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Eissman JM, Archer DB, Mukherjee S, Lee ML, Choi S, Scollard P, Trittschuh EH, Mez JB, Bush WS, Kunkle BW, Naj AC, Gifford KA, Cuccaro ML, Cruchaga C, Pericak‐Vance MA, Farrer LA, Wang L, Schellenberg GD, Mayeux RP, Haines JL, Jefferson AL, Kukull WA, Keene CD, Saykin AJ, Thompson PM, Martin ER, Bennett DA, Barnes LL, Schneider JA, Crane PK, Hohman TJ, Dumitrescu L. Sex-specific genetic architecture of late-life memory performance. Alzheimers Dement 2024; 20:1250-1267. [PMID: 37984853 PMCID: PMC10917043 DOI: 10.1002/alz.13507] [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] [Received: 04/04/2023] [Revised: 08/08/2023] [Accepted: 09/07/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Women demonstrate a memory advantage when cognitively healthy yet lose this advantage to men in Alzheimer's disease. However, the genetic underpinnings of this sex difference in memory performance remain unclear. METHODS We conducted the largest sex-aware genetic study on late-life memory to date (Nmales = 11,942; Nfemales = 15,641). Leveraging harmonized memory composite scores from four cohorts of cognitive aging and AD, we performed sex-stratified and sex-interaction genome-wide association studies in 24,216 non-Hispanic White and 3367 non-Hispanic Black participants. RESULTS We identified three sex-specific loci (rs67099044-CBLN2, rs719070-SCHIP1/IQCJ-SCHIP), including an X-chromosome locus (rs5935633-EGL6/TCEANC/OFD1), that associated with memory. Additionally, we identified heparan sulfate signaling as a sex-specific pathway and found sex-specific genetic correlations between memory and cardiovascular, immune, and education traits. DISCUSSION This study showed memory is highly and comparably heritable across sexes, as well as highlighted novel sex-specific genes, pathways, and genetic correlations that related to late-life memory. HIGHLIGHTS Demonstrated the heritable component of late-life memory is similar across sexes. Identified two genetic loci with a sex-interaction with baseline memory. Identified an X-chromosome locus associated with memory decline in females. Highlighted sex-specific candidate genes and pathways associated with memory. Revealed sex-specific shared genetic architecture between memory and complex traits.
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Archer DB, Eissman JM, Mukherjee S, Lee ML, Choi S, Scollard P, Trittschuh EH, Mez JB, Bush WS, Kunkle BW, Naj AC, Gifford KA, Cuccaro ML, Pericak‐Vance MA, Farrer LA, Wang L, Schellenberg GD, Mayeux RP, Haines JL, Jefferson AL, Kukull WA, Keene CD, Saykin AJ, Thompson PM, Martin ER, Bennett DA, Barnes LL, Schneider JA, Crane PK, Dumitrescu L, Hohman TJ. Longitudinal change in memory performance as a strong endophenotype for Alzheimer's disease. Alzheimers Dement 2024; 20:1268-1283. [PMID: 37985223 PMCID: PMC10896586 DOI: 10.1002/alz.13508] [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] [Received: 06/19/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Although large-scale genome-wide association studies (GWAS) have been conducted on AD, few have been conducted on continuous measures of memory performance and memory decline. METHODS We conducted a cross-ancestry GWAS on memory performance (in 27,633 participants) and memory decline (in 22,365 participants; 129,201 observations) by leveraging harmonized cognitive data from four aging cohorts. RESULTS We found high heritability for two ancestry backgrounds. Further, we found a novel ancestry locus for memory decline on chromosome 4 (rs6848524) and three loci in the non-Hispanic Black ancestry group for memory performance on chromosomes 2 (rs111471504), 7 (rs4142249), and 15 (rs74381744). In our gene-level analysis, we found novel genes for memory decline on chromosomes 1 (SLC25A44), 11 (BSX), and 15 (DPP8). Memory performance and memory decline shared genetic architecture with AD-related traits, neuropsychiatric traits, and autoimmune traits. DISCUSSION We discovered several novel loci, genes, and genetic correlations associated with late-life memory performance and decline. HIGHLIGHTS Late-life memory has high heritability that is similar across ancestries. We discovered four novel variants associated with late-life memory. We identified four novel genes associated with late-life memory. Late-life memory shares genetic architecture with psychiatric/autoimmune traits.
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Anderson C, Cai AWT, Lee ML, Horrey WJ, Liang Y, O’Brien CS, Czeisler CA, Howard ME. Feeling sleepy? stop driving-awareness of fall asleep crashes. Sleep 2023; 46:zsad136. [PMID: 37158173 PMCID: PMC10636256 DOI: 10.1093/sleep/zsad136] [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] [Received: 06/21/2022] [Revised: 04/04/2023] [Indexed: 05/10/2023] Open
Abstract
STUDY OBJECTIVES To examine whether drivers are aware of sleepiness and associated symptoms, and how subjective reports predict driving impairment and physiological drowsiness. METHODS Sixteen shift workers (19-65 years; 9 women) drove an instrumented vehicle for 2 hours on a closed-loop track after a night of sleep and a night of work. Subjective sleepiness/symptoms were rated every 15 minutes. Severe and moderate driving impairment was defined by emergency brake maneuvers and lane deviations, respectively. Physiological drowsiness was defined by eye closures (Johns drowsiness scores) and EEG-based microsleep events. RESULTS All subjective ratings increased post night-shift (p < 0.001). No severe drive events occurred without noticeable symptoms beforehand. All subjective sleepiness ratings, and specific symptoms, predicted a severe (emergency brake) driving event occurring in the next 15 minutes (OR: 1.76-2.4, AUC > 0.81, p < 0.009), except "head dropping down". Karolinska Sleepiness Scale (KSS), ocular symptoms, difficulty keeping to center of the road, and nodding off to sleep, were associated with a lane deviation in the next 15 minutes (OR: 1.17-1.24, p<0.029), although accuracy was only "fair" (AUC 0.59-0.65). All sleepiness ratings predicted severe ocular-based drowsiness (OR: 1.30-2.81, p < 0.001), with very good-to-excellent accuracy (AUC > 0.8), while moderate ocular-based drowsiness was predicted with fair-to-good accuracy (AUC > 0.62). KSS, likelihood of falling asleep, ocular symptoms, and "nodding off" predicted microsleep events, with fair-to-good accuracy (AUC 0.65-0.73). CONCLUSIONS Drivers are aware of sleepiness, and many self-reported sleepiness symptoms predicted subsequent driving impairment/physiological drowsiness. Drivers should self-assess a wide range of sleepiness symptoms and stop driving when these occur to reduce the escalating risk of road crashes due to drowsiness.
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Affiliation(s)
- Clare Anderson
- Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Anna W T Cai
- Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Michael L Lee
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - William J Horrey
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- AAA Foundation for Traffic Safety, Washington, DC, USA
| | - Yulan Liang
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
| | - Conor S O’Brien
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Center for Innovation in Digital Healthcare, Mass General Hospital, Boston MA, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Mark E Howard
- Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC,Australia
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Walters S, Contreras AG, Eissman JM, Mukherjee S, Lee ML, Choi SE, Scollard P, Trittschuh EH, Mez JB, Bush WS, Kunkle BW, Naj AC, Peterson A, Gifford KA, Cuccaro ML, Cruchaga C, Pericak-Vance MA, Farrer LA, Wang LS, Haines JL, Jefferson AL, Kukull WA, Keene CD, Saykin AJ, Thompson PM, Martin ER, Bennett DA, Barnes LL, Schneider JA, Crane PK, Hohman TJ, Dumitrescu L. Associations of Sex, Race, and Apolipoprotein E Alleles With Multiple Domains of Cognition Among Older Adults. JAMA Neurol 2023; 80:929-939. [PMID: 37459083 PMCID: PMC10352930 DOI: 10.1001/jamaneurol.2023.2169] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/15/2023] [Indexed: 07/20/2023]
Abstract
Importance Sex differences are established in associations between apolipoprotein E (APOE) ε4 and cognitive impairment in Alzheimer disease (AD). However, it is unclear whether sex-specific cognitive consequences of APOE are consistent across races and extend to the APOE ε2 allele. Objective To investigate whether sex and race modify APOE ε4 and ε2 associations with cognition. Design, Setting, and Participants This genetic association study included longitudinal cognitive data from 4 AD and cognitive aging cohorts. Participants were older than 60 years and self-identified as non-Hispanic White or non-Hispanic Black (hereafter, White and Black). Data were previously collected across multiple US locations from 1994 to 2018. Secondary analyses began December 2021 and ended September 2022. Main Outcomes and Measures Harmonized composite scores for memory, executive function, and language were generated using psychometric approaches. Linear regression assessed interactions between APOE ε4 or APOE ε2 and sex on baseline cognitive scores, while linear mixed-effect models assessed interactions on cognitive trajectories. The intersectional effect of race was modeled using an APOE × sex × race interaction term, assessing whether APOE × sex interactions differed by race. Models were adjusted for age at baseline and corrected for multiple comparisons. Results Of 32 427 participants who met inclusion criteria, there were 19 007 females (59%), 4453 Black individuals (14%), and 27 974 White individuals (86%); the mean (SD) age at baseline was 74 years (7.9). At baseline, 6048 individuals (19%) had AD, 4398 (14%) were APOE ε2 carriers, and 12 538 (38%) were APOE ε4 carriers. Participants missing APOE status were excluded (n = 9266). For APOE ε4, a robust sex interaction was observed on baseline memory (β = -0.071, SE = 0.014; P = 9.6 × 10-7), whereby the APOE ε4 negative effect was stronger in females compared with males and did not significantly differ among races. Contrastingly, despite the large sample size, no APOE ε2 × sex interactions on cognition were observed among all participants. When testing for intersectional effects of sex, APOE ε2, and race, an interaction was revealed on baseline executive function among individuals who were cognitively unimpaired (β = -0.165, SE = 0.066; P = .01), whereby the APOE ε2 protective effect was female-specific among White individuals but male-specific among Black individuals. Conclusions and Relevance In this study, while race did not modify sex differences in APOE ε4, the APOE ε2 protective effect could vary by race and sex. Although female sex enhanced ε4-associated risk, there was no comparable sex difference in ε2, suggesting biological pathways underlying ε4-associated risk are distinct from ε2 and likely intersect with age-related changes in sex biology.
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Affiliation(s)
- Skylar Walters
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alex G. Contreras
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jaclyn M. Eissman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Michael L. Lee
- Department of Medicine, University of Washington, Seattle
| | - Seo-Eun Choi
- Department of Medicine, University of Washington, Seattle
| | | | - Emily H. Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
- Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, Washington
| | - Jesse B. Mez
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - William S. Bush
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Brian W. Kunkle
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Adam C. Naj
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Amalia Peterson
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Katherine A. Gifford
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St Louis, Missouri
| | - Margaret A. Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Lindsay A. Farrer
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Li-San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Jonathan L. Haines
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Angela L. Jefferson
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Walter A. Kukull
- Department of Epidemiology, School of Public Health, University of Washington, Seattle
| | - C. Dirk Keene
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana University School of Medicine, Indianapolis
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis
| | - Paul M. Thompson
- Keck School of Medicine, University of Southern California, Los Angeles
| | - Eden R. Martin
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Paul K. Crane
- Department of Medicine, University of Washington, Seattle
| | - Timothy J. Hohman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Logan Dumitrescu
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
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Scollard P, Choi SE, Lee ML, Mukherjee S, Trittschuh EH, Sanders RE, Gibbons LE, Joshi P, Devine S, Au R, Dams-O’Connor K, Saykin AJ, Seshadri S, Beiser A, Aparicio HJ, Salinas J, Gonzales MM, Pase MP, Ghosh S, Finney R, Mez J, Crane PK. Ceiling effects and differential measurement precision across calibrated cognitive scores in the Framingham Study. Neuropsychology 2023; 37:383-397. [PMID: 37276135 PMCID: PMC10247160 DOI: 10.1037/neu0000828] [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: 06/07/2023] Open
Abstract
OBJECTIVE To calibrate cognitive assessment data across multiple waves of the Framingham Heart Study (FHS), addressing study design considerations, ceiling effects, and measurement precision. METHOD FHS participants completed several cognitive assessments including screening instruments and more comprehensive batteries at different study visits. We used expert opinion to assign each cognitive test item to a single domain-memory, executive function, language, visuospatial abilities, or none of the above. As part of a larger cross-study harmonization effort, we calibrated each domain separately using bifactor confirmatory factor analysis (CFA) models, incorporating item parameters for anchor items previously calibrated from other studies and freely estimating item parameters for FHS-specific items. We obtained scores and standard errors (SEs) for each participant at each study visit. We addressed psychometric considerations of ceiling effects and measurement precision. RESULTS Overall, memory domain scores were the most precisely estimated. Scores for all domains from visits where the Mini-Mental State Examination (MMSE) was the only test administered were imprecisely estimated and suffered from ceiling effects. Scores from visits with a more extensive battery were estimated more precisely and better differentiated between ability levels. CONCLUSIONS The harmonized and calibrated cognitive data from the FHS should prove useful for future analyses examining cognition and cognitive decline. They will be of particular interest when combining FHS with other studies that have been similarly calibrated. Researchers should be aware of varying levels of measurement precision and the possibility of ceiling effects in their planned analyses of data from the FHS and similar studies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Phoebe Scollard
- Department of Medicine, University of Washington, Seattle, WA USA
| | - Seo-Eun Choi
- Department of Medicine, University of Washington, Seattle, WA USA
| | - Michael L. Lee
- Department of Medicine, University of Washington, Seattle, WA USA
| | | | - Emily H. Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
- VA Puget Sound, Geriatric Research Education and Clinical Center
| | | | - Laura E. Gibbons
- Department of Medicine, University of Washington, Seattle, WA USA
| | - Prajakta Joshi
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA USA
- Department of General Dentistry, Boston University School of Dentistry, Boston, MA USA
| | - Sherral Devine
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY U.S.A
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY U.S.A
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana University, Indianapolis, IN USA
- Indiana Alzheimer’s Disease Research Center, Indiana University, Indianapolis, IN USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, San Antonio, TX USA
| | - Alexa Beiser
- Department of Neurology, Boston University School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Hugo J. Aparicio
- Department of Neurology, Boston University School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Joel Salinas
- Department of Neurology, New York University Grossman School of Medicine, New York, NY USA
| | - Mitzi M. Gonzales
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, San Antonio, TX USA
| | - Matthew P. Pase
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC AUS
- Harvard T.H. Chan School of public health, Boston, MA USA
| | - Saptaparni Ghosh
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Rebecca Finney
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Jesse Mez
- Department of Neurology, Boston University School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Alzheimer’s Disease Research Center, Boston, MA USA
| | - Paul K. Crane
- Department of Medicine, University of Washington, Seattle, WA USA
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Mukherjee S, Choi SE, Lee ML, Scollard P, Trittschuh EH, Mez J, Saykin AJ, Gibbons LE, Sanders RE, Zaman AF, Teylan MA, Kukull WA, Barnes LL, Bennett DA, Lacroix AZ, Larson EB, Cuccaro M, Mercado S, Dumitrescu L, Hohman TJ, Crane PK. Cognitive domain harmonization and cocalibration in studies of older adults. Neuropsychology 2023; 37:409-423. [PMID: 35925737 PMCID: PMC9898463 DOI: 10.1037/neu0000835] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [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: 02/06/2023] Open
Abstract
OBJECTIVE Studies use different instruments to measure cognitirating cognitive tests permit direct comparisons of individuals across studies and pooling data for joint analyses. METHOD We began our legacy item bank with data from the Adult Changes in Thought study (n = 5,546), the Alzheimer's Disease Neuroimaging Initiative (n = 3,016), the Rush Memory and Aging Project (n = 2,163), and the Religious on such as the Mini-Mental State Examination, the Alzheimer's Disease Assessment Scale-Cognitive Subscale, the Wechsler Memory Scale, and the Boston Naming Test. CocalibOrders Study (n = 1,456). Our workflow begins with categorizing items administered in each study as indicators of memory, executive functioning, language, visuospatial functioning, or none of these domains. We use confirmatory factor analysis models with data from the most recent visit on the pooled sample across these four studies for cocalibration and derive item parameters for all items. Using these item parameters, we then estimate factor scores along with corresponding standard errors for each domain for each study. We added additional studies to our pipeline as available and focused on thorough consideration of candidate anchor items with identical content and administration methods across studies. RESULTS Prestatistical harmonization steps such qualitative and quantitative assessment of granular cognitive items and evaluating factor structure are important steps when trying to cocalibrate cognitive scores across studies. We have cocalibrated cognitive data and derived scores for four domains for 76,723 individuals across 10 studies. CONCLUSIONS We have implemented a large-scale effort to harmonize and cocalibrate cognitive domain scores across multiple studies of cognitive aging. Scores on the same metric facilitate meta-analyses of cognitive outcomes across studies or the joint analysis of individual data across studies. Our systematic approach allows for cocalibration of additional studies as they become available and our growing item bank enables robust investigation of cognition in the context of aging and dementia. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Seo-Eun Choi
- Department of Medicine, The University of Washington
| | | | | | - Emily H. Trittschuh
- Department of Psychiatry and Behavioral Sciences, The University of Washington
- VA Puget Sound Health Care System, Seattle, Washington, United States
| | - Jesse Mez
- Department of Neurology, Boston University School of Medicine
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana Alzheimer’s Disease Research Center, Indiana University
| | | | | | - Andrew F. Zaman
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine
| | - Merilee A. Teylan
- National Alzheimer’s Coordinating Center, Department of Epidemiology, University of Washington
| | - Walter A. Kukull
- National Alzheimer’s Coordinating Center, Department of Epidemiology, University of Washington
- Department of Epidemiology, The University of Washington
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, United States
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, United States
| | | | - Eric B. Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, United States
| | - Michael Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine
| | - Shannon Mercado
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Logan Dumitrescu
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Timothy J. Hohman
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Paul K. Crane
- Department of Medicine, The University of Washington
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David NCE, Juliana H, Chok M, Gan YZ, Tan YC, Nur Adlina MN, Tan SL, Tan MV, Aina Mariana AM, Hasri H, Lee ML, Cheah YK. Prevalence of COVID-19 among healthcare workers in the paediatric department: Estimates from a multicenter cross-sectional survey in Negeri Sembilan. Med J Malaysia 2023; 78:80-86. [PMID: 36715196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has reached a phase where many have been infected at least once. Healthcare workers were not spared from being infected. This study aimed to determine the period prevalence of COVID-19 among the paediatric healthcare workers in Negeri Sembilan as the country transitioned into an endemic phase of the pandemic. Additionally, we investigate potential sociodemographic and occupational characteristics associated with SARS-CoV-2 infection among healthcare workers. MATERIALS AND METHODS A cross-sectional study was conducted among the healthcare workers in the paediatric department at three public specialist hospitals in Negeri Sembilan between 15 and 21 April 2022. Data were collected through a self-administered questionnaire. RESULTS Out of the 504 eligible healthcare workers, 493 participated in this study (response rate 97.8%). The overall prevalence of COVID-19 (11 March 2020-15 April 2022) among healthcare workers was 50.9%. The majority (80.1%) were infected during the Omicron wave two months before the survey. Household contacts accounted for 35.9% of infection sources. The proportion of non-doctors in the COVID-19-infected group was significantly higher compared to the non-infected group (74.1% vs 64.0%, p=0.016). The COVID-19-infected group had a higher proportion of schoolgoing children (44.6% vs 30.6%, p=0.001) and children who attended pre-school/sent to the babysitter (49.0% vs 24.4%, p<0.001). There were no significant differences between infection rates among the healthcare workers working in the tertiary hospital and the district hospitals. There were also no significant differences in the proportion of COVID-19- infected doctors and nurses when analysed by seniority. CONCLUSION Our study provided an estimate on the prevalence of COVID-19 among paediatric healthcare workers in Negeri Sembilan and the factors associated with infection, which captures the extent and magnitude of this pandemic on the state's paediatric department. Most infections resulted from household contact, with a higher proportion of infected healthcare workers having young children.
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Affiliation(s)
- N C E David
- Hospital Tuanku Ja'afar, Ministry of Health Malaysia, Seremban, Negeri Sembilan, Malaysia.
| | - H Juliana
- Hospital Tuanku Ja'afar, Ministry of Health Malaysia, Seremban, Negeri Sembilan, Malaysia
| | - M Chok
- Hospital Tuanku Ja'afar, Ministry of Health Malaysia, Seremban, Negeri Sembilan, Malaysia
| | - Y Z Gan
- Hospital Tuanku Ja'afar, Ministry of Health Malaysia, Seremban, Negeri Sembilan, Malaysia
| | - Y C Tan
- Hospital Tuanku Ampuan Najihah, Ministry of Health Malaysia, Kuala Pilah, Negeri Sembilan, Malaysia
| | - M N Nur Adlina
- Hospital Tuanku Ampuan Najihah, Ministry of Health Malaysia, Kuala Pilah, Negeri Sembilan, Malaysia
| | - S L Tan
- Hospital Port Dickson, Ministry of Health Malaysia, Port Dickson, Negeri Sembilan, Malaysia
| | - M V Tan
- Hospital Port Dickson, Ministry of Health Malaysia, Port Dickson, Negeri Sembilan, Malaysia
| | - A M Aina Mariana
- Hospital Port Dickson, Ministry of Health Malaysia, Port Dickson, Negeri Sembilan, Malaysia
| | - H Hasri
- Hospital Tuanku Ampuan Najihah, Ministry of Health Malaysia, Kuala Pilah, Negeri Sembilan, Malaysia
| | - M L Lee
- Hospital Tuanku Ja'afar, Ministry of Health Malaysia, Seremban, Negeri Sembilan, Malaysia
| | - Y K Cheah
- Hospital Tuanku Ja'afar, Ministry of Health Malaysia, Seremban, Negeri Sembilan, Malaysia
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8
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Contreras AG, Walters S, Mukherjee S, Lee ML, Choi S, Scollard P, Trittschuh EH, Mez JB, Bush WS, Engelman CD, Lu Q, Fardo DW, Widaman KF, Buckley RF, Mormino EC, Kunkle BW, Naj AC, Clark LR, Gifford KA, Cuccaro ML, Cruchaga C, Pericak‐Vance MA, Farrer LA, Wang L, Schellenberg GD, Haines JL, Jefferson AL, Johnson SC, Kukull WA, Albert MS, Keene CD, Saykin AJ, Larson EB, Sperling RA, Mayeux R, Thompson PM, Martin ER, Bennett DA, Barnes LL, Schneider JA, Crane PK, Hohman TJ, Dumitrescu L. Sex differences in
APOE
effects on cognition are domain‐specific. Alzheimers Dement 2022. [DOI: 10.1002/alz.068262] [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)
- Alex G Contreras
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center Nashville IN USA
| | - Skylar Walters
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | | | | | | | | | | | - Jesse B. Mez
- Boston University School of Medicine Boston MA USA
| | - William S. Bush
- Case Western Reserve University School of Medicine Cleveland OH USA
| | - Corinne D. Engelman
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Qiongshi Lu
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - David W. Fardo
- University of Kentucky / Sanders‐Brown Center on Aging Lexington KY USA
| | | | - Rachel F. Buckley
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | - Brian W. Kunkle
- John P. Hussman Institute for Human Genomics, Miller School of Medicine Miami FL USA
| | - Adam C. Naj
- University of Pennsylvania, Perelman School of Medicine, Department of Biostatistics and Epidemiology/Center for Clinical Epidemiology and Biostatistics Philadelphia PA USA
| | - Lindsay R. Clark
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | | | | | | | - Margaret A. Pericak‐Vance
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
| | - Lindsay A. Farrer
- Boston University School of Medicine, Department of Medicine, Biomedical Genetics Boston MA USA
| | - Li‐San Wang
- University of Pennsylvania Philadelphia PA USA
| | - Gerard D. Schellenberg
- University of Pennsylvania, Perelman School of Medicine, Path & Lab Med, Stellar Chance Philadelphia PA USA
| | - Jonathan L. Haines
- Case Western Reserve University School of Medicine, Department of Population & Quantitative Health Sciences, Cleveland Institute for Computational Biology Cleveland OH USA
| | - Angela L. Jefferson
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research Center Madison WI USA
- University of Wisconsin‐Madison Madison WI USA
| | - Walter A. Kukull
- University of Washington Seattle WA USA
- National Alzheimer's Coordinating Center, University of Washington Seattle WA USA
| | | | | | | | | | - Reisa A. Sperling
- Massachusetts General Hospital, Harvard Medical SchoolDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | - Paul M Thompson
- Keck School of Medicine, University of Southern California Los Angeles CA USA
| | - Eden R. Martin
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center and Department of Neurological Sciences, Rush University Medical Center Chicago IL USA
| | - Lisa L. Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | - Paul K. Crane
- University of Washington Alzheimer’s Disease Research Center, University of Washington School of Medicine Seattle WA USA
| | - Timothy J. Hohman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | - Logan Dumitrescu
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
| | | | | | | |
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9
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Eissman JM, Smith AN, Mukherjee S, Lee ML, Choi S, Scollard P, Trittschuh EH, Mez JB, Bush WS, Engelman CD, Lu Q, Fardo DW, Widaman KF, Buckley RF, Mormino EC, Kunkle BW, Naj AC, Clark LR, Gifford KA, Cuccaro ML, Cruchaga C, Pericak‐Vance MA, Farrer LA, Wang L, Schellenberg GD, Haines JL, Jefferson AL, Johnson SC, Kukull WA, Albert MS, Keene CD, Saykin AJ, Larson EB, Sperling RA, Mayeux R, Thompson PM, Martin ER, Bennett DA, Barnes LL, Schneider JA, Crane PK, Hohman TJ, Dumitrescu L. Sex‐specific genetic predictors of memory, executive function, and language performance. Alzheimers Dement 2022. [DOI: 10.1002/alz.067842] [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)
- Jaclyn M. Eissman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
| | - Alexandra N. Smith
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
| | | | | | | | | | | | - Jesse B. Mez
- Boston University School of Medicine Boston MA USA
| | - William S. Bush
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
| | | | - Qiongshi Lu
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - David W. Fardo
- College of Public Health, University of Kentucky Lexington KY USA
- Sanders‐Brown Center on Aging, University of Kentucky Lexington KY USA
| | | | - Rachel F. Buckley
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Melbourne School of Psychological Sciences, University of Melbourne Melbourne VIC Australia
- Center for Alzheimer’s Research and Treatment, Brigham and Women’s Hospital/Harvard Medical School Boston MA USA
| | | | - Brian W. Kunkle
- John P. Hussman Institute for Human Genomics, Miller School of Medicine Miami FL USA
| | - Adam C. Naj
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | - Lindsay R. Clark
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Katherine A. Gifford
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
| | | | - Margaret A. Pericak‐Vance
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
| | - Lindsay A. Farrer
- Boston University School of Medicine Boston MA USA
- Boston University School of Public Health Boston MA USA
| | - Li‐San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | - Gerard D. Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | - Jonathan L. Haines
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
| | - Angela L. Jefferson
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | | | | | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins University School of Medicine Baltimore MD USA
| | | | - Andrew J. Saykin
- Indiana Alzheimer’s Disease Research Center, Indiana University School of Medicine Indianapolis IN USA
- Indiana University School of Medicine Indianapolis IN USA
| | - Eric B Larson
- University of Washington Seattle WA USA
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
| | - Reisa A. Sperling
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Center for Alzheimer’s Research and Treatment, Brigham and Women’s Hospital/Harvard Medical School Boston MA USA
| | - Richard Mayeux
- Columbia University New York NY USA
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, Columbia University New York NY USA
- The Institute for Genomic Medicine, Columbia University Medical Center and The New York Presbyterian Hospital New York NY USA
| | - Paul M Thompson
- Keck School of Medicine, University of Southern California Los Angeles CA USA
| | - Eden R Martin
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | - Lisa L. Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | | | - Timothy J. Hohman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
| | - Logan Dumitrescu
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
| | | | | | | | | |
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10
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Phillips J, Dumitrescu L, Archer DB, Smith AN, Mukherjee S, Lee ML, Choi S, Scollard P, Trittschuh EH, Mez JB, Mahoney ER, Bush WS, Engelman CD, Lu Q, Fardo DW, Widaman KF, Buckley RF, Mormino EC, Harrison TM, Sanders E, Clark LR, Gifford KA, Vardarajan BN, Cuccaro ML, Pericak‐Vance MA, Farrer LA, Wang L, Schellenberg GD, Haines JL, Jefferson AL, Johnson SC, Kukull WA, Albert MS, Keene CD, Saykin AJ, Larson EB, Sperling RA, Mayeux R, Goate A, Neuner S, Renton AE, Marcora E, Fulton‐Howard B, Patel T, Bennett DA, Schneider JA, Crane PK, Hohman TJ. Longitudinal GWAS Identifies Novel Genetic Variants and Complex Traits Associated with Resilience to Alzheimer’s Disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.067816] [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)
- Jared Phillips
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | - Logan Dumitrescu
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
| | - Derek B Archer
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
| | - Alexandra N. Smith
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | | | | | | | | | - Emily H. Trittschuh
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System Seattle WA USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine Seattle WA USA
| | - Jesse B. Mez
- Boston University School of Medicine Boston MA USA
| | - Emily R. Mahoney
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
| | - William S. Bush
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
| | - Corinne D Engelman
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Qiongshi Lu
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - David W. Fardo
- College of Public Health, University of Kentucky Lexington KY USA
- Sanders‐Brown Center on Aging, University of Kentucky Lexington KY USA
| | | | - Rachel F. Buckley
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Melbourne School of Psychological Sciences, University of Melbourne Melbourne VIC Australia
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Elizabeth C. Mormino
- Department of Neurology and Neurological Sciences, Stanford University Stanford CA USA
| | | | | | - Lindsay R. Clark
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Katherine A. Gifford
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | - Badri N. Vardarajan
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York Presbyterian Hospital New York NY USA
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, Columbia University New York NY USA
- The Institute for Genomic Medicine, Columbia University Medical Center and The New York Presbyterian Hospital New York NY USA
- Department of Neurology, Columbia University New York NY USA
| | - Michael L. Cuccaro
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine Miami FL USA
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
| | - Margaret A. Pericak‐Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Lindsay A. Farrer
- Department of Neurology, Boston University School of Medicine Boston MA USA
- Department of Biostatistics, Boston University School of Public Health Boston MA USA
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine Boston MA USA
| | - Li‐San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | - Gerard D. Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA
| | - Jonathan L. Haines
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
| | - Angela L. Jefferson
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | | | | | - Marilyn S. Albert
- Department of Neurology, Division of Cognitive Neuroscience, John’s Hopkins University School of Medicine Baltimore MD USA
| | - C Dirk Keene
- Department of Laboratory Medicine and Pathology, University of Washington Seattle WA USA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana University School of Medicine Indianapolis IN USA
| | - Eric B Larson
- University of Washington Seattle WA USA
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
| | - Reisa A. Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Richard Mayeux
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, Columbia University New York NY USA
- The Institute for Genomic Medicine, Columbia University Medical Center and The New York Presbyterian Hospital New York NY USA
- Columbia University, Departments of Neurology, Psychiatry, and Epidemiology, Gertrude H. Sergievsky Center, The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons New York NY USA
| | - Alison Goate
- Ronald M. Loeb Center for Alzheimer’s Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai New York NY USA
| | - Sarah Neuner
- Ronald M. Loeb Center for Alzheimer’s Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai New York NY USA
| | - Alan E. Renton
- Ronald M. Loeb Center for Alzheimer’s Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai New York NY USA
| | - Edoardo Marcora
- Ronald M. Loeb Center for Alzheimer’s Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai New York NY USA
| | - Brian Fulton‐Howard
- Ronald M. Loeb Center for Alzheimer’s Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai New York NY USA
| | - Tulsi Patel
- Ronald M. Loeb Center for Alzheimer’s Disease, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai New York NY USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center Chicago IL USA
| | - Julie A Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center Chicago IL USA
| | | | - Timothy J. Hohman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
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11
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Crane PK, Trittschuh EH, Mez JB, Saykin AJ, Sanders RE, Gibbons LE, Lee ML, Scollard P, Choi S, Rainey‐Smith S, Chooi CK, Gavett BE, Maruff P, Ames D, Culhane JE, Gauthreaux K, Chan KCG, Biber S, Stephens K, Kukull WA, Dumitrescu L, Hohman TJ, Mukherjee S. Development of harmonized and co‐calibrated scores for memory, executive functioning, language, and visuospatial in the AIBL Study, ADNI, and NACC datasets. Alzheimers Dement 2022. [DOI: 10.1002/alz.064534] [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)
| | - Emily H. Trittschuh
- UW School of Medicine Seattle WA USA
- VA Puget Sound Health Care System, Seattle Division Seattle WA USA
| | - Jesse B. Mez
- Boston University School of Medicine Boston MA USA
- Boston University Alzheimer’s Disease Research Center Boston MA USA
| | | | | | | | | | | | | | - Stephanie Rainey‐Smith
- Centre of Excellence for Alzheimer’s Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup Western Australia Australia
- Murdoch University, Murdoch Western Australia Australia
- Edith Cowan University, Joondalup Western Australia Australia
| | - Cheyenne K Chooi
- University of Western Australia, Perth Western Australia Australia
| | - Brandon E Gavett
- University of Western Australia, Perth Western Australia Australia
| | - Paul Maruff
- University of Melbourne Melbourne VIC Australia
| | - David Ames
- The University of Melbourne Melbourne VIC Australia
| | - Jessica E. Culhane
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Kathryn Gauthreaux
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Kwun Chuen Gary Chan
- University of Washington Seattle WA USA
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Sarah Biber
- University of Washington Seattle WA USA
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Kari Stephens
- University of Washington Seattle WA USA
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Walter A. Kukull
- National Alzheimer’s Coordinating Center, University of Washington Seattle WA USA
| | - Logan Dumitrescu
- Department of Neurology, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
| | - Timothy J. Hohman
- Department of Neurology, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt University Nashville TN USA
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12
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Choi S, Mukherjee S, Gibbons LE, Trittschuh EH, Lee ML, Scollard P, Sanders RE, Snitz BE, Sweet R, Lopez OL, Mez JB, Saykin AJ, Hohman TJ, Crane PK. Beyond the Uniform Data Set (UDS): Benefits of incorporating additional items for the measurement of memory, executive functioning, and language from the University of Pittsburgh Alzheimer’s Disease Research Center. Alzheimers Dement 2022. [DOI: 10.1002/alz.067975] [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)
| | - Shubhabrata Mukherjee
- Department of General Internal Medicine, University of Washington School of Medicine Seattle WA USA
| | | | - Emily H. Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine Seattle WA USA
- VA Puget Sound Health Care System, Seattle Division Seattle WA USA
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System Seattle WA USA
| | | | | | | | - Beth E Snitz
- University of Pittsburgh Pittsburgh PA USA
- Alzheimer’s Disease Research Center Pittsburgh PA USA
| | - Robert Sweet
- University of Pittsburgh Pittsburgh PA USA
- VA Pittsburgh Healthcare System Pittsburgh PA USA
| | - Oscar L. Lopez
- University of Pittsburgh Pittsburgh PA USA
- Alzheimer’s Disease Research Center Pittsburgh PA USA
| | - Jesse B. Mez
- Boston University School of Medicine Boston MA USA
- Boston University Alzheimer’s Disease Research Center Boston MA USA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana University School of Medicine Indianapolis IN USA
- Indiana University Indianapolis IN USA
- Indiana University School of Medicine Indianapolis IN USA
| | - Timothy J. Hohman
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center Nashville TN USA
| | - Paul K. Crane
- University of Washington Seattle WA USA
- Department of General Internal Medicine, University of Washington School of Medicine Seattle WA USA
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13
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Eissman JM, Dumitrescu L, Mahoney ER, Smith AN, Mukherjee S, Lee ML, Scollard P, Choi SE, Bush WS, Engelman CD, Lu Q, Fardo DW, Trittschuh EH, Mez J, Kaczorowski CC, Hernandez Saucedo H, Widaman KF, Buckley RF, Properzi MJ, Mormino EC, Yang HS, Harrison TM, Hedden T, Nho K, Andrews SJ, Tommet D, Hadad N, Sanders RE, Ruderfer DM, Gifford KA, Zhong X, Raghavan NS, Vardarajan BN, Pericak-Vance MA, Farrer LA, Wang LS, Cruchaga C, Schellenberg GD, Cox NJ, Haines JL, Keene CD, Saykin AJ, Larson EB, Sperling RA, Mayeux R, Cuccaro ML, Bennett DA, Schneider JA, Crane PK, Jefferson AL, Hohman TJ. Sex differences in the genetic architecture of cognitive resilience to Alzheimer's disease. Brain 2022; 145:2541-2554. [PMID: 35552371 PMCID: PMC9337804 DOI: 10.1093/brain/awac177] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/07/2022] [Accepted: 04/14/2022] [Indexed: 12/04/2022] Open
Abstract
Approximately 30% of elderly adults are cognitively unimpaired at time of death despite the presence of Alzheimer's disease neuropathology at autopsy. Studying individuals who are resilient to the cognitive consequences of Alzheimer's disease neuropathology may uncover novel therapeutic targets to treat Alzheimer's disease. It is well established that there are sex differences in response to Alzheimer's disease pathology, and growing evidence suggests that genetic factors may contribute to these differences. Taken together, we sought to elucidate sex-specific genetic drivers of resilience. We extended our recent large scale genomic analysis of resilience in which we harmonized cognitive data across four cohorts of cognitive ageing, in vivo amyloid PET across two cohorts, and autopsy measures of amyloid neuritic plaque burden across two cohorts. These data were leveraged to build robust, continuous resilience phenotypes. With these phenotypes, we performed sex-stratified [n (males) = 2093, n (females) = 2931] and sex-interaction [n (both sexes) = 5024] genome-wide association studies (GWAS), gene and pathway-based tests, and genetic correlation analyses to clarify the variants, genes and molecular pathways that relate to resilience in a sex-specific manner. Estimated among cognitively normal individuals of both sexes, resilience was 20-25% heritable, and when estimated in either sex among cognitively normal individuals, resilience was 15-44% heritable. In our GWAS, we identified a female-specific locus on chromosome 10 [rs827389, β (females) = 0.08, P (females) = 5.76 × 10-09, β (males) = -0.01, P(males) = 0.70, β (interaction) = 0.09, P (interaction) = 1.01 × 10-04] in which the minor allele was associated with higher resilience scores among females. This locus is located within chromatin loops that interact with promoters of genes involved in RNA processing, including GATA3. Finally, our genetic correlation analyses revealed shared genetic architecture between resilience phenotypes and other complex traits, including a female-specific association with frontotemporal dementia and male-specific associations with heart rate variability traits. We also observed opposing associations between sexes for multiple sclerosis, such that more resilient females had a lower genetic susceptibility to multiple sclerosis, and more resilient males had a higher genetic susceptibility to multiple sclerosis. Overall, we identified sex differences in the genetic architecture of resilience, identified a female-specific resilience locus and highlighted numerous sex-specific molecular pathways that may underly resilience to Alzheimer's disease pathology. This study illustrates the need to conduct sex-aware genomic analyses to identify novel targets that are unidentified in sex-agnostic models. Our findings support the theory that the most successful treatment for an individual with Alzheimer's disease may be personalized based on their biological sex and genetic context.
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Affiliation(s)
- Jaclyn M Eissman
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical
Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical
Center, Nashville, TN, USA
| | - Logan Dumitrescu
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical
Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical
Center, Nashville, TN, USA
| | - Emily R Mahoney
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical
Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical
Center, Nashville, TN, USA
| | - Alexandra N Smith
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical
Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical
Center, Nashville, TN, USA
| | | | - Michael L Lee
- Department of Medicine, University of Washington,
Seattle, WA, USA
| | - Phoebe Scollard
- Department of Medicine, University of Washington,
Seattle, WA, USA
| | - Seo Eun Choi
- Department of Medicine, University of Washington,
Seattle, WA, USA
| | - William S Bush
- Cleveland Institute for Computational Biology, Department of Population and
Quantitative Health Sciences, Case Western Reserve University,
Cleveland, OH, USA
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public
Health, University of Wisconsin-Madison, Madison,
WI, USA
| | - Qiongshi Lu
- Department of Statistics, University of Wisconsin-Madison,
Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of
Wisconsin-Madison, Madison, WI, USA
| | - David W Fardo
- Department of Biostatistics, College of Public Health, University of
Kentucky, Lexington, KY, USA
- Sanders-Brown Center on Aging, University of Kentucky,
Lexington, KY, USA
| | - Emily H Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington
School of Medicine, Seattle, WA, USA
- VA Puget Sound Health Care System, GRECC, Seattle,
WA, USA
| | - Jesse Mez
- Department of Neurology, Boston University School of
Medicine, Boston, MA, USA
| | | | - Hector Hernandez Saucedo
- UC Davis Alzheimer's Disease Research Center, Department of Neurology,
University of California Davis Medical Center, Sacramento,
CA, USA
| | | | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital/Harvard Medical
School, Boston, MA, USA
- Center for Alzheimer's Research and Treatment, Department of Neurology,
Brigham and Women’s Hospital/Harvard Medical School, Boston,
MA, USA
- Melbourne School of Psychological Sciences, University of
Melbourne, Melbourne, Australia
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital/Harvard Medical
School, Boston, MA, USA
| | - Elizabeth C Mormino
- Department of Neurology and Neurological Sciences, Stanford
University, Stanford, CA, USA
| | - Hyun Sik Yang
- Department of Neurology, Massachusetts General Hospital/Harvard Medical
School, Boston, MA, USA
- Center for Alzheimer's Research and Treatment, Department of Neurology,
Brigham and Women’s Hospital/Harvard Medical School, Boston,
MA, USA
| | - Theresa M Harrison
- Helen Wills Neuroscience Institute, University of California
Berkeley, Berkeley, CA, USA
| | - Trey Hedden
- Icahn School of Medicine at Mount Sinai, New York
City, NY, USA
| | - Kwangsik Nho
- Department of Radiology and Imaging Sciences, Indiana Alzheimer Disease
Center, Indiana University School of Medicine, Indianapolis,
IN, USA
- Center for Computational Biology and Bioinformatics, Indiana University
School of Medicine, Indianapolis, IN, USA
| | - Shea J Andrews
- Icahn School of Medicine at Mount Sinai, New York
City, NY, USA
| | - Douglas Tommet
- Department of Psychiatry and Human Behavior, Brown University School of
Medicine, Providence, RI, USA
| | | | | | - Douglas M Ruderfer
- Vanderbilt Genetics Institute, Vanderbilt University Medical
Center, Nashville, TN, USA
| | - Katherine A Gifford
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical
Center, Nashville, TN, USA
| | - Xiaoyuan Zhong
- Department of Statistics, University of Wisconsin-Madison,
Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of
Wisconsin-Madison, Madison, WI, USA
| | - Neha S Raghavan
- Department of Neurology, Columbia University, New
York, NY, USA
- The Taub Institute for Research on Alzheimer's Disease and The Aging Brain,
Columbia University, New York, NY, USA
- The Institute for Genomic Medicine, Columbia University Medical Center and
The New York Presbyterian Hospital, New York, NY,
USA
| | - Badri N Vardarajan
- Department of Neurology, Columbia University, New
York, NY, USA
- The Taub Institute for Research on Alzheimer's Disease and The Aging Brain,
Columbia University, New York, NY, USA
- The Institute for Genomic Medicine, Columbia University Medical Center and
The New York Presbyterian Hospital, New York, NY,
USA
| | | | | | | | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami School of
Medicine, Miami, FL, USA
| | - Lindsay A Farrer
- Department of Neurology, Boston University School of
Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public
Health, Boston, MA, USA
- Department of Medicine (Biomedical Genetics), Boston University School of
Medicine, Boston, MA, USA
| | - Li San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and
Laboratory Medicine, University of Pennsylvania Perelman School of
Medicine, Philadelphia, PA, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of
Medicine, St. Louis, MO, USA
| | - Gerard D Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and
Laboratory Medicine, University of Pennsylvania Perelman School of
Medicine, Philadelphia, PA, USA
| | - Nancy J Cox
- Vanderbilt Genetics Institute, Vanderbilt University Medical
Center, Nashville, TN, USA
| | - Jonathan L Haines
- Cleveland Institute for Computational Biology, Department of Population and
Quantitative Health Sciences, Case Western Reserve University,
Cleveland, OH, USA
| | - C Dirk Keene
- Department of Pathology, University of Washington,
Seattle, WA, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of
Medicine, Indianapolis, IN, USA
| | - Eric B Larson
- Department of Medicine, University of Washington,
Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute,
Seattle, WA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital/Harvard Medical
School, Boston, MA, USA
| | - Richard Mayeux
- Department of Neurology, Columbia University, New
York, NY, USA
- The Taub Institute for Research on Alzheimer's Disease and The Aging Brain,
Columbia University, New York, NY, USA
- The Institute for Genomic Medicine, Columbia University Medical Center and
The New York Presbyterian Hospital, New York, NY,
USA
| | - Michael L Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami School of
Medicine, Miami, FL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL, USA
| | - Paul K Crane
- Department of Medicine, University of Washington,
Seattle, WA, USA
| | - Angela L Jefferson
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical
Center, Nashville, TN, USA
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical
Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical
Center, Nashville, TN, USA
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14
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Vergara P, Taloni ST, Shute AS, Lee ML. Leadless left bundle branch pacing: feasibility in an animal model. Europace 2022. [DOI: 10.1093/europace/euac053.481] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): EBR Systems Inc.
Introduction
Epicardial cardiac resynchronization therapy (CRT) is an established treatment for heart failure; left bundle branch (LBB) pacing has been proposed to overcome epicardial CRT limitations. In this study, we report on the first implants of a leadless electrode for endocardial pacing of the LBB in a porcine model.
Methods
The implant of the leadless, left ventricular endocardial pacing system (WiSE-CRT System) was attempted by transeptal approach in two porcines. Fluoroscopic and transoesophageal echocardiographic guidance were used to navigate the Delivery Sheath to the LBB area; the targeted implant site was selected by analysis of the electrograms from the implanting Electrode. At the end of the procedure, the animals were sacrificed and the hearts were isolated and analysed.
Results
In both animals, the Delivery System was successfully navigated to the LV septum. The target sites showed LBB electrograms preceding the far field ventricular electrogram by 15ms. The Electrode was successfully implanted on both animals with pacing threshold <2.0V @ 0.5ms. The implant of the pacing electrode was associated with minimal, multifocal haemorrhage; Purkinje fibers components of the LBB were observed in the on both sides of the site of implantation site. The lesion was 1.7 mm large and 2 mm deep.
Conclusions
This study supports the feasibility of leadless LBB pacing. Anatomical evaluation showed a close relationship between the Electrode and the LBB, with absence of significant damage to the conduction system from the implanted Electrode.
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Affiliation(s)
- P Vergara
- San Raffaele Hospital (IRCCS), Milan, Italy
| | - ST Taloni
- EBR Systems Inc, Sunnyvale, USA, United States of America
| | - AS Shute
- EBR Systems Inc, Sunnyvale, USA, United States of America
| | - ML Lee
- EBR Systems Inc, Sunnyvale, USA, United States of America
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15
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Lee CS, Gibbons LE, Lee AY, Yanagihara RT, Blazes MS, Lee ML, McCurry SM, Bowen JD, McCormick WC, Crane PK, Larson EB. Association Between Cataract Extraction and Development of Dementia. JAMA Intern Med 2022; 182:134-141. [PMID: 34870676 PMCID: PMC8649913 DOI: 10.1001/jamainternmed.2021.6990] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
IMPORTANCE Visual function is important for older adults. Interventions to preserve vision, such as cataract extraction, may modify dementia risk. OBJECTIVE To determine whether cataract extraction is associated with reduced risk of dementia among older adults. DESIGN, SETTING, AND PARTICIPANTS This prospective, longitudinal cohort study analyzed data from the Adult Changes in Thought study, an ongoing, population-based cohort of randomly selected, cognitively normal members of Kaiser Permanente Washington. Study participants were 65 years of age or older and dementia free at enrollment and were followed up biennially until incident dementia (all-cause, Alzheimer disease, or Alzheimer disease and related dementia). Only participants who had a diagnosis of cataract or glaucoma before enrollment or during follow-up were included in the analyses (ie, a total of 3038 participants). Data used in the analyses were collected from 1994 through September 30, 2018, and all data were analyzed from April 6, 2019, to September 15, 2021. EXPOSURES The primary exposure of interest was cataract extraction. Data on diagnosis of cataract or glaucoma and exposure to surgery were extracted from electronic medical records. Extensive lists of dementia-related risk factors and health-related variables were obtained from study visit data and electronic medical records. MAIN OUTCOMES AND MEASURES The primary outcome was dementia as defined by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Multivariate Cox proportional hazards regression analyses were conducted with the primary outcome. To address potential healthy patient bias, weighted marginal structural models incorporating the probability of surgery were used and the association of dementia with glaucoma surgery, which does not restore vision, was evaluated. RESULTS In total, 3038 participants were included (mean [SD] age at first cataract diagnosis, 74.4 (6.2) years; 1800 women (59%) and 1238 men (41%); and 2752 (91%) self-reported White race). Based on 23 554 person-years of follow-up, cataract extraction was associated with significantly reduced risk (hazard ratio, 0.71; 95% CI, 0.62-0.83; P < .001) of dementia compared with participants without surgery after controlling for years of education, self-reported White race, and smoking history and stratifying by apolipoprotein E genotype, sex, and age group at cataract diagnosis. Similar results were obtained in marginal structural models after adjusting for an extensive list of potential confounders. Glaucoma surgery did not have a significant association with dementia risk (hazard ratio, 1.08; 95% CI, 0.75-1.56; P = .68). Similar results were found with the development of Alzheimer disease dementia. CONCLUSIONS AND RELEVANCE This cohort study found that cataract extraction was significantly associated with lower risk of dementia development. If validated in future studies, cataract surgery may have clinical relevance in older adults at risk of developing dementia.
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Affiliation(s)
- Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle.,Roger and Angie Karalis Johnson Retina Center, Seattle, Washington
| | - Laura E Gibbons
- Department of General Internal Medicine, University of Washington, Seattle
| | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle.,Roger and Angie Karalis Johnson Retina Center, Seattle, Washington
| | | | - Marian S Blazes
- Department of Ophthalmology, University of Washington, Seattle
| | - Michael L Lee
- Department of General Internal Medicine, University of Washington, Seattle
| | | | - James D Bowen
- Department of Neurology, Swedish Medical Center, Seattle, Washington
| | - Wayne C McCormick
- Department of General Internal Medicine, University of Washington, Seattle
| | - Paul K Crane
- Department of General Internal Medicine, University of Washington, Seattle
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
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16
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Crane PK, Choi S, Gibbons LE, Mukherjee S, Zhu R, Scollard P, Lee ML, Trittschuh EH, Saykin AJ, Mez J, Mungas DM, Wang C. Cognitive assessments in ADNI: Lessons learned from the ADNI psychometrics project. Alzheimers Dement 2021. [DOI: 10.1002/alz.056474] [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)
| | | | | | | | - Ryoui Zhu
- University of Washington Seattle WA USA
| | | | | | - Emily H. Trittschuh
- UW School of Medicine Seattle WA USA
- VA Puget Sound Health Care System, Seattle Division Seattle WA USA
| | - Andrew J. Saykin
- Indiana Alzheimer's Disease Research Center Indianapolis IN USA
- Indiana University School of Medicine Indianapolis IN USA
- Department of Radiology and Imaging Sciences Indiana University School of Medicine Indianapolis IN USA
| | - Jesse Mez
- Department of Neurology Boston University School of Medicine Boston MA USA
- Boston University Alzheimer’s Disease Research Center Boston MA USA
- Boston University School of Medicine Boston MA USA
| | - Dan M. Mungas
- University of California, Davis School of Medicine Sacramento CA USA
| | - Chun Wang
- University of Washington Seattle WA USA
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17
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Liao YWL, Lee ML, Poppe KP, Kerr AK, Stewart RS. Predictors and a novel risk score of statin non-adherence after hospitalisation for an acute coronary syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1420] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Statin non-adherence after acute coronary syndrome (ACS) hospitalisation is associated with adverse prognosis. Identifying its risk factors can help to develop strategies and target high risk groups to improve outcomes. We evaluated the predictors and devised a risk score for statin non-adherence following ACS.
Methods
Consecutive ACS hospitalisations enrolled in the ANZACS-QI registry during December 2013 to October 2017 were linked to the National Pharmaceutical database for statin dispensing records. The primary endpoint was mean statin possession ratio (MPR) of <0.8 at 6–12 months after discharge. Multivariable Poisson regression was performed to identify predictors and formulate a risk model for statin non-adherence.
Results
Primary endpoint occurred in 4736/19942 (24%) of ACS patients studied. Patients taking statin on admission with LDL-cholesterol<2mmol/L had the lowest risk and were chosen as the reference group. Adjusted relative risks (RR) and 95% confidence intervals (95% CI) were highest in patients with prior cardiovascular disease (CVD) but not on statins 3.79 (3.42–4.20), followed but no prior CVD and not on statins 2.25 (2.04–2.48). RRs (95% CI) for patients on statin with LDL2.0–2.9 and LDL >3.0mmol/L were 1.33 (1.17–1.50) and 1.96 (1.72–2.24) respectively. Other independent predictors were age<45 years, Māori, Pacific and no revascularisation. Together, a risk score out of 25 for statin non adherence was created.
Conclusion
Statin non-adherence remains prevalent after ACS, with history of CVD, statin use and LDL levels being key predictors. A risk model was developed to help identify at risk patients that may benefit the most from delivery of adherence improving interventions and warrants external validation.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y W L Liao
- Auckland City Hospital, Cardiology, Auckland, New Zealand
| | - M L Lee
- Middlemore Hospital, Auckland, New Zealand
| | - K P Poppe
- The University of Auckland, Auckland, New Zealand
| | - A K Kerr
- Middlemore Hospital, Auckland, New Zealand
| | - R S Stewart
- Auckland City Hospital, Cardiology, Auckland, New Zealand
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18
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Lee CS, Lee ML, Gibbons LE, Yanagihara RT, Blazes M, Kam JP, McCurry SM, Bowen JD, McCormick WC, Lee AY, Larson EB, Crane PK. Associations Between Retinal Artery/Vein Occlusions and Risk of Vascular Dementia. J Alzheimers Dis 2021; 81:245-253. [PMID: 33749651 DOI: 10.3233/jad-201492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/15/2022]
Abstract
BACKGROUND Vascular disease is a risk factor for Alzheimer's disease (AD) and related dementia in older adults. Retinal artery/vein occlusion (RAVO) is an ophthalmic complication of systemic vascular pathology. Whether there are associations between RAVO and dementia risk is unknown. OBJECTIVE To determine whether RAVOs are associated with an increased risk of developing vascular dementia or AD. METHODS Data from Adult Changes in Thought (ACT) study participants were analyzed. This prospective, population-based cohort study followed older adults (age ≥65 years) who were dementia-free at enrollment for development of vascular dementia or AD based on research criteria. RAVO diagnoses were extracted from electronic medical records. Cox-regression survival analyses were stratified by APOEɛ4 genotype and adjusted for demographic and clinical factors. RESULTS On review of 41,216 person-years (4,743 participants), 266 (5.6%) experienced RAVO. APOEɛ4 carriers who developed RAVO had greater than four-fold higher risk for developing vascular dementia (Hazard Ratio [HR] 4.54, 95% Confidence Interval [CI] 1.86, 11.10, p = 0.001). When including other cerebrovascular disease (history of carotid endarterectomy or transient ischemic attack) in the model, the risk was three-fold higher (HR 3.06, 95% CI 1.23, 7.62). No other conditions evaluated in the secondary analyses were found to confound this relationship. There was no effect in non-APOEɛ4 carriers (HR 1.03, 95% CI 0.37, 2.80). There were no significant associations between RAVO and AD in either APOE group. CONCLUSION Older dementia-free patients who present with RAVO and carry the APOEɛ4 allele appear to be at higher risk for vascular dementia.
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Affiliation(s)
- Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Michael L Lee
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Laura E Gibbons
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ryan T Yanagihara
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Marian Blazes
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Jason P Kam
- Kaiser Permanente Washington, Seattle, WA, USA
| | - Susan M McCurry
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, USA
| | - James D Bowen
- Department of Neurology, Swedish Medical Center, Seattle, WA, USA
| | | | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
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19
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Lee CS, Lee ML, Yanagihara RT, Lee AY. Predictors of narrow angle detection rate-a longitudinal study of Massachusetts residents over 1.7 million person years. Eye (Lond) 2021; 35:952-958. [PMID: 32494044 PMCID: PMC8027027 DOI: 10.1038/s41433-020-1003-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/14/2020] [Accepted: 05/21/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND/OBJECTIVES To determine the predictors of narrow angle detection in a United States population-based cohort. MATERIALS AND METHODS This was a retrospective cohort study using the Massachusetts All-Payer Claims Database. Demographic information of all patients and eye care provider information during the years 2011-2015 were extracted from Massachusetts All Payers Claims Data. All payers who received eye care during 1/1/2012-12/31/2015 without any previous eye visit during 2011 were included in the analyses. Laser peripheral iridotomy was identified by Current Procedural Terminology code 66761. Narrow angle detection was defined as the diagnosis of narrow angles by diagnosis code followed by a laser peripheral iridotomy procedure. Different predictors of narrow angle detection were evaluated using Kaplan-Meier curves with the log rank and Cox regression modeling. RESULTS A total of 1,082,144 patients were included. The hazard ratio of narrow angle detection increased with age compared to the reference group of 0-10 years: 21-30 years of age (hazard ratio = 4.5), 31-40 (10.5), 41-50 (27.9), 51-60 (46.1), 61-70 (68.4), 71-80 (56.8) (all p < 0.0002), was 1.47 times higher in women and 1.85 times higher if evaluated by ophthalmologists compared to optometrists, after controlling for provider × time interaction. CONCLUSION Older age and female sex are associated with narrow angles. The rate of narrow angle detection was significantly higher if patients are seen by ophthalmologists compared to optometrists only. Evaluation with an ophthalmologist may be important for patients at high risks for developing primary angle closure glaucoma.
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Affiliation(s)
- Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA.
| | - Michael L Lee
- Department of General Internal Medicine, University of Washington, Seattle, WA, USA
| | - Ryan T Yanagihara
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
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20
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Dumitrescu L, Mahoney ER, Mukherjee S, Lee ML, Bush WS, Engelman CD, Lu Q, Fardo DW, Trittschuh EH, Mez J, Kaczorowski CC, Widaman KF, Buckley RF, Properzi MJ, Mormino EC, Yang H, Andrews SJ, Sanders RE, Raghavan NS, Vardarajan BN, Schellenberg GD, Cruchaga C, Haines JL, Keene CD, Saykin AJ, Larson EB, Sperling RA, Mayeux R, Bennett DA, Schneider JA, Crane PK, Jefferson AL, Hohman TJ. Sex differences in genetic predictors of resilience to Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.043259] [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)
| | | | | | | | - William S. Bush
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Corinne D. Engelman
- Wisconsin Alzheimer’s Disease Research Center University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Qiongshi Lu
- Department of Biostatistics & Medical Informatics University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | | | - Jesse Mez
- Boston University Alzheimer’s Disease Center Boston MA USA
| | | | | | - Rachel F. Buckley
- Athinoula A. Martinos Center for Biomedical Imaging Massachusetts General Hospital Harvard Medical School Charlestown MA USA
| | | | | | | | | | | | | | | | | | - Carlos Cruchaga
- Washington University in St. Louis School of Medicine St. Louis MO USA
| | | | | | | | - Eric B. Larson
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
| | | | | | - David A. Bennett
- Rush Alzheimer’s Disease Center Rush University Medical Center Chicago IL USA
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center Rush University Medical Center Chicago IL USA
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21
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Tommet D, Choi S, Rabin L, Sikkes SA, Jutten RJ, Grandoit E, Foldi N, Jones RN, Lamar M, Gibbons LE, Mukherjee S, Lee ML, Sanders RE, Saykin AJ, Trittschuh EH, Mez J, Risacher SL, Crane PK. Six‐month decline in language, but not other cognitive domains, identifies increased risk of conversion from MCI to AD in ADNI. Alzheimers Dement 2020. [DOI: 10.1002/alz.045357] [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: 11/06/2022]
Affiliation(s)
- Douglas Tommet
- Warren Alpert Medical School Brown University Providence RI USA
| | | | - Laura Rabin
- Brooklyn College of the City University of New York New York NY USA
| | | | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | - Richard N. Jones
- Warren Alpert Medical School of Brown University Providence RI USA
| | | | | | | | | | | | | | | | - Jesse Mez
- Boston University Alzheimer's Disease Center Boston MA USA
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22
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Lee CS, Lee ML, Gibbons LE, Larson EB, Crane PK. Retinal vascular occlusions are associated with increased risk for vascular dementia in
APOE
ε4 carriers in a community‐based cohort. Alzheimers Dement 2020. [DOI: 10.1002/alz.045563] [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)
| | | | | | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
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23
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Lee CS, Gibbons LE, Lee ML, Lee AY, Yanagihara RT, Crane PK, Larson EB. Cataract surgery is associated with reduced risk for Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.044940] [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)
| | | | | | | | | | | | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute Seattle WA USA
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24
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Dumitrescu L, Mahoney ER, Mukherjee S, Lee ML, Bush WS, Engelman CD, Lu Q, Fardo DW, Trittschuh EH, Mez J, Kaczorowski C, Hernandez Saucedo H, Widaman KF, Buckley R, Properzi M, Mormino E, Yang HS, Harrison T, Hedden T, Nho K, Andrews SJ, Tommet D, Hadad N, Sanders RE, Ruderfer DM, Gifford KA, Moore AM, Cambronero F, Zhong X, Raghavan NS, Vardarajan B, Pericak-Vance MA, Farrer LA, Wang LS, Cruchaga C, Schellenberg G, Cox NJ, Haines JL, Keene CD, Saykin AJ, Larson EB, Sperling RA, Mayeux R, Bennett DA, Schneider JA, Crane PK, Jefferson AL, Hohman TJ. Genetic variants and functional pathways associated with resilience to Alzheimer's disease. Brain 2020; 143:2561-2575. [PMID: 32844198 PMCID: PMC7447518 DOI: 10.1093/brain/awaa209] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/22/2020] [Accepted: 05/08/2020] [Indexed: 12/23/2022] Open
Abstract
Approximately 30% of older adults exhibit the neuropathological features of Alzheimer's disease without signs of cognitive impairment. Yet, little is known about the genetic factors that allow these potentially resilient individuals to remain cognitively unimpaired in the face of substantial neuropathology. We performed a large, genome-wide association study (GWAS) of two previously validated metrics of cognitive resilience quantified using a latent variable modelling approach and representing better-than-predicted cognitive performance for a given level of neuropathology. Data were harmonized across 5108 participants from a clinical trial of Alzheimer's disease and three longitudinal cohort studies of cognitive ageing. All analyses were run across all participants and repeated restricting the sample to individuals with unimpaired cognition to identify variants at the earliest stages of disease. As expected, all resilience metrics were genetically correlated with cognitive performance and education attainment traits (P-values < 2.5 × 10-20), and we observed novel correlations with neuropsychiatric conditions (P-values < 7.9 × 10-4). Notably, neither resilience metric was genetically correlated with clinical Alzheimer's disease (P-values > 0.42) nor associated with APOE (P-values > 0.13). In single variant analyses, we observed a genome-wide significant locus among participants with unimpaired cognition on chromosome 18 upstream of ATP8B1 (index single nucleotide polymorphism rs2571244, minor allele frequency = 0.08, P = 2.3 × 10-8). The top variant at this locus (rs2571244) was significantly associated with methylation in prefrontal cortex tissue at multiple CpG sites, including one just upstream of ATPB81 (cg19596477; P = 2 × 10-13). Overall, this comprehensive genetic analysis of resilience implicates a putative role of vascular risk, metabolism, and mental health in protection from the cognitive consequences of neuropathology, while also providing evidence for a novel resilience gene along the bile acid metabolism pathway. Furthermore, the genetic architecture of resilience appears to be distinct from that of clinical Alzheimer's disease, suggesting that a shift in focus to molecular contributors to resilience may identify novel pathways for therapeutic targets.
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Affiliation(s)
- Logan Dumitrescu
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emily R Mahoney
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Michael L Lee
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - William S Bush
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Qiongshi Lu
- Department of Statistics, University of Wisconsin-Madison, Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - David W Fardo
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Emily H Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
- VA Puget Sound Health Care System, GRECC, Seattle, WA, USA
| | - Jesse Mez
- Deparment of Neurology, Boston University School of Medicine, Boston, MA, USA
| | | | - Hector Hernandez Saucedo
- UC Davis Alzheimer’s Disease Research Center, Department of Neurology, University of California Davis Medical Center, Sacramento, CA, USA
| | | | - Rachel Buckley
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, USA
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Michael Properzi
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Elizabeth Mormino
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Hyun-Sik Yang
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, USA
| | - Tessa Harrison
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Trey Hedden
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Kwangsik Nho
- Department of Radiology and Imaging Sciences, Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Shea J Andrews
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Doug Tommet
- Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, RI, USA
| | | | | | - Douglas M Ruderfer
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine A Gifford
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Annah M Moore
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Francis Cambronero
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xiaoyuan Zhong
- Department of Statistics, University of Wisconsin-Madison, Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - Neha S Raghavan
- Department of Neurology, Columbia University, New York, NY, USA
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, Columbia University, New York, NY, USA
- The Institute for Genomic Medicine, Columbia University Medical Center and The New York Presbyterian Hospital, New York, NY, USA
| | - Badri Vardarajan
- Department of Neurology, Columbia University, New York, NY, USA
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, Columbia University, New York, NY, USA
- The Institute for Genomic Medicine, Columbia University Medical Center and The New York Presbyterian Hospital, New York, NY, USA
| | | | | | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami School of Medicine, Miami, FL, USA
| | - Lindsay A Farrer
- Deparment of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Li-San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Gerard Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Nancy J Cox
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jonathan L Haines
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - C Dirk Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Richard Mayeux
- Department of Neurology, Columbia University, New York, NY, USA
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, Columbia University, New York, NY, USA
- The Institute for Genomic Medicine, Columbia University Medical Center and The New York Presbyterian Hospital, New York, NY, USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Angela L Jefferson
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
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Thong PL, Wong SW, Abdul Manaf MR, Lee ML, Kanaheswari Y. Health-related quality of life in paediatric spina bifida. Med J Malaysia 2019; 74:281-287. [PMID: 31424034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The average incidence of spina bifida (SB) in Malaysia is 0.43 among 1,000 live births. The burden of the disease and its impact on the overall development and health though tremendously improved, remains significant. Therefore, current patient management strategies must include quality of life (QOL) measures. METHODS This was a prospective, cross-sectional study on spina bifida children aged 5-20 years, attending the paediatric spina bifida clinics of Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur and Hospital Tuanku Jaanku Seremban. Scores were obtained using the validated disease specific Parkin QOL questionnaire. Univariate and multivariate analysis were used to investigate factors that were determinants for these outcomes. Results were expressed as beta coefficient and 95% confidence intervals (95%CI). RESULTS A total of 54 children and adolescents aged between 5-20 years completed the questionnaires. Presence of neurogenic bowel (p=0.003), neurogenic bladder (p=0.041), shunt (p=0.044), non-ambulators (p=0.007) and being the only child in the family (p=0.037) were associated with lower QOL scores. Multivariate analysis showed presence of neurogenic bowel (β=0.375, 95%CI: 0.00, 0.15) and being the only child in the family (β=0.250, 95%CI: 0.04, 0.17) explained 22.1% of the variance in the QOL mean percentage scores. CONCLUSION Being a single child in the family was the only socio-demographic variable associated with lower QOL scores. Although several clinical factors appeared to contribute significantly to QOL in spina bifida children, the presence of neurogenic bowel had the greatest impact.
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Affiliation(s)
- P L Thong
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Paediatrics, Serdang, Selangor, Malaysia.
| | - S W Wong
- Universiti Kebangsaan Malaysia Medical Centre, Department of Paediatrics, Kuala Lumpur, Malaysia
| | - M R Abdul Manaf
- Universiti Kebangsaan Malaysia Medical Centre, Department of Community Health, Kuala Lumpur, Malaysia
| | - M L Lee
- Hospital Tuanku Ja'afar Seremban, Department of Paediatrics, Negeri Sembilan, Malaysia
| | - Y Kanaheswari
- Universiti Kebangsaan Malaysia Medical Centre, Department of Paediatrics, Kuala Lumpur, Malaysia
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Liang Y, Horrey WJ, Howard ME, Lee ML, Anderson C, Shreeve MS, O'Brien CS, Czeisler CA. Prediction of drowsiness events in night shift workers during morning driving. Accid Anal Prev 2019; 126:105-114. [PMID: 29126462 DOI: 10.1016/j.aap.2017.11.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 11/02/2017] [Accepted: 11/02/2017] [Indexed: 06/07/2023]
Abstract
The morning commute home is an especially vulnerable time for workers engaged in night shift work due to the heightened risk of experiencing drowsy driving. One strategy to manage this risk is to monitor the driver's state in real time using an in vehicle monitoring system and to alert drivers when they are becoming sleepy. The primary objective of this study is to build and evaluate predictive models for drowsiness events occurring in morning drives using a variety of physiological and performance data gathered under a real driving scenario. We used data collected from 16 night shift workers who drove an instrumented vehicle for approximately two hours on a test track on two occasions: after a night shift and after a night of rest. Drowsiness was defined by two outcome events: performance degradation (Lane-Crossing models) and electroencephalogram (EEG) characterized sleep episodes (Microsleep Models). For each outcome, we assessed the accuracy of sets of predictors, including or not including a driver factor, eyelid measures, and driving performance measures. We also compared the predictions using different time intervals relative to the events (e.g., 1-min prior to the event through 10-min prior). By examining the Area Under the receiver operating characteristic Curve (AUC), accuracy, sensitivity, and specificity of the predictive models, the results showed that the inclusion of an individual driver factor improved AUC and prediction accuracy for both outcomes. Eyelid measures improved the prediction for the Lane-Crossing models, but not for Microsleep models. Prediction performance was not changed by adding driving performance predictors or by increasing the time to the event for either outcome. The best models for both measures of drowsiness were those considering driver individual differences and eyelid measures, suggesting that these indicators should be strongly considered when predicting drowsiness events. The results of this paper can benefit the development of real-time drowsiness detection and help to manage drowsiness to avoid related motor-vehicle crashes and loss.
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Affiliation(s)
- Yulan Liang
- Liberty Mutual Research Institute for Safety, 71 Frankland Rd., Hopkinton, MA 01748, USA.
| | - William J Horrey
- Liberty Mutual Research Institute for Safety, 71 Frankland Rd., Hopkinton, MA 01748, USA
| | - Mark E Howard
- Department of Respiratory & Sleep Medicine, Institute for Breathing & Sleep, Austin Health, Heidelberg, VIC 3084, Australia; Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, 18 Innovation Walk, Clayton Campus,Wellington Rd., Monash University, Victoria, 3800, Australia
| | - Michael L Lee
- Sleep Health Institute and Division of Sleep and Medicine, Harvard Medical School, 164 Longwood Ave., Room 106, Boston, MA 02115, USA; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, USA
| | - Clare Anderson
- Sleep Health Institute and Division of Sleep and Medicine, Harvard Medical School, 164 Longwood Ave., Room 106, Boston, MA 02115, USA; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, USA; Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, 18 Innovation Walk, Clayton Campus,Wellington Rd., Monash University, Victoria, 3800, Australia
| | - Michael S Shreeve
- Liberty Mutual Research Institute for Safety, 71 Frankland Rd., Hopkinton, MA 01748, USA
| | - Conor S O'Brien
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, USA
| | - Charles A Czeisler
- Sleep Health Institute and Division of Sleep and Medicine, Harvard Medical School, 164 Longwood Ave., Room 106, Boston, MA 02115, USA; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, USA
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Lee ML, Katsuyama ÂM, Duge LS, Sriram C, Krushelnytskyy M, Kim JJ, de la Iglesia HO. Fragmentation of Rapid Eye Movement and Nonrapid Eye Movement Sleep without Total Sleep Loss Impairs Hippocampus-Dependent Fear Memory Consolidation. Sleep 2016; 39:2021-2031. [PMID: 27568801 DOI: 10.5665/sleep.6236] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 03/08/2016] [Accepted: 06/29/2016] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Sleep is important for consolidation of hippocampus-dependent memories. It is hypothesized that the temporal sequence of nonrapid eye movement (NREM) sleep and rapid eye movement (REM) sleep is critical for the weakening of nonadaptive memories and the subsequent transfer of memories temporarily stored in the hippocampus to more permanent memories in the neocortex. A great body of evidence supporting this hypothesis relies on behavioral, pharmacological, neural, and/or genetic manipulations that induce sleep deprivation or stage-specific sleep deprivation. METHODS We exploit an experimental model of circadian desynchrony in which intact animals are not deprived of any sleep stage but show fragmentation of REM and NREM sleep within nonfragmented sleep bouts. We test the hypothesis that the shortening of NREM and REM sleep durations post-training will impair memory consolidation irrespective of total sleep duration. RESULTS When circadian-desynchronized animals are trained in a hippocampus-dependent contextual fear-conditioning task they show normal short-term memory but impaired long-term memory consolidation. This impairment in memory consolidation is positively associated with the post-training fragmentation of REM and NREM sleep but is not significantly associated with the fragmentation of total sleep or the total amount of delta activity. We also show that the sleep stage fragmentation resulting from circadian desynchrony has no effect on hippocampus-dependent spatial memory and no effect on hippocampus-independent cued fear-conditioning memory. CONCLUSIONS Our findings in an intact animal model, in which sleep deprivation is not a confounding factor, support the hypothesis that the stereotypic sequence and duration of sleep stages play a specific role in long-term hippocampus-dependent fear memory consolidation.
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Affiliation(s)
- Michael L Lee
- Department of Biology, University of Washington, Seattle, WA.,Graduate Program in Neuroscience, University of Washington, Seattle, WA
| | | | - Leanne S Duge
- Department of Biology, University of Washington, Seattle, WA
| | - Chaitra Sriram
- Department of Biology, University of Washington, Seattle, WA
| | | | - Jeansok J Kim
- Graduate Program in Neuroscience, University of Washington, Seattle, WA.,Department of Psychology, University of Washington, Seattle WA
| | - Horacio O de la Iglesia
- Department of Biology, University of Washington, Seattle, WA.,Graduate Program in Neuroscience, University of Washington, Seattle, WA
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Visser LH, Beekman R, Tijssen CC, Uitdehaag BMJ, Lee ML, Movig KLL, Lenderink AW. A randomized, double-blind, placebo-controlled pilot study of IV immune globulins in combination with IV methylprednisolone in the treatment of relapses in patients with MS. Mult Scler 2016; 10:89-91. [PMID: 14760960 DOI: 10.1191/1352458504ms978sr] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: Some patients with multiple sclerosis (MS) do not show a clear improvement of acute relapses after treatment with intravenous methylprednisolone (IVMP). We compared the efficacy of the combination of intravenous immunoglobulins (IVIg) and IVMP with the standard treatment of IVMP alone in promoting recovery from moderate to severe acute relapses in MS. Methods: Patients with clinically definite MS having a relapse with at least a one point increase in Kurtzke’s expanded disability status scale (EDSS) in comparison to the preattack EDSS were randomized to IVMP-IVIg or IVMP-placebo treatment. The primary outcome criterion was the EDSS grade at four weeks. A preplanned interim analysis was performed after inclusion of 19 consecutive MS patients to evaluate the sample size necessary for a larger trial. Findings: Both groups had improved one point on the EDSS four weeks after start of treatment (P =0.81) and one of the stopping rules of the interim analysis was fulfilled. There were also no differences in secondary outcomes: EDSS at eight and 12 weeks, time to improve]-1 EDSS points, difference in Scripps score and ambulation index. Five patients in the IVMP-IVIg group and two in the IVMP group had a new relapse in the six month follow-up. Interpretation: O ur study could not show superiority of IVMP-IVIg in the treatment of moderate to severe acute relapses in MS.
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Affiliation(s)
- L H Visser
- Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
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Hsiao J, Yuan TY, Tsai MS, Lu CY, Lin YC, Lee ML, Lin SW, Chang FC, Liu Pimentel H, Olive C, Coito C, Shen G, Young M, Thorne T, Lawrence M, Magistri M, Faghihi MA, Khorkova O, Wahlestedt C. Upregulation of Haploinsufficient Gene Expression in the Brain by Targeting a Long Non-coding RNA Improves Seizure Phenotype in a Model of Dravet Syndrome. EBioMedicine 2016; 9:257-277. [PMID: 27333023 PMCID: PMC4972487 DOI: 10.1016/j.ebiom.2016.05.011] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 05/02/2016] [Accepted: 05/09/2016] [Indexed: 02/07/2023] Open
Abstract
Dravet syndrome is a devastating genetic brain disorder caused by heterozygous loss-of-function mutation in the voltage-gated sodium channel gene SCN1A. There are currently no treatments, but the upregulation of SCN1A healthy allele represents an appealing therapeutic strategy. In this study we identified a novel, evolutionary conserved mechanism controlling the expression of SCN1A that is mediated by an antisense non-coding RNA (SCN1ANAT). Using oligonucleotide-based compounds (AntagoNATs) targeting SCN1ANAT we were able to induce specific upregulation of SCN1A both in vitro and in vivo, in the brain of Dravet knock-in mouse model and a non-human primate. AntagoNAT-mediated upregulation of Scn1a in postnatal Dravet mice led to significant improvements in seizure phenotype and excitability of hippocampal interneurons. These results further elucidate the pathophysiology of Dravet syndrome and outline a possible new approach for the treatment of this and other genetic disorders with similar etiology.
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Affiliation(s)
- J Hsiao
- OPKO Health Inc., 10320 USA Today Way, Miramar, FL 33025, USA
| | - T Y Yuan
- OPKO Health Inc., 10320 USA Today Way, Miramar, FL 33025, USA
| | - M S Tsai
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 1, Sec. 1, Jen-Ai Rd., Taipei 100, Taiwan
| | - C Y Lu
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei 106, Taiwan
| | - Y C Lin
- OPKO Health Inc., 10320 USA Today Way, Miramar, FL 33025, USA
| | - M L Lee
- Dep. Clinical Laboratory Science and Medical Biotechnology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - S W Lin
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 1, Sec. 1, Jen-Ai Rd., Taipei 100, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung-Shan S. Rd., Taipei 100, Taiwan; Center for Genomic Medicine, National Taiwan University, No. 7, Chung-Shan S. Rd., Taipei 100, Taiwan
| | - F C Chang
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei 106, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, No. 1, Sec. 1, Jen-Ai Rd., Taipei 100, Taiwan; Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - H Liu Pimentel
- OPKO Health Inc., 10320 USA Today Way, Miramar, FL 33025, USA
| | - C Olive
- OPKO Health Inc., 10320 USA Today Way, Miramar, FL 33025, USA
| | - C Coito
- OPKO Health Inc., 10320 USA Today Way, Miramar, FL 33025, USA
| | - G Shen
- OPKO Health Inc., 10320 USA Today Way, Miramar, FL 33025, USA
| | - M Young
- OPKO Health Inc., 10320 USA Today Way, Miramar, FL 33025, USA
| | - T Thorne
- OPKO Health Inc., 10320 USA Today Way, Miramar, FL 33025, USA
| | - M Lawrence
- RxGen, 100 Deepwood Drive, Hamden, CT 06517, USA
| | - M Magistri
- Center for Therapeutic Innovation and the Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1501 NW 10th Avenue, Miami 33136, FL, USA
| | - M A Faghihi
- Center for Therapeutic Innovation and the Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1501 NW 10th Avenue, Miami 33136, FL, USA
| | - O Khorkova
- OPKO Health Inc., 10320 USA Today Way, Miramar, FL 33025, USA
| | - C Wahlestedt
- Center for Therapeutic Innovation and the Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1501 NW 10th Avenue, Miami 33136, FL, USA.
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Kylstra JW, Kalnoski MH, Vo T, Lee ML, Chen SC, Quay SC. Abstract P5-06-02: Proliferative breast disease identified by nipple aspirate fluid cytopathology has the laterality and asymmetry characteristics of breast cancer, supporting the thesis it is a cancer precursor. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-06-02] [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: 11/16/2022]
Abstract
Abstract
Introduction. Within the basket of conditions known as Benign Breast Disease, Proliferative Breast Disease (PBD) is a finding at biopsy or aspiration of either benign hyperplasia or atypical hyperplasia (ADH). PBD is known to confer increased risk of future breast cancer [Hartmann, NEJM 2015;372:78-89]. However, there is some controversy as to whether these lesions are precursors to breast cancer (BCa), in which their synchronicity and asymmetry should match BCa, or alternatively, if they are biomarkers of risk, in which future cancers would not necessarily be linked in time and space to earlier PBD lesions. The Left-dominant asymmetry was first described over half a century ago, but its molecular origins in embryonic development have only recently been characterized.[Wilting. J.Current Medic Chem 2011; 18:5519-27]. This study was conducted to explore if a similar pattern of asymmetry and unilateral v. bilateral incidence might exist in PBD. This could help to resolve the question of whether PBD is a precursor to BCa or merely a biomarker.
Methods. We examined Nipple Aspirate Fluid (NAF) for evidence of proliferative cytopathology, defined as a finding of either hyperplasia or ADH. NAF was collected using either one of two models of aspirator devices (ForeCYTE™ or HALO™). NAF is aspirated, dispersed on a flower filter, sprayed with fixative and stained with the Pap stain prior to cytologic characterization. Filters mounted whole on glass are placed directly under the microscope. This method allows for a diagnostically interpretable specimen in NAF-droplets as little as 0.007 µL, 1000-fold smaller than the unassisted visual detection limit. A central lab evaluated all specimens.
Results. Between 1/2012 and 6/2013, 1154 women without prior BCa (Age range 18-85; median 48, mean 47.9) consented to submit bilateral NAF specimens; 99.7% of breasts yielded NAF adequate for analysis, evidenced by presence of a duct-selective protein assay on the filter. PBD was found in 149 women, of whom 24 bilateral. The distribution is shown in the table below.
Distribution of benign and atypical hyperplasia among 149 women with PBD Left-onlyRight onlyBilateralCCR 4594218CCR 51684CCR4 (L) and CCR5 (R)--2Total Women755024King Classification: CCR4 = Benign hyperplasia; CCR5 - Atypical Hyperplasia (ADH)
Benign hyperplasia was found in 121 women: 10.5% of those tested. It was bilateral in 13% of cases and left-sided only in 57%. ADH was found in 30 women or 2.6% of those tested. When present, ADH was bilateral in 13% (4/30), L-sided only 53% (16/30) and R-sided only 33% (10/30) of the time. Total PBD identified by NAF cytopathology occurred in 13% (149/1154) of this population, was bilateral in 16.1% (24/149), L-only in 50.3% (75/149)and R-only in 33.5% 50/149). The excess left-sided occurrence of 17% was significant (p=0.048 by chi-square).
Conclusion. This is the first report describing laterality and symmetry of PBD as made by non-invasive NAF collection and demonstrates that the pattern observed is similar to what is seen with invasive breast cancer and in situ lesions, supporting the hypothesis that PBD are precursor lesions to breast cancer.
Citation Format: Kylstra JW, Kalnoski MH, Vo T, Lee ML, Chen S-C, Quay SC. Proliferative breast disease identified by nipple aspirate fluid cytopathology has the laterality and asymmetry characteristics of breast cancer, supporting the thesis it is a cancer precursor. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-06-02.
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Affiliation(s)
- JW Kylstra
- Atossa Genetics, Inc., Saattle, WA; National Reference Laboratory for Breast Health, Seattle, WA; UCLA, Los Angeles, CA
| | - MH Kalnoski
- Atossa Genetics, Inc., Saattle, WA; National Reference Laboratory for Breast Health, Seattle, WA; UCLA, Los Angeles, CA
| | - T Vo
- Atossa Genetics, Inc., Saattle, WA; National Reference Laboratory for Breast Health, Seattle, WA; UCLA, Los Angeles, CA
| | - ML Lee
- Atossa Genetics, Inc., Saattle, WA; National Reference Laboratory for Breast Health, Seattle, WA; UCLA, Los Angeles, CA
| | - S-C Chen
- Atossa Genetics, Inc., Saattle, WA; National Reference Laboratory for Breast Health, Seattle, WA; UCLA, Los Angeles, CA
| | - SC Quay
- Atossa Genetics, Inc., Saattle, WA; National Reference Laboratory for Breast Health, Seattle, WA; UCLA, Los Angeles, CA
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Lee ML, Howard ME, Horrey WJ, Liang Y, Anderson C, Shreeve MS, O'Brien CS, Czeisler CA. High risk of near-crash driving events following night-shift work. Proc Natl Acad Sci U S A 2016; 113:176-81. [PMID: 26699470 PMCID: PMC4711869 DOI: 10.1073/pnas.1510383112] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [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: 12/18/2022] Open
Abstract
Night-shift workers are at high risk of drowsiness-related motor vehicle crashes as a result of circadian disruption and sleep restriction. However, the impact of actual night-shift work on measures of drowsiness and driving performance while operating a real motor vehicle remains unknown. Sixteen night-shift workers completed two 2-h daytime driving sessions on a closed driving track at the Liberty Mutual Research Institute for Safety: (i) a postsleep baseline driving session after an average of 7.6 ± 2.4 h sleep the previous night with no night-shift work, and (ii) a postnight-shift driving session following night-shift work. Physiological measures of drowsiness were collected, including infrared reflectance oculography, electroencephalography, and electrooculography. Driving performance measures included lane excursions, near-crash events, and drives terminated because of failure to maintain control of the vehicle. Eleven near-crashes occurred in 6 of 16 postnight-shift drives (37.5%), and 7 of 16 postnight-shift drives (43.8%) were terminated early for safety reasons, compared with zero near-crashes or early drive terminations during 16 postsleep drives (Fishers exact: P = 0.0088 and P = 0.0034, respectively). Participants had a significantly higher rate of lane excursions, average Johns Drowsiness Scale, blink duration, and number of slow eye movements during postnight-shift drives compared with postsleep drives (3.09/min vs. 1.49/min; 1.71 vs. 0.97; 125 ms vs. 100 ms; 35.8 vs. 19.1; respectively, P < 0.05 for all). Night-shift work increases driver drowsiness, degrading driving performance and increasing the risk of near-crash drive events. With more than 9.5 million Americans working overnight or rotating shifts and one-third of United States commutes exceeding 30 min, these results have implications for traffic and occupational safety.
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Affiliation(s)
- Michael L Lee
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115
| | - Mark E Howard
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115; Department of Respiratory & Sleep Medicine, Institute for Breathing & Sleep, Austin Health, Heidelberg, VIC 3084, Australia
| | - William J Horrey
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748
| | - Yulan Liang
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748
| | - Clare Anderson
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115; Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3800, Australia
| | - Michael S Shreeve
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115
| | - Conor S O'Brien
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115;
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Shen J, Song Y, Lee ML, Cha JJ. Spatially resolved In and As distributions in InGaAs/GaP and InGaAs/GaAs quantum dot systems. Nanotechnology 2014; 25:465702. [PMID: 25354930 DOI: 10.1088/0957-4484/25/46/465702] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
InGaAs quantum dots (QDs) on GaP are promising for monolithic integration of optoelectronics with Si technology. To understand and improve the optical properties of InGaAs/GaP QD systems, detailed measurements of the QD atomic structure as well as the spatial distributions of each element at high resolution are crucial. This is because the QD band structure, band alignment, and optical properties are determined by the atomic structure and elemental composition. Here, we directly measure the inhomogeneous distributions of In and As in InGaAs QDs grown on GaAs and GaP substrates at the nanoscale using energy dispersive x-ray spectral mapping in a scanning transmission electron microscope. We find that the In distribution is broader on GaP than on GaAs, and as a result, the QDs appear to be In-poor using a GaP matrix. Our findings challenge some of the assumptions made for the concentrations and distributions of In within InGaAs/GaAs or InGaAs/GaP QD systems and provide detailed structural and elemental information to modify the current band structure understanding. In particular, the findings of In deficiency and inhomogeneous distribution in InGaAs/GaP QD systems help to explain photoluminescence spectral differences between InGaAs/GaAs and InGaAs/GaP QD systems.
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Affiliation(s)
- J Shen
- Department of Mechanical Engineering and Materials Science, Yale University, New Haven, CT, 06511, USA
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Liu SY, Sheu JK, Lin YC, Chen YT, Tu SJ, Lee ML, Lai WC. InGaN working electrodes with assisted bias generated from GaAs solar cells for efficient water splitting. Opt Express 2013; 21 Suppl 6:A991-A996. [PMID: 24514940 DOI: 10.1364/oe.21.00a991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Hydrogen generation through water splitting by n-InGaN working electrodes with bias generated from GaAs solar cell was studied. Instead of using an external bias provided by power supply, a GaAs-based solar cell was used as the driving force to increase the rate of hydrogen production. The water-splitting system was tuned using different approaches to set the operating points to the maximum power point of the GaAs solar cell. The approaches included changing the electrolytes, varying the light intensity, and introducing the immersed ITO ohmic contacts on the working electrodes. As a result, the hybrid system comprising both InGaN-based working electrodes and GaAs solar cells operating under concentrated illumination could possibly facilitate efficient water splitting.
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Liu SY, Sheu JK, Lin YC, Tu SJ, Huang FW, Lee ML, Lai WC. Mn-doped GaN as photoelectrodes for the photoelectrolysis of water under visible light. Opt Express 2012; 20 Suppl 5:A678-A683. [PMID: 23037534 DOI: 10.1364/oe.20.00a678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Hydrogen generation through direct photoelectrolysis of water was studied using photoelectrochemical (PEC) cells made of Mn-doped GaN photoelectrodes. In addition to its absorption of the ultraviolet spectrum, Mn-doped GaN photoelectrodes could absorb photons in the visible spectrum. The photocurrents measured from PEC cells made of Mn-doped GaN were at least one order higher than those measured from PEC cells made of undoped GaN-working electrodes. Under the visible light illumination and a bias voltage below 1.2 V, the Mn-doped GaN photoelectrodes could drive the water splitting reaction for hydrogen generation. However, hydrogen generation could not be achieved under the same condition wherein undoped GaN photoelectrodes were used. According to the results of the spectral responses and transmission spectra obtained from the experimental photoelectrodes, the enhanced photocurrent in the Mn-doped GaN photoelectrodes, compared with the undoped GaN photoelectrodes, was attributable to the Mn-related intermediate band within the band gap of GaN that resulted in further photon absorption.
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Affiliation(s)
- Shu-Yen Liu
- Department of Photonics & Advanced Optoelectronic Technology Center, National Cheng Kung University, Tainan City 70101, Taiwan
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Liu SY, Sheu JK, Lee ML, Lin YC, Tu SJ, Huang FW, Lai WC. Immersed finger-type indium tin oxide ohmic contacts on p-GaN photoelectrodes for photoelectrochemical hydrogen generation. Opt Express 2012; 20 Suppl 2:A190-A196. [PMID: 22418667 DOI: 10.1364/oe.20.00a190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In this study, we demonstrated photoelectrochemical (PEC) hydrogen generation using p-GaN photoelectrodes associated with immersed finger-type indium tin oxide (IF-ITO) ohmic contacts. The IF-ITO/p-GaN photoelectrode scheme exhibits higher photocurrent and gas generation rate compared with p-GaN photoelectrodes without IF-ITO ohmic contacts. In addition, the critical external bias for detectable hydrogen generation can be effectively reduced by the use of IF-ITO ohmic contacts. This finding can be attributed to the greatly uniform distribution of the IF-ITO/p-GaN photoelectrode applied fields over the whole working area. As a result, the collection efficiency of photo-generated holes by electrode contacts is higher than that of p-GaN photoelectrodes without IF-ITO contacts. Microscopy revealed a tiny change on the p-GaN surfaces before and after hydrogen generation. In contrast, photoelectrodes composed of n-GaN have a short lifetime due to n-GaN corrosion during hydrogen generation. Findings of this study indicate that the ITO finger contacts on p-GaN layer is a potential candidate as photoelectrodes for PEC hydrogen generation.
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Affiliation(s)
- Shu-Yen Liu
- Department of Photonics & Advanced Optoelectronic Technology Center, National Cheng Kung University, Tainan City 70101, Taiwan
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Davidson MB, Tareen N, Duran P, Aguilar V, Lee ML. Aggressive versus Low Dose Inhibition of the Renin-Angiotensin System for the Treatment of Microalbuminuria in Type 2 Diabetic Patients: A Pilot Study. ISRN Endocrinol 2012; 2011:696124. [PMID: 22363885 PMCID: PMC3262631 DOI: 10.5402/2011/696124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 08/15/2011] [Indexed: 11/23/2022]
Abstract
Objective. This study compares low dose versus aggressive inhibition of the renin angiotensin system (RAS) to treat microalbuminuria (MA). Methods. Patients with MA after a run-in period to control BP to <130/80 mm Hg with 10 mg benazepril plus other drugs and HbA1c levels to <8.0% were randomized to either continue 10 mg benazepril (N = 12) or to take maximal doses of benazepril plus losartan in monthly stepwise increases to achieve normoalbuminuria (N = 11). Because MA is associated with CVD and inflammation, carotid intima medial thickness (CIMT) and endothelial function by peripheral arterial tonometry (PAT) as surrogate indices of atherosclerosis and highly sensitive C-reactive protein (hs-CRP) to assess inflammation were measured every six months. Results. BP, HbA1c levels, albumin : creatinine ratios, CIMT, PAT, and hs-CRP did not differ over a mean of 12 months between the two groups. Conclusions. Aggressive inhibition of the RAS is unnecessary to treat MA.
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Affiliation(s)
- M B Davidson
- Department of Internal Medicine, Charles R. Drew University, Los Angeles, CA 90059, USA
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Liu SY, Lin YC, Ye JC, Tu SJ, Huang FW, Lee ML, Lai WC, Sheu JK. Hydrogen gas generation using n-GaN photoelectrodes with immersed Indium Tin Oxide ohmic contacts. Opt Express 2011; 19 Suppl 6:A1196-A1201. [PMID: 22109615 DOI: 10.1364/oe.19.0a1196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
An n-GaN photoelectrochemical (PEC) cell with immersed finger-type indium tin oxide (ITO) ohmic contacts was demonstrated in the present study to enhance the hydrogen generation rate. The finger-type ITO ohmic contacts were covered with SiO₂ layers to prevent the PEC cell from generating leakage current. Using a 1M NaCl electrolyte and external biases, the typical photocurrent density and gas generation rate of the n-GaN working electrodes with ITO finger contacts were found to be higher than those with Cr/Au finger contacts. The enhancement in photocurrent density or gas generation rate can be attributed to the transparent ITO contacts which allowed the introduction of relatively more photons into the GaN layer. No significant corrosion was observed in the ITO layer after the PEC process compared with the Cr/Au finger contacts which were significantly peeled from the GaN layer. These results indicate that the use of n-GaN working electrodes with finger-type ITO ohmic contacts is a promising approach for PEC cells.
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Affiliation(s)
- Shu-Yen Liu
- Institute of Electro-Optical Science and Engineering, Advanced Optoelectronic Technology Center, National Cheng Kung University, Tainan City 70101, Taiwan
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Friedman TC, Ghods DE, Shahinian HK, Zachery L, Shayesteh N, Seasholtz S, Zuckerbraun E, Lee ML, McCutcheon IE. High prevalence of normal tests assessing hypercortisolism in subjects with mild and episodic Cushing's syndrome suggests that the paradigm for diagnosis and exclusion of Cushing's syndrome requires multiple testing. Horm Metab Res 2010; 42:874-81. [PMID: 20803415 PMCID: PMC2978784 DOI: 10.1055/s-0030-1263128] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [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] [Indexed: 10/19/2022]
Abstract
Many Endocrinologists believe that a single determination of eucortisolism or a single demonstration of appropriate suppression to dexamethasone excluded Cushing's syndrome, except in what was previously thought to be the rare patient with episodic or periodic Cushing's syndrome. We hypothesize that episodic Cushing's syndrome is relatively common and a single test assessing hypercortisolism may not be sufficient to accurately rule out or diagnose Cushing's syndrome and retrospectively examined the number of normal and abnormal tests assessing hypercortisolism performed on multiple occasions in 66 patients found to have mild and/or episodic Cushing's syndrome compared to a similar group of 54 patients evaluated for, but determined not to have Cushing's syndrome. We found that 65 of the 66 patients with Cushing's syndrome had at least one normal test of cortisol status and most patients had several normal tests. The probability of having Cushing's syndrome when one test was negative was 92% for 23:00 h salivary cortisol, 88% for 24-h UFC, 86% for 24-h 17OHS, and 54% for nighttime plasma cortisol. These results demonstrated that episodic hypercortisolism is highly prevalent in subjects with mild Cushing's syndrome and no single test was effective in conclusively diagnosing or excluding the condition. Rather, the paradigm for the diagnosis should be a careful history and physical examination and in those patients in whom mild Cushing's syndrome/disease is strongly suspected, multiple tests assessing hypercortisolism should be performed on subsequent occasions, especially when the patient is experiencing signs and symptoms of short-term hypercortisolism.
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Affiliation(s)
- T C Friedman
- Division of Endocrinology, Metabolism, and Molecular Medicine, Charles Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
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Lee BW, Aw MM, Chiang WC, Daniel M, George GM, Goh EN, Han WM, Lee ML, Leong KP, Liew WK, Phuah KY, Shek LP, Van Bever H. Academy of medicine, Singapore-Ministry of Health clinical practice guidelines: management of food allergy. Singapore Med J 2010; 51:599-607. [PMID: 20730402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The Academy of Medicine, Singapore (AMS) and the Ministry of Health (MOH) publish clinical practice guidelines to provide doctors and patients in Singapore with evidence-based guidance on managing important medical conditions. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the AMS-MOH clinical practice guidelines on the Management of Food Allergy, for the information of readers of the Singapore Medical Journal. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Academy of Medicine website: http://www.ams.edu.sg/guidelines.asp#foodallergy. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
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Affiliation(s)
- B W Lee
- Academy of Medicine, Singapore-Ministry of Health Clinical Practice Guidelines Workgroup on Management of Food Allergy.
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Lee ML. The use of animal pharmacokinetic data to evaluate human dosing. Haemophilia 2010; 16:508-509. [PMID: 19563482 DOI: 10.1111/j.1365-2516.2009.02055.x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- M L Lee
- Department of Biostatistics, UCLA School of Public Health, Los Angeles, CA 900095-1772, USA.
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Anghel A, Jamieson CAM, Ren X, Young J, Porche R, Ozigbo E, Ghods DE, Lee ML, Liu Y, Lutfy K, Friedman TC. Gene expression profiling following short-term and long-term morphine exposure in mice uncovers genes involved in food intake. Neuroscience 2010; 167:554-66. [PMID: 20144693 DOI: 10.1016/j.neuroscience.2010.01.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Revised: 01/07/2010] [Accepted: 01/21/2010] [Indexed: 10/19/2022]
Abstract
Addictive drugs including opioids activate signal transduction pathways that regulate gene expression in the brain. However, changes in CNS gene expression following morphine exposure are poorly understood. We determined changes in gene expression following short- and long-term morphine treatment in the hypothalamus and pituitary using genome-wide DNA microarray analysis and confirmed those alterations in gene expression by real-time reverse transcriptase polymerase chain reaction (RT-PCR) analysis. In the hypothalamus, short-term morphine administration up-regulated (at least twofold) 39 genes and down-regulated six genes. Long-term morphine treatment up-regulated 35 genes and down-regulated 51 genes. In the pituitary, short-term morphine administration up-regulated 110 genes and down-regulated 29 genes. Long-term morphine treatment up-regulated 85 genes and down-regulated 37 pituitary genes. Microarray analysis uncovered several genes involved in food intake (neuropeptide Y, agouti-related protein, and cocaine and amphetamine-regulated transcript) whose expression was strongly altered by morphine exposure in either the hypothalamus or pituitary. Subsequent RT-PCR analysis confirmed similar regulation in expression of these genes in the hypothalamus and pituitary. Finally, we found functional correlation between morphine-induced alterations in food intake and regulation of genes involved in this process. Changes in genes related to food intake may uncover new pathways related to some of the physiological effects of opioids.
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Affiliation(s)
- A Anghel
- Division of Endocrinology, Department of Medicine, Charles Drew University of Medicine and Sciences-UCLA School of Medicine, Los Angeles, CA 90059, USA
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Clayton CC, Bruchas MR, Lee ML, Chavkin C. Phosphorylation of the mu-opioid receptor at tyrosine 166 (Tyr3.51) in the DRY motif reduces agonist efficacy. Mol Pharmacol 2009; 77:339-47. [PMID: 19959593 DOI: 10.1124/mol.109.060558] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The effects of phosphorylation of the tyrosine residue in the highly conserved DRY motif expressed in the putative second cytoplasmic loop of the mu-opioid receptor were assessed after expression in human embryonic kidney (HEK) 293 cells. Tyrosine kinase activation by epidermal growth factor (EGF) or hydrogen peroxide treatment effectively increased phosphorylation of the tyrosine-166 in the mu-opioid receptor (MOR-Tyr166p) as measured by a novel phosphoselective antibody. We were surprised to find that the increase in MOR-Tyr166p immunoreactivity (ir) required coactivation by the opioid agonist [D-Ala(2),methyl-Phe(4),Gly(5)-ol]enkephalin (DAMGO), as demonstrated by both Western blot imaging of membrane proteins and confocal microscopy of transfected cells; MOR-Tyr166p-ir did not significantly increase after either DAMGO, EGF, or H(2)O(2) treatment alone. The increase in MOR-Tyr166p-ir was blocked by pretreatment with the opioid antagonist naloxone or the Src kinase inhibitor 4-amino-5-(4-chloro-phenyl)-7-(t-butyl)pyrazolo[3,4-d]pyrimidine. Consistent with these data, mutation of the tyrosine-166 to phenylalanine blocked the increased immunoreactivity, and untransfected HEK293 cells did not increase MOR-Tyr166p-ir after treatment. DAMGO increased guanosine 5'-O-(3-[(35)S]thio)triphosphate ([(35)S]GTP gamma S) binding to membranes from cells expressing wild-type MOR or MOR-Y166F receptors in a dose-dependent manner. Pretreatment of the wild-type MOR-expressing cells with the combination of DAMGO and EGF completely blocked subsequent DAMGO stimulation of [(35)S]GTP gamma S binding membranes, whereas [(35)S]GTP gamma S binding to membranes from cells expressing mutated MOR(Y166F) was only partially inhibited. These results suggest that G-protein activation as measured by [(35)S]GTP gamma S binding can be regulated by DAMGO and EGF by convergent mechanisms and support the hypothesis that tyrosine phosphorylation within the DRY motif may reduce mu-opioid receptor-G-protein coupling efficiency.
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Affiliation(s)
- Cecilea C Clayton
- Department of Pharmacology, University of Washington School of Medicine, Seattle, WA 98195-7280, USA
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Tong YC, Lee ML, Ting OS, Wu A. Phy27 Preliminary Result on the Effectiveness of ADL Efficacy Training for Fractured Hip Patients. Hong Kong J Occup Ther 2009. [DOI: 10.1016/s1569-1861(10)70029-2] [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: 10/19/2022] Open
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Lee ML, Swanson BE, de la Iglesia HO. Circadian timing of REM sleep is coupled to an oscillator within the dorsomedial suprachiasmatic nucleus. Curr Biol 2009; 19:848-52. [PMID: 19375313 DOI: 10.1016/j.cub.2009.03.051] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Revised: 02/14/2009] [Accepted: 03/18/2009] [Indexed: 11/25/2022]
Abstract
Sleep is consistently concentrated to a specific time of the day. Its timing and consolidation depend on the interplay between a homeostatic and a circadian process of sleep regulation [1-3]. Sleep propensity rises as a homeostatic response to increasing wake time, whereas a circadian clock determines the specific time when sleep will probably occur. This two-process regulation of sleep also determines which specific sleep stage will be manifested, and the circadian process governs tightly the manifestation of rapid eye movement sleep (REMS) [1, 4]. The role of the hypothalamic suprachiasmatic nucleus (SCN) in the circadian gating of sleep and wakefulness has been unequivocally established by lesion studies [5], but its role in the timing of specific sleep stages has remained unknown. Using a forced desynchrony paradigm that induces the stable dissociation of the ventrolateral (vl) and dorsomedial (dm) SCN, and a jetlag paradigm that induces desynchronization between these SCN subregions, we show that the SCN can time the occurrence of specific sleep stages. Specifically, the circadian regulation of REMS is associated with clock gene expression within the dmSCN. We provide the first neurophysiological model for the disruption of sleep architecture that may result from temporal challenges such as rotational-shift work and jetlag.
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Affiliation(s)
- Michael L Lee
- Department of Biology and Program of Neurobiology and Behavior, University of Washington, P.O. Box 351800, Seattle, WA 98195-1800, USA
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Lee ML, Chou NK, Ko WJ, Chi NH, Chen YS, Yu HY, Wu IH, Huang SC, Wang CH, Chang CI, Wang SS. Cardiac Arrest After Methylprednisolone Pulse Therapy Rescued Using Extracorporeal Membrane Oxygenation in Patients With Acute Cardiac Rejection: Two Case Reports. Transplant Proc 2008; 40:2611-3. [PMID: 18929816 DOI: 10.1016/j.transproceed.2008.08.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- M L Lee
- Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan
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Abstract
BACKGROUND Carpal tunnel syndrome (CTS) is a common entrapment neuropathy. Electrodiagnostic testing (EMG) is used to confirm the diagnosis. It is not known what the diagnostic accuracy of high-resolution sonography is in comparison to EMG. OBJECTIVE The aim of this study was to compare the diagnostic accuracy of both tests in CTS patients. METHODS A prospective cohort of 207 patients with possible CTS underwent high-resolution sonography and EMG. The diagnosis of CTS was based on clinical signs and symptoms. The cross-sectional area of the median nerve at the carpal tunnel inlet and at the distal one-third level of the forearm was assessed by an investigator, blinded to the clinical and EMG data. Normal sonographic values were obtained from 137 controls. All patients and 40 controls underwent a standardised nerve conduction study. The kappa coefficient was used to evaluate the relationship between sonography, EMG and clinical diagnosis. RESULTS The cross-sectional area at the distal one-third of the forearm was not significantly different between the controls and patients (p = 0.59), whereas the cross-sectional area at the carpal tunnel inlet was significantly increased in the patient group (p<0.0001). The kappa coefficient for EMG using the median-ulnar distal sensory latency difference versus clinical evaluation was 0.64 and, for sonography, this coefficient was 0.69; these were not statistically different (p = 0.37). Combining the two tests resulted in a kappa coefficient of 0.72, which was not significantly different from sonography alone (p = 0.73). CONCLUSION In patients with a clinical diagnosis of CTS, the accuracy of sonography is similar to that for EMG. Sonography is probably preferable because it is painless, easily accessible and preferred by the patients.
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Affiliation(s)
- L H Visser
- Department of Neurology, St. Elisabeth Hospital, PO Box 90151, 5000 LC Tilburg, The Netherlands.
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Friedman TC, Zuckerbraun E, Lee ML, Kabil MS, Shahinian H. Dynamic pituitary MRI has high sensitivity and specificity for the diagnosis of mild Cushing's syndrome and should be part of the initial workup. Horm Metab Res 2007; 39:451-6. [PMID: 17578763 DOI: 10.1055/s-2007-980192] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The diagnosis of mild or episodic Cushing's syndrome is difficult. The standard tests include 24-hour urinary free cortisol (UFC), night-time blood, or salivary cortisol measurements, and dexamethasone suppression tests. Imaging studies of the pituitary have not been recommended as part of the initial workup (only to help distinguish pituitary Cushing's disease from the ectopic ACTH syndrome) because of poor sensitivity and specificity. With the development of dynamic pituitary MRI which uses multiple coronal dynamic sequences following gadolinium intravenous contrast, we hypothesized that the sensitivity and specificity would be increased and MRI would provide useful information for the initial diagnosis of Cushing's syndrome. METHODS This was a retrospective chart review examining charts from 87 consecutive patients who were evaluated for Cushing's syndrome in a tertiary Endocrinology clinic over a one-year period. Most patients had mild and/or episodic hypercortisolism. Of these patients, 24 eventually were diagnosed with pituitary Cushing's syndrome by biochemical testing (24-h UFC and urinary 17-hydroxycorticosteroids, 11 PM salivary cortisol measurements, evening plasma cortisol), and 22 had the diagnosis of Cushing's syndrome excluded. Dynamic pituitary MRI (1.5 Tesla) was performed on all patients. The reader of the MRI was blind to the diagnosis. RESULTS Twenty-three of 24 patients had a MRI consistent with a pituitary lesion (21 with a microadenoma, two with pituitary asymmetry). In contrast, only 3 of 20 patients (2 patient did not have MRIs) in the Cushing's excluded group had a pituitary lesion on dynamic MRI. Dynamic pituitary MRI had the highest sensitivity and negative predictive value of any testing modalities and its specificity and positive predictive value were similar to that of other tests. CONCLUSION We conclude that almost all patients in this series with Cushing's syndrome have a lesion on dynamic pituitary MRI, a rate much higher than the 50-60% rate reported for non-dynamic MRIs. The false positive rate of 16% in our group of Cushing's excluded patients is similar to the literature value of 10% seen in normal volunteers and is acceptable since MRI is not used solely as a determinant for the diagnosis. While a negative MRI will miss those patients with adrenal or ectopic Cushing's syndrome, those patients can usually be diagnosed by other testing. Thus this preliminary study implies that dynamic pituitary MRI adds valuable information to assist in the diagnosis of Cushing's syndrome and should be ordered as part of the initial workup.
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Affiliation(s)
- T C Friedman
- Division of Endocrinology, Metabolism, and Molecular Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
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Cambras T, Weller JR, Anglès-Pujoràs M, Lee ML, Christopher A, Díez-Noguera A, Krueger JM, de la Iglesia HO. Circadian desynchronization of core body temperature and sleep stages in the rat. Proc Natl Acad Sci U S A 2007; 104:7634-9. [PMID: 17452631 PMCID: PMC1863469 DOI: 10.1073/pnas.0702424104] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Proper functioning of the human circadian timing system is crucial to physical and mental health. Much of what we know about this system is based on experimental protocols that induce the desynchronization of behavioral and physiological rhythms within individual subjects, but the neural (or extraneural) substrates for such desynchronization are unknown. We have developed an animal model of human internal desynchrony in which rats are exposed to artificially short (22-h) light-dark cycles. Under these conditions, locomotor activity, sleep-wake, and slow-wave sleep (SWS) exhibit two rhythms within individual animals, one entrained to the 22-h light-dark cycle and the other free-running with a period >24 h (tau(>24 h)). Whereas core body temperature showed two rhythms as well, further analysis indicates this variable oscillates more according to the tau(>24 h) rhythm than to the 22-h rhythm, and that this oscillation is due to an activity-independent circadian regulation. Paradoxical sleep (PS), on the other hand, shows only one free-running rhythm. Our results show that, similarly to humans, (i) circadian rhythms can be internally dissociated in a controlled and predictable manner in the rat and (ii) the circadian rhythms of sleep-wake and SWS can be desynchronized from the rhythms of PS and core body temperature within individual animals. This model now allows for a deeper understanding of the human timekeeping mechanism, for testing potential therapies for circadian dysrhythmias, and for studying the biology of PS and SWS states in a neurologically intact model.
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Affiliation(s)
- Trinitat Cambras
- *Departament de Fisiologia, Facultat de Farmàcia, Universitat de Barcelona, Barcelona 08028, Spain
- To whom correspondence may be addressed. E-mail: or
| | - John R. Weller
- Department of Biology and Program of Neurobiology and Behavior, Box 351800, University of Washington, Seattle, WA 98195-1800; and
| | | | - Michael L. Lee
- Department of Biology and Program of Neurobiology and Behavior, Box 351800, University of Washington, Seattle, WA 98195-1800; and
| | - Andrea Christopher
- Department of Biology and Program of Neurobiology and Behavior, Box 351800, University of Washington, Seattle, WA 98195-1800; and
| | - Antoni Díez-Noguera
- *Departament de Fisiologia, Facultat de Farmàcia, Universitat de Barcelona, Barcelona 08028, Spain
| | - James M. Krueger
- Department of Veterinary and Comparative Anatomy, Pharmacology and Physiology, Washington State University, Pullman, WA 99164-6520
| | - Horacio O. de la Iglesia
- Department of Biology and Program of Neurobiology and Behavior, Box 351800, University of Washington, Seattle, WA 98195-1800; and
- To whom correspondence may be addressed. E-mail: or
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Abstract
To define the roles of the calmodulin-stimulated adenylyl cyclases (AC1 and AC8) in morphine-induced analgesia, tolerance, physical dependence, and conditioned place preference, we used mice having targeted disruptions of either the AC1 or AC8 genes or both genes [double knockout mice (DKO)]. Mice lacking either AC1 or AC8 genes or DKO did not differ from wild-type mice in short-term antinociceptive responses to morphine measured in the tail-flick analgesia assay. Morphine tolerance that developed immediately within 3 h of morphine administration (10 mg/kg s.c.) was significantly attenuated in DKO mice and AC8 single knockout mice. Tolerance induced continually by daily injections of morphine (10 mg/kg s.c.) was also reduced in DKO mice. In DKO mice continually treated with morphine, there was a significant reduction in withdrawal behaviors, including reduced wet-dog shakes and forepaw tremor after naloxone injection (10 mg/kg i.p.). Morphine produced hyperlocomotion and conditioned place preference in wild-type mice, whereas DKO mice displayed significantly less hyperlocomotion and conditioned place preference. Furthermore, the significant increase in phosphorylated cAMP-response element binding protein (CREB) staining in ventral tegmental area induced by long-term morphine treatment was not evident in DKO mice, suggesting that CREB activation by morphine requires cAMP generated by AC1 and AC8. These results support the hypothesis that calmodulin-stimulated adenylyl cyclases are important mediators of the neuronal responses to morphine.
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Affiliation(s)
- Shuang Li
- Department of Pharmacology, Box 357280, University of Washington School of Medicine, Seattle, 98195-7280, USA
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Chin PS, Berg AT, Spencer SS, Lee ML, Shinnar S, Sperling MR, Langfitt JT, Walczak TS, Pacia SV, Bazil CW, Vassar S, Vickrey BG. Patient-perceived impact of resective epilepsy surgery. Neurology 2006; 66:1882-7. [PMID: 16801655 DOI: 10.1212/01.wnl.0000219729.08924.54] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the patient-perceived impact of resective epilepsy surgery, a key outcome to consider in evaluating such a highly invasive, elective procedure. METHODS Impact measures obtained from 396 patients in a multicenter cohort study of resective epilepsy surgery included (1) willingness to undergo surgery if that decision could be made again and (2) the overall impact of surgery on the patient's life. Predictors of impact were analyzed using multivariate ordinal logistic regression. RESULTS Of study participants, 73.8%, 77.4%, and 75.5% would definitely undergo surgery again and 78.2%, 80.2%, and 79.1% reported a very strong or strong positive overall impact of surgery at 3, 12, and 24 months. Multivariate ordinal logistic regression showed that seizure freedom predicted more positive perceptions at 3, 12, and 24 months (all p < 0.04). Becoming employed was uniquely associated with willingness to undergo surgery again and with overall impact at 24 months (all p < 0.05), but only a net 7% of the cohort improved their employment status. Right-sided resection (at 12 and 24 months, p < 0.005) and female gender (at 3 and 12 months, p = 0.006) were each positively associated with perceived overall impact. CONCLUSIONS Most epilepsy surgery patients report a positive overall impact of the procedure on their lives and a high willingness to undergo surgery again if that choice could be made. Seizure-free individuals express consistently more positive perceptions of the procedure. Findings suggest that it is important to make early efforts to reintegrate epilepsy surgery patients into employment.
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Affiliation(s)
- P S Chin
- Robert Wood Johnson Clinical Scholars Program, Department of Neurology and Medicine at UCLA and the Greater Los Angeles VA Health Care System, USA.
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