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Main LR, Song YE, Lynn A, Laux RA, Miskimen KL, Osterman MD, Cuccaro ML, Ogrocki PK, Lerner AJ, Vance JM, Fuzzell MD, Fuzzell SL, Hochstetler SD, Dorfsman DA, Caywood LJ, Prough MB, Adams LD, Clouse JE, Herington SD, Scott WK, Pericak-Vance MA, Haines JL. Genetic analysis of cognitive preservation in the midwestern Amish reveals a novel locus on chromosome 2. medRxiv 2023:2023.12.13.23299932. [PMID: 38168325 PMCID: PMC10760262 DOI: 10.1101/2023.12.13.23299932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Alzheimer disease (AD) remains a debilitating condition with limited treatments and additional therapeutic targets needed. Identifying AD protective genetic loci may identify new targets and accelerate identification of therapeutic treatments. We examined a founder population to identify loci associated with cognitive preservation into advanced age. METHODS Genome-wide association and linkage analyses were performed on 946 examined and sampled Amish individuals, aged 76-95, who were either cognitively unimpaired (CU) or impaired (CI). RESULTS 12 SNPs demonstrated suggestive association (P≤5×10-4) with cognitive preservation. Genetic linkage analyses identified >100 significant (LOD≥3.3) SNPs, some which overlapped with the association results. Only one locus on chromosome 2 retained significance across multiple analyses. DISCUSSION A novel significant result for cognitive preservation on chromosome 2 includes the genes LRRTM4 and CTNNA2. Additionally, the lead SNP, rs1402906, impacts the POU3F2 transcription factor binding affinity, which regulates LRRTM4 and CTNNA2.
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Affiliation(s)
- Leighanne R Main
- Departments of Genetics and Genome Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, USA, 44106
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44016
- Cleveland Institute of Computational Biology, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44106
| | - Yeunjoo E Song
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44016
- Cleveland Institute of Computational Biology, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44106
| | - Audrey Lynn
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44016
- Cleveland Institute of Computational Biology, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44106
| | - Renee A Laux
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44016
| | - Kristy L Miskimen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44016
| | - Michael D Osterman
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44016
| | - Michael L Cuccaro
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
- Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
| | - Paula K Ogrocki
- Department of Neurology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, USA, 44106
- Department of Neurology, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44106
| | - Alan J Lerner
- Department of Neurology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, USA, 44106
- Department of Neurology, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44106
| | - Jeffery M Vance
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
- Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
| | - M Denise Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44016
| | - Sarada L Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44016
| | - Sherri D Hochstetler
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44016
| | - Daniel A Dorfsman
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
- Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
| | - Laura J Caywood
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
| | - Michael B Prough
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
| | - Larry D Adams
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
| | - Jason E Clouse
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
| | - Sharlene D Herington
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
| | - William K Scott
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
- Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
| | - Margaret A Pericak-Vance
- John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
- Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, 1501 NW 10th Ave, Miami, FL, USA, 33136
| | - Jonathan L Haines
- Departments of Genetics and Genome Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, USA, 44106
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44016
- Cleveland Institute of Computational Biology, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH, USA, 44106
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Ramos J, Caywood LJ, Prough MB, Clouse JE, Herington SD, Slifer SH, Fuzzell MD, Fuzzell SL, Hochstetler SD, Miskimen KL, Main LR, Osterman MD, Zaman AF, Whitehead PL, Adams LD, Laux RA, Song YE, Foroud TM, Mayeux RP, George-Hyslop PS, Ogrocki PK, Lerner AJ, Vance JM, Cuccaro ML, Haines JL, Pericak-Vance MA, Scott WK. Genetic variants in the SHISA6 gene are associated with delayed cognitive impairment in two family datasets. Alzheimers Dement 2023; 19:611-620. [PMID: 35490390 PMCID: PMC9622429 DOI: 10.1002/alz.12686] [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: 09/23/2021] [Revised: 03/08/2022] [Accepted: 03/28/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Studies of cognitive impairment (CI) in Amish communities have identified sibships containing CI and cognitively unimpaired (CU) individuals. We hypothesize that CU individuals may carry protective alleles delaying age at onset (AAO) of CI. METHODS A total of 1522 individuals screened for CI were genotyped. The outcome studied was AAO for CI individuals or age at last normal exam for CU individuals. Cox mixed-effects models examined association between age and single nucleotide variants (SNVs). RESULTS Three SNVs were significantly associated (P < 5 × 10-8 ) with AAO on chromosomes 6 (rs14538074; hazard ratio [HR] = 3.35), 9 (rs534551495; HR = 2.82), and 17 (rs146729640; HR = 6.38). The chromosome 17 association was replicated in the independent National Institute on Aging Genetics Initiative for Late-Onset Alzheimer's Disease dataset. DISCUSSION The replicated genome-wide significant association with AAO on chromosome 17 is located in the SHISA6 gene, which is involved in post-synaptic transmission in the hippocampus and is a biologically plausible candidate gene for Alzheimer's disease.
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Affiliation(s)
- Jairo Ramos
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Laura J. Caywood
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michael B. Prough
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jason E. Clouse
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sharlene D. Herington
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Susan H. Slifer
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M. Denise Fuzzell
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Sarada L. Fuzzell
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | | | - Leighanne R. Main
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Michael D. Osterman
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - Andrew F. Zaman
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Patrice L. Whitehead
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Larry D. Adams
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Renee A. Laux
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Yeunjoo E. Song
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Tatiana M. Foroud
- Indiana Alzheimer’s Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Richard P. Mayeux
- Taub Institute on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | | | - Paula K. Ogrocki
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Alan J. Lerner
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Jeffery M. Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
- The Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
- The Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jonathan L. Haines
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - Margaret A. Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
- The Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - William K. Scott
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
- The Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
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Main LR, Song YE, Laux RA, Miskimen KL, Cuccaro ML, Ogrocki PK, Lerner AJ, Vance JM, Fuzzell MD, Fuzzell SL, Hochstetler SD, Osterman MD, Lynn A, Dorfsman DA, Caywood LJ, Prough MB, Adams LD, Clouse JE, Herington SD, Scott WK, Pericak‐Vance MA, Haines JL. Detecting genetic loci for preservation of cognition in the Midwestern United States Amish. Alzheimers Dement 2022. [DOI: 10.1002/alz.061554] [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)
- Leighanne R. Main
- Department of Genetics and Genome Sciences, Case Western Reserve University Cleveland OH USA
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
| | - Yeunjoo E. Song
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Renee A. Laux
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Kristy L. Miskimen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Paula K. Ogrocki
- Brain Health and Memory Center, University Hospital Cleveland OH USA
- Department of Neurology, Case Western Reserve University School of Medicine Cleveland OH USA
| | - Alan J. Lerner
- Brain Health and Memory Center, University Hospital Cleveland OH USA
- Department of Neurology, Case Western Reserve University School of Medicine Cleveland OH USA
| | - Jeffery M. Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miami FL USA
| | - M. Denise Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Sarada L. Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Sherri D. Hochstetler
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Michael D. Osterman
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Audrey Lynn
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Daniel A. Dorfsman
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Laura J. Caywood
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Michael B. Prough
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Larry D. Adams
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Jason E. Clouse
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Sharlene D. Herington
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - William K. Scott
- 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
| | - Jonathan L. Haines
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
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4
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Osterman MD, Song YE, Wheeler NR, Laux RA, Adams LD, Caywood LJ, Prough MB, Clouse JE, Herington SD, Slifer SH, Lynn A, Bartlett J, Fuzzell MD, Fuzzell SL, Hochstetler SD, Miskimen KL, Main LR, Dorfsman DA, Ogrocki PK, Lerner AJ, Vance JM, Cuccaro ML, Bush WS, Scott WK, Pericak‐Vance MA, Haines JL. Assessing a Network‐Specific Polygenic Risk Score for Alzheimer’s Disease in the Midwestern Amish and Across Diverse Ancestries. Alzheimers Dement 2022. [DOI: 10.1002/alz.067210] [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)
- Michael D. Osterman
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
| | - Yeunjoo E. Song
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
| | | | - Renee A. Laux
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
| | - Larry D. Adams
- University of Miami Miller School of Medicine Miami FL USA
| | | | | | | | | | | | - Audrey Lynn
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
| | | | - M. Denise Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
| | - Sarada L. Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
| | | | - Kristy L. Miskimen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
| | - Leighanne R. Main
- Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
| | | | - Paula K. Ogrocki
- Department of Neurology, Case Western Reserve University School of Medicine Cleveland OH USA
- University Hospitals Cleveland Medical Center Cleveland OH USA
| | - Alan J. Lerner
- Department of Neurology, Case Western Reserve University School of Medicine Cleveland OH USA
- University Hospitals Cleveland Medical Center Cleveland OH USA
| | | | | | - William S. Bush
- Case Western Reserve University School of Medicine Cleveland OH 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
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5
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Dorfsman DA, Prough MB, Caywood LJ, Clouse JE, Herington SD, Slifer SH, Adams LD, Laux RA, Song YE, Lynn A, Fuzzell MD, Fuzzell SL, Hochstetler SD, Miskimen KL, Main LR, Osterman MD, Ogrocki PK, Lerner AJ, Vance JM, Cuccaro ML, Haines JL, Pericak‐Vance MA, Scott WK. Association of mitochondrial haplogroups and cognitive impairment in the Amish. Alzheimers Dement 2022. [DOI: 10.1002/alz.067658] [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)
- Daniel A. Dorfsman
- 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, University of Miami Miller School of Medicine Miami FL USA
| | - Michael B. Prough
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Laura J. Caywood
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Jason E. Clouse
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Sharlene D. Herington
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Susan H. Slifer
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Larry D. Adams
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Renee A. Laux
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Yeunjoo E. Song
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Audrey Lynn
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - M. Denise Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Sarada L. Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Sherri D. Hochstetler
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Kristy L. Miskimen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Leighanne R. Main
- Department of Genetics and Genome Sciences, Case Western Reserve University Cleveland OH USA
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
| | - Michael D. Osterman
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
| | - Paula K. Ogrocki
- University Hospitals Cleveland Medical Center Cleveland OH USA
- Department of Neurology, Case Western Reserve University School of Medicine Cleveland OH USA
| | - Alan J. Lerner
- University Hospitals Cleveland Medical Center Cleveland OH USA
- Department of Neurology, Case Western Reserve University School of Medicine Cleveland OH USA
| | - Jeffery M. Vance
- 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
| | - 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, University of Miami Miller School of Medicine Miami FL USA
| | - Jonathan L. Haines
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
| | - Margaret A. Pericak‐Vance
- 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, University of Miami Miller School of Medicine Miami FL USA
| | - William K. Scott
- 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, University of Miami Miller School of Medicine Miami FL USA
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6
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Prough MB, Caywood LJ, Clouse JE, Herington SD, Slifer SH, Dorfsman DA, Adams LD, Laux RA, Song YE, Lynn A, Fuzzell MD, Fuzzell SL, Miller SD, Miskimen KL, Main LR, Osterman MD, Ogrocki PK, Lerner AJ, Vance JM, Cuccaro ML, Haines JL, Scott WK, Pericak‐Vance MA. Plasma pTau181 is associated with impaired cognition in the Old Order Amish and adds additional information beyond the known genetic risk factors for AD. Alzheimers Dement 2022. [DOI: 10.1002/alz.067752] [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)
- Michael B. Prough
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Laura J. Caywood
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Jason E. Clouse
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Sharlene D. Herington
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Susan H. Slifer
- University of Miami, Miller School of Medicine, John P. Hussman Institute for Human Genomics Miami FL USA
| | - Daniel A. Dorfsman
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Larry D. Adams
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Renee A. Laux
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Yeunjoo E. Song
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Audrey Lynn
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - M. Denise Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Sarada L. Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Sherri D. Miller
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Kristy L. Miskimen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
| | - Leighanne R. Main
- Department of Genetics and Genome Sciences, Case Western Reserve University Cleveland OH USA
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
| | - Michael D. Osterman
- Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
- Cleveland Institute for Computational Biology, Case Western Reserve University Cleveland OH USA
| | - Paula K. Ogrocki
- Department of Neurology, Case Western Reserve University School of Medicine Cleveland OH USA
- University Hospitals Cleveland Medical Center Cleveland OH USA
| | - Alan J. Lerner
- Department of Neurology, Case Western Reserve University School of Medicine Cleveland OH USA
- University Hospitals Cleveland Medical Center Cleveland OH USA
| | - Jeffery M. Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine Miami FL USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine Miami FL USA
| | - Jonathan L. Haines
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University Cleveland OH USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine Cleveland OH USA
| | - William K. Scott
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine Miami FL USA
| | - Margaret A. Pericak‐Vance
- 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
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7
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Scott WK, Ramos J, Slifer SH, Caywood LJ, Prough MB, Clouse JE, Dorfsman DA, Herington SD, Fuzzell MD, Fuzzell SL, Sewell JL, Miller SD, Osterman MD, Main LR, Miskimen KL, Lynn A, Whitehead PL, Adams LD, Laux RA, Song YE, Foroud TM, Mayeux R, Ogrocki PK, Lerner AJ, Vance JM, Cuccaro ML, Haines JL, Pericak‐Vance MA. Association of a locus on chromosome 17 with earlier age at onset of cognitive impairment in a familial Amish dataset. Alzheimers Dement 2021. [DOI: 10.1002/alz.056288] [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: 11/10/2022]
Affiliation(s)
- William K. Scott
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics University of Miami Miller School of Medicine Miami FL USA
| | - Jairo Ramos
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Susan H. Slifer
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Laura J. Caywood
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Michael B. Prough
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Jason E. Clouse
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Daniel A. Dorfsman
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Sharlene D. Herington
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - M. Denise Fuzzell
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Sarada L. Fuzzell
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Jane L. Sewell
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Sherri D. Miller
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Michael D. Osterman
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Leighanne R Main
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Kristy L. Miskimen
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Audrey Lynn
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Patrice L. Whitehead
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Larry D. Adams
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Renee A. Laux
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Yeunjoo E. Song
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
- Cleveland Institute for Computational Biology Case Western Reserve University Cleveland OH USA
| | | | - Richard Mayeux
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain Columbia University New York NY USA
| | - Paula K. Ogrocki
- Case Western Reserve University School of Medicine Cleveland OH USA
- University Hospitals Cleveland Medical Center Cleveland OH USA
| | - Alan J. Lerner
- Case Western Reserve University School of Medicine Cleveland OH USA
- University Hospitals Cleveland Medical Center Cleveland OH USA
| | - Jeffery M. Vance
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics University of Miami Miller School of Medicine Miami FL USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics University of Miami Miller School of Medicine Miami FL USA
| | - Jonathan L. Haines
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
- Cleveland Institute for Computational Biology Case Western Reserve University Cleveland OH USA
| | - Margaret A. Pericak‐Vance
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
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8
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Prough MB, Caywood LJ, Clouse JE, Herington SD, Slifer SH, Dorfsman DA, Adams LD, Laux RA, Song YE, Lynn A, Fuzzell MD, Fuzzell SL, Sewell JL, Miller SD, Miskimen KL, Main LR, Osterman MD, Ogrocki PK, Lerner AJ, Ramos J, Vance JM, Cuccaro ML, Haines JL, Scott WK, Pericak‐Vance MA. Preferential preservation of constructional praxis delayed recall compared to word list delayed recall in the Amish. Alzheimers Dement 2021. [DOI: 10.1002/alz.056386] [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: 11/10/2022]
Affiliation(s)
- Michael B. Prough
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Laura J. Caywood
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Jason E. Clouse
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Sharlene D. Herington
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Susan H. Slifer
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Daniel A. Dorfsman
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Larry D. Adams
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Renee A. Laux
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Yeunjoo E. Song
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
- Cleveland Institute for Computational Biology Case Western Reserve University Cleveland OH USA
| | - Audrey Lynn
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - M. Denise Fuzzell
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Sarada L. Fuzzell
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Jane L. Sewell
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Sherri D. Miller
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Kristy L. Miskimen
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Leighanne R Main
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Michael D. Osterman
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Paula K. Ogrocki
- Case Western Reserve University School of Medicine Cleveland OH USA
- University Hospitals Cleveland Medical Center Cleveland OH USA
| | - Alan J. Lerner
- Case Western Reserve University School of Medicine Cleveland OH USA
- University Hospitals Cleveland Medical Center Cleveland OH USA
| | - Jairo Ramos
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Jeffery M. Vance
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics University of Miami Miller School of Medicine Miami FL USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics University of Miami Miller School of Medicine Miami FL USA
| | - Jonathan L. Haines
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
- Cleveland Institute for Computational Biology Case Western Reserve University Cleveland OH USA
| | - William K. Scott
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics University of Miami Miller School of Medicine Miami FL USA
| | - Margaret A. Pericak‐Vance
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics University of Miami Miller School of Medicine Miami FL USA
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Gaussoin SA, Pajewski NM, Chelune G, Cleveland M, Crowe MG, Launer LJ, Lerner AJ, Martindale‐Adams J, Nichols LO, Ogrocki PK, Sachs BC, Sink KM, Supiano MA, Wadley VG, Wilson VM, Wright CB, Williamson JD, Reboussin DM, Rapp SR. Mild cognitive impairment and transitions in cognitive status in the Systolic Blood Pressure Intervention Trial (SPRINT). Alzheimers Dement 2021. [DOI: 10.1002/alz.053865] [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)
| | | | | | | | | | | | - Alan J Lerner
- Case Western Reserve University School of Medicine Cleveland OH USA
| | | | | | - Paula K Ogrocki
- Case Western Reserve University School of Medicine Cleveland OH USA
| | | | | | - Mark A Supiano
- University of Utah Salt Lake City UT USA
- Salt Lake City VA Geriatric Research, Education and Clinical Center Salt Lake City UT USA
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Main LR, Song YE, Laux RA, Miskimen KL, Cuccaro ML, Ogrocki PK, Lerner AJ, Vance JM, Fuzzell MD, Fuzzell SL, Sewell JL, Caywood LJ, Prough MB, Adams LD, Clouse JE, Herington SD, Scott WK, Pericak‐Vance MA, Haines JL. Genome‐wide association for protective variants in Alzheimer’s disease in the Midwestern Amish. Alzheimers Dement 2021. [DOI: 10.1002/alz.056363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Leighanne R Main
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Yeunjoo E. Song
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Renee A. Laux
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Kristy L. Miskimen
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | | | - Alan J. Lerner
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
- University Hospitals Cleveland Medical Center Cleveland OH USA
| | - Jeffery M. Vance
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - M. Denise Fuzzell
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Sarada L. Fuzzell
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Jane L. Sewell
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
| | - Laura J. Caywood
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Michael B. Prough
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Larry D. Adams
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Jason E. Clouse
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Sharlene D. Herington
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - William K. Scott
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Margaret A. Pericak‐Vance
- John P. Hussman Institute for Human Genomics University of Miami Miller School of Medicine Miami FL USA
| | - Jonathan L. Haines
- Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland OH USA
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11
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Gaussoin SA, Pajewski NM, Chelune G, Cleveland ML, Crowe MG, Launer LJ, Lerner AJ, Martindale-Adams J, Nichols LO, Ogrocki PK, Sachs BC, Sink KM, Supiano MA, Wadley VG, Wilson VM, Wright CB, Williamson JD, Reboussin DM, Rapp SR. Effect of intensive blood pressure control on subtypes of mild cognitive impairment and risk of progression from SPRINT study. J Am Geriatr Soc 2021; 70:1384-1393. [PMID: 34826341 PMCID: PMC9106821 DOI: 10.1111/jgs.17583] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 09/27/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND To examine the effect of intensive blood pressure control on the occurrence of subtypes of mild cognitive impairment (MCI) and determine the risk of progression to dementia or death. METHODS Secondary analysis of a randomized trial of community-dwelling adults (≥50 years) with hypertension. Participants were randomized to a systolic blood pressure (SBP) goal of <120 mm Hg (intensive treatment; n = 4678) or <140 mm Hg (Standard treatment; n = 4683). Outcomes included adjudicated MCI, MCI subtype (amnestic, non-amnestic, multi-domain, single domain), and probable dementia. Multistate survival models were used to examine transitions in cognitive status accounting for the competing risk of death. RESULTS Among 9361 randomized participants (mean age, 67.9 years; 3332 women [35.6%]), 640 participants met the protocol definition for MCI, with intensive treatment reducing the risk of MCI overall (hazard ratio [HR], 0.81 [95% confidence interval {CI}, 0.69-0.94]), as previously reported. This effect was largely reflected in amnestic subtypes (HR, 0.78 [95% CI, 0.66-0.92]) and multi-domain subtypes (HR, 0.78 [95% CI, 0.65-0.93]). An adjudication of MCI, as compared with normal cognitive function, substantially increased the probability of progressing to probable dementia (5.9% [95% CI: 4.5%-7.7%] vs. 0.6% [95% CI: 0.3%-0.9%]) and to death (10.0% [95% CI: 8.3%-11.9%] vs. 2.3% [95% CI: 2.0%-2.7%]) within 2 years. CONCLUSIONS Intensive treatment reduced the risk for amnestic and multi-domain subtypes of MCI. An adjudication of MCI was associated with increased risk of progression to dementia and death, highlighting the relevance of MCI as a primary outcome in clinical and research settings.
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Affiliation(s)
- Sarah A Gaussoin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Nicholas M Pajewski
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Gordon Chelune
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Maryjo L Cleveland
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Michael G Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lenore J Launer
- Neuroepidemiology Section, Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA
| | - Alan J Lerner
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Jennifer Martindale-Adams
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | | | - Paula K Ogrocki
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Bonnie C Sachs
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Mark A Supiano
- Division of Geriatrics, University of Utah School of Medicine, Salt Lake City, Ohio, USA.,VA Geriatric Research, Education and Clinical Center, Salt Lake City, Ohio, USA
| | - Virginia G Wadley
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Valerie M Wilson
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Clinton B Wright
- Division of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
| | - Jeff D Williamson
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - David M Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Stephen R Rapp
- Department of Social Sciences and Health Policy, Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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12
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Nasrallah IM, Pajewski NM, Auchus AP, Chelune G, Cheung AK, Cleveland ML, Coker LH, Crowe MG, Cushman WC, Cutler JA, Davatzikos C, Desiderio L, Doshi J, Erus G, Fine LJ, Gaussoin SA, Harris D, Johnson KC, Kimmel PL, Kurella Tamura M, Launer LJ, Lerner AJ, Lewis CE, Martindale-Adams J, Moy CS, Nichols LO, Oparil S, Ogrocki PK, Rahman M, Rapp SR, Reboussin DM, Rocco MV, Sachs BC, Sink KM, Still CH, Supiano MA, Snyder JK, Wadley VG, Walker J, Weiner DE, Whelton PK, Wilson VM, Woolard N, Wright JT, Wright CB, Williamson JD, Bryan RN. Association of Intensive vs Standard Blood Pressure Control With Cerebral White Matter Lesions. JAMA 2019; 322:524-534. [PMID: 31408137 PMCID: PMC6692679 DOI: 10.1001/jama.2019.10551] [Citation(s) in RCA: 250] [Impact Index Per Article: 50.0] [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] [Received: 08/23/2018] [Accepted: 06/27/2019] [Indexed: 01/18/2023]
Abstract
Importance The effect of intensive blood pressure lowering on brain health remains uncertain. Objective To evaluate the association of intensive blood pressure treatment with cerebral white matter lesion and brain volumes. Design, Setting, and Participants A substudy of a multicenter randomized clinical trial of hypertensive adults 50 years or older without a history of diabetes or stroke at 27 sites in the United States. Randomization began on November 8, 2010. The overall trial was stopped early because of benefit for its primary outcome (a composite of cardiovascular events) and all-cause mortality on August 20, 2015. Brain magnetic resonance imaging (MRI) was performed on a subset of participants at baseline (n = 670) and at 4 years of follow-up (n = 449); final follow-up date was July 1, 2016. Interventions Participants were randomized to a systolic blood pressure (SBP) goal of either less than 120 mm Hg (intensive treatment, n = 355) or less than 140 mm Hg (standard treatment, n = 315). Main Outcomes and Measures The primary outcome was change in total white matter lesion volume from baseline. Change in total brain volume was a secondary outcome. Results Among 670 recruited patients who had baseline MRI (mean age, 67.3 [SD, 8.2] years; 40.4% women), 449 (67.0%) completed the follow-up MRI at a median of 3.97 years after randomization, after a median intervention period of 3.40 years. In the intensive treatment group, based on a robust linear mixed model, mean white matter lesion volume increased from 4.57 to 5.49 cm3 (difference, 0.92 cm3 [95% CI, 0.69 to 1.14]) vs an increase from 4.40 to 5.85 cm3 (difference, 1.45 cm3 [95% CI, 1.21 to 1.70]) in the standard treatment group (between-group difference in change, -0.54 cm3 [95% CI, -0.87 to -0.20]). Mean total brain volume decreased from 1134.5 to 1104.0 cm3 (difference, -30.6 cm3 [95% CI, -32.3 to -28.8]) in the intensive treatment group vs a decrease from 1134.0 to 1107.1 cm3 (difference, -26.9 cm3 [95% CI, 24.8 to 28.8]) in the standard treatment group (between-group difference in change, -3.7 cm3 [95% CI, -6.3 to -1.1]). Conclusions and Relevance Among hypertensive adults, targeting an SBP of less than 120 mm Hg, compared with less than 140 mm Hg, was significantly associated with a smaller increase in cerebral white matter lesion volume and a greater decrease in total brain volume, although the differences were small. Trial Registration ClinicalTrials.gov Identifier: NCT01206062.
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Affiliation(s)
- Ilya M Nasrallah
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Nicholas M Pajewski
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Alexander P Auchus
- Department of Neurology, University of Mississippi Medical Center, Jackson
| | - Gordon Chelune
- Department of Neurology, University of Utah School of Medicine, Salt Lake City
| | - Alfred K Cheung
- Division of Nephrology and Hypertension, University of Utah School of Medicine, Salt Lake City
| | - Maryjo L Cleveland
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Laura H Coker
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michael G Crowe
- Department of Psychology, University of Alabama at Birmingham
| | - William C Cushman
- Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, Tennessee
| | - Jeffrey A Cutler
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | | | - Lisa Desiderio
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Jimit Doshi
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Guray Erus
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Larry J Fine
- Clinical Applications and Prevention Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Sarah A Gaussoin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Darrin Harris
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis
| | - Paul L Kimmel
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Disorders, Bethesda, Maryland
| | | | - Lenore J Launer
- Neuroepidemiology Section, Intramural Research Program, National Institute on Aging, Bethesda, Maryland
| | - Alan J Lerner
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama at Birmingham
| | | | - Claudia S Moy
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | - Linda O Nichols
- Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, Tennessee
| | - Suzanne Oparil
- Department of Medicine, University of Alabama at Birmingham
| | - Paula K Ogrocki
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Mahboob Rahman
- Department of Medicine, Louis Stokes Cleveland Veterans Affairs Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - David M Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michael V Rocco
- Section of Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Bonnie C Sachs
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kaycee M Sink
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Now with Genentech, South San Francisco, California
| | - Carolyn H Still
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
| | - Mark A Supiano
- Division of Geriatrics, University of Utah School of Medicine, Salt Lake City
| | - Joni K Snyder
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | | | - Jennifer Walker
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Daniel E Weiner
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
| | - Paul K Whelton
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Valerie M Wilson
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nancy Woolard
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jackson T Wright
- Division of Nephrology and Hypertension, Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Clinton B Wright
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | - Jeff D Williamson
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - R Nick Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia
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13
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Williamson JD, Pajewski NM, Auchus AP, Bryan RN, Chelune G, Cheung AK, Cleveland ML, Coker LH, Crowe MG, Cushman WC, Cutler JA, Davatzikos C, Desiderio L, Erus G, Fine LJ, Gaussoin SA, Harris D, Hsieh MK, Johnson KC, Kimmel PL, Tamura MK, Launer LJ, Lerner AJ, Lewis CE, Martindale-Adams J, Moy CS, Nasrallah IM, Nichols LO, Oparil S, Ogrocki PK, Rahman M, Rapp SR, Reboussin DM, Rocco MV, Sachs BC, Sink KM, Still CH, Supiano MA, Snyder JK, Wadley VG, Walker J, Weiner DE, Whelton PK, Wilson VM, Woolard N, Wright JT, Wright CB. Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial. JAMA 2019; 321:553-561. [PMID: 30688979 PMCID: PMC6439590 DOI: 10.1001/jama.2018.21442] [Citation(s) in RCA: 682] [Impact Index Per Article: 136.4] [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: 12/17/2022]
Abstract
IMPORTANCE There are currently no proven treatments to reduce the risk of mild cognitive impairment and dementia. OBJECTIVE To evaluate the effect of intensive blood pressure control on risk of dementia. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted at 102 sites in the United States and Puerto Rico among adults aged 50 years or older with hypertension but without diabetes or history of stroke. Randomization began on November 8, 2010. The trial was stopped early for benefit on its primary outcome (a composite of cardiovascular events) and all-cause mortality on August 20, 2015. The final date for follow-up of cognitive outcomes was July 22, 2018. INTERVENTIONS Participants were randomized to a systolic blood pressure goal of either less than 120 mm Hg (intensive treatment group; n = 4678) or less than 140 mm Hg (standard treatment group; n = 4683). MAIN OUTCOMES AND MEASURES The primary cognitive outcome was occurrence of adjudicated probable dementia. Secondary cognitive outcomes included adjudicated mild cognitive impairment and a composite outcome of mild cognitive impairment or probable dementia. RESULTS Among 9361 randomized participants (mean age, 67.9 years; 3332 women [35.6%]), 8563 (91.5%) completed at least 1 follow-up cognitive assessment. The median intervention period was 3.34 years. During a total median follow-up of 5.11 years, adjudicated probable dementia occurred in 149 participants in the intensive treatment group vs 176 in the standard treatment group (7.2 vs 8.6 cases per 1000 person-years; hazard ratio [HR], 0.83; 95% CI, 0.67-1.04). Intensive BP control significantly reduced the risk of mild cognitive impairment (14.6 vs 18.3 cases per 1000 person-years; HR, 0.81; 95% CI, 0.69-0.95) and the combined rate of mild cognitive impairment or probable dementia (20.2 vs 24.1 cases per 1000 person-years; HR, 0.85; 95% CI, 0.74-0.97). CONCLUSIONS AND RELEVANCE Among ambulatory adults with hypertension, treating to a systolic blood pressure goal of less than 120 mm Hg compared with a goal of less than 140 mm Hg did not result in a significant reduction in the risk of probable dementia. Because of early study termination and fewer than expected cases of dementia, the study may have been underpowered for this end point. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01206062.
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Affiliation(s)
| | - Jeff D Williamson
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nicholas M Pajewski
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Alexander P Auchus
- Department of Neurology, University of Mississippi Medical Center, Jackson
| | - R Nick Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Gordon Chelune
- Department of Neurology, University of Utah School of Medicine, Salt Lake City
| | - Alfred K Cheung
- Division of Nephrology and Hypertension, University of Utah School of Medicine, Salt Lake City
| | - Maryjo L Cleveland
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Laura H Coker
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michael G Crowe
- Department of Psychology, University of Alabama at Birmingham
| | - William C Cushman
- Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, Tennessee
| | - Jeffrey A Cutler
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | | | - Lisa Desiderio
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Guray Erus
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Larry J Fine
- Clinical Applications and Prevention Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Sarah A Gaussoin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Darrin Harris
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Meng-Kang Hsieh
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis
| | - Paul L Kimmel
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Disorders, Bethesda, Maryland
| | | | - Lenore J Launer
- Neuroepidemiology Section, Intramural Research Program, National Institute on Aging, Bethesda, Maryland
| | - Alan J Lerner
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama at Birmingham
| | | | - Claudia S Moy
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | - Ilya M Nasrallah
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Linda O Nichols
- Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, Tennessee
| | - Suzanne Oparil
- Department of Medicine, University of Alabama at Birmingham
| | - Paula K Ogrocki
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Mahboob Rahman
- Department of Medicine, Louis Stokes Cleveland Veterans Affairs Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - David M Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michael V Rocco
- Section of Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Bonnie C Sachs
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kaycee M Sink
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Carolyn H Still
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
| | - Mark A Supiano
- Division of Geriatrics, University of Utah School of Medicine, Salt Lake City
| | - Joni K Snyder
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | | | - Jennifer Walker
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Daniel E Weiner
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
| | - Paul K Whelton
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Valerie M Wilson
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nancy Woolard
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jackson T Wright
- Division of Nephrology and Hypertension, Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Clinton B Wright
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
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Abstract
Numerous studies have examined self-identification of deficits in persons with dementia. Few of these studies consider the influence of interpersonal and social factors on deficit identification, and most focus on whether or why deficits are ‘underreported’ by persons with dementia. In our studies, we found considerable variation in deficit identification within and among persons with dementia, and some ‘overreporting’ of deficits in comparison with caregiver reports across all of the domains studied. Thus, focusing on ‘underreporting’ and aggregate level data neglects information that could be important to measuring and understanding quality of life in dementia. Current approaches to measuring and understanding quality of life in dementia make divergent assumptions about the impact of deficit identification. Emerging phenomenological perspectives suggest that proactive interventions that treat deficit identification as an interpersonal and social challenge inherent in the experience of dementia would enhance the quality of life of caregiving dyads.
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Affiliation(s)
- Kathleen A. Smyth
- University Memory and Aging Center, University Hospitals of Cleveland and Case Western Reserve University
| | | | - Elisabeth Koss
- Alzheimer’s Disease Centers Program, Neuroscience and Neuropsychology of Aging, National Institute on Aging
| | - David S. Geldmacher
- University Memory and Aging Center, University Hospitals of Cleveland and Case Western Reserve University
| | - Paula K. Ogrocki
- University Memory and Aging Center, University Hospitals of Cleveland and Case Western Reserve University
| | - Peter J. Whitehouse
- University Memory and Aging Center, University Hospitals of Cleveland and Case Western Reserve University
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15
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Schoenberg MR, Maddux BN, Riley DE, Whitney CM, Ogrocki PK, Gould D, Maciunas RJ. Five-months-postoperative neuropsychological outcome from a pilot prospective randomized clinical trial of thalamic deep brain stimulation for Tourette syndrome. Neuromodulation 2014; 18:97-104. [PMID: 25250712 DOI: 10.1111/ner.12233] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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: 02/25/2014] [Revised: 05/31/2014] [Accepted: 07/02/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Tourette syndrome (TS) is a neuropsychiatric disorder presenting with motor and/or sonic tics associated with frontostriatal dysfunction. This study provided pilot data of the neuropsychological safety of bilateral thalamic deep brain stimulation (DBS) to treat medication-refractory TS in adults. METHOD This study used a repeated-measures design with pretest and 3-month follow-up from start of continuous bilateral DBS. Five male patients underwent DBS surgery for medically refractory TS. Repeated-measures ANOVA was used to evaluate for any change in neuropsychological test scores, employing a false discovery rate. Outcome measures included 14 neuropsychological tests assessing psychomotor speed, attention, memory, language, visuoconstructional, and executive functions, as well as subjective mood ratings of depression and anxiety. RESULTS Average age was 28.2 years (SD = 7.5) with 12-17 years of education. Participants were disabled by tics, with a tic frequency of 50-80 per minute before surgery. At baseline, subjects' cognitive function was generally average, although mild deficits in sequencing and verbal fluency were present, as were clinically mild obsessive-compulsive symptoms. At 3 months of continuous DBS (5 months after implantation), 3 of 5 participants had clinical reductions in motor and sonic tics. Cognitive scores generally remained stable, but declines of moderate to large effect size (Cohen's d > 0.6) in verbal fluency, visual immediate memory, and reaction time were observed. Fewer symptoms of depression and anxiety, as well as fewer obsessions and compulsions, were reported after 3 months of continuous high-frequency DBS. CONCLUSIONS Bilateral centromedian-parafascicular thalamic DBS for medically refractory TS shows promise for treatment of medically refractory TS without marked neuropsychological morbidity. Symptoms of depression and anxiety improved.
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Affiliation(s)
- Mike R Schoenberg
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida Morsani College of Medicine, Tampa, FL, USA
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16
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Bush ALH, Allen PA, Kaut KP, Ogrocki PK. Influence of mild cognitive impairment on visual word recognition. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2007; 14:329-52. [PMID: 17612812 DOI: 10.1080/13825580600630278] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The present study examined the effects of normal aging and mild cognitive impairment (MCI) on visual word recognition. Madden et al. (1999) reported evidence of general slowing of cognitive processes in Alzheimer's disease (AD) patients relative to younger adults and healthy older adults using a lexical decision task. It was of interest to determine whether similar effects would be observed in MCI patients relative to healthy younger and older adults. We extended the lexical decision task paradigm developed by Allen et al. (2004b) on younger adults to an examination of the effect(s) of MCI on visual word recognition. Results from the present study showed that healthy older adults and MCI patients performed similarly. That is, both groups took longer than younger adults to process words presented in mixed-case than in consistent-case letters. Mild cognitive impairment patients, however, responded significantly more slowly than healthy older adults across all lexical decision task conditions and showed a trend toward larger case-mixing effects than healthy older adults, which suggests that MCI may result in poorer analytic processing ability. Based on the current findings, evidence of a generalized slowing of cognitive processes using a standard lexical decision task can be expanded to include not only AD patients, but also the preclinical stages of the disease as well.
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Affiliation(s)
- Aryn L H Bush
- University of Akron, Department of Psychology, OH 44325-4301, USA
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17
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Fritsch T, Smyth KA, McClendon MJ, Ogrocki PK, Santillan C, Larsen JD, Strauss ME. Associations Between Dementia/Mild Cognitive Impairment and Cognitive Performance and Activity Levels in Youth. J Am Geriatr Soc 2005; 53:1191-6. [PMID: 16108937 DOI: 10.1111/j.1532-5415.2005.53361.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [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: 11/28/2022]
Abstract
OBJECTIVES To study the associations between dementia/mild cognitive impairment (MCI) and cognitive performance and activity levels in youth. DESIGN Retrospective cohort study. SETTING Research volunteers living throughout the United States. PARTICIPANTS A total of 396 persons (mean age 75) who were graduates of the same high school in the mid-1940s. MEASUREMENTS Adolescent intelligence quotient (IQ) scores were gathered from archived student records, and activity levels were determined from yearbooks. A two-stage telephone screening procedure (Modified Telephone Interview for Cognitive Status or Informant Questionnaire on Cognitive Decline in the Elderly followed by Dementia Questionnaire) was used to determine adult cognitive status. Data were analyzed using logistic regression to model the risk of cognitive impairment (dementia/MCI) versus no cognitive impairment as a function of IQ and activity level, adjusting for sex and education. RESULTS High adolescent IQ and greater activity level were each independently associated with a lower risk for dementia/MCI (odds ratio (OR) for a 1-standard deviation increase in IQ=0.51, 95% confidence interval (CI)=0.32-0.79; OR for a unit increase in activity=0.32, 95% CI=0.12-0.84). No association was found between sex or education and adult cognitive status in this model. CONCLUSION High IQ and greater activity levels in youth reduce the risk for cognitive impairments in aging. The mechanism(s) underlying these associations are unknown, but intelligence may be a marker for cognitive/neurological "reserve," and involvement in activities may contribute to "reserve." Early neuropathology and ascertainment bias are also possible explanations for the observed associations.
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Affiliation(s)
- Thomas Fritsch
- University Memory and Aging Center, University Hospitals of Cleveland and Case Western Reserve University, Cleveland, Ohio 44120, USA
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18
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Allen PA, Bucur B, Lemaire P, Duverne S, Ogrocki PK, Sanders RE. Influence of Probable Alzheimer's Disease on Multiplication Verification and Production Abstract. Aging, Neuropsychology, and Cognition 2005. [DOI: 10.1080/13825580490521322] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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19
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Fritsch T, McClendon MJ, Smyth KA, Ogrocki PK. Effects of educational attainment and occupational status on cognitive and functional decline in persons with Alzheimer-type dementia. Int Psychogeriatr 2002; 14:347-63. [PMID: 12670057 DOI: 10.1017/s1041610202008554] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.3] [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: 11/06/2022]
Abstract
Researchers have suggested that educational attainment and occupational status--indicators of cognitive and/or neurologic "reserve"--can help persons compensate for clinical manifestations of Alzheimer's disease (AD), such as the rates of cognitive and functional decline. The effects of educational attainment on rates of decline could be "direct" independent of occupational status), "indirect" (working through occupational status), or both. We used multilevel analysis for repeated measures to study the effects of educational attainment and occupational status on rates of decline in cognition (Mini-Mental State Examination, MMSE) and function (Cleveland Scale for Activities of Daily Living). Subjects included persons with "probable" or "possible" AD, drawn from our Alzheimer's Disease Research Center registry (N = 482 in the analysis of cognitive decline, and N = 450 in the analysis of functional decline). When controlling for year of birth, gender, ethnicity, and duration of illness, we found that there was an inverse relationship between number of years of education and rate of decline in MMSE, but effects of occupational status were not significant. This implies a "direct" effect of education on decline in MMSE, but no "indirect" effect through occupational status. Neither educational attainment nor occupational status affected rate of decline in functional ability. We conclude that education slows the rate of cognitive decline in persons with AD, but not through its impact on occupational status. Thus, the protective effects of reserve may be established early in life, before people enter the workforce.
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Affiliation(s)
- Thomas Fritsch
- University Memory and Aging Center, University Hospitals of Cleveland and Case Western Reserve University, Cleveland, Ohio 44120, USA.
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20
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Ogrocki PK, Hills AC, Strauss ME. Visual exploration of facial emotion by healthy older adults and patients with Alzheimer disease. Neuropsychiatry Neuropsychol Behav Neurol 2000; 13:271-8. [PMID: 11186163] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate eye movement patterns of patients with Alzheimer disease (AD) and healthy older adults while viewing photographs of facial expression. BACKGROUND Individuals with Alzheimer disease appear to have deficits in emotion perception, but the underlying mechanisms are not understood well. It is not known whether individuals with AD visually explore facial stimuli and extract information needed to make emotion identification from faces in the same way as do healthy older adults. METHOD Seventeen AD patients and 15 older adult control patients were shown faces that depicted different emotions and were asked to identify the emotion displayed from two alternatives. The eye movements of participants were recorded during the emotion identification task. RESULTS No differences were seen between AD patients and older adult controls regarding their accuracy of emotion identification. However, AD patients differed from older adult controls on eye movement patterns during the emotion identification task. Alzheimer disease patients fixated less on the face and, in particular, on the eyes. Alzheimer disease patients also spent more time viewing areas off the face. There was no relationship between the severity of cognitive impairment and emotion identification or eye movement patterns. CONCLUSIONS Although the AD patients and older adult controls showed similar accuracy for the emotion identification task, their visual processing strategies differed. Relative to older adult controls, AD patients fixated less on discriminating regions and attended more to irrelevant aspects of stimuli. The eye movement differences were particularly evident in AD patients who did more poorly for the emotion identification task. These differences were not attributable to the global cognitive deterioration accompanying AD, but suggested a specific deficit in visual processing abilities.
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Affiliation(s)
- P K Ogrocki
- University Alzheimer Center, University Hospitals of Cleveland, Ohio, USA.
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21
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Abstract
OBJECTIVE The authors' goal was to replicate an earlier finding of a familial liability for depression in Alzheimer's disease. METHOD The family histories of depression and dementia were compared in 28 patients experiencing a first episode of major depression after onset of Alzheimer's disease and 74 nondepressed patients with Alzheimer's disease. RESULTS Significantly more families of depressed dementia patients included depressed first-degree relatives. There was no difference between Alzheimer's disease patients with and without depression in the proportion of families with a history of dementia. CONCLUSIONS Major depression in Alzheimer's disease is associated with a familial liability for depression that is independent of any familial liability for dementia.
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Affiliation(s)
- M E Strauss
- Alzheimer Center, University Hospitals of Cleveland, OH USA.
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22
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Abstract
Although many caregivers place their relative in a nursing home in an attempt to reduce their own burden, caregiving stress often continues after institutionalization. This research examined sources of stress for 66 caregivers who cared for their impaired relative at home and later placed that individual in a nursing home. We hypothesized that although these caregivers no longer had primary responsibility for direct care, they would continue to experience distress because of the stressors associated with the nursing home. Results ran counter to our expectations. Although many caregivers reported stressors related to nursing home care, stressors stemming from the patient's Alzheimer's disease (AD) symptoms accounted for more variance in caregivers' levels of anxiety and depression, and in the quality of their interpersonal relations. Even though caregivers were assisted in their caregiving responsibilities by the nursing home staff, their relative's AD symptoms continued to prompt distress.
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23
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Stephens MA, Kinney JM, Ogrocki PK. Stressors and well-being among caregivers to older adults with dementia: the in-home versus nursing home experience. Gerontologist 1991; 31:217-23. [PMID: 2044994 DOI: 10.1093/geront/31.2.217] [Citation(s) in RCA: 89] [Impact Index Per Article: 2.7] [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: 12/30/2022] Open
Abstract
We examined differences in stressors and well-being for caregivers who care for a relative with dementia at home and those who had placed their relative in a nursing home. The groups did not differ in depression or somatic complaints, but nursing home caregivers had fewer social and interpersonal disruptions. Controlling for caregiving problems, nursing home caregivers reported more stressors due to ADL (activities of daily living) assistance, their relatives' behavioral and cognitive functioning, and lack of caregiving support from family and friends.
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Affiliation(s)
- M A Stephens
- Department of Psychology, Kent State University, OH 44242
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