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Florack J, Abele C, Baisch S, Forstmeier S, Garmann D, Grond M, Hornke I, Karakaya T, Karneboge J, Knopf B, Lindl G, Müller T, Oswald F, Pfeiffer N, Prvulovic D, Poth A, Reif A, Schmidtmann I, Theile-Schürholz A, Ullrich H, Haberstroh J. Project DECIDE, part II: decision-making places for people with dementia in Alzheimer's disease: supporting advance decision-making by improving person-environment fit. BMC Med Ethics 2023; 24:26. [PMID: 37118723 PMCID: PMC10148477 DOI: 10.1186/s12910-023-00905-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/29/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The UN Convention on the Rights of Persons with Disabilities, and the reformed guardianship law in Germany, require that persons with a disability, including people with dementia in Alzheimer's disease (PwAD), are supported in making self-determined decisions. This support is achieved through communication. While content-related communication is a deficit of PwAD, relational aspects of communication are a resource. Research in supported decision-making (SDM) has investigated the effectiveness of different content-related support strategies for PwAD but has only succeeded in improving understanding, which, although one criterion of capacity to consent, is not sufficient to ensure overall capacity to consent. The aim of the 'spatial intervention study' of the DECIDE project is to examine an innovative resource-oriented SDM approach that focuses on relational aspects. We hypothesise that talking to PwAD in their familiar home setting (as opposed to a clinical setting) will reduce the complexity of the decision-making process and enhance overall capacity to consent. METHODS People with a suspected or confirmed diagnosis of dementia in Alzheimer's disease will be recruited from two memory clinics (N = 80). We will use a randomised crossover design to investigate the intervention effect of the decision-making place on capacity to consent. Besides reasoning capacity, which is part of overall capacity to consent and will be the primary outcome, various secondary outcomes (e.g., other aspects of capacity to consent, subjective task complexity, decisional conflict) and suspected moderating or mediating variables (e.g., meaning of home, demographic characteristics) will be assessed. DISCUSSION The results of the study will be used to develop a new SDM strategy that is based on relational resources for PwAD. If a change in location achieves the anticipated improvement in capacity to consent, future research should focus on implementing this SDM strategy in a cost-effective manner in clinical practice. TRIAL REGISTRATION DRKS00030799 .
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Affiliation(s)
- Janina Florack
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany.
- Klinikum Siegen, Siegen, Germany.
| | - Christina Abele
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
- University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stefanie Baisch
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
| | - Simon Forstmeier
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
| | - Daniel Garmann
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
- Klinikum Siegen, Siegen, Germany
| | | | | | - Tarik Karakaya
- University Hospital Frankfurt, Frankfurt Am Main, Germany
| | - Jonas Karneboge
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
| | | | - Gregor Lindl
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
- University Hospital Frankfurt, Frankfurt Am Main, Germany
| | - Tanja Müller
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
| | - Frank Oswald
- Goethe University Frankfurt, Frankfurt Am Main, Germany
| | - Nathalie Pfeiffer
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
- University Hospital Frankfurt, Frankfurt Am Main, Germany
| | | | - Aoife Poth
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
- University Hospital Frankfurt, Frankfurt Am Main, Germany
| | - Andreas Reif
- University Hospital Frankfurt, Frankfurt Am Main, Germany
| | - Irene Schmidtmann
- University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anna Theile-Schürholz
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
| | | | - Julia Haberstroh
- Faculty V: School of Life Sciences, Department of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
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Baisch S, Abele C, Theile-Schürholz A, Schmidtmann I, Oswald F, Karakaya T, Müller T, Florack J, Garmann D, Karneboge J, Lindl G, Pfeiffer N, Poth A, Caba BA, Grond M, Hornke I, Prvulovic D, Reif A, Ullrich H, Haberstroh J. Project DECIDE, part 1: increasing the amount of valid advance directives in people with Alzheimer's disease by offering advance care planning-a prospective double-arm intervention study. BMC Med Ethics 2022; 23:132. [PMID: 36494718 PMCID: PMC9733090 DOI: 10.1186/s12910-022-00854-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/02/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Everybody has the right to decide whether to receive specific medical treatment or not and to provide their free, prior and informed consent to do so. As dementia progresses, people with Alzheimer's dementia (PwAD) can lose their capacity to provide informed consent to complex medical treatment. When the capacity to consent is lost, the autonomy of the affected person can only be guaranteed when an interpretable and valid advance directive exists. Advance directives are not yet common in Germany, and their validity is often questionable. Once the dementia diagnosis has been made, it is assumed to be too late to write an advance directive. One approach used to support the completion of advance directives is 'Respecting Choices'®-an internationally recognised, evidence-based model of Advance Care Planning (ACP), which, until now, has not been evaluated for the target group of PwAD. This study's aims include (a) to investigate the proportion of valid advance directives in a memory clinic population of persons with suspected AD, (b) to determine the predictors of valid advance directives, and (c) to examine whether the offer of ACP can increase the proportion of valid advance directives in PwAD. METHOD We intend to recruit at least N = 250 participants from two memory clinics in 50 consecutive weeks. Of these, the first 25 weeks constitute the baseline phase (no offer of ACP), the following 25 weeks constitute the intervention phase (offer of ACP). The existence and validity of an advance directive will be assessed twice (before and after the memory clinic appointment). Moreover, potential predictors of valid advance directives are assessed. DISCUSSION The results of this study will enhance the development of consent procedures for advance directives of PwAD based on the ACP/Respecting Choices (R) approach. Therefore, this project contributes towards increasing the autonomy and inclusion of PwAD and the widespread acceptance of valid advance directives in PwAD. Trial Registration DRKS, DRKS00026691, registered 15th of October 2021, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00026691.
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Affiliation(s)
- Stefanie Baisch
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany
| | - Christina Abele
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany ,grid.410607.4University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Anna Theile-Schürholz
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany
| | - Irene Schmidtmann
- grid.410607.4University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Frank Oswald
- grid.7839.50000 0004 1936 9721Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Tarik Karakaya
- grid.411088.40000 0004 0578 8220University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Tanja Müller
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany
| | - Janina Florack
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany ,Kreisklinikum Siegen, Siegen, Germany
| | - Daniel Garmann
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany ,Kreisklinikum Siegen, Siegen, Germany
| | - Jonas Karneboge
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany
| | - Gregor Lindl
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany ,grid.411088.40000 0004 0578 8220University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Nathalie Pfeiffer
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany ,grid.411088.40000 0004 0578 8220University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Aoife Poth
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany
| | | | | | | | - David Prvulovic
- grid.411088.40000 0004 0578 8220University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Andreas Reif
- grid.411088.40000 0004 0578 8220University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - Julia Haberstroh
- grid.5836.80000 0001 2242 8751Faculty V: School of Life Sciences, Institute of Psychology, Psychological Aging Research (PAR), University of Siegen, Adolf-Reichwein-Str. 2a, 57068 Siegen, Germany
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3
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Ibnidris A, Fußer F, Kranz TM, Prvulovic D, Reif A, Pantel J, Albanese E, Karakaya T, Matura S. Investigating the Association Between Polygenic Risk Scores for Alzheimer’s Disease With Cognitive Performance and Intrinsic Functional Connectivity in Healthy Adults. Front Aging Neurosci 2022; 14:837284. [PMID: 35645768 PMCID: PMC9131016 DOI: 10.3389/fnagi.2022.837284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background Alzheimer’s disease (AD) pathology is present many years before the onset of clinical symptoms. AD dementia cannot be treated. Timely and early detection of people at risk of developing AD is key for primary and secondary prevention. Moreover, understanding the underlying pathology that is present in the earliest stages of AD, and the genetic predisposition to that might contribute to the development of targeted disease-modifying treatments. Objectives In this study, we aimed to explore whether genetic disposition to AD in asymptomatic individuals is associated with altered intrinsic functional connectivity as well as cognitive performance on neuropsychological tests. Methods We examined 136 cognitively healthy adults (old group: mean age = 69.32, SD = 4.23; young group: mean age = 31.34, SD = 13.12). All participants had undergone resting-state functional magnetic resonance imagining (fMRI), DNA genotyping to ascertain polygenic risk scores (PRS), and neuropsychological testing for global cognition, working memory, verbal fluency, and executive functions. Results Two-step hierarchical regression analysis revealed that higher PRS was significantly associated with lower scores in working memory tasks [Letter Number Span: ΔR2 = 0.077 (p < 0.05); Spatial Span: ΔR2 = 0.072 (p < 0.05)] in older adults (>60 years). PRS did not show significant modulations of the intrinsic functional connectivity of the posterior cingulate cortex (PCC) with other regions of interest in the brain that are affected in AD. Conclusion Allele polymorphisms may modify the effect of other AD risk factors. This potential modulation warrants further investigations, particularly in cognitively healthy adults.
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Affiliation(s)
- Aliaa Ibnidris
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- *Correspondence: Aliaa Ibnidris,
| | - Fabian Fußer
- Department of Gerontopsychiatry, Psychosomatic Medicine, and Psychotherapy, Pfalzklinikum, Klingenmünster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Thorsten M. Kranz
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - David Prvulovic
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Johannes Pantel
- Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany
| | - Emiliano Albanese
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Tarik Karakaya
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
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4
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Abstract
Aromatic nitration has tremendous importance in organic chemistry as nitroaromatic compounds serve as versatile building blocks. This study represents the electrochemical aromatic nitration with NBu4 NO2 , which serves a dual role as supporting electrolyte and as a safe, readily available, and easy-to-handle nitro source. Stoichiometric amounts of 1,1,1-3,3,3-hexafluoroisopropan-2-ol (HFIP) in MeCN significantly increase the yield by solvent control. The reaction mechanism is based on electrochemical oxidation of nitrite to NO2 , which initiates the nitration reaction in a divided electrolysis cell with inexpensive graphite electrodes. Overall, the reaction is demonstrated for 20 examples with yields of up to 88 %. Scalability is demonstrated by a 13-fold scale-up.
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Affiliation(s)
- Stephan P. Blum
- Department of ChemistryJohannes Gutenberg University MainzDuesbergweg 10–1455128MainzGermany
| | - Christean Nickel
- Department of ChemistryJohannes Gutenberg University MainzDuesbergweg 10–1455128MainzGermany
| | - Lukas Schäffer
- Department of ChemistryJohannes Gutenberg University MainzDuesbergweg 10–1455128MainzGermany
| | - Tarik Karakaya
- Department of ChemistryJohannes Gutenberg University MainzDuesbergweg 10–1455128MainzGermany
| | - Siegfried R. Waldvogel
- Department of ChemistryJohannes Gutenberg University MainzDuesbergweg 10–1455128MainzGermany
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5
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Blum SP, Karakaya T, Schollmeyer D, Klapars A, Waldvogel SR. Frontispiece: Metal‐Free Electrochemical Synthesis of Sulfonamides Directly from (Hetero)arenes, SO
2
, and Amines. Angew Chem Int Ed Engl 2021. [DOI: 10.1002/anie.202181061] [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: 11/05/2022]
Affiliation(s)
- Stephan P. Blum
- Department of Chemistry Johannes Gutenberg University Mainz Duesbergweg 10–14 Mainz Germany
| | - Tarik Karakaya
- Department of Chemistry Johannes Gutenberg University Mainz Duesbergweg 10–14 Mainz Germany
| | - Dieter Schollmeyer
- Department of Chemistry Johannes Gutenberg University Mainz Duesbergweg 10–14 Mainz Germany
| | - Artis Klapars
- Department of Process Research and Development Merck & Co., Inc. P.O. Box 2000 Rahway New Jersey 07065 USA
| | - Siegfried R. Waldvogel
- Department of Chemistry Johannes Gutenberg University Mainz Duesbergweg 10–14 Mainz Germany
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Blum SP, Karakaya T, Schollmeyer D, Klapars A, Waldvogel SR. Frontispiz: Metallfreie, elektrochemische Synthese von Sulfonamiden direkt aus (Hetero)arenen, SO
2
und Aminen. Angew Chem Int Ed Engl 2021. [DOI: 10.1002/ange.202181061] [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)
- Stephan P. Blum
- Department für Chemie Johannes Gutenberg Universität Mainz Duesbergweg 10–14 Mainz Deutschland
| | - Tarik Karakaya
- Department für Chemie Johannes Gutenberg Universität Mainz Duesbergweg 10–14 Mainz Deutschland
| | - Dieter Schollmeyer
- Department für Chemie Johannes Gutenberg Universität Mainz Duesbergweg 10–14 Mainz Deutschland
| | - Artis Klapars
- Department of Process Research and Development Merck & Co., Inc. P.O. Box 2000 Rahway New Jersey 07065 USA
| | - Siegfried R. Waldvogel
- Department für Chemie Johannes Gutenberg Universität Mainz Duesbergweg 10–14 Mainz Deutschland
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7
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Blum SP, Karakaya T, Schollmeyer D, Klapars A, Waldvogel SR. Metal-Free Electrochemical Synthesis of Sulfonamides Directly from (Hetero)arenes, SO 2 , and Amines. Angew Chem Int Ed Engl 2021; 60:5056-5062. [PMID: 33372349 PMCID: PMC7985875 DOI: 10.1002/anie.202016164] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Indexed: 12/16/2022]
Abstract
Sulfonamides are among the most important chemical motifs in pharmaceuticals and agrochemicals. However, there is no methodology to directly introduce the sulfonamide group to a non-prefunctionalized aromatic compound. Herein, we present the first dehydrogenative electrochemical sulfonamide synthesis protocol by exploiting the inherent reactivity of (hetero)arenes in a highly convergent reaction with SO2 and amines via amidosulfinate intermediate. The amidosulfinate serves a dual role as reactant and supporting electrolyte. Direct anodic oxidation of the aromatic compound triggers the reaction, followed by nucleophilic attack of the amidosulfinate. Boron-doped diamond (BDD) electrodes and a HFIP-MeCN solvent mixture enable selective formation of the sulfonamides. In total, 36 examples are demonstrated with yields up to 85 %.
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Affiliation(s)
- Stephan P. Blum
- Department of ChemistryJohannes Gutenberg University MainzDuesbergweg 10–14MainzGermany
| | - Tarik Karakaya
- Department of ChemistryJohannes Gutenberg University MainzDuesbergweg 10–14MainzGermany
| | - Dieter Schollmeyer
- Department of ChemistryJohannes Gutenberg University MainzDuesbergweg 10–14MainzGermany
| | - Artis Klapars
- Department of Process Research and DevelopmentMerck & Co., Inc.P.O. Box 2000RahwayNew Jersey07065USA
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8
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Blum SP, Karakaya T, Schollmeyer D, Klapars A, Waldvogel SR. Metallfreie, elektrochemische Synthese von Sulfonamiden direkt aus (Hetero)arenen, SO
2
und Aminen. Angew Chem Int Ed Engl 2021. [DOI: 10.1002/ange.202016164] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Stephan P. Blum
- Department für Chemie Johannes Gutenberg Universität Mainz Duesbergweg 10–14 Mainz Deutschland
| | - Tarik Karakaya
- Department für Chemie Johannes Gutenberg Universität Mainz Duesbergweg 10–14 Mainz Deutschland
| | - Dieter Schollmeyer
- Department für Chemie Johannes Gutenberg Universität Mainz Duesbergweg 10–14 Mainz Deutschland
| | - Artis Klapars
- Department of Process Research and Development Merck & Co., Inc. P.O. Box 2000 Rahway New Jersey 07065 USA
| | - Siegfried R. Waldvogel
- Department für Chemie Johannes Gutenberg Universität Mainz Duesbergweg 10–14 Mainz Deutschland
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Wied TS, Haberstroh J, Gather J, Karakaya T, Oswald F, Qubad M, Scholten M, Vollmann J, Pantel J. Supported Decision-Making in Persons With Dementia: Development of an Enhanced Consent Procedure for Lumbar Puncture. Front Psychiatry 2021; 12:780276. [PMID: 34867561 PMCID: PMC8635234 DOI: 10.3389/fpsyt.2021.780276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
The right to make autonomous decisions is enshrined in law. However, the question how persons with cognitive deficits can be enabled to make autonomous decisions has not been satisfactorily addressed. In particular, the concept of supported decision-making and its implementation into practice has been poorly explored for persons with dementia (PwD).This article describes the empirical development and implementation of support tools to enhance informed consent processes (so called enhanced consent procedures/ECP) for PwD on whether to undergo lumbar puncture. In the end of the process of pilot testing and further development of the tools, the following tools were defined: (1) Standardized Interview Structure, (2) Elaborated Plain Language, (3) Ambience and Room Design, (4) Keyword Lists, (5) Priority Cards, (6) Visualization, and (7) Simplified Written Informed Consent (Patient Information), as well as the general attitude (8) Person-Centered Attitude of the facilitator. As the development, implementation and evaluation of ECP tools is one objective of the transnational ENSURE project, we also include an overview of future empirical procedures. So far, our findings can serve as a selection of possibilities to support PwD in decision-making and help practitioners achieve an appropriate balance between the autonomy and protection of PwD in complex decision-making situation. Future studies should address the question if the proposed set of tools is effective to enhance informed consent processes in PwD.
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Affiliation(s)
- Theresa S Wied
- Geriatric Medicine, Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany
| | - Julia Haberstroh
- Psychological Aging Research, Institute of Psychology, University of Siegen, Siegen, Germany
| | - Jakov Gather
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum, Germany.,Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Tarik Karakaya
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Frank Oswald
- Interdisciplinary Ageing Research, Faculty of Educational Sciences, Goethe University Frankfurt, Frankfurt, Germany
| | - Mishal Qubad
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Matthé Scholten
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Jochen Vollmann
- Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Johannes Pantel
- Geriatric Medicine, Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany
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Karakaya T, Prvulovic D, Mohadjer N, Fusser F, Miller J, Oertel‐Knoechel V, Reif A, Pantel J, Matura S. [P4–367]: DIETARY FAT COMPOSITION CORRELATES WITH VERBAL MEMORY AND FRONTAL GREY AND WHITE MATTER VOLUME IN HEALTHY INDIVIDUALS: AN MRI STUDY. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2238] [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: 11/29/2022]
Affiliation(s)
- Tarik Karakaya
- University Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - David Prvulovic
- University Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - Nina Mohadjer
- University Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - Fabian Fusser
- University Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - Juliane Miller
- University Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | | | - Andreas Reif
- University Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - Johannes Pantel
- Institute of General Practice, Goethe UniversityFrankfurt am MainGermany
| | - Silke Matura
- University Hospital Frankfurt, Goethe UniversityFrankfurtGermany
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11
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Matura S, Prvulovic D, Hartmann D, Scheibe M, Sepanski B, Butz M, Oertel-Knöchel V, Knöchel C, Karakaya T, Fußer F, Hattingen E, Pantel J. Age-Related Effects of the Apolipoprotein E Gene on Brain Function. J Alzheimers Dis 2016; 52:317-31. [DOI: 10.3233/jad-150990] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Silke Matura
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
- Institute of General Practice, Goethe University, Frankfurt/Main, Germany
| | - David Prvulovic
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Daniel Hartmann
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Monika Scheibe
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Beate Sepanski
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Marius Butz
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Viola Oertel-Knöchel
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | | | - Tarik Karakaya
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Fabian Fußer
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Elke Hattingen
- Institute of Neuroradiology, Goethe University, Frankfurt/Main, Germany
| | - Johannes Pantel
- Institute of General Practice, Goethe University, Frankfurt/Main, Germany
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12
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Matura S, Prvulovic D, Butz M, Hartmann D, Sepanski B, Linnemann K, Oertel-Knöchel V, Karakaya T, Fußer F, Pantel J, van de Ven V. Recognition memory is associated with altered resting-state functional connectivity in people at genetic risk for Alzheimer's disease. Eur J Neurosci 2014; 40:3128-35. [PMID: 24989884 DOI: 10.1111/ejn.12659] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 05/03/2014] [Accepted: 05/18/2014] [Indexed: 11/30/2022]
Abstract
The apolipoprotein E ε4 (ApoE ε4) allele not only represents the strongest single genetic risk factor for sporadic Alzheimer's disease, but also imposes independent effects on brain function in healthy individuals where it has been shown to promote subtle memory deficits and altered intrinsic functional brain network connectivity. Based on previous work showing a potential relevance of the default mode network (DMN) functional connectivity for episodic memory function, we hypothesized that the ApoE ε4 genotype would affect memory performance via modulation of the DMN. We assessed 63 healthy individuals (50-80 years old), of which 20 carried the ε4 allele. All participants underwent resting-state functional magnetic resonance imaging (fMRI), high-resolution 3D anatomical MRI imaging and neuropsychological assessment. Functional connectivity analysis of resting-state activity was performed with a predefined seed region located in the left posterior cingulate cortex (PCC), a core region of the DMN. ApoE ε4 carriers performed significantly poorer than non-carriers in wordlist recognition and cued recall. Furthermore, ε4 carriers showed increased connectivity relative to ε4 non-carriers between the PCC seed region and left-hemispheric middle temporal gyrus (MTG). There was a positive correlation between recognition memory scores and resting-state connectivity in the left MTG in ε4 carriers. These results can be interpreted as compensatory mechanisms strengthening the cross-links between DMN core areas and cortical areas involved in memory processing.
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Affiliation(s)
- Silke Matura
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
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13
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Matura S, Prvulovic D, Jurcoane A, Hartmann D, Miller J, Scheibe M, O'Dwyer L, Oertel-Knöchel V, Knöchel C, Reinke B, Karakaya T, Fußer F, Pantel J. Differential effects of the ApoE4 genotype on brain structure and function. Neuroimage 2013; 89:81-91. [PMID: 24296331 DOI: 10.1016/j.neuroimage.2013.11.042] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 11/20/2013] [Accepted: 11/21/2013] [Indexed: 11/16/2022] Open
Abstract
The apolipoprotein E ε4 allele is a well established genetic risk factor for sporadic Alzheimer's disease. It is associated with structural and functional brain changes in healthy young, middle-aged and elderly subjects. In the current study, we assessed the impact of the ApoE genotype on brain macro- and microstructure, cognitive functioning and brain activity in fifty healthy young subjects (25 ApoE ε4 (ε4+) carriers and 25 non-carriers (ε4-), mean age 26.4±4.6years). We used diffusion tensor imaging (DTI) and voxel based morphometry (VBM) to assess brain structure, an extensive neuropsychological battery to test cognitive functioning and event-related functional magnetic resonance imaging (fMRI) to capture brain activity during episodic memory encoding and retrieval. ApoE ε4 carriers differed from non-carriers in fMRI activations but not in cognitive performance nor in brain micro- and macrostructure. These results suggest functional alterations in the episodic memory network that are modulated by the ε4 allele and might precede clinical or structural neurodegeneration.
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Affiliation(s)
- Silke Matura
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany.
| | - David Prvulovic
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany
| | - Alina Jurcoane
- Institute of Neuroradiology, Goethe Univ., Frankfurt/Main, Germany; Centre for Research on Individual Development and Adaptive Education (IDeA), Goethe Univ., Frankfurt/Main, Germany
| | - Daniel Hartmann
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany
| | - Julia Miller
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany
| | - Monika Scheibe
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany
| | - Laurence O'Dwyer
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany
| | - Viola Oertel-Knöchel
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany
| | - Christian Knöchel
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany
| | - Britta Reinke
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany
| | - Tarik Karakaya
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany
| | - Fabian Fußer
- Laboratory of Neurophysiology and Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany
| | - Johannes Pantel
- Institute of General Practice, Goethe Univ., Frankfurt/Main, Germany
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14
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Oertel-Knöchel V, Reinke B, Feddern R, Knake A, Knöchel C, Prvulovic D, Fußer F, Karakaya T, Loellgen D, Freitag C, Pantel J, Linden DEJ. Verbal episodic memory deficits in remitted bipolar patients: a combined behavioural and fMRI study. J Affect Disord 2013; 150:430-40. [PMID: 23764381 DOI: 10.1016/j.jad.2013.04.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 04/23/2013] [Accepted: 04/25/2013] [Indexed: 01/24/2023]
Abstract
BACKGROUND Episodic memory deficits affect the majority of patients with bipolar disorder (BD). AIMS The study investigates episodic memory performance through different approaches, including behavioural measures, physiological parameters, and the underlying functional activation patterns with functional neuroimaging (fMRI). METHODS 26 Remitted BD patients and a matched group of healthy controls underwent a verbal episodic memory test together with monitored autonomic response, psychopathological ratings and functional magnetic resonance imaging (fMRI) during the verbal episodic memory test. RESULTS Compared to healthy controls, BD patients performed significantly worse during the episodic memory task. The results further indicate that verbal episodic memory deficits in BD are associated with abnormal functional activity patterns in frontal, occipital and limbic regions, and an increase in stress parameters. LIMITATIONS We aimed to minimise sample heterogeneity by setting clear criteria for remission, based on the scores of a depression (BDI II) and mania scale (BRMAS) and on the DSM IV criteria. However, our patients were not symptom-free and scored higher on BDI II scores than the control group. CONCLUSIONS The results are of interest for the treatment of cognitive symptoms in BD patients, as persistent cognitive impairment may hamper full rehabilitation.
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Affiliation(s)
- Viola Oertel-Knöchel
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany.
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15
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Matura S, Prvulovic D, Hartmann D, Miller J, Scheibe M, Sepanski B, Linnemann K, Butz M, Rujescu D, Oertel‐Knöchel V, Fusser F, Karakaya T, Pantel J. P1–270: Effects of age and apolipoprotein E genotype on memory function: An fMRI study. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.495] [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: 11/16/2022]
Affiliation(s)
- Silke Matura
- University Hospital Frankfurt/Main Frankfurt Germany
| | | | | | | | | | | | | | | | - Dan Rujescu
- Ludwig‐Maximilians‐University Munich Munich Germany
| | | | - Fabian Fusser
- University Hospital Frankfurt/Main Frankfurt Germany
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16
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Karakaya T, Fußer F, Schröder J, Pantel J. Pharmacological Treatment of Mild Cognitive Impairment as a Prodromal Syndrome of Alzheimer´s Disease. Curr Neuropharmacol 2013; 11:102-8. [PMID: 23814542 PMCID: PMC3580783 DOI: 10.2174/157015913804999487] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Revised: 07/24/2012] [Accepted: 08/06/2012] [Indexed: 01/08/2023] Open
Abstract
Mild cognitive impairment (MCI) is a syndrome which, depending on various neurobiological, psychological and social factors, carries a high risk of developing into dementia. As far as diagnostic uncertainty and the heterogeneous underlying pathophysiological mechanisms are concerned, only limited therapeutic options are currently available. Clinical trials involving a wide range of substances have failed to show efficacy on primary and secondary outcome parameters. Most results reflect not only a lack of effectiveness of drug therapy but also methodological constraints in true prodromal Alzheimer´s disease (AD) based on clinical criteria. Biomarkers may help to identify MCI as a prodromal phase of dementia, so it is important to use them to improve specificity of case selection in future studies. For MCI as a prodromal syndrome of AD, clinical trials with disease modifying drugs that target underlying pathological mechanisms such as amyloid-beta accumulation and neurofibrillary tangle formation may help develop effective treatment options in the future. Alternative pharmacological approaches are currently being evaluated in ongoing phase 1 and phase 2 studies. Nevertheless, a lack of approved pharmacotherapeutic options has led to specific interventions that focus on patient education and life-style related factors receiving increasing attention.
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Affiliation(s)
- Tarik Karakaya
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt am Main, Germany
| | - Fabian Fußer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt am Main, Germany
| | - Johannes Schröder
- Department of Psychiatry, Section of Geriatric Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Johannes Pantel
- Institute of General Practice, Geriatric Medicine, Goethe-University, Frankfurt am Main, Germany
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17
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Karakaya T, Fußer F, Schröder J, Pantel J. Pharmacological Treatment of Mild Cognitive Impairment as a Prodromal Syndrome of Alzheimer´s Disease. Curr Neuropharmacol 2013. [DOI: 10.2174/1570159x11311010012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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18
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Alves GS, O'Dwyer L, Jurcoane A, Oertel-Knöchel V, Knöchel C, Prvulovic D, Sudo F, Alves CE, Valente L, Moreira D, Fußer F, Karakaya T, Pantel J, Engelhardt E, Laks J. Different patterns of white matter degeneration using multiple diffusion indices and volumetric data in mild cognitive impairment and Alzheimer patients. PLoS One 2012; 7:e52859. [PMID: 23300797 PMCID: PMC3534120 DOI: 10.1371/journal.pone.0052859] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 11/23/2012] [Indexed: 01/15/2023] Open
Abstract
Alzheimeŕs disease (AD) represents the most prevalent neurodegenerative disorder that causes cognitive decline in old age. In its early stages, AD is associated with microstructural abnormalities in white matter (WM). In the current study, multiple indices of diffusion tensor imaging (DTI) and brain volumetric measurements were employed to comprehensively investigate the landscape of AD pathology. The sample comprised 58 individuals including cognitively normal subjects (controls), amnestic mild cognitive impairment (MCI) and AD patients. Relative to controls, both MCI and AD subjects showed widespread changes of anisotropic fraction (FA) in the corpus callosum, cingulate and uncinate fasciculus. Mean diffusivity and radial changes were also observed in AD patients in comparison with controls. After controlling for the gray matter atrophy the number of regions of significantly lower FA in AD patients relative to controls was decreased; nonetheless, unique areas of microstructural damage remained, e.g., the corpus callosum and uncinate fasciculus. Despite sample size limitations, the current results suggest that a combination of secondary and primary degeneration occurrs in MCI and AD, although the secondary degeneration appears to have a more critical role during the stages of disease involving dementia.
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Affiliation(s)
- Gilberto Sousa Alves
- Alzheimer's Disease Center-Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Brazil.
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Abstract
OPINION STATEMENT To date, there are no approved and established pharmacologic treatment options for tauopathies, a very heterogenous group of neuropsychiatric diseases often leading to dementia and clinically diagnosed as atypical Parkinson syndromes. Among these so-called Parkinson plus syndromes are progressive supranuclear palsy (PSP), also referred to as Steele-Richardson-Olszewski syndrome; frontotemporal dementia (FTD); and corticobasal degeneration (CBD). Available treatment strategies are based mainly on small clinical trials, miscellaneous case reports, or small case-controlled studies. The results of these studies and conclusions about the efficacy of the medication used are often contradictory. Approved therapeutic agents for Alzheimer´s dementia, such as acetylcholinesterase inhibitors and memantine, have been used off-label to treat cognitive and behavioral symptoms in tauopathies, but the outcome has not been consistent. Therapeutic agents for the symptomatic treatment of Parkinson's disease (levodopa or dopamine agonists) are used for motor symptoms in tauopathies. For behavioral or psychopathological symptoms, treatment with antidepressants-especially selective serotonin reuptake inhibitors-could be helpful. Antipsychotics are often not well tolerated because of their adverse effects, which are pronounced in tauopathies; these drugs should be given very carefully because of an increased risk of cerebrovascular events. In addition to pharmacologic options, physical, occupational, or speech therapy can be applied to improve functional abilities. Each pharmacologic or nonpharmacologic intervention should be fitted to the specific symptoms of the individual patient, and decisions about the type and duration of treatment should be based on its efficacy for the individual and the patient's tolerance. Currently, no effective treatment is available that targets the cause of these diseases. Current research focuses on targeting tau protein pathology, including pathologic aggregation or phosphorylation; these approaches seem to be very promising.
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Affiliation(s)
- Tarik Karakaya
- Department of Psychiatry, J.W. Goethe-University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt, Germany,
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20
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Alves GS, Karakaya T, Fußer F, Kordulla M, O'Dwyer L, Christl J, Magerkurth J, Oertel-Knöchel V, Knöchel C, Prvulovic D, Jurcoane A, Laks J, Engelhardt E, Hampel H, Pantel J. Association of microstructural white matter abnormalities with cognitive dysfunction in geriatric patients with major depression. Psychiatry Res 2012; 203:194-200. [PMID: 22959814 DOI: 10.1016/j.pscychresns.2011.12.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [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] [Received: 06/03/2011] [Revised: 12/15/2011] [Accepted: 12/16/2011] [Indexed: 10/27/2022]
Abstract
Major depression disorder (MDD) is one of the most common causes of disability in people over 60years of age. Previous studies have linked affective and cognitive symptoms of MDD to white matter (WM) disruption in limbic-cortical circuits. However, the relationship between clinical cognitive deficits and loss of integrity in particular WM tracts is poorly understood. Fractional anisotropy (FA) as a measure of WM integrity was investigated in 17 elderly MDD subjects in comparison with 18 age-matched controls using tract-based spatial statistics (TBSS) and correlated with clinical and cognitive parameters. MDD patients revealed significantly reduced FA in the right posterior cingulate cluster (PCC) compared with controls. FA in the right PCC (but not in the left PCC) showed a significant positive correlation with performance in a verbal naming task, and showed a non-significant trend toward a correlation with verbal fluency and episodic memory performance. In control subjects, no correlations were found between cognitive tasks and FA values either in the right or left PCC. Results provide additional evidence supporting the neuronal disconnection hypothesis in MDD and suggest that cognitive deficits are related to the loss of integrity in WM tracts associated with the disorder.
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Affiliation(s)
- Gilberto Sousa Alves
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt, Germany.
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Prvulovic D, Matura S, Miller J, Scheibe M, O'Dwyer L, Fusser F, Karakaya T, Magerkurth J, Oertel‐Knöchel V, Rujescu D, Faltraco F, Hampel H. O4‐03‐05: APOE‐ε4 genotype affects brain function without apparent micro‐ and macrostructural changes in young adults: A multimodal fMRI, DTI and VBM study. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.1650] [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: 10/28/2022]
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Matura S, Ven V, Prvulovic D, Miller J, Scheibe M, O'Dwyer L, Fusser F, Karakaya T, Oertel‐Knöchel V, Rujescu D, Hampel H. P4‐151: Effects of the apolipoprotein E genotype on intrinsic functional connectivity in young, healthy adults. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.1855] [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: 10/28/2022]
Affiliation(s)
- Silke Matura
- University Hospital Frankfurt/MainFrankfurt/MainGermany
| | | | | | - Julia Miller
- University Hospital Frankfurt/MainFrankfurt/MainGermany
| | | | | | - Fabian Fusser
- University Hospital Frankfurt/MainFrankfurt/MainGermany
| | | | | | | | - Harald Hampel
- University Hospital Frankfurt/MainFrankfurt/ MainGermany
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