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de la Torre R, de Sola S, Farré M, Xicota L, Cuenca-Royo A, Rodriguez J, León A, Langohr K, Gomis-González M, Hernandez G, Esteba S, Del Hoyo L, Sánchez-Gutiérrez J, Cortés MJ, Ozaita A, Espadaler JM, Novell R, Martínez-Leal R, Milá M, Dierssen M. A phase 1, randomized double-blind, placebo controlled trial to evaluate safety and efficacy of epigallocatechin-3-gallate and cognitive training in adults with Fragile X syndrome. Clin Nutr 2019; 39:378-387. [PMID: 30962103 DOI: 10.1016/j.clnu.2019.02.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/13/2019] [Accepted: 02/16/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS Despite the wide spectrum of experimental compounds tested in clinical trials, there is still no proven pharmacological treatment available for Fragile-X syndrome (FXS), since several targeted clinical trials with high expectations of success have failed to demonstrate significant improvements. Here we tested epigallocatechin-3-gallate (EGCG) as a treatment option for ameliorating core cognitive and behavioral features in FXS. METHODS We conducted preclinical studies in Fmr1 knockout mice (Fmr1-/y) using novel object-recognition memory paradigm upon acute EGCG (10 mg/kg) administration. Furthermore we conducted a double-blind placebo-controlled phase I clinical trial (TESXF; NCT01855971). Twenty-seven subjects with FXS (18-55 years) were administered of EGCG (5-7 mg/kg/day) combined with cognitive training (CT) during 3 months with 3 months of follow-up after treatment discontinuation. RESULTS Preclinical studies showed an improvement in memory using the Novel Object Recognition paradigm. We found that FXS patients receiving EGCG + CT significantly improved cognition (visual episodic memory) and functional competence (ABAS II-Home Living skills) in everyday life compared to subjects receiving Placebo + CT. CONCLUSIONS Phase 2 clinical trials in larger groups of subjects are necessary to establish the therapeutic potential of EGCG for the improvement of cognition and daily life competences in FXS.
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Affiliation(s)
- Rafael de la Torre
- IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain; CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), E-08003 Barcelona, Spain; University Pompeu Fabra (CEXS-UPF), E-08003 Barcelona, Spain.
| | - Susana de Sola
- IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain; CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), E-08003 Barcelona, Spain
| | - Magí Farré
- Autonomous University of Barcelona (UDIMAS-UAB), E-08003 Barcelona, Spain
| | - Laura Xicota
- IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain; CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), E-08003 Barcelona, Spain
| | - Aida Cuenca-Royo
- IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain; CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), E-08003 Barcelona, Spain
| | - Joan Rodriguez
- IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain; CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), E-08003 Barcelona, Spain
| | - Alba León
- Neurofunctionality of Brain and Language Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain
| | - Klaus Langohr
- IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain; Polytechnic University of Catalonia, E-08034 Barcelona, Spain
| | | | - Gimena Hernandez
- IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain; CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), E-08003 Barcelona, Spain
| | - Susanna Esteba
- Parc Hospitalari Martí í Julià-Institut d'Assistència Sanitària, E-17190 Salt, Spain
| | - Laura Del Hoyo
- IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain; CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), E-08003 Barcelona, Spain
| | | | - Maria José Cortés
- Intellectual Disabilities and Developmental Disorders Research Unit (UNIVIDD), Fundació Villablanca, IISPV, URV, CIBERSAM, E-43206, Reus, Spain
| | - Andrés Ozaita
- University Pompeu Fabra (CEXS-UPF), E-08003 Barcelona, Spain
| | - Josep María Espadaler
- Neurofunctionality of Brain and Language Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain
| | - Ramón Novell
- Parc Hospitalari Martí í Julià-Institut d'Assistència Sanitària, E-17190 Salt, Spain
| | - Rafael Martínez-Leal
- Intellectual Disabilities and Developmental Disorders Research Unit (UNIVIDD), Fundació Villablanca, IISPV, URV, CIBERSAM, E-43206, Reus, Spain
| | - Montserrat Milá
- Biochemistry and Molecular Genetics Department, Hospital Clínic I Provincial de Barcelona, E-08036, Spain
| | - Mara Dierssen
- IMIM-Hospital del Mar Medical Research Institute, E-08003 Barcelona, Spain; University Pompeu Fabra (CEXS-UPF), E-08003 Barcelona, Spain; Center for Genomic Regulation (CRG), E-08003 Barcelona, Spain; CIBER of Rare Diseases (CIBERER), E-08003 Barcelona, Spain; The Barcelona Institute of Science and Technology, E-08003 Barcelona, Spain.
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Fenoll R, Pujol J, Esteba-Castillo S, de Sola S, Ribas-Vidal N, García-Alba J, Sánchez-Benavides G, Martínez-Vilavella G, Deus J, Dierssen M, Novell-Alsina R, de la Torre R. Anomalous White Matter Structure and the Effect of Age in Down Syndrome Patients. J Alzheimers Dis 2018; 57:61-70. [PMID: 28222523 DOI: 10.3233/jad-161112] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Neural tissue alterations in Down syndrome are fully expressed at relatively late developmental stages. In addition, there is an early presence of neurodegenerative changes in the late life stages. OBJECTIVE The aims of this study were both to characterize white matter abnormalities in the brain of adult Down syndrome patients using diffusion tensor imaging (DTI) and to investigate whether degenerative alterations in white matter structure are detectable before dementia is clinically evident. METHODS Forty-five adult non-demented Down syndrome patients showing a wide age range (18-52 years) and a matched 45-subject control group were assessed. DTI fractional anisotropy (FA) brain maps were generated and selected cognitive tests were administered. RESULTS Compared with healthy controls, non-demented Down syndrome patients showed lower DTI FA in white matter involving the major pathways, but with more severe alterations in the frontal-subcortical circuits. White matter FA decreased with age at a similar rate in both DS and control groups. CONCLUSIONS Our results contribute to characterizing the expression of white matter structural alterations in adult Down syndrome. However, an accelerated aging effect was not demonstrated, which may suggest that the FA measurements used are not sufficiently sensitive or, alternatively, age-related white matter neurodegeneration is not obvious prior to overt clinical dementia.
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Affiliation(s)
- Raquel Fenoll
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain.,Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
| | - Susanna Esteba-Castillo
- Specialized Department in Mental Health and Intellectual Disability, Institut d'Assistència Sanitària (IAS), Girona, Catalonia, Spain
| | - Susana de Sola
- Integrative Pharmacology and Neuroscience Systems Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Cellular & Systems Neurobiology, Centre for Genomic Regulation (CRG), Barcelona, Spain
| | - Núria Ribas-Vidal
- Specialized Department in Mental Health and Intellectual Disability, Institut d'Assistència Sanitària (IAS), Girona, Catalonia, Spain
| | - Javier García-Alba
- Specialized Department in Mental Health and Intellectual Disability, Institut d'Assistència Sanitària (IAS), Girona, Catalonia, Spain
| | - Gonzalo Sánchez-Benavides
- Integrative Pharmacology and Neuroscience Systems Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Gerard Martínez-Vilavella
- Integrative Pharmacology and Neuroscience Systems Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Joan Deus
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain.,Department of Clinical and Health Psychology, Autonomous University of Barcelona, Spain
| | - Mara Dierssen
- Cellular & Systems Neurobiology, Centre for Genomic Regulation (CRG), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Ramón Novell-Alsina
- Cellular & Systems Neurobiology, Centre for Genomic Regulation (CRG), Barcelona, Spain
| | - Rafael de la Torre
- Integrative Pharmacology and Neuroscience Systems Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain.,Department de Ciències Experimentals i de la Salut Universitat Pompeu Fabra (CEXS-UPF), Barcelona, Spain
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3
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Del Hoyo L, Xicota L, Langohr K, Sánchez-Benavides G, de Sola S, Cuenca-Royo A, Rodriguez J, Rodríguez-Morató J, Farré M, Dierssen M, de la Torre R. VNTR-DAT1 and COMTVal158Met Genotypes Modulate Mental Flexibility and Adaptive Behavior Skills in Down Syndrome. Front Behav Neurosci 2016; 10:193. [PMID: 27799900 PMCID: PMC5065956 DOI: 10.3389/fnbeh.2016.00193] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/26/2016] [Indexed: 02/02/2023] Open
Abstract
Down syndrome (DS) is an aneuploidy syndrome that is caused by trisomy for human chromosome 21 resulting in a characteristic cognitive and behavioral phenotype, which includes executive functioning and adaptive behavior difficulties possibly due to prefrontal cortex (PFC) deficits. DS also present a high risk for early onset of Alzheimer Disease-like dementia. The dopamine (DA) system plays a neuromodulatory role in the activity of the PFC. Several studies have implicated trait differences in DA signaling on executive functioning based on genetic polymorphisms in the genes encoding for the catechol-O-methyltransferase (COMTVal158Met) and the dopamine transporter (VNTR-DAT1). Since it is known that the phenotypic consequences of genetic variants are modulated by the genetic background in which they occur, we here explore whether these polymorphisms variants interact with the trisomic genetic background to influence gene expression, and how this in turn mediates DS phenotype variability regarding PFC cognition. We genotyped 69 young adults of both genders with DS, and found that VNTR-DAT1 was in Hardy-Weinberg equilibrium but COMTVal158Met had a reduced frequency of Met allele homozygotes. In our population, genotypes conferring higher DA availability, such as Met allele carriers and VNTR-DAT1 10-repeat allele homozygotes, resulted in improved performance in executive function tasks that require mental flexibility. Met allele carriers showed worse adaptive social skills and self-direction, and increased scores in the social subscale of the Dementia Questionnaire for People with Intellectual Disabilities than Val allele homozygotes. The VNTR-DAT1 was not involved in adaptive behavior or early dementia symptoms. Our results suggest that genetic variants of COMTVal158Met and VNTR-DAT1 may contribute to PFC-dependent cognition, while only COMTVal158Met is involved in behavioral phenotypes of DS, similar to euploid population.
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Affiliation(s)
- Laura Del Hoyo
- Integrative Pharmacology and Systems Neuroscience Group, Neurosciences Research Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain; Departament de Farmacologia, de Terapèutica i de Toxicologia, Universidad Autónoma de BarcelonaBarcelona, Spain
| | - Laura Xicota
- Integrative Pharmacology and Systems Neuroscience Group, Neurosciences Research Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain; Cellular & Systems Neurobiology, Systems Biology Program, Centre for Genomic Regulation, The Barcelona Institute of Science and TechnologyBarcelona, Spain; Department of Experimental and Health Sciences, Universidad Pompeu FabraBarcelona, Spain
| | - Klaus Langohr
- Integrative Pharmacology and Systems Neuroscience Group, Neurosciences Research Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain; Department of Statistics and Operations Research, Universidad Politècnica de Cataluña/BarcelonaTechBarcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Integrative Pharmacology and Systems Neuroscience Group, Neurosciences Research Program, IMIM-Hospital del Mar Medical Research Institute Barcelona, Spain
| | - Susana de Sola
- Integrative Pharmacology and Systems Neuroscience Group, Neurosciences Research Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain; Cellular & Systems Neurobiology, Systems Biology Program, Centre for Genomic Regulation, The Barcelona Institute of Science and TechnologyBarcelona, Spain
| | - Aida Cuenca-Royo
- Integrative Pharmacology and Systems Neuroscience Group, Neurosciences Research Program, IMIM-Hospital del Mar Medical Research Institute Barcelona, Spain
| | - Joan Rodriguez
- Integrative Pharmacology and Systems Neuroscience Group, Neurosciences Research Program, IMIM-Hospital del Mar Medical Research Institute Barcelona, Spain
| | - Jose Rodríguez-Morató
- Integrative Pharmacology and Systems Neuroscience Group, Neurosciences Research Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain; Department of Experimental and Health Sciences, Universidad Pompeu FabraBarcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición, Instituto Salud Carlos IIIMadrid, Spain
| | - Magí Farré
- Integrative Pharmacology and Systems Neuroscience Group, Neurosciences Research Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain; Departament de Farmacologia, de Terapèutica i de Toxicologia, Universidad Autónoma de BarcelonaBarcelona, Spain
| | - Mara Dierssen
- Cellular & Systems Neurobiology, Systems Biology Program, Centre for Genomic Regulation, The Barcelona Institute of Science and TechnologyBarcelona, Spain; Department of Experimental and Health Sciences, Universidad Pompeu FabraBarcelona, Spain; CIBER de Enfermedades Raras, Instituto Salud Carlos IIIMadrid, Spain
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neuroscience Group, Neurosciences Research Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain; Department of Experimental and Health Sciences, Universidad Pompeu FabraBarcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición, Instituto Salud Carlos IIIMadrid, Spain
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de la Torre R, de Sola S, Hernandez G, Farré M, Pujol J, Rodriguez J, Espadaler JM, Langohr K, Cuenca-Royo A, Principe A, Xicota L, Janel N, Catuara-Solarz S, Sanchez-Benavides G, Bléhaut H, Dueñas-Espín I, del Hoyo L, Benejam B, Blanco-Hinojo L, Videla S, Fitó M, Delabar JM, Dierssen M. Safety and efficacy of cognitive training plus epigallocatechin-3-gallate in young adults with Down's syndrome (TESDAD): a double-blind, randomised, placebo-controlled, phase 2 trial. Lancet Neurol 2016; 15:801-810. [DOI: 10.1016/s1474-4422(16)30034-5] [Citation(s) in RCA: 178] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 03/23/2016] [Accepted: 03/31/2016] [Indexed: 12/29/2022]
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5
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Liogier d'Ardhuy X, Edgin JO, Bouis C, de Sola S, Goeldner C, Kishnani P, Nöldeke J, Rice S, Sacco S, Squassante L, Spiridigliozzi G, Visootsak J, Heller J, Khwaja O. Assessment of Cognitive Scales to Examine Memory, Executive Function and Language in Individuals with Down Syndrome: Implications of a 6-month Observational Study. Front Behav Neurosci 2015; 9:300. [PMID: 26635554 PMCID: PMC4650711 DOI: 10.3389/fnbeh.2015.00300] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/28/2015] [Indexed: 02/04/2023] Open
Abstract
Down syndrome (DS) is the most commonly identifiable genetic form of intellectual disability. Individuals with DS have considerable deficits in intellectual functioning (i.e., low intellectual quotient, delayed learning and/or impaired language development) and adaptive behavior. Previous pharmacological studies in this population have been limited by a lack of appropriate endpoints that accurately measured change in cognitive and functional abilities. Therefore, the current longitudinal observational study assessed the suitability and reliability of existing cognitive scales to determine which tools would be the most effective in future interventional clinical studies. Subtests of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Cambridge Neuropsychological Test Automated Battery (CANTAB), and Clinical Evaluation of Language Fundamentals-Preschool-2 (CELF-P-2), and the Observer Memory Questionnaire-Parent Form (OMQ-PF), Behavior Rating Inventory of Executive Function®-Preschool Version (BRIEF-P) and Leiter International Performance Scale-Revised were assessed. The results reported here have contributed to the optimization of trial design and endpoint selection for the Phase 2 study of a new selective negative allosteric modulator of the GABAA receptor α5-subtype (Basmisanil), and can be applied to other studies in the DS population.
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Affiliation(s)
- Xavier Liogier d'Ardhuy
- F. Hoffmann-La Roche, Roche Pharma Research and Early Development, Neuroscience, Roche Innovation Center Basel Basel, Switzerland
| | - Jamie O Edgin
- Department of Psychology, University of Arizona Tucson, AZ, USA
| | - Charles Bouis
- Research Department, Institut Jérôme Lejeune Paris, France
| | - Susana de Sola
- Cellular and Systems Neurobiology Research Group, Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, Systems Biology Program, Centre for Genomic Regulation, Hospital del Mar Medical Research Institute Barcelona, Spain
| | - Celia Goeldner
- F. Hoffmann-La Roche, Roche Pharma Research and Early Development, Neuroscience, Roche Innovation Center Basel Basel, Switzerland
| | - Priya Kishnani
- Medical Genetics, Duke University Medical Center Durham, NC, USA
| | - Jana Nöldeke
- F. Hoffmann-La Roche, Roche Pharma Research and Early Development, Neuroscience, Roche Innovation Center Basel Basel, Switzerland
| | - Sydney Rice
- Department of Pediatrics, University of Arizona Tucson, AZ, USA
| | - Silvia Sacco
- Research Department, Institut Jérôme Lejeune Paris, France
| | | | | | - Jeannie Visootsak
- F. Hoffmann-La Roche, Roche Pharma Research and Early Development, Neuroscience and Rare Diseases, Roche Innovation Center New York New York, NY, USA
| | - James Heller
- Formerly of Duke University Medical Center Durham, NC, USA
| | - Omar Khwaja
- F. Hoffmann-La Roche, Roche Pharma Research and Early Development, Rare Diseases, Roche Innovation Center Basel Basel, Switzerland
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6
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Hoyo LD, Xicota L, Sánchez-Benavides G, Cuenca-Royo A, de Sola S, Langohr K, Fagundo AB, Farré M, Dierssen M, de la Torre R. Semantic Verbal Fluency Pattern, Dementia Rating Scores and Adaptive Behavior Correlate With Plasma Aβ42 Concentrations in Down Syndrome Young Adults. Front Behav Neurosci 2015; 9:301. [PMID: 26635555 PMCID: PMC4649024 DOI: 10.3389/fnbeh.2015.00301] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 10/28/2015] [Indexed: 12/19/2022] Open
Abstract
Down syndrome (DS) is an intellectual disability (ID) disorder in which language and specifically, verbal fluency are strongly impaired domains; nearly all adults show neuropathology of Alzheimer’s disease (AD), including amyloid deposition by their fifth decade of life. In the general population, verbal fluency deficits are considered a strong AD predictor being the semantic verbal fluency task (SVFT) a useful tool for enhancing early diagnostic. However, there is a lack of information about the association between the semantic verbal fluency pattern (SVFP) and the biological amyloidosis markers in DS. In the current study, we used the SVFT in young adults with DS to characterize their SVFP, assessing total generated words, clustering, and switching. We then explored its association with early indicators of dementia, adaptive behavior and amyloidosis biomarkers, using the Dementia Questionnaire for Persons with Intellectual Disability (DMR), the Adaptive Behavior Assessment System-Second Edition (ABAS-II), and plasma levels of Aβ peptides (Aβ40 and Aβ42), as a potent biomarker of AD. In DS, worse performance in SVFT and poorer communication skills were associated with higher plasma Aβ42 concentrations, a higher DMR score and impaired communication skills (ABAS–II). The total word production and switching ability in SVFT were good indicators of plasma Aβ42 concentration. In conclusion, we propose the SVFT as a good screening test for early detection of dementia and amyloidosis in young adults with DS.
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Affiliation(s)
- Laura Del Hoyo
- Neurosciences Research Program, Integrative Pharmacology and Systems Neuroscience Research Group, IMIM-Institut de Hospital del Mar d'Investigacions Mèdiques Barcelona, Spain ; Departamento de farmacología, Universitat Autònoma de Barcelona Barcelona, Spain
| | - Laura Xicota
- Neurosciences Research Program, Integrative Pharmacology and Systems Neuroscience Research Group, IMIM-Institut de Hospital del Mar d'Investigacions Mèdiques Barcelona, Spain ; Systems Biology Program, Cellular and Systems Neurobiology, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology Barcelona, Spain ; Department of Experimental and Health Sciences, Universitat Pompeu Fabra Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Neurosciences Research Program, Integrative Pharmacology and Systems Neuroscience Research Group, IMIM-Institut de Hospital del Mar d'Investigacions Mèdiques Barcelona, Spain
| | - Aida Cuenca-Royo
- Neurosciences Research Program, Integrative Pharmacology and Systems Neuroscience Research Group, IMIM-Institut de Hospital del Mar d'Investigacions Mèdiques Barcelona, Spain
| | - Susana de Sola
- Neurosciences Research Program, Integrative Pharmacology and Systems Neuroscience Research Group, IMIM-Institut de Hospital del Mar d'Investigacions Mèdiques Barcelona, Spain ; Systems Biology Program, Cellular and Systems Neurobiology, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology Barcelona, Spain
| | - Klaus Langohr
- Neurosciences Research Program, Integrative Pharmacology and Systems Neuroscience Research Group, IMIM-Institut de Hospital del Mar d'Investigacions Mèdiques Barcelona, Spain ; Department of Statistics and Operations Research, Universitat Politècnica de Barcelona/BarcelonaTech Barcelona, Spain
| | - Ana B Fagundo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III Madrid, Spain
| | - Magí Farré
- Neurosciences Research Program, Integrative Pharmacology and Systems Neuroscience Research Group, IMIM-Institut de Hospital del Mar d'Investigacions Mèdiques Barcelona, Spain ; Departamento de farmacología, Universitat Autònoma de Barcelona Barcelona, Spain
| | - Mara Dierssen
- Systems Biology Program, Cellular and Systems Neurobiology, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology Barcelona, Spain ; Department of Experimental and Health Sciences, Universitat Pompeu Fabra Barcelona, Spain ; CIBER de Enfermedades Raras (CIBERER), Instituto Salud Carlos III Madrid, Spain
| | - Rafael de la Torre
- Neurosciences Research Program, Integrative Pharmacology and Systems Neuroscience Research Group, IMIM-Institut de Hospital del Mar d'Investigacions Mèdiques Barcelona, Spain ; Department of Experimental and Health Sciences, Universitat Pompeu Fabra Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III Madrid, Spain
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7
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de Sola S, de la Torre R, Sánchez-Benavides G, Benejam B, Cuenca-Royo A, del Hoyo L, Rodríguez J, Catuara-Solarz S, Sanchez-Gutierrez J, Dueñas-Espin I, Hernandez G, Peña-Casanova J, Langohr K, Videla S, Blehaut H, Farre M, Dierssen M. A new cognitive evaluation battery for Down syndrome and its relevance for clinical trials. Front Psychol 2015; 6:708. [PMID: 26089807 PMCID: PMC4455308 DOI: 10.3389/fpsyg.2015.00708] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 05/12/2015] [Indexed: 12/13/2022] Open
Abstract
The recent prospect of pharmaceutical interventions for cognitive impairment of Down syndrome (DS) has boosted a number of clinical trials in this population. However, running the trials has raised some methodological challenges and questioned the prevailing methodology used to evaluate cognitive functioning of DS individuals. This is usually achieved by comparing DS individuals to matched healthy controls of the same mental age. We propose a new tool, the TESDAD Battery that uses comparison with age-matched typically developed adults. This is an advantageous method for probing the clinical efficacy of DS therapies, allowing the interpretation and prediction of functional outcomes in clinical trials. In our DS population the TESDAD battery permitted a quantitative assessment of cognitive defects, which indicated language dysfunction and deficits in executive function, as the most important contributors to other cognitive and adaptive behavior outcomes as predictors of functional change in DS. Concretely, auditory comprehension and functional academics showed the highest potential as end-point measures of therapeutic intervention for clinical trials: the former as a cognitive key target for therapeutic intervention, and the latter as a primary functional outcome measure of clinical efficacy. Our results also emphasize the need to explore the modulating effects of IQ, gender and age on cognitive enhancing treatments. Noticeably, women performed significantly better than men of the same age and IQ in most cognitive tests, with the most consistent differences occurring in memory and executive functioning and negative trends rarely emerged on quality of life linked to the effect of age after adjusting for IQ and gender. In sum, the TESDAD battery is a useful neurocognitive tool for probing the clinical efficacy of experimental therapies in interventional studies in the DS population suggesting that age-matched controls are advantageous for determining normalization of DS.
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Affiliation(s)
- Susana de Sola
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
- Cellular and Systems Neurobiology Research Group, Systems Biology Program, Centre for Genomic RegulationBarcelona, Spain
| | - Rafael de la Torre
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN)Santiago de Compostela, Spain
- CEXS, Universitat Pompeu FabraBarcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
- Neurofunctionality of Brain and Language Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
| | | | - Aida Cuenca-Royo
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
- Drug Abuse Epidemiology Research Group-Epidemiology and Public Health Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
| | - Laura del Hoyo
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
| | - Joan Rodríguez
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
| | - Silvina Catuara-Solarz
- Cellular and Systems Neurobiology Research Group, Systems Biology Program, Centre for Genomic RegulationBarcelona, Spain
| | | | - Ivan Dueñas-Espin
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
- CEXS, Universitat Pompeu FabraBarcelona, Spain
| | - Gimena Hernandez
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
- Universitat Autónoma de BarcelonaUDIMAS, Barcelona, Spain
| | - Jordi Peña-Casanova
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
- Neurofunctionality of Brain and Language Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
| | - Klaus Langohr
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
- Department of Statistics and Operations Research, Universitat Politècnica de CatalunyaBarcelona, Spain
| | | | | | - Magi Farre
- Human Pharmacology and Clinical Neurosciences Research Group-Neurosciences Program, IMIM-Hospital del Mar Medical Research InstituteBarcelona, Spain
- Universitat Autònoma de Barcelona, i Hospital Universitari Germans Trias i Pujol (IGTP)Barcelona, Spain
| | - Mara Dierssen
- Cellular and Systems Neurobiology Research Group, Systems Biology Program, Centre for Genomic RegulationBarcelona, Spain
- Biomedical Research Centre on Rare Diseases (CIBERER)Valencia, Barcelona, Spain
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8
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Pujol J, del Hoyo L, Blanco-Hinojo L, de Sola S, Macià D, Martínez-Vilavella G, Amor M, Deus J, Rodríguez J, Farré M, Dierssen M, de la Torre R. Anomalous brain functional connectivity contributing to poor adaptive behavior in Down syndrome. Cortex 2015; 64:148-56. [DOI: 10.1016/j.cortex.2014.10.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 09/08/2014] [Accepted: 10/16/2014] [Indexed: 12/22/2022]
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9
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Rubial-Álvarez S, de Sola S, Machado MC, Sintas E, Böhm P, Sánchez-Benavides G, Langohr K, Muñiz R, Peña-Casanova J. The Comparison of Cognitive and Functional Performance in Children and Alzheimer's Disease Supports the Retrogenesis Model. ACTA ACUST UNITED AC 2012; 33:191-203. [DOI: 10.3233/jad-2012-121123] [Citation(s) in RCA: 3] [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: 11/15/2022]
Affiliation(s)
- Sandra Rubial-Álvarez
- Behavioral Neurology and Dementias Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
- Centro de Promoción de la Autonomía Personal de Bergondo, IMSERSO, Ministerio de Sanidad y Política Social, Bergondo, A Coruña, Spain
| | - Susana de Sola
- Human Pharmacology and Clinical Neurosciences Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
| | - María-Clara Machado
- Behavioral Neurology and Dementias Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
| | - Elena Sintas
- Behavioral Neurology and Dementias Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
| | - Peter Böhm
- Behavioral Neurology and Dementias Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
- Fundación Maria Wolff, Madrid, Spain
| | - Gonzalo Sánchez-Benavides
- Behavioral Neurology and Dementias Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
- Human Pharmacology and Clinical Neurosciences Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
| | - Klaus Langohr
- Human Pharmacology and Clinical Neurosciences Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
- Departament d'Estadística i Investigació Operativa, Universitat Politècnica de Catalunya, Barcelona, Spain
| | | | - Jordi Peña-Casanova
- Behavioral Neurology and Dementias Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
- Human Pharmacology and Clinical Neurosciences Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain
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10
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Peña-Casanova J, Sánchez-Benavides G, de Sola S, Manero-Borrás RM, Casals-Coll M. Neuropsychology of Alzheimer's disease. Arch Med Res 2012; 43:686-93. [PMID: 23072720 DOI: 10.1016/j.arcmed.2012.08.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 08/29/2012] [Indexed: 12/16/2022]
Abstract
The expression of neurodegenerative diseases can be categorized into three main symptomatic domains: neurological, cognitive and, neuropsychiatric. This review focuses on the cognitive profile and neuropsychological assessment of Alzheimer's disease (AD). The topography and progression of brain neuropathology determines the cognitive expression of the disease. Thus, in accordance with the initial involvement of the medial temporal lobe, cognitive changes in AD start with specific difficulties in encoding and storage of new information. This particular memory deficit can be optimally detected with memory tests that enhance mnemonic retrieval by means of encoding specificity technique such as the Free and Cued Selective Reminding Test (FCSRT). Along the course of the disease, the neuropathology spreads to association cortices, and other neuropsychological deficits can be detected. A comprehensive neuropsychological examination encompassing several cognitive domains can provide a pattern of altered and preserved functions that is helpful to early detection, differential diagnosis and even prognosis of progression in predementia stages. The use of adapted and standardized instruments is necessary to properly estimate cognitive and functional performance in AD.
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Affiliation(s)
- Jordi Peña-Casanova
- Section of Behavioral Neurology, Service of Neurology, Hospital del Mar, Barcelona, Spain.
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11
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Rubial-Alvarez S, Machado MC, Sintas E, de Sola S, Böhm P, Peña-Casanova J. A preliminary study of the mini-mental state examination in a Spanish child population. J Child Neurol 2007; 22:1269-73. [PMID: 18006955 DOI: 10.1177/0883073807307098] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [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: 11/17/2022]
Abstract
The Mini-Mental State Examination is one of the most widely used screening tests for the adult population in daily neurologic practice. The aim of this study was to describe and to analyze the results of the Mini-Mental State Examination administered to Spanish children and to assess the relationship between Mini-Mental State Examination scores and the child's mental age/intelligence quotient. The study population included 181 children whose ages ranged between 4 and 12 years. The neuropsychologic battery consisted of the Mini-Mental State Examination and Kaufman Brief Intelligence Test. Percentiles were obtained for the Mini-Mental State Examination total score according to age ranges. Performance gradually increased from 4 to 10 years of age when a plateau in the total Mini-Mental State Examination score was reached. At the age of 6 years, results exceeded 24 on average. Pairwise mean comparisons showed statistically significant differences between the age groups (P < .05). Data distribution could be classified in 4 independent groups for the following chronologic ages: 4, 5, and 6 years and from 7 to 12 years of age. The total Mini-Mental State Examination score correlated significantly with the child's chronologic (r = 0.80, P < .001) and mental (r = 0.76, P < .001) ages. This is a preliminary study of the application of the Mini-Mental State Examination in a Spanish child population as well as a first step for the assessment of the usefulness of this instrument as a cognitive screening tool for children's development.
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Affiliation(s)
- Sandra Rubial-Alvarez
- Section of Behavioral Neurology Institut Municipal d'Assistència Sanitària (IMAS), Hospital Universitari del Mar, Barcelona, Spain
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