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Song BX, Azhar L, Koo GKY, Marzolini S, Gallagher D, Swardfager W, Chen C, Ba J, Herrmann N, Lanctôt KL. The effect of exercise on blood concentrations of angiogenesis markers in older adults: A systematic review and meta-analysis. Neurobiol Aging 2024; 135:15-25. [PMID: 38147807 DOI: 10.1016/j.neurobiolaging.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/24/2023] [Accepted: 12/15/2023] [Indexed: 12/28/2023]
Abstract
Impaired angiogenesis is associated with cognitive decline in older adults. While exercise has been broadly associated with increased angiogenesis, the relevant mechanisms in older adults are not clear. Here, we present a systematic review and meta-analysis on the relationship between exercise and specific blood angiogenesis markers in older adults to better understand the relevant mechanisms. MEDLINE, Embase, and Cochrane CENTRAL were searched for original reports of angiogenesis markers' concentrations in blood before and after exercise in older adults (≥50 years). Heterogeneity was investigated using sub-group analyses and meta-regressions. Of the 44 articles included in the review, 38 were included in the meta-analyses for five markers: vascular endothelial growth factor (VEGF), e-selectin (CD62E), endostatin, fibroblast growth factor 2, and matrix metallopeptidase-9. VEGF levels were higher (SMD[95%CI]= 0.18[0.03, 0.34], and CD62E levels were lower (SMD[95%CI]= -0.72[-1.42, -0.03], p = 0.04) after exercise. No other markers were altered. Although more studies are needed, changes in angiogenesis markers may help explain the beneficial effects of exercise on angiogenesis in older adults.
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Affiliation(s)
- Bing Xin Song
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Laiba Azhar
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Grace Ka Yi Koo
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Susan Marzolini
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Walter Swardfager
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Clara Chen
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Joycelyn Ba
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada; Toronto Dementia Research Alliance, Toronto, ON, Canada
| | - Krista L Lanctôt
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada; Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada; Toronto Dementia Research Alliance, Toronto, ON, Canada.
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Gaur A, Rivet L, Mah E, Bawa KK, Gallagher D, Herrmann N, Lanctôt KL. Novel fluid biomarkers for mild cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev 2023; 91:102046. [PMID: 37647995 DOI: 10.1016/j.arr.2023.102046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 08/01/2023] [Accepted: 08/27/2023] [Indexed: 09/01/2023]
Abstract
Mild cognitive impairment (MCI) is a well-established prodromal stage of dementia (e.g., Alzheimer's disease) that is often accompanied by early signs of neurodegeneration. To facilitate a better characterization of the underlying pathophysiology, we assessed the available literature to evaluate potential fluid biomarkers in MCI. Peer-reviewed articles that measured cerebrospinal fluid (CSF) and/or peripheral biomarkers of neuronal injury (total-tau [T-tau], neurofilament light chain [NfL], heart-type fatty acid binding protein [HFABP], neuron-specific enolase, ubiquitin C-terminal hydrolase L1) and/or astroglial pathology (glial fibrillary acidic protein [GFAP], S100 calcium-binding protein B) in MCI and healthy controls were assessed. Group differences were summarized by standardized mean differences (SMDs) and 95% confidence intervals calculated using a random-effects model. Heterogeneity was quantified using I2. A total of 107 studies were included in the meta-analysis and 10 studies were qualitatively reviewed. In CSF, concentrations of NfL (SMD = 0.69 [0.56, 0.83]), GFAP (SMD = 0.41 [0.07, 0.75]), and HFABP (SMD = 0.57 [0.26, 0.89]) were elevated in MCI. In blood, increased concentrations of T-tau (SMD = 0.19 [0.09, 0.29]), NfL (SMD = 0.41 [0.32, 0.49]), and GFAP (SMD = 0.39 [0.23, 0.55]) were found in MCI. Heterogeneity that was identified in all comparisons was explored using meta-regression and subgroup analysis. Elevated NfL and GFAP can be detected in both CSF and peripheral blood. Monitoring these biomarkers in clinical settings may provide important insight into underlying neurodegenerative processes in MCI.
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Affiliation(s)
- Amish Gaur
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Luc Rivet
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Ethan Mah
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Kritleen K Bawa
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Damien Gallagher
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada
| | - Nathan Herrmann
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada.
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Feng V, Lanctot K, Herrmann N, Kiss A, Fischer CE, Flint AJ, Mah L, Mulsant BH, Pollock BG, Rajji TK, Tumati S, Verhoeff NP, Graff-Guerrero A, Gallagher D. Lipopolysaccharide, Immune Biomarkers and Cerebral Amyloid-Beta Deposition in Older Adults With Mild Cognitive Impairment & Major Depressive Disorder. Am J Geriatr Psychiatry 2023; 31:786-795. [PMID: 37211499 DOI: 10.1016/j.jagp.2023.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Inflammatory activation and increased immune response to lipopolysaccharide occur in both depression and cognitive decline and may link these two conditions. We investigated whether lipopolysaccharide (LPS), LPS binding protein (LBP) and peripheral biomarkers of immune response were associated with increased cerebral deposition of amyloid-beta (Abeta) in older adults with mild cognitive impairment (MCI) and remitted major depressive disorder (rMDD). DESIGN Cross-sectional analysis. SETTING Five academic health centers in Toronto. PARTICIPANTS Older adults with MCI with/without rMDD. MEASUREMENTS We investigated the associations among serum LPS, LBP, biomarkers of inflammatory activation - Interleukin-6 (IL-6), C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP-1), and cerebral Abeta deposition quantified by positron emission tomography. RESULTS Among 133 study participants (82 with MCI and 51 with MCI+rMDD) there was no association between LPS (beta - 0.17, p = 0.8) or LBP (beta - 0.11, p = 0.12) and global deposition of Abeta following adjustment for age, gender, and APOE genotype in multivariable regression analyses. LBP was positively correlated with CRP (r = 0.5, p <0.001) and IL-6 (r = 0.2, p = 0.02) but no inflammatory biomarker was associated with Abeta deposition; rMDD was not associated with deposition of Abeta (beta -0.09, p = 0.22). CONCLUSION In this cross-sectional analysis, we did not find an association among LPS/LBP, immune biomarkers or rMDD and global deposition of Abeta. Future analyses should assess the longitudinal relationships between peripheral and central biomarkers of immune activation, depression and cerebral Abeta deposition.
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Affiliation(s)
- Vivian Feng
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada
| | - Krista Lanctot
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada; Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada; Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Alex Kiss
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada; Department of Health Policy, Management and Evaluation (AK), University of Toronto, Toronto, Canada
| | - Corinne E Fischer
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science (CEF), St. Michael's Hospital, Toronto, Canada
| | - Alastair J Flint
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Centre for Mental Health (AJF), University Health Network and University of Toronto, Toronto, Canada
| | - Linda Mah
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Psychiatry (LM, NPV), Baycrest Health Sciences Centre, Toronto, Canada; Rotman Research Institute (LM), Baycrest Health Sciences Centre, Toronto, Canada
| | - Benoit H Mulsant
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Adult Neurodevelopment and Geriatric Psychiatry Division (BHM, BGP, TKR, AG-G), Centre for Addiction and Mental Health, Toronto, Canada; Toronto Dementia Research Alliance (BMH, BGP, TKR, NPV), University of Toronto, Toronto, Canada
| | - Bruce G Pollock
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Adult Neurodevelopment and Geriatric Psychiatry Division (BHM, BGP, TKR, AG-G), Centre for Addiction and Mental Health, Toronto, Canada; Toronto Dementia Research Alliance (BMH, BGP, TKR, NPV), University of Toronto, Toronto, Canada
| | - Tarek K Rajji
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Adult Neurodevelopment and Geriatric Psychiatry Division (BHM, BGP, TKR, AG-G), Centre for Addiction and Mental Health, Toronto, Canada; Toronto Dementia Research Alliance (BMH, BGP, TKR, NPV), University of Toronto, Toronto, Canada
| | - Shankar Tumati
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada
| | - Nicolaas Paul Verhoeff
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Psychiatry (LM, NPV), Baycrest Health Sciences Centre, Toronto, Canada; Toronto Dementia Research Alliance (BMH, BGP, TKR, NPV), University of Toronto, Toronto, Canada
| | - Ariel Graff-Guerrero
- Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Adult Neurodevelopment and Geriatric Psychiatry Division (BHM, BGP, TKR, AG-G), Centre for Addiction and Mental Health, Toronto, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group (VF, KL, NH, AK, ST, DG), Sunnybrook Research Institute, Toronto, Canada; Department of Psychiatry (KL, NH, CEF, AJF, LM, BHM, BGP, TKR, NPV, AG-G, DG), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
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Acuff J, Waterman K, Wu J, Murphy C, Gallagher D, Ponder M. Inactivation kinetics of a surrogate yield conservative predictions of foodborne pathogen reductions from low water activity foods of varying size and composition during low-temperature steam processing. Heliyon 2023; 9:e17893. [PMID: 37449168 PMCID: PMC10336792 DOI: 10.1016/j.heliyon.2023.e17893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/12/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023] Open
Abstract
There is a growing interest in using models to predict foodborne pathogen inactivation as a way to validate or verify preventive controls. Unlike liquid foods, solid, low water activity foods (LWAF) are heterogenous in composition and structure and do not transfer heat uniformly. Using models constructed from one food to predict pathogen inactivation on another LWAF is complex and may not always be possible, even if the foods have similar composition. Using models constructed from inactivation kinetics of three foodborne pathogens and a surrogate from vacuum-steam-pasteurized (72 and 82 °C) whole macadamia nuts and dried apricot halves, 3-log reductions were predicted for the same pathogens and foods of reduced size. Model fits (First-order, Weibull, and Gompertz) were significantly impacted by the food type regardless of particle size. Despite the foods being identical in composition with particle size as the only altered characteristic, best-fit models accurately predicted the 3-log reductions only 50% of the time, but the surrogate inactivation models provided conservative predictions for pathogen reductions, highlighting that a surrogate's model may be a suitable tool for predicting pathogen reduction on LWAFs.
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Affiliation(s)
- J.C. Acuff
- Virginia Tech, Food Science and Technology Department, 1230 Washington St., Blacksburg, VA 24061, USA
| | - K. Waterman
- Virginia Tech, Food Science and Technology Department, 1230 Washington St., Blacksburg, VA 24061, USA
| | - J. Wu
- Virginia Tech, Food Science and Technology Department, 1230 Washington St., Blacksburg, VA 24061, USA
| | - C.M. Murphy
- Virginia Tech, Food Science and Technology Department, 1230 Washington St., Blacksburg, VA 24061, USA
| | - D. Gallagher
- Virginia Tech, Civil and Environmental Engineering Department, 409 Durham Hall, Blacksburg, VA 24061, USA
| | - M.A. Ponder
- Virginia Tech, Food Science and Technology Department, 1230 Washington St., Blacksburg, VA 24061, USA
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Chen JJ, Herrmann N, Survilla K, Black S, Ramirez J, Andreazza A, Gallagher D, Graham S, Lanctot K. Changes in brain glutathione in patients with mild vascular cognitive impairment. The American Journal of Geriatric Psychiatry 2023. [DOI: 10.1016/j.jagp.2022.12.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Gaur A, Rivet L, Mah E, Bawa K, Gallagher D, Herrmann N, Lanctôt K. A meta-analysis of neurofilament light chain as a biomarker for mild cognitive impairment. The American Journal of Geriatric Psychiatry 2023. [DOI: 10.1016/j.jagp.2022.12.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Koo GK, Gaur A, Tumati S, Kusumo RW, Bawa KK, Herrmann N, Gallagher D, Lanctôt KL. Identifying factors influencing cognitive outcomes after anodal transcranial direct current stimulation in older adults with and without cognitive impairment: A systematic review. Neurosci Biobehav Rev 2023; 146:105047. [PMID: 36646259 DOI: 10.1016/j.neubiorev.2023.105047] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Anodal transcranial direct current stimulation (tDCS) can improve cognition in healthy older adults, those with Alzheimer's disease (AD) and mild cognitive impairment (MCI), albeit with considerable variability in response. This systematic review identifies interindividual factors that may influence tDCS outcomes in older individuals with or without cognitive impairment. Peer-reviewed articles were included if they assessed whether cognitive outcomes (memory or global cognition) after tDCS were associated with pre-intervention factors in healthy older adults or individuals with AD/MCI. We identified eight factors that may affect cognitive outcomes after tDCS. Improved tDCS outcomes were predicted by lower baseline cognitive function when tDCS was combined with a co-intervention (but not when used alone). Preserved brain structure and better baseline functional connectivity, genetic polymorphisms, and the use of concomitant medications may predict better tDCS outcomes, but further research is warranted. tDCS outcomes were not consistently associated with age, cognitive reserve, sex, and AD risk factors. Accounting for individual differences in baseline cognition, particularly for combined interventions, may thus maximize the therapeutic potential of tDCS.
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Affiliation(s)
- Grace Ky Koo
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Amish Gaur
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Shankar Tumati
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Raphael W Kusumo
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Kritleen K Bawa
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada.
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Rivet L, Tumati S, Datta D, Seitz DP, Gallagher D, Herrmann N, Lanctôt K. The Relationship Between Grey Matter Atrophy and Apathy Severity in Alzheimer's, Parkinson's, and Mixed Dementia: A COMPASS-ND study. The American Journal of Geriatric Psychiatry 2023. [DOI: 10.1016/j.jagp.2022.12.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Daly E, Collins G, Hall E, O'Dwyer J, Gallagher D, Kelly J. Telehealth Rehabilitation for the Management of Long Covid Symptoms. Ir Med J 2023; 115:677. [PMID: 36920416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Song BX, Azhar L, Koo GKY, Marzolini S, Gallagher D, Swardfager W, Chen C, Ba J, Herrmann N, Lanctôt K. The effect of exercise on blood concentrations of angiogenesis markers in older adults: a systematic review and meta-analysis. Res Sq 2023:rs.3.rs-2468576. [PMID: 36711740 PMCID: PMC9882692 DOI: 10.21203/rs.3.rs-2468576/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background Physical exercise has positive impacts on health and can improve angiogenesis, which is impaired during aging, but the underlying mechanisms of benefit are unclear. This meta-analysis and systematic review investigated the effects of exercise on several peripheral angiogenesis markers in older adults to better understand the relationship between exercise and angiogenesis. Methods MEDLINE, Embase, and Cochrane CENTRAL were searched for original, peer-reviewed reports of peripheral concentrations of angiogenesis markers before and after exercise interventions in older adults (> 50 years). The risk of bias was assessed with standardized criteria. Standardized mean differences (SMD) with 95% confidence intervals (CIs) were calculated from random-effects models. Publication bias was assessed with Egger's test, funnel plots, and trim-and-fill. A priori subgroup analyses and meta-regressions were performed to investigate heterogeneity where possible. Results Of the 44 articles included in the review, 38 were included in meta-analyses for five proteins. Vascular endothelial growth factor (VEGF) was found to be higher after exercise (SMD[95%CI] = 0.18[0.03, 0.34], p = 0.02), and e-selectin (CD62E) was found to be lower after exercise (SMD[95%CI]= -0.72[-1.42, -0.03], p = 0.04). Endostatin (SMD[95%CI] = 0.28[-0.56, 1.11], p = 0.5), fibroblast growth factor 2 (SMD[95%CI] = 0.03[-0.18, 0.23], p = 0.8), and matrix metallopeptidase-9 (SMD[95%CI] = -0.26[-0.97, 0.45], p = 0.5) levels did not change after exercise. Conclusions Of the five angiogenesis blood markers evaluated in this meta-analysis, only VEGF and CD62E changed with exercise. Although more studies are needed, changes in angiogenesis markers may explain the beneficial effects of exercise on angiogenesis and health in older adults.
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Bawa KK, Ba J, Kiss A, Wang R, Feng V, Swardfager W, Andreazza AC, Gallagher D, Marotta G, Herrmann N, Lanctôt KL. Lipid oxidation as a marker of apathy and executive dysfunction in patients at risk of vascular cognitive impairment. Alzheimers Dement 2022. [DOI: 10.1002/alz.063958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Kritleen Kaur Bawa
- Sunnybrook Research Institute Toronto ON Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
| | - Joycelyn Ba
- Neuropsychopharmacology Research Group Toronto ON Canada
| | - Alex Kiss
- Sunnybrook Research Institute Toronto ON Canada
- ICES Toronto ON Canada
- Department of Research Design and Biostatistics, Sunnybrook Research Institute, University of Toronto Toronto ON Canada
| | | | - Vivian Feng
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Walter Swardfager
- University of Toronto Toronto ON Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute Toronto ON Canada
- Department of Pharmacology & Toxicology University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | - Damien Gallagher
- Neuropsychopharmacology Research Group Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Krista L. Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
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Koo GKY, Herrmann N, Gallagher D, Rapoport MJ, Charles J, Papneja P, Rajji TK, Andreazza AC, Oh PI, Marzolini S, Kiss A, Swardfager W, Vieira D, Song BX, Rivet L, Lanctôt KL. Variability of response to exercise‐primed tDCS in those with mild cognitive impairment and Alzheimer’s disease (the EXPRESS study): a preliminary analysis. Alzheimers Dement 2022. [DOI: 10.1002/alz.063960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Grace KY Koo
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Nathan Herrmann
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Damien Gallagher
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Mark J. Rapoport
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Jocelyn Charles
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | - Tarek K. Rajji
- University of Toronto Toronto ON Canada
- Adult Neurodevelopment and Geriatric Psychiatry Division CAMH Toronto ON Canada
| | | | - Paul I. Oh
- KITE‐Toronto Rehabilitation Institute, University Health Network Toronto ON Canada
| | - Susan Marzolini
- KITE‐Toronto Rehabilitation Institute, University Health Network Toronto ON Canada
| | - Alex Kiss
- Sunnybrook Research Institute Toronto ON Canada
| | - Walter Swardfager
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | | | - Bing Xin Song
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Luc Rivet
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Krista L. Lanctôt
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
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Ruthirakuhan M, Ismail Z, Herrmann N, Gallagher D, Lanctot KL. Mild behavioral impairment is associated with progression to Alzheimer's disease: A clinicopathological study. Alzheimers Dement 2022; 18:2199-2208. [PMID: 35103400 PMCID: PMC9339594 DOI: 10.1002/alz.12519] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/24/2021] [Accepted: 09/28/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Mild behavioral impairment (MBI) is characterized by later-life emergence of neuropsychiatric symptoms. Investigating its relationship with progression to Alzheimer's disease (AD) would provide insight on its importance as a predictor of AD. METHODS Cognitively normal participants (N = 11,372) from the National Alzheimer's Coordinating Center were stratified by MBI status, using the Neuropsychiatric Inventory-Questionnaire. We investigated whether MBI and its domains were predictors of progression to clinically-diagnosed AD. MBI as a predictor of progression to neuropathology-confirmed AD was also investigated in those with neuropathological data. RESULTS Six percent (N = 671) of participants progressed to AD. MBI (N = 2765) was a significant predictor of progression to clinically-diagnosed (hazard ratio [HR] = 1.75) and neuropathology-confirmed AD (HR = 1.59). MBI domains were also associated with clinically-diagnosed AD, with psychosis having the greatest effect (HR = 6.49). DISCUSSION These findings support the biological underpinnings of MBI, emphasizing the importance of later life behavioral changes in dementia detection and prognostication.
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Affiliation(s)
- Myuri Ruthirakuhan
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada
| | - Zahinoor Ismail
- Department of Psychiatry, Hotchkiss Brain Institute and O’Brien Institute for Public Health University of Calgary, Calgary, Canada
| | - Nathan Herrmann
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Damien Gallagher
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Krista L. Lanctot
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
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14
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Kim D, Kiss A, Bronskill SE, Lanctôt KL, Herrmann N, Gallagher D. Association between depression, gender and Alzheimer's neuropathology in older adults without dementia. Int J Geriatr Psychiatry 2022; 37. [PMID: 36047339 DOI: 10.1002/gps.5809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Previous studies regarding the relationship between depression and Alzheimer's neuropathology in older adults without dementia have reported conflicting findings. This study examined whether depression is associated with Alzheimer's neuropathology and whether sex moderates these relationships. METHODS This is a cross-sectional study of older adults without dementia (normal cognition or mild cognitive impairment, age 50+; CDR ≤ 0.5) who had autopsy within 1 year of their last clinic visit in the National Alzheimer's Coordinating Center database (2005-2020). Logistic regression models were fitted to determine if a recent or remote history of depression was associated with amyloid spread beyond the neocortex measured by modified Thal phase score, density of amyloid plaques measured by CERAD score or tau neuropathology measured by modified Braak score. A moderator analysis was performed to determine if any of these associations were moderated by sex. RESULTS This study included 407 participants (96 Thal, 405 Braak, and 406 CERAD). Those who had recently active depression (within previous 2 years) but not remote depression only were more likely to have higher Thal phase score compared to those without a history of depression (OR = 3.74; 95% CI, 1.15-12.17; p = 0.028). Sex did not moderate this association. No significant associations between recent depression and Braak or CERAD scores were observed. CONCLUSION Our findings indicate that the association between late life depression and Alzheimer's neuropathology is associated with spread of amyloid pathology beyond the neocortex to include allocortical and subcortical regions critical for regulation of mood and motivated behavior.
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Affiliation(s)
- Doyoung Kim
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Susan E Bronskill
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Bawa KK, Ba J, Kiss A, Wang R, Feng V, Swardfager W, Andreazza A, Gallagher D, Marotta G, Herrmann N, Lanctôt KL. Lipid Peroxidation as a Marker of Apathy and Executive Dysfunction in Patients at Risk for Vascular Cognitive Impairment. J Alzheimers Dis 2022; 89:733-743. [DOI: 10.3233/jad-220274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The co-occurrence of apathy and executive dysfunction, a correlate of vascular cognitive impairment (VCI), is highly prevalent, yet facilitating factors are largely unknown. Objective: This study investigates the relationship between lipid peroxidation, apathy, and executive dysfunction in patients at risk for VCI. Methods: In participants with coronary artery disease, who are at a high risk of VCI, apathy (Apathy Evaluation Scale), and executive function (composite z-score based on age and education population norms from trails making test B, animal naming, and phonemic fluency tests) were assessed. Serum concentrations of an early (lipid hydroperoxide (LPH)) and late (8-isoprostane (8-ISO)) lipid peroxidation marker, were measured and the 8-ISO/LPH ratio was calculated. Results: Participants (n = 206, age±SD = 63.0±7.5, 80% men, total years of education = 15.9±3.4, AES score = 28.3±8.8, executive function = 0±1) demonstrated significantly different 8-ISO/LPH ratios between groups (F(3, 202) = 10.915, p < 0.001) with increasing levels in the following order: no apathy or executive dysfunction, only executive dysfunction (executive function composite score≤–1), only apathy (AES≥28), and both apathy and executive dysfunction. A model adjusting for demographics showed that lipid peroxidation was associated with both apathy (B(SE) = 4.63 (0.954), t = 4.852, p < 0.001) and executive function (B(SE) = –0.19 (0.079), t = –2.377, p = 0.018). However, when controlling for both demographics and vascular risk factors, lipid peroxidation was associated with only apathy (B(SE) = 3.11 (0.987), t = 3.149, p = 0.002). Conclusion: The results highlight a potentially important involvement of lipid peroxidation in the co-occurrence of apathy and executive dysfunction in those at risk for VCI.
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Affiliation(s)
- Kritleen K. Bawa
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Joycelyn Ba
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Alex Kiss
- ICES, Sunnybrook Research Institute, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - RuoDing Wang
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Vivian Feng
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Walter Swardfager
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Ana Andreazza
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Damien Gallagher
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Giovanni Marotta
- Division of Geriatric Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Krista L. Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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16
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Siddiqui F, Gallagher D, Shuster-Hyman H, Gauthier-Fisher A, Librach C. Mesenchymal Stem/Stromal Cells: FIRST TRIMESTER HUMAN UMBILICAL CORD PERIVASCULAR CELLS (HUCPVC) MODULATE THE KYNURENINE PATHWAY AND GLUTAMATE NEUROTRANSMISSION IN AN LPS-INDUCED MOUSE MODEL OF NEUROINFLAMMATION AND DEPRESSION. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00158-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Lopez L, Dviri M, Madjunkov M, Haham LM, Kuperman A, Mander P, Gallagher D, Gauthier-Fisher A, Librach C. Mesenchymal Stem/Stromal Cells: HUMAN UMBILICAL CORD PERIVASCULAR CELLS (HUCPVC) REDUCE OVARIAN FIBROSIS AND IMPROVE PREGNANCY RATE IN A MOUSE MODEL OF NATURAL OVARIAN AGING. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00183-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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18
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Chen JJ, Thiyagarajah M, Song J, Chen C, Herrmann N, Gallagher D, Rapoport MJ, Black SE, Ramirez J, Andreazza AC, Oh P, Marzolini S, Graham SJ, Lanctôt KL. Altered central and blood glutathione in Alzheimer's disease and mild cognitive impairment: a meta-analysis. Alzheimers Res Ther 2022; 14:23. [PMID: 35123548 PMCID: PMC8818133 DOI: 10.1186/s13195-022-00961-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 01/06/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Increasing evidence implicates oxidative stress (OS) in Alzheimer disease (AD) and mild cognitive impairment (MCI). Depletion of the brain antioxidant glutathione (GSH) may be important in OS-mediated neurodegeneration, though studies of post-mortem brain GSH changes in AD have been inconclusive. Recent in vivo measurements of the brain and blood GSH may shed light on GSH changes earlier in the disease. AIM To quantitatively review in vivo GSH in AD and MCI compared to healthy controls (HC) using meta-analyses. METHOD Studies with in vivo brain or blood GSH levels in MCI or AD with a HC group were identified using MEDLINE, PsychInfo, and Embase (1947-June 2020). Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcomes using random effects models. Outcome measures included brain GSH (Meshcher-Garwood Point Resolved Spectroscopy (MEGA-PRESS) versus non-MEGA-PRESS) and blood GSH (intracellular versus extracellular) in AD and MCI. The Q statistic and Egger's test were used to assess heterogeneity and risk of publication bias, respectively. RESULTS For brain GSH, 4 AD (AD=135, HC=223) and 4 MCI (MCI=213, HC=211) studies were included. For blood GSH, 26 AD (AD=1203, HC=1135) and 7 MCI (MCI=434, HC=408) studies were included. Brain GSH overall did not differ in AD or MCI compared to HC; however, the subgroup of studies using MEGA-PRESS reported lower brain GSH in AD (SMD [95%CI] -1.45 [-1.83, -1.06], p<0.001) and MCI (-1.15 [-1.71, -0.59], z=4.0, p<0.001). AD had lower intracellular and extracellular blood GSH overall (-0.87 [-1. 30, -0.44], z=3.96, p<0.001). In a subgroup analysis, intracellular GSH was lower in MCI (-0.66 [-1.11, -0.21], p=0.025). Heterogeneity was observed throughout (I2 >85%) and not fully accounted by subgroup analysis. Egger's test indicated risk of publication bias. CONCLUSION Blood intracellular GSH decrease is seen in MCI, while both intra- and extracellular decreases were seen in AD. Brain GSH is decreased in AD and MCI in subgroup analysis. Potential bias and heterogeneity suggest the need for measurement standardization and additional studies to explore sources of heterogeneity.
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Affiliation(s)
- Jinghan Jenny Chen
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Room FG52, Toronto, ON, M4N 3M5, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Mathura Thiyagarajah
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Room FG52, Toronto, ON, M4N 3M5, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Jianmeng Song
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Room FG52, Toronto, ON, M4N 3M5, Canada
| | - Clara Chen
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Room FG52, Toronto, ON, M4N 3M5, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Room FG52, Toronto, ON, M4N 3M5, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Damien Gallagher
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Mark J Rapoport
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Sandra E Black
- Evaluative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Joel Ramirez
- Evaluative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Ana C Andreazza
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Paul Oh
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Susan Marzolini
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Simon J Graham
- Physical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Room FG52, Toronto, ON, M4N 3M5, Canada. .,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada. .,Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. .,Evaluative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.
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19
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Dissanayake AS, Tan YB, Bowie CR, Butters MA, Flint AJ, Gallagher D, Golas AC, Herrmann N, Ismail Z, Kennedy JL, Kumar S, Lanctot KL, Mah L, Mulsant BH, Pollock BG, Rajji TK, Tau M, Maraj A, Churchill NW, Tsuang D, Schweizer TA, Munoz DG, Fischer CE. Sex Modifies the Associations of APOEɛ4 with Neuropsychiatric Symptom Burden in Both At-Risk and Clinical Cohorts of Alzheimer's Disease. J Alzheimers Dis 2022; 90:1571-1588. [PMID: 36314203 DOI: 10.3233/jad-220586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recent work suggests that APOEɛ4/4 females with Alzheimer's disease (AD) are more susceptible to developing neuropsychiatric symptoms (NPS). OBJECTIVE To examine the interaction of sex and APOEɛ4 status on NPS burden using two independent cohorts: 1) patients at risk for AD with mild cognitive impairment and/or major depressive disorder (n = 252) and 2) patients with probable AD (n = 7,261). METHODS Regression models examined the interactive effects of sex and APOEɛ4 on the number of NPS experienced and NPS Severity. APOEɛ3/4 and APOEɛ4/4 were pooled in the at-risk cohort due to the sample size. RESULTS In the at-risk cohort, there was a significant sex*APOEɛ4 interaction (p = 0.007) such that the association of APOEɛ4 with NPS was greater in females than in males (incident rate ratio (IRR) = 2.0). APOEɛ4/4 females had the most NPS (mean = 1.9) and the highest severity scores (mean = 3.5) of any subgroup. In the clinical cohort, APOEɛ4/4 females had significantly more NPS (IRR = 1.1, p = 0.001, mean = 3.1) and higher severity scores (b = 0.31, p = 0.015, mean = 3.7) than APOEɛ3/3 females (meanNPS = 2.9, meanSeverity = 3.3). No association was found in males. CONCLUSION Our study suggests that sex modifies the association of APOEɛ4 on NPS burden. APOEɛ4/4 females may be particularly susceptible to increased NPS burden among individuals with AD and among individuals at risk for AD. Further investigation into the mechanisms behind these associations are needed.
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Affiliation(s)
- Andrew S Dissanayake
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Yu Bin Tan
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Christopher R Bowie
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Queen's University, Kingston, ON, Canada
| | - Meryl A Butters
- University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Alastair J Flint
- Centre for Mental Health, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Damien Gallagher
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Angela C Golas
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Zahinoor Ismail
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - James L Kennedy
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Krista L Lanctot
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Linda Mah
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Health Science Centre, Toronto, ON, Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bruce G Pollock
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Michael Tau
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Anika Maraj
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Nathan W Churchill
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Debby Tsuang
- GRECC, VA Puget Sound and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Tom A Schweizer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
| | - David G Munoz
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Unity Health, St. Michaels Hospital, University of Toronto, Toronto, Ontario, Canada
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20
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Liu CS, Herrmann N, Song BX, Ba J, Gallagher D, Oh PI, Marzolini S, Rajji TK, Charles J, Papneja P, Rapoport MJ, Andreazza AC, Vieira D, Kiss A, Lanctôt KL. Exercise priming with transcranial direct current stimulation: a study protocol for a randomized, parallel-design, sham-controlled trial in mild cognitive impairment and Alzheimer's disease. BMC Geriatr 2021; 21:677. [PMID: 34863115 PMCID: PMC8645072 DOI: 10.1186/s12877-021-02636-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/16/2021] [Indexed: 12/14/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) is a non-invasive type of brain stimulation that uses electrical currents to modulate neuronal activity. A small number of studies have investigated the effects of tDCS on cognition in patients with Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD), and have demonstrated variable effects. Emerging evidence suggests that tDCS is most effective when applied to active brain circuits. Aerobic exercise is known to increase cortical excitability and improve brain network connectivity. Exercise may therefore be an effective, yet previously unexplored primer for tDCS to improve cognition in MCI and mild AD. Methods Participants with MCI or AD will be randomized to receive 10 sessions over 2 weeks of either exercise primed tDCS, exercise primed sham tDCS, or tDCS alone in a blinded, parallel-design trial. Those randomized to an exercise intervention will receive individualized 30-min aerobic exercise prescriptions to achieve a moderate-intensity dosage, equivalent to the ventilatory anaerobic threshold determined by cardiopulmonary assessment, to sufficiently increase cortical excitability. The tDCS protocol consists of 20 min sessions at 2 mA, 5 times per week for 2 weeks applied through 35 cm2 bitemporal electrodes. Our primary aim is to assess the efficacy of exercise primed tDCS for improving global cognition using the Montreal Cognitive Assessment (MoCA). Our secondary aims are to evaluate the efficacy of exercise primed tDCS for improving specific cognitive domains using various cognitive tests (n-back, Word Recall and Word Recognition Tasks from the Alzheimer’s Disease Assessment Scale-Cognitive subscale) and neuropsychiatric symptoms (Neuropsychiatric Inventory). We will also explore whether exercise primed tDCS is associated with an increase in markers of neurogenesis, oxidative stress and angiogenesis, and if changes in these markers are correlated with cognitive improvement. Discussion We describe a novel clinical trial to investigate the effects of exercise priming before tDCS in patients with MCI or mild AD. This proof-of-concept study may identify a previously unexplored, non-invasive, non-pharmacological combination intervention that improves cognitive symptoms in patients. Findings from this study may also identify potential mechanistic actions of tDCS in MCI and mild AD. Trial registration Clinicaltrials.gov, NCT03670615. Registered on September 13, 2018.
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Affiliation(s)
- Celina S Liu
- Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 3K1, Canada.,Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Bing Xin Song
- Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 3K1, Canada.,Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Joycelyn Ba
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Biology, Faculty of Science, The University of Western Ontario, London, ON, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Paul I Oh
- Cardiovascular Prevention and Rehabilitation Program, KITE - Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON, M5G 1R7, Canada
| | - Susan Marzolini
- Cardiovascular Prevention and Rehabilitation Program, KITE - Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON, M5G 1R7, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction & Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Jocelyn Charles
- Family & Community Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Purti Papneja
- Family & Community Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Mark J Rapoport
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Ana C Andreazza
- Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 3K1, Canada
| | - Danielle Vieira
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Alex Kiss
- Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Krista L Lanctôt
- Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 3K1, Canada. .,Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada. .,Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada. .,Cardiovascular Prevention and Rehabilitation Program, KITE - Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON, M5G 1R7, Canada.
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21
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Teselink J, Bawa KK, Koo GKY, Sankhe K, Liu CS, Rapoport M, Oh P, Marzolini S, Gallagher D, Swardfager W, Herrmann N, Lanctôt KL. Efficacy of non-invasive brain stimulation on global cognition and neuropsychiatric symptoms in Alzheimer's disease and mild cognitive impairment: A meta-analysis and systematic review. Ageing Res Rev 2021; 72:101499. [PMID: 34700007 DOI: 10.1016/j.arr.2021.101499] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/07/2021] [Accepted: 10/19/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Non-invasive brain stimulation (NIBS) techniques have shown some promise in improving cognitive and neuropsychiatric symptoms (NPS) in people with Alzheimer's disease (AD) and its prodromal stage, mild cognitive impairment (MCI). However, data from clinical trials involving NIBS have shown inconsistent results. This meta-analysis investigated the efficacy of NIBS, specifically repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS) compared to sham stimulation on global cognition and NPS in people with AD and MCI. METHOD Multi-session randomized sham-controlled clinical trials were identified through MEDLINE, PsycINFO, and Embase until June 2021. Standardized mean difference (SMD) and 95% confidence interval (CI) between the active and sham treatments were calculated using random-effects meta-analyses. Included studies reported outcome measures for global cognition and/or NPS. Heterogeneity, from different NIBS techniques, disease populations, or tests used to assess global cognition or NPS, was measured using chi-square and I2, and investigated using subgroup analyses. Possible effects of covariates were also investigated using meta-regressions. RESULT The pooled meta-analyses included 19 studies measuring global cognition (Nactive=288, Nsham=264), and 9 studies investigating NPS (Nactive=165, Nsham=140). NIBS significantly improved global cognition (SMD=1.14; 95% CI=0.49,1.78; p = 0.001; I2 = 90.2%) and NPS (SMD=0.82; 95% CI=0.13, 1.50; p = 0.019; I2 = 86.1%) relative to sham stimulation in patients with AD and MCI. Subgroup analyses found these effects were restricted to rTMS but not tDCS, and to patients with AD but not MCI. Meta-regression showed that age was significantly associated with global cognition response (Nstudies=16, p = 0.020, I2 = 89.51%, R2 = 28.96%), with larger effects sizes in younger populations. All significant meta-analyses had large effect sizes (SMD ≥0.8), suggesting clinical utility of NIBS in the short term. There remained substantial heterogeneity across all subgroup analyses and meta-regressions (all I2 > 50%). Egger's tests showed no evidence of publication biases. CONCLUSION rTMS improved global cognition and NPS in those with AD. Further studies in MCI and using tDCS will help to fully evaluate the specific NIBS techniques and populations most likely to benefit on global cognition and NPS measures. Additional research should investigate the long term clinical utility of NIBS in these populations.
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22
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Feng V, Tumati S, Wang R, Bawa KK, Gallagher D, Herrmann N, Andreazza AC, Swardfager W, Marzolini S, Oh PI, Lanctôt KL. Lipid peroxidation mediates the relationship between cardiopulmonary fitness and depressive symptoms in people with coronary artery disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.054646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Vivian Feng
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Shankar Tumati
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- University of Groningen, University Medical Center Groningen Groningen Netherlands
| | | | - Kritleen Kaur Bawa
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
| | - Damien Gallagher
- Sunnybrook Research Institute Toronto ON Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Nathan Herrmann
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | - Walter Swardfager
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
- Canadian Partnership for Stroke Recovery Toronto ON Canada
- LC Campbell Cognitive Neurology Research Unit, Sunnybrook Research Institute Toronto ON Canada
| | - Susan Marzolini
- KITE‐Toronto Rehabilitation Institute, University Health Network Toronto ON Canada
| | - Paul I. Oh
- KITE‐Toronto Rehabilitation Institute, University Health Network Toronto ON Canada
| | - Krista L. Lanctôt
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
- KITE UHN Toronto Rehabilitation Institute Toronto ON Canada
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23
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Koo GKY, Herrmann N, Gallagher D, Rapoport M, Charles J, Papneja P, Rajji TK, Andreazza AC, Oh PI, Marzolini S, Kiss A, Swardfager W, Liu C, Vieira D, Kim D, Song BX, Lanctôt KL. The association between brain‐derived neurotrophic factor and improved cognition in mild cognitive impairment and Alzheimer's disease patients in an exercise‐primed transcranial‐direct current stimulation study. Alzheimers Dement 2021. [DOI: 10.1002/alz.052303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Grace KY Koo
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | | | | | | | - Tarek K. Rajji
- Centre for Addiction and Mental Health Toronto ON Canada
- Toronto Dementia Research Alliance Toronto ON Canada
| | | | - Paul I. Oh
- KITE‐Toronto Rehabilitation Institute, University Health Network Toronto ON Canada
| | - Susan Marzolini
- KITE‐Toronto Rehabilitation Institute, University Health Network Toronto ON Canada
| | | | | | - Celina Liu
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
| | - Danielle Vieira
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
| | - Doyoung Kim
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Bing Xin Song
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Krista L. Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
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24
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Song BX, Herrmann N, Gallagher D, Rapoport M, Charles J, Papneja P, Rajji TK, Andreazza AC, Oh PI, Marzolini S, Kiss A, Swardfager W, Liu C, Vieira D, Kim D, Koo GKY, Lanctôt KL. Evaluating the relationship between vascular endothelial growth factor (VEGF) and cognitive improvements following exercised‐primed transcranial direct current stimulation (tDCS) in mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Alzheimers Dement 2021. [DOI: 10.1002/alz.052145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bing Xin Song
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Nathan Herrmann
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Damien Gallagher
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Mark Rapoport
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Jocelyn Charles
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | - Tarek K. Rajji
- University of Toronto Toronto ON Canada
- Centre for Addiction and Mental Health Toronto ON Canada
| | | | - Paul I. Oh
- KITE‐Toronto Rehabilitation Institute, University Health Network Toronto ON Canada
| | - Susan Marzolini
- KITE‐Toronto Rehabilitation Institute, University Health Network Toronto ON Canada
| | - Alex Kiss
- Sunnybrook Research Institute Toronto ON Canada
| | - Walter Swardfager
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Celina Liu
- Sunnybrook Research Institute Toronto ON Canada
| | | | - Doyoung Kim
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Grace KY Koo
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Krista L. Lanctôt
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
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25
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Wang R, Bawa K, Feng V, Herrmann N, Gallagher D, Black SE, Ramirez J, Graham SJ, Oh PI, Andreazza AC, Kiss A, Swardfager W, Lanctôt KL. The relationship between homocysteine, oxidative stress, and cognition in mild cognitive impairment. Alzheimers Dement 2021. [DOI: 10.1002/alz.052381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- RuoDing Wang
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Kritleen Bawa
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Vivian Feng
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Nathan Herrmann
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Damien Gallagher
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | | | | | | | - Paul I. Oh
- KITE‐Toronto Rehabilitation Institute, University Health Network Toronto ON Canada
| | | | - Alex Kiss
- Sunnybrook Research Institute Toronto ON Canada
| | - Walter Swardfager
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Krista L. Lanctôt
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
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Feng V, Bawa KK, Marzolini S, Kiss A, Oh P, Herrmann N, Lanctôt KL, Gallagher D. Impact of 12-week exercise program on biomarkers of gut barrier integrity in patients with coronary artery disease. PLoS One 2021; 16:e0260165. [PMID: 34797867 PMCID: PMC8604291 DOI: 10.1371/journal.pone.0260165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/28/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction Breakdown of gut barrier integrity has been associated with inflammatory activation and is implicated in the etiology of several chronic medical conditions. Acute exercise is known to increase gut barrier permeability but the impact of chronic exercise is not clear. Most studies to date have examined how acute exercise impacts gut barrier integrity in healthy adults, while few studies have examined the impact of chronic exercise in older adults with comorbidities. We aim to investigate the impact of a 12-week program of aerobic and resistance training on biomarkers of gut barrier integrity in a sample of older adults with coronary artery disease. Methods Participants were adults with coronary artery disease undergoing a moderate-intensity 12-week cardiac rehabilitation exercise program. Fasting blood samples were taken at baseline and study termination. Serum levels of biomarkers of gut barrier integrity (zonulin and fatty acid-binding protein 2 (FABP2)) were measured by ELISA. Cardiorespiratory fitness was assessed by peak oxygen uptake (VO2peak) at study start & completion. Data analyses were performed using SPSS software version 24.0. Results Among study participants (n = 41, 70% male, age = 62.7± 9.35) we found a significant negative association between baseline FABP2 levels and baseline VO2peak in a multiple linear regression model adjusting for covariates (B = -0.3, p = 0.009). Over the course of the exercise program an increase in VO2peak (≥ 5 mL/kg/min) was independently associated with a relative decrease in FABP2 (B = -0.45, p = 0.018) after controlling for medical covariates. Conclusion Our findings indicate that an increase in cardiorespiratory fitness during a 12-week exercise program resulted in a relative improvement in a biomarker of gut barrier integrity. This indicates a potential mechanism by which longer term exercise may improve gut barrier integrity.
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Affiliation(s)
- Vivian Feng
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Kritleen K. Bawa
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Susan Marzolini
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada
- KITE Toronto Rehabilitation Institute, University Health Network, East York, Ontario, Canada
| | - Alex Kiss
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Paul Oh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Krista L. Lanctôt
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada
- KITE Toronto Rehabilitation Institute, University Health Network, East York, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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Penugonda M, Walsh J, Barry JJ, Govern RM, Bradley D, Bolger M, English G, Moore J, Nolan N, Treacy E, Burke J, Dwyer N, Gallagher D, Macken S, McCaffrey S, Moloney S, Murphy R, Murray M, Hanlon EO. 231 ESTABLISHING AN INTERVENTIONS BUNDLE TO IMPROVE INPATIENT CARE FOR PATIENTS WITH PARKINSON’S DISEASE: A MULTIDISCIPLINARY QUALITY IMPROVEMENT PROJECT. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Patients with Parkinson’s (PwP) are at a higher risk of complications once admited to hospital compared to their age-matched peers. Medication mismanagement is a well-known obstacle, which puts PwP at risk of sub-optimal treatment leading to an unnecessary deterioration of baseline and potentially increases risk of adverse sequelae.
Methods
Retrospective electronic patient records (EPR)/chart review of 47 admissions was conducted, across three hospital sites.
Data attaining to correct prescribing of medication on admission and discharge, prescribing of contraindicated medications, reasons for medication lapses and complications of inpatient stay were collected. EPR of 17 patients’ were reviewed to assess if Parkinson’s disease (PD) medication administrations occurred within 30 minutes of patient schedule, as recommended by NICE guidelines. Key areas for improvement were identified based on the results.
Results
47 charts (30 Males, 17 Females) with mean age 72 (range:57–90), were reviewed. Average number of co-morbidities:4.5 and Clinical Frailty Scale ranged 5–9 (n = 30). LOS averaged 12.4 days and 43% of patients had ≥2 hospital admissions in the preceeding year.
38% (17/44) of admissions correctly documented patient specific medication times. Only 48% of patients (n = 638) received their medications within 30 minutes of the scheduled time. 47% (22/47) experienced complications attributable to PD. Contraindicated medications were noted in 5 cases. 84% of discharging prescriptions did not mention timing of PD medication and 3 prescriptions had errors with regards to dosage/omission of medication.
Conclusion
We implemented across two sites: 1) Care protocol flag in patient’s chart highlighting simple avoidable complications. 2) Laminated over the bed signpost alerting ‘time critical medication’. 3) ‘Time critical medication’ stickers in drug kardex 4) Education sessions for Medical, Nursing and Ward staff. 6) Establishing out of hours access to PD medications and protocols for NPO/poor swallow. We plan to reassess significance of efforts post intervention.
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Affiliation(s)
| | - J Walsh
- St. Luke's General Hospital , Kilkenny, Ireland
| | - J J Barry
- St. Michael's Hospital , Dublin, Ireland
| | - R M Govern
- St. Luke's General Hospital , Kilkenny, Ireland
| | - D Bradley
- St. James Hospital , Dublin, Ireland
| | - M Bolger
- St. Luke's General Hospital , Kilkenny, Ireland
| | - G English
- St. Luke's General Hospital , Kilkenny, Ireland
| | - J Moore
- St. Luke's General Hospital , Kilkenny, Ireland
| | - N Nolan
- St. Luke's General Hospital , Kilkenny, Ireland
| | - E Treacy
- St. Luke's General Hospital , Kilkenny, Ireland
| | - J Burke
- St. Michael's Hospital , Dublin, Ireland
| | - N Dwyer
- St. Michael's Hospital , Dublin, Ireland
| | | | - S Macken
- St. Michael's Hospital , Dublin, Ireland
| | | | - S Moloney
- St. Michael's Hospital , Dublin, Ireland
| | - R Murphy
- St. Michael's Hospital , Dublin, Ireland
| | - M Murray
- St. Michael's Hospital , Dublin, Ireland
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Kim D, Wang R, Kiss A, Bronskill SE, Lanctot KL, Herrmann N, Gallagher D. Depression and Increased Risk of Alzheimer's Dementia: Longitudinal Analyses of Modifiable Risk and Sex-Related Factors. Am J Geriatr Psychiatry 2021; 29:917-926. [PMID: 33455858 PMCID: PMC8257760 DOI: 10.1016/j.jagp.2020.12.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/11/2020] [Accepted: 12/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Our understanding of why older adults with depression are at increased risk of Alzheimer's disease (AD) remains incomplete. Most adults living with AD are women, and women have a near twofold lifetime risk of depression. We examined the risk of depression upon incident AD, and how sex influences this risk. METHODS Using the National Alzheimer's Coordinating Center database, older adults (age 50+) with normal cognition, who visited memory clinics across the United States between September 2005 and December 2019, were followed until first diagnosis of AD or loss to follow up. Multivariable survival analyses were performed to determine if recent and/or remote depression were independent risk factors for AD, if this depression-related risk exists for each sex or was moderated by sex. RESULTS Six hundred and fifty-two of 10,739 enrolled participants developed AD over a median follow-up of 55.3 months. Recent depression (active within the last 2 years) was independently associated with increased risk of AD (hazard ratio [HR] = 2.0; 95%CI, 1.5-2.6) while a remote history of depression was not (HR = 1.0; 95%CI, 0.7-1.5). After stratification by sex, recent depression was an independent predictor in females (HR = 2.3; 95%CI, 1.7-3.1) but not in males (HR = 1.4; 95%CI, 0.8-2.6). No interaction between recent depression and sex was observed. CONCLUSION Only a recent history of depression was associated with higher risk of AD. This association was significant among women only, but was not moderated by sex. Future analyses should determine if these findings extend to other populations and may be explained by variable distribution of neurobiological or other modifiable risk factors between the sexes.
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Affiliation(s)
- Doyoung Kim
- Neuropsychopharmacology Research Group (DK, RW, KLL, NH, DG), Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology (DK, RW, KLL), University of Toronto, Toronto, Ontario, Canada.
| | - RuoDing Wang
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- ICES, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Susan E. Bronskill
- ICES, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Krista L. Lanctot
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Talbot A, McCabe M, Daly B, Gallagher D. Heart Rate Variability-Guided Exercise During Chemotherapy in Triathlete with Stage 1 BRCA1-Mutated Breast Cancer. Ir Med J 2021; 114:420. [PMID: 35476380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- A Talbot
- Royal College of Surgeons in Ireland, Dublin
| | - M McCabe
- Sports Med Ireland, 32 Kildare St, Dublin
| | - B Daly
- Sports Med Ireland, 32 Kildare St, Dublin
| | - D Gallagher
- Mater Private Hospital, Eccles Street, Dublin
- St. James' Hospital, James' Street, Dublin
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Lopez L, Shuster Hyman H, Gasner A, Khan H, Marco E, Mouazz S, Kauffman A, Gallagher D, Gauthier-Fisher A, Librach C. Systemically administered human umbilical cord perivascular cells (HUCPVC) prevent tumor growth in a human melanoma tumor-bearing mouse model. Cytotherapy 2021. [DOI: 10.1016/s1465324921003509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Kim D, Wang R, Kiss A, Bronskill SE, Lanctot KL, Herrmann N, Gallagher D. Depression and increased risk of Alzheimer’s dementia: Longitudinal analyses of modifiable risk and sex‐related factors. Alzheimers Dement 2020. [DOI: 10.1002/alz.047436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Doyoung Kim
- Neuropsychopharmacology Research Group Sunnybrook Research Institute Toronto ON Canada
| | - Ruoding Wang
- Neuropsychopharmacology Research Group Sunnybrook Research Institute Toronto ON Canada
| | - Alex Kiss
- Institute for Clinical Evaluative Sciences Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Susan E Bronskill
- Institute for Clinical Evaluative Sciences Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Krista L Lanctot
- Neuropsychopharmacology Research Group Sunnybrook Research Institute Toronto ON Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group Sunnybrook Research Institute Toronto ON Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group Sunnybrook Research Institute Toronto ON Canada
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Dissanayake AS, Bowie CR, Butters MA, Flint A, Gallagher D, Golas AC, Herrmann N, Kennedy JL, Kumar S, Lanctot KL, Mah L, Mulsant BH, Pollock BG, Rajji TK, Schweizer TA, Munoz DG, Fischer CE. Does sex impact neuropsychiatric symptom burden in APOε4 carriers with at‐risk cognitive conditions? Alzheimers Dement 2020. [DOI: 10.1002/alz.047038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Andrew S Dissanayake
- Keenan Research Centre for Biomedical Research St. Michael’s Hospital Toronto ON Canada
| | - Christopher R Bowie
- Centre for Addiction and Mental Health Toronto ON Canada
- Queen's University Kingston ON Canada
| | - Meryl A Butters
- University of Pittsburgh, School of Medicine Pittsburgh PA USA
| | - Alastair Flint
- Centre for Mental Health University Health Network Toronto ON Canada
| | - Damien Gallagher
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Angela C Golas
- Centre for Addiction and Mental Health Toronto ON Canada
- University of Toronto Toronto ON Canada
- St. Michael's Hospital Toronto ON Canada
| | - Nathan Herrmann
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | - Sanjeev Kumar
- Centre for Addiction and Mental Health Toronto ON Canada
| | - Krista L Lanctot
- University of Toronto Toronto ON Canada
- Neuropsychopharmacology Research Group Sunnybrook Research Institute Toronto ON Canada
| | - Linda Mah
- University of Toronto Toronto ON Canada
- Rotman Research Institute Baycrest Health Science Centre Toronto ON Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Bruce G Pollock
- Campbell Family Mental Health Research Institute Division of Geriatric Psychiatry Centre for Addiction and Mental Health Toronto ON Canada
| | - Tarek K Rajji
- Centre for Addiction and Mental Health Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Tom A Schweizer
- Keenan Research Centre for Biomedical Research St. Michael’s Hospital Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - David G Munoz
- Keenan Research Centre for Biomedical Research St. Michael’s Hospital Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Research St. Michael’s Hospital Toronto ON Canada
- University of Toronto Toronto ON Canada
- St. Michael's Hospital Toronto ON Canada
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33
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Ruthirakuhan M, Herrmann N, Andreazza AC, Verhoeff NPL, Gallagher D, Black SE, Lanctot KL. Biomarkers of agitation in moderate‐to‐severe Alzheimer's disease patients enrolled in an RCT with nabilone. Alzheimers Dement 2020. [DOI: 10.1002/alz.042269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Myuri Ruthirakuhan
- University of Toronto Toronto ON Canada
- Neuropsychopharmacology Research Group Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group Sunnybrook Research Institute Toronto ON Canada
| | | | | | - Damien Gallagher
- Neuropsychopharmacology Research Group Sunnybrook Research Institute Toronto ON Canada
| | - Sandra E. Black
- Sunnybrook Research Institute University of Toronto Toronto ON Canada
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34
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Lanctot KL, Gallagher D, Rapoport MJ, Oh PI, Marzolini S, Charles J, Papneja P, Rajji TK, Andreazza AC, Kiss A, Liu C, Vieira D, Herrmann N. Investigating the relationship between neuropsychiatric symptoms and cognition in mild cognitive impairment and Alzheimer’s disease patients undergoing an exercise‐primed transcranial direct current stimulation clinical trial (The EXPRESS Study). Alzheimers Dement 2020. [DOI: 10.1002/alz.046158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Krista L. Lanctot
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
- Neuropsychopharmacology Research Group Toronto ON Canada
- KITE UHN Toronto Rehabilitation Institute Toronto ON Canada
| | - Damien Gallagher
- University of Toronto Toronto ON Canada
- Neuropsychopharmacology Research Group Toronto ON Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Mark J. Rapoport
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Paul I. Oh
- Sunnybrook Health Sciences Centre Toronto ON Canada
- University Health Network Toronto Rehabilitation Institute Toronto ON Canada
| | - Susan Marzolini
- University Health Network Toronto Rehabilitation Institute Toronto ON Canada
| | - Jocelyn Charles
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Purti Papneja
- Sunnybrook Academic Family Health Team Toronto ON Canada
| | - Tarek K. Rajji
- University of Toronto Toronto ON Canada
- Centre for Addiction and Mental Health Toronto ON Canada
| | | | - Alex Kiss
- Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Celina Liu
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
- Neuropsychopharmacology Research Group Toronto ON Canada
| | - Danielle Vieira
- Sunnybrook Research Institute Toronto ON Canada
- Neuropsychopharmacology Research Group Toronto ON Canada
| | - Nathan Herrmann
- University of Toronto Toronto ON Canada
- Sunnybrook Research Institute Toronto ON Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
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35
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Ruthirakuhan M, Herrmann N, Andreazza AC, Verhoeff NPLG, Gallagher D, Black SE, Kiss A, Lanctôt KL. 24S-Hydroxycholesterol Is Associated with Agitation Severity in Patients with Moderate-to-Severe Alzheimer's Disease: Analyses from a Clinical Trial with Nabilone. J Alzheimers Dis 2020; 71:21-31. [PMID: 31322567 PMCID: PMC6839471 DOI: 10.3233/jad-190202] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Agitation is a prevalent and difficult-to-treat symptom of Alzheimer’s disease (AD). The endocannabinoid system (ECS) has been a target of interest for the treatment of agitation. However, ECS signaling may interact with AD-related changes in brain cholesterol metabolism. Elevated brain cholesterol, reflected by reduced serum 24-S-hydroxycholesterol (24S-OHC), is associated with reduced membrane fluidity, preventing ligand binding to cannabinoid receptor 1. Objective: To assess whether 24S-OHC was associated with agitation severity and response to nabilone. Methods: 24S-OHC was collected from AD patients enrolled in a clinical trial on nabilone at the start and end of each phase. This allowed for the cross-sectional and longitudinal investigation between 24S-OHC and agitation (Cohen Mansfield Agitation Inventory, CMAI). Post-hoc analyses included adjustments for baseline standardized Mini-Mental Status Exam (sMMSE), and analyses with CMAI subtotals consistent with the International Psychogeriatric Association (IPA) definition for agitation (physical aggression and nonaggression, and verbal aggression). Results: 24S-OHC was not associated with CMAI scores cross-sectionally or longitudinally, before and after adjusting for baseline sMMSE. However, 24S-OHC was associated with greater CMAI IPA scores at baseline (F(1,36) = 4.95, p = 0.03). In the placebo phase only, lower 24S-OHC at baseline was associated with increases in CMAI IPA scores (b = –35.2, 95% CI –65.6 to –5.0, p = 0.02), and decreases in 24S-OHC were associated with increases in CMAI IPA scores (b = –20.94, 95% CI –57.9 to –4.01, p = 0.03). Conclusion: 24S-OHC was associated with agitation severity cross-sectionally, and longitudinally in patients with AD. However, 24S-OHC did not predict treatment response, and does not change over time with nabilone.
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Affiliation(s)
- Myuri Ruthirakuhan
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Ana C Andreazza
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | | | - Damien Gallagher
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Sandra E Black
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto and Sunnybrook HSC, Toronto, ON, Canada
| | - Alex Kiss
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Research Design and Biostatistics, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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36
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Power Foley M, Kelly ME, Kerr C, Kennedy C, Gallagher D, Gillham C, Mehigan BJ, McCormick PH, Bergin C, Larkin JO. Management of anal intraepithelial neoplasia and anal squamous cell carcinoma at a tertiary referral centre with a dedicated infectious diseases unit: an 18-year review. Int J Colorectal Dis 2020; 35:1855-1864. [PMID: 32500433 DOI: 10.1007/s00384-020-03640-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Anal squamous cell carcinoma (ASCC) is a rare malignancy with rising incidence rates. Risk factors include human immunodeficiency virus (HIV) infection, high-risk sexual activity and HPV-related genitourinary dysplasia/neoplasia. There is an overlap between high-risk patients and those attending HIV Medicine/Sexual Health (HMSH) services. We hypothesised that HMSH involvement may facilitate earlier referral to colorectal surgeons, with better outcomes. METHODS Retrospective review of all ASCC and anal intraepithelial neoplasia (AIN) treated at a tertiary-referral hospital with a dedicated HMSH clinic between 2000 and 2018. Comparative analysis was performed of demographics, management and outcomes between HMSH and non-HMSH patients. RESULTS One hundred and nine patients had anal pathology, eighty-five with ASCC (78%) and twenty-four with AIN (22%). Seventy (64%) were male. Median (range) age at ASCC diagnosis was 51 years (26-88). Thirty-six percent of all patients attended HMSH services, 28% were HIV positive, and 41% of males were men-who-have-sex-with-men (MSM). Eighty-one ASCC patients (97.5%) were treated with curative intent. Sixty-seven (80%) had primary chemoradiation therapy. Fifteen (17.5%) had primary surgical excision. Twelve (14%) developed recurrent disease. Ultimately, seven required salvage APR. Overall 3-year survival (3YS) was 76%. HMSH patients were significantly younger at ASCC diagnosis (p < 0.001), with a higher prevalence of HIV, HPV and MSM. HMSH attenders also tended to be diagnosed at earlier stages, were less likely to develop recurrence and achieved better overall outcomes, with a superior overall 3YS than non-HMSH patients (92% vs 72%, p = 0.037). CONCLUSION ASCC incidence is increasing worldwide. The HMSH cohort has emerged as a distinct subpopulation of younger, high-risk, male patients. Collaboration between HMSH and colorectal surgeons offers an opportunity for risk reduction strategies and earlier intervention.
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Affiliation(s)
- M Power Foley
- Department of Colorectal & General Surgery, St James' Hospital, Dublin, 8, Ireland. .,School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
| | - M E Kelly
- Department of Colorectal & General Surgery, St James' Hospital, Dublin, 8, Ireland.,School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - C Kerr
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland.,Department of Genitourinary Medicine and Infectious Disease, St James' Hospital, Dublin, 8, Ireland
| | - C Kennedy
- Department of Colorectal & General Surgery, St James' Hospital, Dublin, 8, Ireland.,School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - D Gallagher
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland.,Department of Medical Oncology, St James' Hospital, Dublin, 8, Ireland
| | - C Gillham
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland.,Department of Radiation Oncology, St James' Hospital, Dublin, 8, Ireland
| | - B J Mehigan
- Department of Colorectal & General Surgery, St James' Hospital, Dublin, 8, Ireland.,School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - P H McCormick
- Department of Colorectal & General Surgery, St James' Hospital, Dublin, 8, Ireland.,School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - C Bergin
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland.,Department of Genitourinary Medicine and Infectious Disease, St James' Hospital, Dublin, 8, Ireland
| | - J O Larkin
- Department of Colorectal & General Surgery, St James' Hospital, Dublin, 8, Ireland.,School of Medicine, Trinity College Dublin, Dublin 2, Ireland
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Yuen K, Rashidi-Ranjbar N, Verhoeff NPLG, Kumar S, Gallagher D, Flint AJ, Herrmann N, Pollock BG, Mulsant BH, Rajji TK, Voineskos AN, Fischer CE, Mah L. Association between Sleep Disturbances and Medial Temporal Lobe Volume in Older Adults with Mild Cognitive Impairment Free of Lifetime History of Depression. J Alzheimers Dis 2020; 69:413-421. [PMID: 31104028 DOI: 10.3233/jad-190160] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Previous studies examining the link between neuropsychiatric symptoms (NPS) and biomarkers of Alzheimer's disease (AD) may be confounded by remitted or past history of psychiatric illness, which in itself is associated with AD biomarkers such as reduced medial temporal lobe (MTL) volume. OBJECTIVE We examined associations between mood and anxiety-related NPS and MTL in older adults with mild cognitive impairment (MCI) free of lifetime history of depression. We hypothesized an inverse relationship between NPS severity and MTL. METHODS Forty-two MCI participants without current or past history of depression or other major psychiatric illness were assessed using the Neuropsychiatric Inventory-Questionnaire (NPI-Q). Correlation and regression analyses were performed between selected NPI-Q items and regional MTL volumes from structural magnetic resonance imaging. RESULTS Sleep disturbances were inversely associated with several regional volumes within the MTL. Sleep disturbances remained significantly correlated with left hippocampal and amygdala volume following correction for multiple comparisons. In contrast, depression and anxiety were not correlated with MTL. CONCLUSIONS The relationship between reduced MTL and sleep, but not with depressed or anxious states, in MCI free of lifetime history of depression, suggests a potential mechanism for sleep as a risk factor for AD. The current findings highlight the importance of accounting for remitted psychiatric conditions in studies of the link between NPS and AD biomarkers and support the need for further research on sleep as clinical biomarker of AD and target for AD prevention.
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Affiliation(s)
- Kimberley Yuen
- Rotman Research Institute, Baycrest Health Sciences, North York, Ontario, Canada
| | - Neda Rashidi-Ranjbar
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Nicolaas Paul L G Verhoeff
- Baycrest Health Sciences Department of Psychiatry, North York, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sanjeev Kumar
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Damien Gallagher
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Sunnybrook Health Sciences, Toronto, Ontario, Canada
| | - Alastair J Flint
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,University Health Network, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Sunnybrook Health Sciences, Toronto, Ontario, Canada
| | - Bruce G Pollock
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Corinne E Fischer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Linda Mah
- Rotman Research Institute, Baycrest Health Sciences, North York, Ontario, Canada.,Baycrest Health Sciences Department of Psychiatry, North York, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Yeung A, Kiss A, Gallagher D. Intensive control of hypertension and risk of Alzheimer's dementia in older adults with depression. Int J Geriatr Psychiatry 2020; 35:888-896. [PMID: 32281159 PMCID: PMC7375011 DOI: 10.1002/gps.5309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Intensive control of hypertension has been reported to decrease risk of cognitive decline. However, the effect of this in older adults with hypertension and comorbid depression is not well understood. We aim to identify whether intensive control of systolic blood pressure (BP) is associated with reduced risk of Alzheimer's dementia (AD) in a clinical population. METHODS Using data from the National Alzheimer's Coordinating Center, we conducted survival analyses in older adults with normal cognition at baseline and treated hypertension. We also examined those with comorbid depression, to determine if intensive control of systolic BP (≤120 mmHg) was associated with reduced risk of AD. RESULTS In all older adults with treated hypertension (n = 4505), 298 (6.6%) developed AD during a median follow-up duration of 4.2 years. In the comorbid depression subgroup (n = 1327), 152 (11.5%) developed AD. Intensive control of systolic BP was not significantly associated with reduced risk of AD in the overall sample (HR 1.13, 95%, 0.79-1.64). However, in the comorbid depression subgroup, intensive control of systolic BP (≤120 mmHg) was associated with increased risk of AD (HR 1.49, 95%, 1.03-2.15) compared to standard control (121-139 mmHg). CONCLUSIONS In a clinical population of older adults with hypertension and comorbid depression, we found that an intensive systolic BP target of ≤120 mmHg was associated with increased risk of AD. While these findings are preliminary, they suggest that a more cautious approach to hypertension treatment may be warranted in this vulnerable subgroup.
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Affiliation(s)
- Anthony Yeung
- Department of Psychiatry, University of Toronto, Ontario
| | - Alex Kiss
- Evaluative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute
| | - Damien Gallagher
- Department of Psychiatry, University of Toronto, Ontario
- Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario
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Ruthirakuhan M, Herrmann N, Andreazza AC, Verhoeff NPLG, Gallagher D, Black SE, Kiss A, Lanctôt KL. Agitation, Oxidative Stress, and Cytokines in Alzheimer Disease: Biomarker Analyses From a Clinical Trial With Nabilone for Agitation. J Geriatr Psychiatry Neurol 2020; 33:175-184. [PMID: 31547752 DOI: 10.1177/0891988719874118] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The endocannabinoid system has been a target of interest for agitation in Alzheimer disease (AD) because of potential behavioral effects and its potential impact on mechanisms implicated in AD such as oxidative stress (OS) and neuroinflammation. We explored whether serum markers of OS and neuroinflammation were associated with response to the cannabinoid nabilone in agitated patients with AD (N = 38). All participants were enrolled in a 14-week, double-blind, cross-over trial comparing nabilone to placebo (6 weeks each) with a 1-week washout between phases. Samples were collected at the start and end of each phase. The cross-sectional relationship agitation (Cohen Mansfield Agitation Inventory) and OS and inflammatory markers were investigated to select markers of interest. Significant markers were then explored for their relationship with response. The OS marker, 4-hydroxynonenal (4-HNE; F1, 35 = 6.41, P = .016), and the proinflammatory cytokine, tumor necrosis factor-α (TNF-α; F1, 29 = 3.97, P = .06), were associated with agitation severity, and TNF-α remained significantly associated (F2, 25 = 3.69, P = .04) after adjustment for cognition. In the placebo phase, lower baseline 4-HNE was associated with decreases in agitation severity only (b = 0.01, P = .01), while lower baseline TNF-α was associated with decreases in agitation severity in the nabilone phase only (b = 1.14, P = .045). Changes in 4-HNE were not associated with changes in agitation severity in either phase. In the nabilone phase, lower baseline TNF-α was associated with decreases in agitation severity (b = 1.14, P = .045), and decreases in TNF-α were associated with decreases in agitation severity (b = 1.12, P = .006). These findings suggest that OS and neuroinflammation may be associated with agitation severity, while nabilone may have anti-inflammatory effects.
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Affiliation(s)
- Myuri Ruthirakuhan
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ana C Andreazza
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Nicolaas Paul L G Verhoeff
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Baycrest Health Science Centre, Toronto, Ontario, Canada
| | - Damien Gallagher
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sandra E Black
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Alex Kiss
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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40
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Fischer CE, Kortebi I, Karameh WK, Kumar S, Gallagher D, Golas A, Munoz D, Barfett J, Butters MA, Bowie CR, Flint A, Rajji T, Herrmann N, Pollock BG, Mulsant B, Schweizer TA, Mah L. Examining the Link Between Cardiovascular Risk Factors and Neuropsychiatric Symptoms in Mild Cognitive Impairment and Major Depressive Disorder in Remission. J Alzheimers Dis 2020; 67:1305-1311. [PMID: 30741676 DOI: 10.3233/jad-181099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiovascular risk factors (CVRFs) have been linked to both depression and cognitive decline but their role in neuropsychiatric symptoms (NPS) has yet to be clarified. OBJECTIVE Understanding the role of CVRFs in the etiology of NPS for prospective treatments and preventive strategies to minimize these symptoms. METHODS We examined the distribution of NPS using the Neuropsychiatric Inventory (NPI) scores in three cohorts from the Prevention of Alzheimer's Dementia with Cognitive Remediation Plus Transcranial Direct Current Stimulation in Mild Cognitive Impairment and Depression (PACt-MD) study: older patients with a lifetime history of major depressive disorder (MDD) in remission, patients with mild cognitive impairment (MCI), and patients with combined MCI and MDD. We also examined the link between individual NPS and CVRFs, Framingham risk score, and Hachinski ischemic score in a combined sample. RESULTS Analyses were based on a sample of 140 subjects, 70 with MCI, 38 with MCI plus MDD, and 32 with MDD. There was no effect of age, gender, education, cognition, or CVRFs on the presence (NPI >1) or absence (NPI = 0) of NPS. Depression was the most prevalent affective NPS domain followed by night-time behaviors and appetite changes across all three diagnostic groups. Agitation and aggression correlated negatively while anxiety, disinhibition, night-time behaviors, and irritability correlated positively with CVRFs (all p-values <0.05). Other NPS domains showed no significant association with CVRFs. CONCLUSION CVRFs are significantly associated with individual NPI sub-scores but not with total NPI scores, suggesting that different pathologies may contribute to different NPS domains.
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Affiliation(s)
- Corinne E Fischer
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Canada
| | | | - Wael K Karameh
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada.,St. Michael's Hospital, Toronto, Canada
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Damien Gallagher
- University of Toronto, Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Angela Golas
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada.,St. Michael's Hospital, Toronto, Canada
| | - David Munoz
- Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Joseph Barfett
- Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Canada.,St. Michael's Hospital, Toronto, Canada
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh School of Medicine, USA
| | - Christopher R Bowie
- Centre for Addiction and Mental Health, Toronto, Canada.,Queen's University, Kingston, Canada
| | - Alastair Flint
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Mental Health, University Health Network, Toronto, Canada
| | - Tarek Rajji
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada
| | - Nathan Herrmann
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Bruce G Pollock
- Campbell Family Mental Health Research Institute, Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada
| | - Benoit Mulsant
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada
| | - Tom A Schweizer
- Keenan Research Centre for Biomedical Research, St. Michael's Hospital, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Linda Mah
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Canada
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41
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Feldsine PT, Lienau AH, Forgey RL, Calhoon RD, Al-Hasani S, Arling V, Bandiera T, Barnes M, Beatty S, Beaudoin A, Beyer D, Bryant J, Burzynski M, Carey B, Copeland F, Culver D, Danisavich T, Destro C, Diaz B, Fitzgerald S, Gallagher D, Franke W, Freshly J, Gary J, Harper M, Hermann C, Isakson T, Jenkins P, Johnson S, Ke J, Krause C, Lange K, Maki G, McDonagh S, McKee B, McLenaghan J, Miller L, Phebus R, Raghubeer E, Redding R, Retzlaff D, Richter D, Ritger C, Robinson J, Saunders L, Schwants D, Trottier Y, Tuncan E, Vanderbilt K, Ward D, West D, Woo L, Zebchek A. Visual Immunoprecipitate Assay (VIP) for Listeria monocytogenes and Related Listeria Species Detection in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.791] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Six foods representing a variety of food products were analyzed by the Assurance Listeria polyclonal enzyme immunoassay (EIA) and by either the Bacteriological Analytical Manual or the U.S. Department of Agriculture culture method for detecting Listeria monocytogenes and related Listeria species. Samples of each food type, at each inoculation level, were analyzed simultaneously by both methods. A total of 19 laboratories representing federal government agencies and private industry in the United States and Canada participated. Food types were inoculated with Listeria species including L. monocytogenes, with the exception of 3 lots of green beans, which were naturally contaminated. During this study, 1764 samples and controls were analyzed and confirmed, of which 492 were positive and 947 were negative by both methods. There were 159 samples that were positive by culture method but negative by the EIA and 188 that were negative by culture method but positive by EIA. Twenty-two samples were negative by EIA and by culture method but confirmed positive when Assurance selective enrichment broths were subcultured to selective agar. The Assurance polyclonal EIA for detecting L. monocytogenes and related Listeria species in foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Roger D Calhoon
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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42
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Feldsine PT, Lienau AH, Forgey RL, Calhoon RD, Al-Hasani S, Arling V, Bandiera T, Barnes M, Beatty S, Beaudoin A, Beyer D, Bryant J, Burzynski M, Carey B, Copeland F, Culver D, Destro C, Diaz B, Franke W, Gallagher D, Gary J, Harper M, Hermann C, Isakson T, Jenkins P, Johnson S, Ke J, Krause C, Lange K, Trottier YL, Maki G, McDonagh S, McLenaghan J, Miller L, Phebus R, Raghubeer E, Redding R, Retzlaff D, Richter D, Ritger C, Robinson J, Saunders L, Schwants D, Tuncan E, Vanderbilt K, Ward D, West D, Woo L, Zebchek A. Assurance Polyclonal Enzyme Immunoassay for Detection of Listeria monocytogenes and Related Listeria Species in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.775] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Six foods representing a variety of food products were analyzed by the Assurance Listeria polyclonal enzyme immunoassay (EIA) and by either the Bacteriological Analytical Manual or the U.S. Department of Agriculture culture method for detecting Listeria monocytogenes and related Listeria species. Samples of each food type, at each inoculation level, were analyzed simultaneously by both methods. A total of 19 laboratories representing federal government agencies and private industry in the United States and Canada participated. Food types were inoculated with Listeria species including L. monocytogenes, with the exception of 3 lots of green beans, which were naturally contaminated. During this study, 1764 samples and controls were analyzed and confirmed, of which 492 were positive and 947 were negative by both methods. There were 159 samples that were positive by culture method but negative by the EIA and 188 that were negative by culture method but positive by EIA. Twenty-two samples were negative by EIA and by culture method but confirmed positive when Assurance selective enrichment broths were subcultured to selective agar. The Assurance polyclonal EIA for detecting L. monocytogenes and related Listeria species in foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Roger D Calhoon
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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Kasper JC, Bale SD, Belcher JW, Berthomier M, Case AW, Chandran BDG, Curtis DW, Gallagher D, Gary SP, Golub L, Halekas JS, Ho GC, Horbury TS, Hu Q, Huang J, Klein KG, Korreck KE, Larson DE, Livi R, Maruca B, Lavraud B, Louarn P, Maksimovic M, Martinovic M, McGinnis D, Pogorelov NV, Richardson JD, Skoug RM, Steinberg JT, Stevens ML, Szabo A, Velli M, Whittlesey PL, Wright KH, Zank GP, MacDowall RJ, McComas DJ, McNutt RL, Pulupa M, Raouafi NE, Schwadron NA. Alfvénic velocity spikes and rotational flows in the near-Sun solar wind. Nature 2019; 576:228-231. [PMID: 31802006 DOI: 10.1038/s41586-019-1813-z] [Citation(s) in RCA: 216] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/17/2019] [Indexed: 11/09/2022]
Abstract
The prediction of a supersonic solar wind1 was first confirmed by spacecraft near Earth2,3 and later by spacecraft at heliocentric distances as small as 62 solar radii4. These missions showed that plasma accelerates as it emerges from the corona, aided by unidentified processes that transport energy outwards from the Sun before depositing it in the wind. Alfvénic fluctuations are a promising candidate for such a process because they are seen in the corona and solar wind and contain considerable energy5-7. Magnetic tension forces the corona to co-rotate with the Sun, but any residual rotation far from the Sun reported until now has been much smaller than the amplitude of waves and deflections from interacting wind streams8. Here we report observations of solar-wind plasma at heliocentric distances of about 35 solar radii9-11, well within the distance at which stream interactions become important. We find that Alfvén waves organize into structured velocity spikes with duration of up to minutes, which are associated with propagating S-like bends in the magnetic-field lines. We detect an increasing rotational component to the flow velocity of the solar wind around the Sun, peaking at 35 to 50 kilometres per second-considerably above the amplitude of the waves. These flows exceed classical velocity predictions of a few kilometres per second, challenging models of circulation in the corona and calling into question our understanding of how stars lose angular momentum and spin down as they age12-14.
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Affiliation(s)
- J C Kasper
- Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI, USA. .,Smithsonian Astrophysical Observatory, Cambridge, MA, USA.
| | - S D Bale
- Physics Department, University of California, Berkeley, CA, USA.,Space Sciences Laboratory, University of California, Berkeley, CA, USA.,The Blackett Laboratory, Imperial College London, London, UK
| | - J W Belcher
- Kavli Center for Astrophysics and Space Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - M Berthomier
- Laboratoire de Physique des Plasmas, CNRS, Sorbonne Université, Ecole Polytechnique, Observatoire de Paris, Université Paris-Saclay, Paris, France
| | - A W Case
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
| | - B D G Chandran
- Department of Physics and Astronomy, University of New Hampshire, Durham, NH, USA.,Space Science Center, University of New Hampshire, Durham, NH, USA
| | - D W Curtis
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D Gallagher
- Heliophysics and Planetary Science Branch ST13, Marshall Space Flight Center, Huntsville, AL, USA
| | - S P Gary
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - L Golub
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
| | - J S Halekas
- Department of Physics and Astronomy, University of Iowa, IA, USA
| | - G C Ho
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - T S Horbury
- The Blackett Laboratory, Imperial College London, London, UK
| | - Q Hu
- Department of Space Science and Center for Space Plasma and Aeronomic Research, University of Alabama in Huntsville, Huntsville, AL, USA
| | - J Huang
- Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - K G Klein
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA.,Department of Planetary Sciences, University of Arizona, Tucson, AZ, USA
| | - K E Korreck
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
| | - D E Larson
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - R Livi
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - B Maruca
- Department of Physics and Astronomy, University of Delaware, Newark, DE, USA.,Bartol Research Institute, University of Delaware, Newark, DE, USA
| | - B Lavraud
- Institut de Recherche en Astrophysique et Planétologie, CNRS, UPS, CNES, Université de Toulouse, Toulouse, France
| | - P Louarn
- Institut de Recherche en Astrophysique et Planétologie, CNRS, UPS, CNES, Université de Toulouse, Toulouse, France
| | - M Maksimovic
- LESIA, Observatoire de Paris, Université PSL, CNRS, Sorbonne Université, Université de Paris, Meudon, France
| | - M Martinovic
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
| | - D McGinnis
- Department of Physics and Astronomy, University of Iowa, IA, USA
| | - N V Pogorelov
- Department of Space Science and Center for Space Plasma and Aeronomic Research, University of Alabama in Huntsville, Huntsville, AL, USA
| | - J D Richardson
- Kavli Center for Astrophysics and Space Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - R M Skoug
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | - M L Stevens
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
| | - A Szabo
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Velli
- Department of Earth, Planetary and Space Sciences, University of California, Los Angeles, CA, USA
| | - P L Whittlesey
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - K H Wright
- Universities Space Research Association, Science and Technology Institute, Huntsville, AL, USA
| | - G P Zank
- Department of Space Science and Center for Space Plasma and Aeronomic Research, University of Alabama in Huntsville, Huntsville, AL, USA
| | - R J MacDowall
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - D J McComas
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
| | - R L McNutt
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - M Pulupa
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - N E Raouafi
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - N A Schwadron
- Department of Physics and Astronomy, University of New Hampshire, Durham, NH, USA.,Space Science Center, University of New Hampshire, Durham, NH, USA
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Aharchi J, Aldridge I, Arling V, Bullard C, Carlson P, Cox C, Deiss K, Dillon J, Ellingson J, Fitzgerald S, Forgey R, Gailbreath K, Gallagher D, Geftman V, Herbst K, Hillis P, Johnson M, Koch S, Lewis D, Luepke J, McDonagh S, McGovern B, Moon B, Moreland L, Murray L, Richter D, Rucker C, Siu MC, Smith C, Smith J, Stoltzfus E, Summers C, Taylor B, Toth J, White S, Witt JL, Young S. Method Extension Study to Validate Applicability of AOAC Official Method 996.14 Assurance® Polyclonal Enzyme Immunoassay for Detection of Listeria monocytogenes and Related Listeria spp. from Environmental Surfaces: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Test portions from 3 environmental surface types, representative of typical surfaces found in a food production facility, were analyzed by the Assurance®Listeria Polyclonal Enzyme Immunoassay (EIA) and the U.S. Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) culture method for Listeria monocytogenes and related Listeria species. In all cases, naturally contaminated environmental test samples were collected from an actual food production facility by sponge or swab. Test samples from concrete surfaces were collected by both swab and sponge; sponge test samples were collected from rubber surfaces, and swabs were used to sample steel surfaces. Test portions from each surface type were simultaneously analyzed by both methods. A total of 23 collaborators, representing government agencies, as well as private industry in both the United States and Canada, participated in the study. During this study, a total of 550 test portions and controls was analyzed and confirmed, of which 207 were positive and 336 were negative by both methods. Six test portions were positive by culture, but negative by the EIA. Three test portions were negative by culture, but positive by the EIA. Two test portions were negative by EIA and by culture, but confirmed positive when EIA enrichment broths were subcultured to selective agars. The data reported here indicate that the Assurance®Listeria EIA method and the USDA/FSIS culture method are statistically equivalent for detection of L. monocytogenes and related Listeria species from environmental surfaces taken by sponges or swabs.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | | | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Aguilar G, Aharchi J, Aldridge I, Arling V, Bitner B, Bullard C, Carlson P, Cox C, Deiss K, Dillon J, Dombroski P, Ellingson J, Fitzgerald S, Forgey R, Gailbreath K, Gallagher D, Geftman V, Herbst K, Hillis P, Johnson M, Koch S, Lewis D, Luepke J, Martensen D, McDonagh S, McGovern B, Moon B, Moreland L, Murray L, Richter D, Robertson M, Rogers P, Rucker C, Sacca J, Siu MC, Smith C, Smith J, Stoltzfus E, Summers C, Taylor B, Toth J, Vess R, White S, Witt JL, Young S. Method Extension Study to Validate Applicability of AOAC Official Method 997.03 Visual Immunoprecipitate Assay (VIP®) for Listeria monocytogenes and Related Listeria spp. from Environmental Surfaces: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Test portions from 3 environmental surface types, representative of typical surfaces found in a food production facility, were analyzed by the Visual Immunoprecipitate assay (VIP®) and the U.S. Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) culture method for Listeria monocytogenes and related Listeria species. In all cases, naturally contaminated environmental test samples were collected from an actual food production facility by sponge or swab. Test samples from concrete surfaces were collected by both swab and sponge; sponge test samples were collected from rubber surfaces, and swabs were used to sample steel surfaces. Test portions from each surface type were simultaneously analyzed by both methods. A total of 27 laboratories, representing government agencies as well as private industry in both the United States and Canada, participated in the study. During this study, a total of 615 test portions and controls was analyzed and confirmed, of which 227 were positive and 378 were negative by both methods. Nine test portions were positive by culture, but negative by the VIP. Five test portions were negative by culture, but positive by the VIP. Four test portions were negative by VIP and by culture, but confirmed positive when VIP enrichment broths were subcultured to selective agars. The data reported here indicate that the VIP method and the USDA/FSIS culture method are statistically equivalent for detection of L. monocytogenes and related Listeria species from environmental surfaces taken by sponges or swabs.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | | | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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Herrmann N, Ruthirakuhan M, Gallagher D, Verhoeff NPLG, Kiss A, Black SE, Lanctôt KL. Randomized Placebo-Controlled Trial of Nabilone for Agitation in Alzheimer's Disease. Am J Geriatr Psychiatry 2019; 27:1161-1173. [PMID: 31182351 DOI: 10.1016/j.jagp.2019.05.002] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the efficacy and safety of nabilone for agitation in patients with moderate-to-severe Alzheimer's disease (AD). DESIGN This 14-week randomized double-blind crossover trial compared nabilone to placebo (6 weeks each) with a 1-week washout between phases. SETTING Patients were recruited from a long-term care facility and geriatric psychiatry clinics. PARTICIPANTS Patients had AD (standardized Mini-Mental State Examination [sMMSE ≤24]) and agitation (Neuropsychiatric Inventory-Nursing Home version [NPI-NH]-agitation/aggression subscore ≥3). INTERVENTION Nabilone (target 1-2 mg) versus placebo. MEASUREMENTS The primary outcome was agitation (Cohen Mansfield Agitation Inventory [CMAI]). Secondary outcomes included NPI-NH total, NPI-NH caregiver distress, cognition (sMMSE and Severe Impairment Battery [SIB] or Alzheimer's Disease Assessment Scale of Cognition), global impression (Clinician's Global Impression of Change [CGIC]), and adverse events. RESULTS Thirty-nine patients (mean ± SD age = 87 ± 10, sMMSE = 6.5 ± 6.8, CMAI = 67.9 ± 17.6, NPI-NH total = 34.3 ± 15.8, 77% male, nabilone dose = 1.6 ± 0.5 mg) were randomized. There were no crossover or treatment-order effects. Using a linear mixed model, treatment differences (95% CI) in CMAI (b = -4.0 [-6.5 to -1.5], t(30.2) = -3.3, p = 0.003), NPI-NH total (b = -4.6 [-7.5 to -1.6], t(32.9) = -3.1, p = 0.004), NPI-NH caregiver distress (b = -1.7 [-3.4 to -0.07, t(33.7) = -2.1, p = 0.041), and sMMSE (b = 1.1 [0.1-2.0], t(22.6) = 2.4, p = 0.026) all favored nabilone. However, in those who completed the SIB (n = 25) treatment differences favored placebo (b = -4.6 [-7.3 to -1.8], t(20.7) = -4.8, p = 0.003). CGIC improvement during nabilone (47%) and placebo (23%) was not significantly different (McNemar's test, exact p = 0.09). There was more sedation during nabilone (45%) compared to placebo (16%) phases (McNemar's test, exact p = 0.02), but treatment-limiting sedation was not significantly different (McNemar's test, exact p = 0.22). CONCLUSIONS Nabilone may be an effective treatment for agitation. However, sedation and cognition should be closely monitored.
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Affiliation(s)
- Nathan Herrmann
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Myuri Ruthirakuhan
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Damien Gallagher
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | | | - Alex Kiss
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Sandra E Black
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Krista L Lanctôt
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
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Ruthirakuhan M, Herrmann N, Vieira D, Gallagher D, Lanctôt KL. The Roles of Apathy and Depression in Predicting Alzheimer Disease: A Longitudinal Analysis in Older Adults With Mild Cognitive Impairment. Am J Geriatr Psychiatry 2019; 27:873-882. [PMID: 30910421 PMCID: PMC6646066 DOI: 10.1016/j.jagp.2019.02.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Apathy and depression have each been associated with an increased risk of conversion from mild cognitive impairment (MCI) to Alzheimer disease (AD).These symptoms often co-occur and the contribution of each to risk of AD is not clear. METHODS National Alzheimer's Coordinating Center participants diagnosed with MCI at baseline and followed until development of AD or loss to follow-up (n = 4,932) were included. The risks of developing AD in MCI patients with neuropsychiatric symptoms (NPS) (apathy only, depression only, or both) were compared to that in those without NPS in a multivariate Cox regression survival analysis adjusting for baseline cognitive impairment, years of smoking, antidepressant use, and AD medication use. RESULTS Thirty-seven percent (N = 1713) of MCI patients developed AD (median follow-up 23 months). MCI patients with both apathy and depression had the greatest risk (hazard ratio [HR] = 1.37; 95% confidence interval [CI]: 1.17-1.61; p < 0.0001; Wald χ2 = 14.70; df = 1). Those with apathy only also had a greater risk (HR = 1.24; 95% CI: 1.05-1.47; p = 0.01; Wald χ2 = 6.22; df = 1), but not those with depression only (HR = 1.08; 95% CI: 0.95-1.22; p=0.25; Wald χ2 = 1.30; df = 1). Post-hoc analyses suggested depression may exacerbate cognitive decline in MCI patients with apathy (odds ratio = 0.70; 95% CI 0.52-0.95; p = 0.02; Wald χ2 = 5.28; df = 1), compared to those without apathy. CONCLUSION MCI patients with apathy alone or both apathy and depression are at a greater risk of developing AD compared to those with no NPS. Interventions targeting apathy and depression may reduce risk of AD.
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Affiliation(s)
- Myuri Ruthirakuhan
- Hurvitz Brain Sciences Program (MR, NH, DV, KLL), Sunnybrook Research Institute, Toronto; Departments of Pharmacology and Toxicology (MR, KLL), and Psychiatry (NH, DG, KLL), University of Toronto, Toronto
| | - Nathan Herrmann
- Hurvitz Brain Sciences Program (MR, NH, DV, KLL), Sunnybrook Research Institute, Toronto; Departments of Pharmacology and Toxicology (MR, KLL), and Psychiatry (NH, DG, KLL), University of Toronto, Toronto; Department of Psychiatry (NH, DG), Sunnybrook Health Sciences Centre, Toronto
| | - Danielle Vieira
- Hurvitz Brain Sciences Program (MR, NH, DV, KLL), Sunnybrook Research Institute, Toronto
| | - Damien Gallagher
- Departments of Pharmacology and Toxicology (MR, KLL), and Psychiatry (NH, DG, KLL), University of Toronto, Toronto; Department of Psychiatry (NH, DG), Sunnybrook Health Sciences Centre, Toronto
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program (MR, NH, DV, KLL), Sunnybrook Research Institute, Toronto; Departments of Pharmacology and Toxicology (MR, KLL), and Psychiatry (NH, DG, KLL), University of Toronto, Toronto.
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Karameh WK, Kortebi I, Kumar S, Gallagher D, Golas A, Schweizer TA, Munoz DG, Barfett J, Butters M, Bowie CR, Flint A, Rajji TK, Herrmann N, Pollock BG, Mulsant B, Mah L, Fischer CE. P4-080: COGNITION AND CARDIOVASCULAR DISEASE BURDEN IN OLDER ADULTS WITH MAJOR DEPRESSIVE DISORDER AND MILD COGNITIVE IMPAIRMENT. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Wael K. Karameh
- Centre for Addiction and Mental Health; Toronto ON Canada
- University of Toronto; Toronto ON Canada
- Keenan Research Centre for Biomedical Research; St. Michael's Hospital; Toronto ON Canada
- St. Michael's Hospital; Toronto ON Canada
| | | | - Sanjeev Kumar
- Centre for Addiction and Mental Health; Toronto ON Canada
- University of Toronto; Toronto ON Canada
| | - Damien Gallagher
- University of Toronto; Toronto ON Canada
- Sunnybrook Health Sciences Centre; Toronto ON Canada
| | - Angela Golas
- Centre for Addiction and Mental Health; Toronto ON Canada
- St. Michael's Hospital; Toronto ON Canada
- Keenan Research Centre for Biomedical Research; St. Michael's Hospital; Toronto ON Canada
| | - Tom A. Schweizer
- University of Toronto; Toronto ON Canada
- Keenan Research Centre for Biomedical Research; St. Michael's Hospital; Toronto ON Canada
| | - David G. Munoz
- University of Toronto; Toronto ON Canada
- Keenan Research Centre for Biomedical Research; St. Michael's Hospital; Toronto ON Canada
| | - Joseph Barfett
- St. Michael's Hospital; Toronto ON Canada
- Keenan Research Centre for Biomedical Research; St. Michael's Hospital; Toronto ON Canada
| | - Meryl Butters
- University of Pittsburgh; School of Medicine; Pittsburgh PA USA
| | - Christopher R. Bowie
- Centre for Addiction and Mental Health; Toronto ON Canada
- Queen's University; Kingston ON Canada
| | - Alastair Flint
- University of Toronto; Toronto ON Canada
- Centre for Mental Health; University Health Network; Toronto ON Canada
| | - Tarek K. Rajji
- Centre for Addiction and Mental Health; Toronto ON Canada
- University of Toronto; Toronto ON Canada
| | - Nathan Herrmann
- University of Toronto; Toronto ON Canada
- Sunnybrook Health Sciences Centre; Toronto ON Canada
| | - Bruce G. Pollock
- Campbell Family Mental Health Research Institute; Division of Geriatric Psychiatry, Centre for Addiction and Mental Health; Toronto ON Canada
| | - Benoit Mulsant
- Centre for Addiction and Mental Health; Toronto ON Canada
- University of Toronto; Toronto ON Canada
| | - Linda Mah
- University of Toronto; Toronto ON Canada
- Rotman Research Institute; Toronto ON Canada
| | - Corinne E. Fischer
- University of Toronto; Toronto ON Canada
- Keenan Research Centre for Biomedical Research; St. Michael's Hospital; Toronto ON Canada
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Khan MM, Lanctôt KL, Fremes SE, Wijeysundera HC, Radhakrishnan S, Gallagher D, Gandell D, Brenkel MC, Hazan EL, Docteur NG, Herrmann N. The value of screening for cognition, depression, and frailty in patients referred for TAVI. Clin Interv Aging 2019; 14:841-848. [PMID: 31190770 PMCID: PMC6512610 DOI: 10.2147/cia.s201615] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/19/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Current surgical risk assessment tools fall short of appreciating geriatric risk factors including cognitive deficits, depressive, and frailty symptoms that may worsen outcomes post-transcatheter aortic valve implantation (TAVI). This study hypothesized that a screening tool, SMARTIE, would improve detection of these risks pre-TAVI, and thus be predictive of postoperative delirium (POD) and 30-day mortality post-TAVI. Design: Prospective observational cohort study, using a historical cohort for comparison. Participants: A total of 234 patients (age: 82.2±6.7 years, 59.4% male) were included. Half were screened using SMARTIE. Methods: The SMARTIE cohort was assessed for cognitive deficits and depressive symptoms using the Mini-Cog test and PHQ-2, respectively. Measures of frailty included activities of daily living inventory, the Timed Up and Go test and grip strength. For the pre-SMARTIE cohort, we extracted cognitive deficits, depression and frailty symptoms from clinic charts. The incidence of POD and 30-day mortality were recorded. Bivariate chi-square analysis or t-tests were used to report associations between SMARTIE and pre-SMARTIE groups. Multivariable logistic regression models were employed to identify independent predictors of POD and 30-day mortality. Results: More patients were identified with cognitive deficits (χ2=11.73, p=0.001), depressive symptoms (χ2=8.15, p=0.004), and physical frailty (χ2=5.73, p=0.017) using SMARTIE. Cognitive deficits were an independent predictor of POD (OR: 8.4, p<0.01) and 30-day mortality (OR: 4.04, p=0.03). Conclusion: This study emphasized the value of screening for geriatric risk factors prior to TAVI by demonstrating that screening increased identification of at-risk patients. It also confirmed findings that cognitive deficits are predictive of POD and mortality following TAVI.
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Affiliation(s)
- Maisha M Khan
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
| | - Stephen E Fremes
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | | | - Sam Radhakrishnan
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Damien Gallagher
- Department of Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
| | - Dov Gandell
- Department of Geriatric Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Megan C Brenkel
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Elias L Hazan
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Natalia G Docteur
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
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Liu C, Herrmann N, Gallagher D, Rajji T, Oh P, Marzolini S, Banks L, Vieira D, Lanctot K. Designing a randomized, sham-controlled, parallel-design trial to investigate the effects of a combined exercise priming and transcranial direct current stimulation intervention in mild cognitive impairment and alzheimer’s disease. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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