard TP, Grilli MD, Alexander GE. Influence of regional white matter hyperintensity volume and apolipoprotein E ε4 status on hippocampal volume in healthy older adults. Hippocampus 2021; 31:469-480. [PMID: 33586848 PMCID: PMC9119498 DOI: 10.1002/hipo.23308] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 12/22/2020] [Accepted: 01/23/2021] [Indexed: 11/08/2022]
Abstract
While total white matter hyperintensity (WMH) volume on magnetic resonance imaging (MRI) has been associated with hippocampal atrophy, less is known about how the regional distribution of WMH volume may differentially affect the hippocampus in healthy aging. Additionally, apolipoprotein E (APOE) ε4 carriers may be at an increased risk for greater WMH volumes and hippocampal atrophy in aging. The present study sought to investigate whether regional WMH volume mediates the relationship between age and hippocampal volume and if this association is moderated by APOE ε4 status in a group of 190 cognitively healthy adults (APOE ε4 status [carrier/non-carrier] = 59/131), ages 50-89. Analyses revealed that temporal lobe WMH volume significantly mediated the relationship between age and average bilateral hippocampal volume, and this effect was moderated by APOE ε4 status (-0.020 (SE = 0.009), 95% CI, [-0.039, -0.003]). APOE ε4 carriers, but not non-carriers, showed negative indirect effects of age on hippocampal volume through temporal lobe WMH volume (APOE ε4 carriers: -0.016 (SE = 0.007), 95% CI, [-0.030, -0.003]; APOE ε4 non-carriers: .005 (SE = 0.006), 95% CI, [-0.006, 0.017]). These findings remained significant after additionally adjusting for sex, years of education, hypertension status and duration, cholesterol status, diabetes status, Body Mass Index, history of smoking, and the Wechsler Adult Intelligence Scale-IV Full Scale IQ. There were no significant moderated mediation effects for frontal, parietal, and occipital lobe WMH volumes, with or without covariates. Our findings indicate that in cognitively healthy older adults, elevated WMH volume regionally localized to the temporal lobes in APOE ε4 carriers is associated with reduced hippocampal volume, suggesting greater vulnerability to brain aging and the risk for Alzheimer's disease.
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Affiliation(s)
- Emily J Van Etten
- Department of Psychology, University of Arizona, Tucson, Arizona, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology, University of Arizona, Tucson, Arizona, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA
| | - Georg A Hishaw
- Department of Neurology, University of Arizona, Tucson, Arizona, USA
| | - Matthew J Huentelman
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA.,Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, Arizona, USA.,Arizona Alzheimer's Consortium, Phoenix, Arizona, USA
| | - Theodore P Trouard
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA.,Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA.,Arizona Alzheimer's Consortium, Phoenix, Arizona, USA
| | - Matthew D Grilli
- Department of Psychology, University of Arizona, Tucson, Arizona, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA.,Department of Neurology, University of Arizona, Tucson, Arizona, USA
| | - Gene E Alexander
- Department of Psychology, University of Arizona, Tucson, Arizona, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA.,Department of Psychiatry, University of Arizona, Tucson, Arizona, USA.,Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, Arizona, USA.,Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, Arizona, USA.,Arizona Alzheimer's Consortium, Phoenix, Arizona, USA
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