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Mez J, Alosco ML, Daneshvar DH, Saltiel N, Baucom Z, Abdolmohammadi B, Uretsky M, Nicks R, Martin BM, Palmisano JN, Nowinski CJ, Montenigro P, Solomon TM, Mahar I, Cherry JD, Alvarez VE, Dwyer B, Goldstein LE, Katz DI, Cantu RC, Kowall NW, Tripodis Y, Huber BR, Stein TD, Stern RA, McKee AC. Validity of the 2014 traumatic encephalopathy syndrome criteria for CTE pathology. Alzheimers Dement 2021; 17:1709-1724. [PMID: 33826224 PMCID: PMC8596795 DOI: 10.1002/alz.12338] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [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: 10/12/2020] [Revised: 01/19/2021] [Accepted: 03/05/2021] [Indexed: 12/14/2022]
Abstract
Introduction Validity of the 2014 traumatic encephalopathy syndrome (TES) criteria, proposed to diagnose chronic traumatic encephalopathy (CTE) in life, has not been assessed. Methods A total of 336 consecutive brain donors exposed to repetitive head impacts from contact sports, military service, and/or physical violence were included. Blinded to clinical information, neuropathologists applied National Institute on Neurological Disorders and Stroke/National Institute of Biomedical Imaging and Bioengineering CTE criteria. Blinded to neuropathological information, clinicians interviewed informants and reviewed medical records. An expert panel adjudicated TES diagnoses. Results A total of 309 donors were diagnosed with TES; 244 donors had CTE pathology. TES criteria demonstrated sensitivity and specificity of 0.97 and 0.21, respectively. Cognitive (odds ratio [OR] = 3.6; 95% confidence interval [CI]: 1.2–5.1), but not mood/behavior or motor symptoms, were significantly associated with CTE pathology. Having Alzheimer's disease (AD) pathology was significantly associated with reduced TES accuracy (OR = 0.27; 95% CI: 0.12–0.59). Discussion TES criteria provided good evidence to rule out, but limited evidence to rule in, CTE pathology. Requiring cognitive symptoms in revised criteria and using AD biomarkers may improve CTE pathology prediction.
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Affiliation(s)
- Jesse Mez
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Michael L Alosco
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Daniel H Daneshvar
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Rehabilitation Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Nicole Saltiel
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Veterans Affairs Medical Center, Bedford, Massachusetts, USA
| | - Zachary Baucom
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Boston University Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Bobak Abdolmohammadi
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Madeline Uretsky
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Raymond Nicks
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Veterans Affairs Medical Center, Bedford, Massachusetts, USA
| | - Brett M Martin
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Biostatistics & Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Joseph N Palmisano
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Biostatistics & Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Christopher J Nowinski
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Concussion Legacy Foundation, Boston, Massachusetts, USA
| | - Philip Montenigro
- Department of Neuropsychology, University of New Hampshire, Durham, New Hampshire, USA
| | - Todd M Solomon
- Avanir Pharmaceuticals Inc, Aliso Viejo, California, USA
| | - Ian Mahar
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jonathan D Cherry
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Veterans Affairs Medical Center, Bedford, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Victor E Alvarez
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Veterans Affairs Medical Center, Bedford, Massachusetts, USA
| | - Brigid Dwyer
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,Braintree Rehabilitation Hospital, Braintree, Massachusetts, USA
| | - Lee E Goldstein
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.,Departments of Biomedical, Electrical & Computer Engineering, Boston University College of Engineering, Boston, Massachusetts, USA
| | - Douglas I Katz
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,Braintree Rehabilitation Hospital, Braintree, Massachusetts, USA
| | - Robert C Cantu
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Concussion Legacy Foundation, Boston, Massachusetts, USA.,Department of Neurosurgery, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurosurgery, Emerson Hospital, Concord, Massachusetts, USA
| | - Neil W Kowall
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Yorghos Tripodis
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Boston University Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Bertrand R Huber
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Veterans Affairs Medical Center, Bedford, Massachusetts, USA
| | - Thor D Stein
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Veterans Affairs Medical Center, Bedford, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Robert A Stern
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurosurgery, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ann C McKee
- Boston University Alzheimer's Disease and CTE Centers, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Veterans Affairs Medical Center, Bedford, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
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Solomon TM, Barbone JM, Feaster HT, Miller DS, deBros GB, Murphy CA, Michalczuk D. Comparing the Standard and Electronic Versions of the Alzheimer's Disease Assessment Scale - Cognitive Subscale: A Validation Study. J Prev Alzheimers Dis 2020; 6:237-241. [PMID: 31686095 DOI: 10.14283/jpad.2019.27] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Alzheimer's Disease Assessment Scale (ADAS-Cog) has become the de facto gold-standard for assessing the efficacy of putative anti-dementia treatments. There has been an increasing interest in providing greater standardization, automation, and administration consistency to the scale. Recently, electronic versions of the ADAS-Cog (eADAS-Cog) have been utilized in clinical trials and demonstrated significant reductions in frequency of rater error as compared to paper. In order to establish validity of the electronic version (eADAS-Cog), 20 subjects who had received a diagnosis of probable Alzheimer's disease (AD) at a private US Memory Clinic completed a single-center, randomized, counterbalanced, prospective trial comparing a version of the eADAS-Cog to the standard paper scale. Interclass Correlation Coefficient on total scores and Kappa analysis on domain scores yielded high agreement (0.88 - 0.99). Effects of order and mode of administration on ADAS-Cog total scores did not demonstrate a significant main effect. Overall, this study establishes adequate concurrent validity between the ADAS-Cog and eADAS-Cog among an adult population with diagnosed AD.
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Affiliation(s)
- T M Solomon
- Todd M. Solomon, Bracket, 575 E Swedesford Road, Wayne, PA 19087. E-mail:
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3
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Alosco ML, Mez J, Tripodis Y, Kiernan PT, Abdolmohammadi B, Murphy L, Kowall NW, Stein TD, Huber BR, Goldstein LE, Cantu RC, Katz DI, Chaisson CE, Martin B, Solomon TM, McClean MD, Daneshvar DH, Nowinski CJ, Stern RA, McKee AC. Age of first exposure to tackle football and chronic traumatic encephalopathy. Ann Neurol 2019; 83:886-901. [PMID: 29710395 DOI: 10.1002/ana.25245] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 04/09/2018] [Accepted: 04/16/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine the effect of age of first exposure to tackle football on chronic traumatic encephalopathy (CTE) pathological severity and age of neurobehavioral symptom onset in tackle football players with neuropathologically confirmed CTE. METHODS The sample included 246 tackle football players who donated their brains for neuropathological examination. Two hundred eleven were diagnosed with CTE (126 of 211 were without comorbid neurodegenerative diseases), and 35 were without CTE. Informant interviews ascertained age of first exposure and age of cognitive and behavioral/mood symptom onset. RESULTS Analyses accounted for decade and duration of play. Age of exposure was not associated with CTE pathological severity, or Alzheimer's disease or Lewy body pathology. In the 211 participants with CTE, every 1 year younger participants began to play tackle football predicted earlier reported cognitive symptom onset by 2.44 years (p < 0.0001) and behavioral/mood symptoms by 2.50 years (p < 0.0001). Age of exposure before 12 predicted earlier cognitive (p < 0.0001) and behavioral/mood (p < 0.0001) symptom onset by 13.39 and 13.28 years, respectively. In participants with dementia, younger age of exposure corresponded to earlier functional impairment onset. Similar effects were observed in the 126 CTE-only participants. Effect sizes were comparable in participants without CTE. INTERPRETATION In this sample of deceased tackle football players, younger age of exposure to tackle football was not associated with CTE pathological severity, but predicted earlier neurobehavioral symptom onset. Youth exposure to tackle football may reduce resiliency to late-life neuropathology. These findings may not generalize to the broader tackle football population, and informant-report may have affected the accuracy of the estimated effects. Ann Neurol 2018;83:886-901.
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Affiliation(s)
- Michael L Alosco
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Jesse Mez
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Yorghos Tripodis
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Patrick T Kiernan
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ
| | - Bobak Abdolmohammadi
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Lauren Murphy
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Neil W Kowall
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Departments of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA.,VA Boston Healthcare System, U.S. Department of Veteran Affairs, Boston, MA
| | - Thor D Stein
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Departments of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA.,VA Boston Healthcare System, U.S. Department of Veteran Affairs, Boston, MA.,Department of Veterans Affairs Medical Center, Bedford, MA
| | - Bertrand Russell Huber
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,VA Boston Healthcare System, U.S. Department of Veteran Affairs, Boston, MA
| | - Lee E Goldstein
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Departments of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA.,Departments of Psychiatry, Ophthalmology, Boston University School of Medicine, Boston, MA.,Departments of Biomedical, Electrical & Computer Engineering, Boston University College of Engineering, Boston, MA
| | - Robert C Cantu
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Department of Neurosurgery, Boston University School of Medicine, Boston, MA.,Concussion Legacy Foundation, Boston, MA.,Department of Neurosurgery, Emerson Hospital, Boston, MA
| | - Douglas I Katz
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Braintree Rehabilitation Hospital, Braintree, MA
| | - Christine E Chaisson
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Data Coordinating Center, Boston University School of Public Health, Boston, MA
| | - Brett Martin
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Data Coordinating Center, Boston University School of Public Health, Boston, MA
| | - Todd M Solomon
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Michael D McClean
- Department of Environmental Health, Boston University School of Public Health, Boston, MA
| | - Daniel H Daneshvar
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Department of Orthopaedics, Stanford University, Stanford, CA
| | - Christopher J Nowinski
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Concussion Legacy Foundation, Boston, MA
| | - Robert A Stern
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Department of Neurosurgery, Boston University School of Medicine, Boston, MA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA
| | - Ann C McKee
- Boston University Alzheimer's Disease and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA.,Departments of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA.,VA Boston Healthcare System, U.S. Department of Veteran Affairs, Boston, MA.,Department of Veterans Affairs Medical Center, Bedford, MA
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Solomon TM, Feaster HT, Karas SM, Garcia-Valdecasas M, Barbone JM, DiGregorio DT, DeBonis D, Miller DS. TD‐P‐21: THE EVOLUTION OF TECHNOLOGY IN DATA QUALITY PROGRAMS FOR ALZHEIMER'S DISEASE CLINICAL TRIALS: WHAT HAVE WE LEARNED AND WHERE ARE WE GOING? Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4332] [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: 10/25/2022]
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5
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Feaster HT, Barbone JM, Miller DS, Solomon TM. P4-254: RATER REMEDIATION ON THE ADAS-COG LEADS TO LONGITUDINAL IMPROVEMENT IN CLINICAL TRIAL DATA QUALITY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3923] [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: 10/25/2022]
Affiliation(s)
| | | | | | - Todd M. Solomon
- CRF Bracket; Wayne PA USA
- Boston University School of Medicine; Boston MA USA
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6
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Karas SM, Barbone JM, Solomon TM, Hong B, Feaster HT. P1-307: IMPACT OF DATA QUALITY PROGRAMS ON MMSE INCLUSION CRITERIA IN ALZHEIMER'S DISEASE CLINICAL RESEARCH TRIALS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.862] [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: 11/25/2022]
Affiliation(s)
| | | | - Todd M. Solomon
- CRF Bracket; Wayne PA USA
- Boston University School of Medicine; Boston MA USA
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7
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Adams JW, Alvarez VE, Mez J, Huber BR, Tripodis Y, Xia W, Meng G, Kubilus CA, Cormier K, Kiernan PT, Daneshvar DH, Chua AS, Svirsky S, Nicks R, Abdolmohammadi B, Evers L, Solomon TM, Cherry JD, Aytan N, Mahar I, Devine S, Auerbach S, Alosco ML, Nowinski CJ, Kowall NW, Goldstein LE, Dwyer B, Katz DI, Cantu RC, Stern RA, Au R, McKee AC, Stein TD. Lewy Body Pathology and Chronic Traumatic Encephalopathy Associated With Contact Sports. J Neuropathol Exp Neurol 2018; 77:757-768. [PMID: 30053297 PMCID: PMC6097837 DOI: 10.1093/jnen/nly065] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Traumatic brain injury has been associated with increased risk of Parkinson disease and parkinsonism, and parkinsonism and Lewy body disease (LBD) can occur with chronic traumatic encephalopathy (CTE). To test whether contact sports and CTE are associated with LBD, we compared deceased contact sports athletes (n = 269) to cohorts from the community (n = 164) and the Boston University Alzheimer disease (AD) Center (n = 261). Participants with CTE and LBD were more likely to have β-amyloid deposition, dementia, and parkinsonism than CTE alone (p < 0.05). Traditional and hierarchical clustering showed a similar pattern of LBD distribution in CTE compared to LBD alone that was most frequently neocortical, limbic, or brainstem. In the community-based cohort, years of contact sports play were associated with neocortical LBD (OR = 1.30 per year, p = 0.012), and in a pooled analysis a threshold of >8 years of play best predicted neocortical LBD (ROC analysis, OR = 6.24, 95% CI = 1.5-25, p = 0.011), adjusting for age, sex, and APOE ɛ4 allele status. Clinically, dementia was significantly associated with neocortical LBD, CTE stage, and AD; parkinsonism was associated with LBD pathology but not CTE stage. Contact sports participation may increase risk of developing neocortical LBD, and increased LBD frequency may partially explain extrapyramidal motor symptoms sometimes observed in CTE.
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Affiliation(s)
- Jason W Adams
- Boston University Alzheimer’s Disease and CTE Center
| | - Victor E Alvarez
- Department of Neurology,Framingham Heart Study, Boston University School of Medicine, Boston, MA,VA Boston Healthcare System, Boston, MA
| | - Jesse Mez
- Department of Neurology,Framingham Heart Study, Boston University School of Medicine, Boston, MA
| | | | - Yorghos Tripodis
- Boston University Alzheimer’s Disease and CTE Center,Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Weiming Xia
- Boston University Alzheimer’s Disease and CTE Center,Department of Veterans Affairs Medical Center, Bedford, MA
| | - Gaoyuan Meng
- Boston University Alzheimer’s Disease and CTE Center,VA Boston Healthcare System, Boston, MA,Department of Veterans Affairs Medical Center, Bedford, MA
| | | | - Kerry Cormier
- Boston University Alzheimer’s Disease and CTE Center
| | | | | | - Alicia S Chua
- Boston University Alzheimer’s Disease and CTE Center,Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Sarah Svirsky
- Boston University Alzheimer’s Disease and CTE Center
| | - Raymond Nicks
- Boston University Alzheimer’s Disease and CTE Center
| | | | - Laney Evers
- Boston University Alzheimer’s Disease and CTE Center
| | | | | | | | | | - Sherral Devine
- Department of Neurology,Framingham Heart Study, Boston University School of Medicine, Boston, MA
| | - Sanford Auerbach
- Department of Neurology,Framingham Heart Study, Boston University School of Medicine, Boston, MA
| | - Michael L Alosco
- Department of Neurology,Framingham Heart Study, Boston University School of Medicine, Boston, MA
| | | | - Neil W Kowall
- Department of Neurology,VA Boston Healthcare System, Boston, MA
| | - Lee E Goldstein
- Boston University Alzheimer’s Disease and CTE Center,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA
| | - Brigid Dwyer
- Department of Neurology,Brain Injury Program, Braintree Rehabilitation Hospital, Braintree, MA
| | - Douglas I Katz
- Department of Neurology,Brain Injury Program, Braintree Rehabilitation Hospital, Braintree, MA
| | - Robert C Cantu
- Boston University Alzheimer’s Disease and CTE Center,Concussion Legacy Foundation,Department of Anatomy and Neurobiology,Department of Neurosurgery, Boston University School of Medicine, Boston, MA,Department of Neurosurgery, Emerson Hospital, Concord, MA
| | - Robert A Stern
- Department of Neurology,Department of Anatomy and Neurobiology,Department of Neurosurgery, Boston University School of Medicine, Boston, MA
| | - Rhoda Au
- Department of Neurology,Framingham Heart Study, Boston University School of Medicine, Boston, MA,Department of Biostatistics, Boston University School of Public Health, Boston, MA,Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Ann C McKee
- Department of Neurology,Framingham Heart Study, Boston University School of Medicine, Boston, MA,VA Boston Healthcare System, Boston, MA,Department of Veterans Affairs Medical Center, Bedford, MA,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA
| | - Thor D Stein
- Boston University Alzheimer’s Disease and CTE Center,Framingham Heart Study, Boston University School of Medicine, Boston, MA,VA Boston Healthcare System, Boston, MA,Department of Veterans Affairs Medical Center, Bedford, MA,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA,Send correspondence to: Thor D. Stein, MD, PhD, Department of Pathology and Laboratory Medicine, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA 02130; E-mail:
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8
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Solomon TM, Barbone JM, Miller DS, Feaster HT. P2‐035: PILOT VALIDATION OF AN ELECTRONIC ALZHEIMER'S DISEASE ASSESSMENT SCALE: COGNITIVE SUBSCALE (EADAS‐COG). Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.719] [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)
- Todd M. Solomon
- BracketWaynePAUSA
- Boston University School of MedicineBostonMAUSA
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9
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Solomon TM, Karas SM, Barbone JM, DiGregorio DT, Miller DS, Feaster HT. P1‐068: ANALYSIS OF THE RATES AND TYPES OF ERRORS ON ENHANCED ECOA VERSIONS OF THE ALZHEIMER'S DISEASE ASSESSMENT SCALE‐COGNITIVE SUBSCALE AND MINI MENTAL STATE EXAMINATION USED IN CLINICAL TRIALS OF DEMENTIA. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.070] [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: 11/27/2022]
Affiliation(s)
- Todd M. Solomon
- BracketWaynePAUSA
- Boston University School of MedicineBostonMAUSA
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10
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Karas SM, Barbone JM, DeBonis D, Solomon TM. P1‐064: THE USE OF STATISTICAL MODELING TO COMPLEMENT DATA QUALITY PROGRAMS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.066] [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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Cherry JD, Stein TD, Tripodis Y, Alvarez VE, Huber BR, Au R, Kiernan PT, Daneshvar DH, Mez J, Solomon TM, Alosco ML, McKee AC. CCL11 is increased in the CNS in chronic traumatic encephalopathy but not in Alzheimer's disease. PLoS One 2017; 12:e0185541. [PMID: 28950005 PMCID: PMC5614644 DOI: 10.1371/journal.pone.0185541] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 09/14/2017] [Indexed: 12/14/2022] Open
Abstract
CCL11, a protein previously associated with age-associated cognitive decline, is observed to be increased in the brain and cerebrospinal fluid (CSF) in chronic traumatic encephalopathy (CTE) compared to Alzheimer's disease (AD). Using a cohort of 23 deceased American football players with neuropathologically verified CTE, 50 subjects with neuropathologically diagnosed AD, and 18 non-athlete controls, CCL11 was measured with ELISA in the dorsolateral frontal cortex (DLFC) and CSF. CCL11 levels were significantly increased in the DLFC in subjects with CTE (fold change = 1.234, p < 0.050) compared to non-athlete controls and AD subjects with out a history of head trauma. This increase was also seen to correlate with years of exposure to American football (β = 0.426, p = 0.048) independent of age (β = -0.046, p = 0.824). Preliminary analyses of a subset of subjects with available post-mortem CSF showed a trend for increased CCL11 among individuals with CTE (p = 0.069) mirroring the increase in the DLFC. Furthermore, an association between CSF CCL11 levels and the number of years exposed to football (β = 0.685, p = 0.040) was observed independent of age (β = -0.103, p = 0.716). Finally, a receiver operating characteristic (ROC) curve analysis demonstrated CSF CCL11 accurately distinguished CTE subjects from non-athlete controls and AD subjects (AUC = 0.839, 95% CI 0.62-1.058, p = 0.028). Overall, the current findings provide preliminary evidence that CCL11 may be a novel target for future CTE biomarker studies.
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Affiliation(s)
- Jonathan D. Cherry
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA, United States of America
- Department of Neurology, Boston University School of Medicine, Boston, MA. United States of America
- VA Boston Healthcare System, Boston, MA, United States of America
- * E-mail:
| | - Thor D. Stein
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA, United States of America
- Department of Neurology, Boston University School of Medicine, Boston, MA. United States of America
- Department of Veterans Affairs Medical Center, Bedford, MA, United States of America
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States of America
| | - Victor E. Alvarez
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA, United States of America
- Department of Neurology, Boston University School of Medicine, Boston, MA. United States of America
- VA Boston Healthcare System, Boston, MA, United States of America
- Department of Veterans Affairs Medical Center, Bedford, MA, United States of America
| | - Bertrand R. Huber
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA, United States of America
- Department of Neurology, Boston University School of Medicine, Boston, MA. United States of America
- VA Boston Healthcare System, Boston, MA, United States of America
| | - Rhoda Au
- Department of Neurology, Boston University School of Medicine, Boston, MA. United States of America
- Framingham Heart Study, Boston University School of Medicine, Boston, MA, United States of America
| | - Patrick T. Kiernan
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA, United States of America
| | - Daniel H. Daneshvar
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA, United States of America
| | - Jesse Mez
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA, United States of America
- Department of Neurology, Boston University School of Medicine, Boston, MA. United States of America
| | - Todd M. Solomon
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA, United States of America
| | - Michael L. Alosco
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA, United States of America
- Department of Neurology, Boston University School of Medicine, Boston, MA. United States of America
| | - Ann C. McKee
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA, United States of America
- Department of Neurology, Boston University School of Medicine, Boston, MA. United States of America
- VA Boston Healthcare System, Boston, MA, United States of America
- Department of Veterans Affairs Medical Center, Bedford, MA, United States of America
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, United States of America
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Mez J, Daneshvar DH, Kiernan PT, Abdolmohammadi B, Alvarez VE, Huber BR, Alosco ML, Solomon TM, Nowinski CJ, McHale L, Cormier KA, Kubilus CA, Martin BM, Murphy L, Baugh CM, Montenigro PH, Chaisson CE, Tripodis Y, Kowall NW, Weuve J, McClean MD, Cantu RC, Goldstein LE, Katz DI, Stern RA, Stein TD, McKee AC. Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football. JAMA 2017; 318:360-370. [PMID: 28742910 PMCID: PMC5807097 DOI: 10.1001/jama.2017.8334] [Citation(s) in RCA: 581] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Players of American football may be at increased risk of long-term neurological conditions, particularly chronic traumatic encephalopathy (CTE). OBJECTIVE To determine the neuropathological and clinical features of deceased football players with CTE. DESIGN, SETTING, AND PARTICIPANTS Case series of 202 football players whose brains were donated for research. Neuropathological evaluations and retrospective telephone clinical assessments (including head trauma history) with informants were performed blinded. Online questionnaires ascertained athletic and military history. EXPOSURES Participation in American football at any level of play. MAIN OUTCOMES AND MEASURES Neuropathological diagnoses of neurodegenerative diseases, including CTE, based on defined diagnostic criteria; CTE neuropathological severity (stages I to IV or dichotomized into mild [stages I and II] and severe [stages III and IV]); informant-reported athletic history and, for players who died in 2014 or later, clinical presentation, including behavior, mood, and cognitive symptoms and dementia. RESULTS Among 202 deceased former football players (median age at death, 66 years [interquartile range, 47-76 years]), CTE was neuropathologically diagnosed in 177 players (87%; median age at death, 67 years [interquartile range, 52-77 years]; mean years of football participation, 15.1 [SD, 5.2]), including 0 of 2 pre-high school, 3 of 14 high school (21%), 48 of 53 college (91%), 9 of 14 semiprofessional (64%), 7 of 8 Canadian Football League (88%), and 110 of 111 National Football League (99%) players. Neuropathological severity of CTE was distributed across the highest level of play, with all 3 former high school players having mild pathology and the majority of former college (27 [56%]), semiprofessional (5 [56%]), and professional (101 [86%]) players having severe pathology. Among 27 participants with mild CTE pathology, 26 (96%) had behavioral or mood symptoms or both, 23 (85%) had cognitive symptoms, and 9 (33%) had signs of dementia. Among 84 participants with severe CTE pathology, 75 (89%) had behavioral or mood symptoms or both, 80 (95%) had cognitive symptoms, and 71 (85%) had signs of dementia. CONCLUSIONS AND RELEVANCE In a convenience sample of deceased football players who donated their brains for research, a high proportion had neuropathological evidence of CTE, suggesting that CTE may be related to prior participation in football.
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Affiliation(s)
- Jesse Mez
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Daniel H. Daneshvar
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Patrick T. Kiernan
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Bobak Abdolmohammadi
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Victor E. Alvarez
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- VA Boston Healthcare System, US Department of Veteran Affairs, Boston, Massachusetts
- Department of Veterans Affairs Medical Center, Bedford, Massachusetts
| | - Bertrand R. Huber
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- VA Boston Healthcare System, US Department of Veteran Affairs, Boston, Massachusetts
- Department of Veterans Affairs Medical Center, Bedford, Massachusetts
| | - Michael L. Alosco
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Todd M. Solomon
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
| | - Christopher J. Nowinski
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Concussion Legacy Foundation, Waltham, Massachusetts
| | - Lisa McHale
- Concussion Legacy Foundation, Waltham, Massachusetts
| | - Kerry A. Cormier
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Caroline A. Kubilus
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Brett M. Martin
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts
| | - Lauren Murphy
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Christine M. Baugh
- Interfaculty Initiative in Health Policy, Harvard University, Boston, Massachusetts
- Division of Sports Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Phillip H. Montenigro
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Christine E. Chaisson
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts
| | - Yorghos Tripodis
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Biostatistics, Boston University, Boston, Massachusetts
- School of Public Health, Boston University, Boston, Massachusetts
| | - Neil W. Kowall
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- VA Boston Healthcare System, US Department of Veteran Affairs, Boston, Massachusetts
- Department of Pathology, Boston University School of Medicine, Boston, Massachusetts
| | - Jennifer Weuve
- School of Public Health, Boston University, Boston, Massachusetts
- Department of Epidemiology, Boston University, Boston, Massachusetts
| | - Michael D. McClean
- School of Public Health, Boston University, Boston, Massachusetts
- Department of Environmental Health, Boston University, Boston, Massachusetts
| | - Robert C. Cantu
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Concussion Legacy Foundation, Waltham, Massachusetts
- Department of Neurosurgery, Emerson Hospital, Concord, Massachusetts
| | - Lee E. Goldstein
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Department of Pathology, Boston University School of Medicine, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts
- Department of Biomedical Engineering, Boston University College of Engineering, Boston, Massachusetts
- Department of Electrical and Computer Engineering, Boston University College of Engineering, Boston, Massachusetts
| | - Douglas I. Katz
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Braintree Rehabilitation Hospital, Braintree, Massachusetts
| | - Robert A. Stern
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurosurgery, Boston University School of Medicine, Boston, Massachusetts
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Thor D. Stein
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- VA Boston Healthcare System, US Department of Veteran Affairs, Boston, Massachusetts
- Department of Veterans Affairs Medical Center, Bedford, Massachusetts
- Department of Pathology, Boston University School of Medicine, Boston, Massachusetts
| | - Ann C. McKee
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- VA Boston Healthcare System, US Department of Veteran Affairs, Boston, Massachusetts
- Department of Veterans Affairs Medical Center, Bedford, Massachusetts
- Department of Pathology, Boston University School of Medicine, Boston, Massachusetts
- Boston University School of Medicine, Boston, Massachusetts
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Mez J, Daneshvar DH, Abdolmohammadi B, Kiernan PT, Alosco ML, Baugh CM, Solomon TM, Murphy L, Kriegel J, Martin BM, Chaisson CE, Montenigro PH, Alvarez VE, Huber BR, Stein TD, Goldstein LE, Katz DI, Cantu R, Kowall NW, Weuve J, Stern RA, Tripodis Y, McClean MD, McKee AC. [O5–07–01]: THE RELATIONSHIP BETWEEN REPETITIVE HEAD IMPACT EXPOSURE AND CHRONIC TRAUMATIC ENCEPHALOPATHY IN AMERICAN FOOTBALL PLAYERS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.543] [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: 10/18/2022]
Affiliation(s)
- Jesse Mez
- Boston UniversityBostonMAUSA
- Boston University School of MedicineBostonMAUSA
- Harvard UniversityCambridgeMAUSA
- Boston University School of Public HealthBostonMAUSA
- VA Boston Healthcare SystemJamaica PlainMAUSA
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14
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Alosco ML, Mez J, Kowall NW, Stein TD, Goldstein LE, Cantu RC, Katz DI, Solomon TM, Kiernan PT, Murphy L, Abdolmohammadi B, Daneshvar D, Montenigro PH, Nowinski CJ, Stern RA, McKee AC. Cognitive Reserve as a Modifier of Clinical Expression in Chronic Traumatic Encephalopathy: A Preliminary Examination. J Neuropsychiatry Clin Neurosci 2017; 29:6-12. [PMID: 27539377 PMCID: PMC5288278 DOI: 10.1176/appi.neuropsych.16030043] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study conducted a preliminary examination on cognitive reserve (CR) as a modifier of symptom expression in subjects with autopsy-confirmed chronic traumatic encephalopathy (CTE). The sample included 25 former professional football players neuropathologically diagnosed with CTE stage III or IV. Next of kin interviews ascertained age at cognitive and behavioral/mood symptom onset and demographic/athletic characteristics. Years of education and occupational attainment defined CR. High occupational achievement predicted later age at cognitive (p=0.02) and behavioral/mood (p=0.02) onset. Education was not an individual predictor. These preliminary findings suggest that CR may forestall the clinical manifestation of CTE.
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Affiliation(s)
- Michael L. Alosco
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Jesse Mez
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Neil W. Kowall
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA,VA Boston Healthcare System, U.S. Department of Veteran Affairs, Boston, MA,Departments of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA
| | - Thor D. Stein
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA,VA Boston Healthcare System, U.S. Department of Veteran Affairs, Boston, MA,Departments of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA,Department of Veterans Affairs Medical Center, Bedford, MA
| | - Lee E. Goldstein
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA,Departments of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA,Departments of Psychiatry and Ophthalmology, Boston University School of Medicine, Boston, MA,Departments Biomedical, Electrical & Computer Engineering, Boston University College of Engineering, Boston, MA
| | - Robert C. Cantu
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Concussion Legacy Foundation,Department of Neurosurgery, Boston University School of Medicine, Boston, MA,Department of Neurosurgery, Emerson Hospital
| | - Douglas I. Katz
- Department of Neurology, Boston University School of Medicine, Boston, MA,Braintree Rehabilitation Hospital, Braintree, MA
| | - Todd M. Solomon
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Patrick T. Kiernan
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Lauren Murphy
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Bobak Abdolmohammadi
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Daniel Daneshvar
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Philip H. Montenigro
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA
| | - Christopher J. Nowinski
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Concussion Legacy Foundation
| | - Robert A. Stern
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA,Department of Neurosurgery, Boston University School of Medicine, Boston, MA,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA
| | - Ann C. McKee
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, MA,Department of Neurology, Boston University School of Medicine, Boston, MA,VA Boston Healthcare System, U.S. Department of Veteran Affairs, Boston, MA,Departments of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA,Department of Veterans Affairs Medical Center, Bedford, MA
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15
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Cherry JD, Tripodis Y, Alvarez VE, Huber B, Kiernan PT, Daneshvar DH, Mez J, Montenigro PH, Solomon TM, Alosco ML, Stern RA, McKee AC, Stein TD. Microglial neuroinflammation contributes to tau accumulation in chronic traumatic encephalopathy. Acta Neuropathol Commun 2016; 4:112. [PMID: 27793189 PMCID: PMC5084333 DOI: 10.1186/s40478-016-0382-8] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 10/17/2016] [Indexed: 12/14/2022] Open
Abstract
The chronic effects of repetitive head impacts (RHI) on the development of neuroinflammation and its relationship to chronic traumatic encephalopathy (CTE) are unknown. Here we set out to determine the relationship between RHI exposure, neuroinflammation, and the development of hyperphosphorylated tau (ptau) pathology and dementia risk in CTE. We studied a cohort of 66 deceased American football athletes from the Boston University-Veteran's Affairs-Concussion Legacy Foundation Brain Bank as well as 16 non-athlete controls. Subjects with a neurodegenerative disease other than CTE were excluded. Counts of total and activated microglia, astrocytes, and ptau pathology were performed in the dorsolateral frontal cortex (DLF). Binary logistic and simultaneous equation regression models were used to test associations between RHI exposure, microglia, ptau pathology, and dementia. Duration of RHI exposure and the development and severity of CTE were associated with reactive microglial morphology and increased numbers of CD68 immunoreactive microglia in the DLF. A simultaneous equation regression model demonstrated that RHI exposure had a significant direct effect on CD68 cell density (p < 0.0001) and ptau pathology (p < 0.0001) independent of age at death. The effect of RHI on ptau pathology was partially mediated through increased CD68 positive cell density. A binary logistic regression demonstrated that a diagnosis of dementia was significantly predicted by CD68 cell density (OR = 1.010, p = 0.011) independent of age (OR = 1.055, p = 0.007), but this effect disappeared when ptau pathology was included in the model. In conclusion, RHI is associated with chronic activation of microglia, which may partially mediate the effect of RHI on the development of ptau pathology and dementia in CTE. Inflammatory molecules may be important diagnostic or predictive biomarkers as well as promising therapeutic targets in CTE.
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16
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Mez J, Solomon TM, Daneshvar DH, Stein TD, McKee AC. Pathologically Confirmed Chronic Traumatic Encephalopathy in a 25-Year-Old Former College Football Player. JAMA Neurol 2016; 73:353-5. [PMID: 26747562 DOI: 10.1001/jamaneurol.2015.3998] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Jesse Mez
- Alzheimer's Disease Center, Chronic Traumatic Encephalopathy Program, Boston University School of Medicine, Boston, Massachusetts2Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Todd M Solomon
- Alzheimer's Disease Center, Chronic Traumatic Encephalopathy Program, Boston University School of Medicine, Boston, Massachusetts
| | - Daniel H Daneshvar
- Alzheimer's Disease Center, Chronic Traumatic Encephalopathy Program, Boston University School of Medicine, Boston, Massachusetts3Concussion Legacy Foundation, Waltham, Massachusetts
| | - Thor D Stein
- Alzheimer's Disease Center, Chronic Traumatic Encephalopathy Program, Boston University School of Medicine, Boston, Massachusetts4US Department of Veterans Affairs, VA Boston Healthcare System, Jamaica Plain, Massachusetts5US Department of Veterans Affair
| | - Ann C McKee
- Alzheimer's Disease Center, Chronic Traumatic Encephalopathy Program, Boston University School of Medicine, Boston, Massachusetts2Department of Neurology, Boston University School of Medicine, Boston, Massachusetts4US Department of Veterans Affairs, VA Bo
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Solomon TM, Feaster HT, Miller D. P3‐024: Initial Pilot Validation of an Electronic Alzheimer’s Disease Assessment Scale–Cognitive Subscale (EADAS‐COG): Rationale and Methods. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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18
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Miller D, Solomon TM, Meyer J. P4‐393: Intelligent Clinical Interviews for Alzheimer’S Disease: How the Addition of Audio Reviews to Ecoa Scale Administration Results in Improved Data Quality. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.07.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Solomon TM, Leech J, deBros GB, Murphy CA, Budson AE, Vassey EA, Solomon PR. A randomized, double-blind, placebo controlled, parallel group, efficacy study of alpha BRAIN® administered orally. Hum Psychopharmacol 2016; 31:135-43. [PMID: 26876224 DOI: 10.1002/hup.2520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/01/2015] [Accepted: 12/16/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Alpha BRAIN® is a nootropic supplement that purports to enhance cognitive functioning in healthy adults. The goal of this study was to investigate the efficacy of this self-described cognitive enhancing nootropic on cognitive functioning in a group of healthy adults by utilizing a randomized, double blind, placebo-controlled design. METHODS A total of 63-treatment naïve individuals between 18 and 35 years of age completed the randomized, double-blind, placebo controlled trial. All participants completed a 2-week placebo run in before receiving active product, Alpha BRAIN® or new placebo, for 6 weeks. Participants undertook a battery of neuropsychological tests at randomization and at study completion. Primary outcome measures included a battery of neuropsychological tests and measures of sleep. RESULTS Compared with placebo, Alpha BRAIN® significantly improved on tasks of delayed verbal recall and executive functioning. Results also indicated significant time-by-group interaction in delayed verbal recall for the Alpha BRAIN® group. CONCLUSIONS The use of Alpha BRAIN® for 6 weeks significantly improved recent verbal memory when compared with controls, in a group of healthy adults. While the outcome of the study is encouraging, this is the first randomized controlled trial of Alpha BRAIN®, and the results merit further study.
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Affiliation(s)
- Todd M Solomon
- Boston Center for Memory, Newton, MA, USA.,The Memory Clinic, Bennington, VT, USA.,Boston University School of Medicine, Boston, MA, USA
| | | | | | - Cynthia A Murphy
- Boston Center for Memory, Newton, MA, USA.,The Memory Clinic, Bennington, VT, USA
| | - Andrew E Budson
- Boston Center for Memory, Newton, MA, USA.,Boston University School of Medicine, Boston, MA, USA
| | - Elizabeth A Vassey
- Boston Center for Memory, Newton, MA, USA.,Boston University School of Medicine, Boston, MA, USA
| | - Paul R Solomon
- Boston Center for Memory, Newton, MA, USA.,The Memory Clinic, Bennington, VT, USA.,Williams College, Williamstown, MA, USA
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20
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Mez J, Solomon TM, Daneshvar DH, Murphy L, Kiernan PT, Montenigro PH, Kriegel J, Abdolmohammadi B, Fry B, Babcock KJ, Adams JW, Bourlas AP, Papadopoulos Z, McHale L, Ardaugh BM, Martin BR, Dixon D, Nowinski CJ, Chaisson C, Alvarez VE, Tripodis Y, Stein TD, Goldstein LE, Katz DI, Kowall NW, Cantu RC, Stern RA, McKee AC. Assessing clinicopathological correlation in chronic traumatic encephalopathy: rationale and methods for the UNITE study. Alzheimers Res Ther 2015; 7:62. [PMID: 26455775 PMCID: PMC4601147 DOI: 10.1186/s13195-015-0148-8] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 09/15/2015] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Chronic traumatic encephalopathy (CTE) is a progressive neurodegeneration associated with repetitive head impacts. Understanding Neurologic Injury and Traumatic Encephalopathy (UNITE) is a U01 project recently funded by the National Institute of Neurological Disorders and Stroke and the National Institute of Biomedical Imaging and Bioengineering. The goal of the UNITE project is to examine the neuropathology and clinical presentation of brain donors designated as "at risk" for the development of CTE based on prior athletic or military exposure. Here, we present the rationale and methodology for UNITE. METHODS Over the course of 4 years, we will analyze the brains and spinal cords of 300 deceased subjects who had a history of repetitive head impacts sustained during participation in contact sports at the professional or collegiate level or during military service. Clinical data are collected through medical record review and retrospective structured and unstructured family interviews conducted by a behavioral neurologist or neuropsychologist. Blinded to the clinical data, a neuropathologist conducts a comprehensive assessment for neurodegenerative disease, including CTE, using published criteria. At a clinicopathological conference, a panel of physicians and neuropsychologists, blinded to the neuropathological data, reaches a clinical consensus diagnosis using published criteria, including proposed clinical research criteria for CTE. RESULTS We will investigate the validity of these clinical criteria and sources of error by using recently validated neuropathological criteria as a gold standard for CTE diagnosis. We also will use statistical modeling to identify diagnostic features that best predict CTE pathology. CONCLUSIONS The UNITE study is a novel and methodologically rigorous means of assessing clinicopathological correlation in CTE. Our findings will be critical for developing future iterations of CTE clinical diagnostic criteria.
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Affiliation(s)
- Jesse Mez
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Todd M Solomon
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA.
| | - Daniel H Daneshvar
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Sports Legacy Institute, 230 Second Avenue, Waltham, MA, 02451, USA.
| | - Lauren Murphy
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Patrick T Kiernan
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Philip H Montenigro
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Anatomy and Neurobiology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Joshua Kriegel
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Bobak Abdolmohammadi
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Brian Fry
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Katharine J Babcock
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Jason W Adams
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Alexandra P Bourlas
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Zachary Papadopoulos
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Lisa McHale
- Sports Legacy Institute, 230 Second Avenue, Waltham, MA, 02451, USA.
| | - Brent M Ardaugh
- Data Coordinating Center, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA.
| | - Brett R Martin
- Data Coordinating Center, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA.
| | - Diane Dixon
- Data Coordinating Center, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA.
| | | | - Christine Chaisson
- Data Coordinating Center, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA.
| | - Victor E Alvarez
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,VA Boston Healthcare System, U.S. Department of Veterans Affairs, 150 South Huntington Street, Jamaica Plain, MA, 02130, USA. .,Department of Veterans Affairs Medical Center, 200 Springs Road, Bedford, MA, 01730, USA. .,Department of Pathology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Thor D Stein
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,VA Boston Healthcare System, U.S. Department of Veterans Affairs, 150 South Huntington Street, Jamaica Plain, MA, 02130, USA. .,Department of Veterans Affairs Medical Center, 200 Springs Road, Bedford, MA, 01730, USA. .,Department of Pathology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Lee E Goldstein
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Douglas I Katz
- Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA. .,Braintree Rehabilitation Hospital, 250 Pond Street, Braintree, MA, 02184, USA.
| | - Neil W Kowall
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,VA Boston Healthcare System, U.S. Department of Veterans Affairs, 150 South Huntington Street, Jamaica Plain, MA, 02130, USA. .,Department of Pathology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA. .,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Robert C Cantu
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA. .,Sports Legacy Institute, 230 Second Avenue, Waltham, MA, 02451, USA. .,Department of Neurosurgery, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA. .,Department of Neurosurgery, Emerson Hospital, 133 Old Road to Nine Acre Corner, Concord, MA, 01742, USA.
| | - Robert A Stern
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA. .,Department of Anatomy and Neurobiology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA. .,Department of Neurosurgery, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
| | - Ann C McKee
- Alzheimer's Disease Center, Boston University School of Medicine, 72 East Concord Street, B-7800, Boston, MA, 02118, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA. .,VA Boston Healthcare System, U.S. Department of Veterans Affairs, 150 South Huntington Street, Jamaica Plain, MA, 02130, USA. .,Department of Veterans Affairs Medical Center, 200 Springs Road, Bedford, MA, 01730, USA. .,Department of Pathology, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA. .,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA.
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Solomon TM, Leech J, Murphy C, DeBros G, Budson A, Solomon P. A randomized, double-blind, placebo controlled, parallel group, efficacy study of alpha BRAIN® administered orally. J Int Soc Sports Nutr 2015. [PMCID: PMC4595564 DOI: 10.1186/1550-2783-12-s1-p54] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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22
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Kupprat SA, Halkitis PN, Pérez-Figueroa R, Solomon TM, Ashman T, Kingdon MJ, Levy MD. Age- and education-matched comparison of aging HIV+ men who have sex with men to general population on common neuropsychological assessments. J Health Psychol 2015; 20:1175-85. [PMID: 24265296 PMCID: PMC4451431 DOI: 10.1177/1359105313509844] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Little is known about the impact of HIV and aging on cognitive functioning. This New York City cross-sectional study of aging HIV-positive gay and bisexual men assessed their neuropsychological state. Working memory and verbal abstract reasoning were relatively intact. After 55 years of age, attention abilities were impaired. Executive function impairment was present regardless of age and education. Results suggest the need for HIV-specific norms, and the use of neuropsychological assessments (i.e. baseline and over time) as a cost-effective way to assess HIV-related cognitive decline in developed and under-developed countries.
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Mez J, Solomon TM, Daneshvar D, Montenigro P, Murphy L, Kiernan P, Kriegel J, Stein T, Katz DI, Cantu R, Kowall NW, Stern RA, McKee A. O5‐03‐06: The unite study: Understanding chronic traumatic encephalopathy through clinico‐pathological correlation — methods and instructive cases. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.07.497] [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: 10/22/2022]
Affiliation(s)
- Jesse Mez
- Boston University School of MedicineBostonMAUSA
| | | | | | | | | | | | | | - Thor Stein
- Boston University School of MedicineBostonMAUSA
| | | | | | | | | | - Ann McKee
- Boston University School of MedicineBostonMAUSA
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24
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Leech JD, Cecchi M, Solomon TM, Solomon PR. P1‐289: Effects of the nootropic compound alpha brain
®
on erp and eeg measures of cognitive performance. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.490] [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: 11/28/2022]
Affiliation(s)
- Jarrett D. Leech
- Tufts University School of MedicineBostonMAUSA
- Onnit LabsAustinTXUSA
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25
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Solomon TM, Leech J, Murphy C, DeBros G, Budson A, Solomon P. P2‐296: A randomized, double‐blind, placebo‐controlled, parallel group efficacy study of alphabrain
(tm)
administered orally. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Todd M. Solomon
- Boston University School of MedicineBostonMAUSA
- Boston Center for MemoryNewtonMAUSA
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26
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Kiernan PT, Montenigro PH, Solomon TM, McKee AC. Chronic traumatic encephalopathy: a neurodegenerative consequence of repetitive traumatic brain injury. Semin Neurol 2015; 35:20-8. [PMID: 25714864 DOI: 10.1055/s-0035-1545080] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that develops as a result of repetitive mild traumatic brain injury. Chronic traumatic encephalopathy is characterized by a unique pattern of accumulation of hyperphosphorylated tau in neurons and astrocytes. The tau abnormalities begin focally and perivascularly at the depths of the cerebral sulci, spread to the superficial layers of the adjacent cortex, and eventually become widespread throughout the medial temporal lobes, diencephalon, and brainstem. Abnormalities in 43 kDa TAR DNA-binding protein are also found in most cases of CTE. To date, CTE can only be diagnosed by postmortem neuropathological examination, although there are many ongoing research studies examining imaging techniques and biomarkers that might prove to have diagnostic utility. Currently, the incidence and prevalence of CTE are unknown, although great strides are being made to better understand the clinical symptoms and signs of CTE. Further research is critically needed to better identify the genetic and environmental risk factors for CTE as well as potential rehabilitation and therapeutic strategies.
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Affiliation(s)
- Patrick T Kiernan
- Chronic Traumatic Encephalopathy Center, Boston University, Boston, Massachusetts
| | - Philip H Montenigro
- Chronic Traumatic Encephalopathy Center, Boston University, Boston, Massachusetts
| | - Todd M Solomon
- Chronic Traumatic Encephalopathy Center, Boston University, Boston, Massachusetts
| | - Ann C McKee
- Chronic Traumatic Encephalopathy Center, Boston University, Boston, Massachusetts
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Solomon TM, deBros GB, Budson AE, Mirkovic N, Murphy CA, Solomon PR. Correlational analysis of 5 commonly used measures of cognitive functioning and mental status: an update. Am J Alzheimers Dis Other Demen 2014; 29:718-22. [PMID: 24829061 PMCID: PMC10852956 DOI: 10.1177/1533317514534761] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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] [Indexed: 04/03/2024]
Abstract
There are numerous measures for detecting the presence of dementia and quantifying its severity and progression. We analyzed the relations between scores on 5 commonly used measures (Mini-Mental State Examination, Montreal Cognitive Assessment, Alzheimer's Disease Assessment Scale-Cognitive Subscale, Activities of Daily Living Scale, and Global Deterioration Scale) of 101 successive admissions to a memory clinic. Patients were included in the analysis only if they received a diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease (AD) pathophysiological process or probable AD and if they received all measures. Regression analysis yielded 20 linear equations that allow for conversion between test scores on any 2 measures. Further, participants were grouped by MMSE scores with regard to level of disease severity, allowing for the creation of a quick reference table for estimating an approximate score range between measures. Results from this study provide a useful tool for clinicians when comparing between multiple different instruments that measure the mental status and functional ability of individuals with AD and MCI due to AD pathology.
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Affiliation(s)
- Todd M Solomon
- The Memory Clinic, Bennington, VT, USA Boston University Alzheimer's Disease Center, Boston, MA, USA
| | | | - Andrew E Budson
- Boston University Alzheimer's Disease Center, Boston, MA, USA
| | | | | | - Paul R Solomon
- The Memory Clinic, Bennington, VT, USA Williams College Department of Psychology, Williamstown, MA, USA
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Halkitis PN, Levy MD, Solomon TM. Temporal relations between methamphetamine use and HIV seroconversion in gay, bisexual, and other men who have sex with men. J Health Psychol 2014; 21:93-9. [DOI: 10.1177/1359105314522675] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Data from a cross-sectional study of gay, bisexual, and other men who have sex with men who were active methamphetamine users were analyzed to assess temporal relations between HIV seroconversion and initiation of methamphetamine use. Of the 100 men, 58 reported being HIV-positive. Most HIV-positive participants (65%) initiated methamphetamine use after seroconverting. Among those who initiated use before seroconversion, 8 years elapsed between onset of use and time of infection. Findings suggest the need to develop nuanced and targeted interventions aimed at disentangling the “meth-sex” link in this population. Findings also suggest use of the drug as a coping mechanism for those living with HIV.
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Siconolfi DE, Kapadia F, Halkitis PN, Moeller RW, Storholm ED, Barton SC, Solomon TM, Jones D. Sexual health screening among racially/ethnically diverse young gay, bisexual, and other men who have sex with men. J Adolesc Health 2013; 52:620-6. [PMID: 23298989 PMCID: PMC3634893 DOI: 10.1016/j.jadohealth.2012.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 10/02/2012] [Accepted: 10/05/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE Screening for sexually transmitted infections (STIs) is a crucial element of improving health and reducing disparities, and young men who have sex with men (YMSM) face high rates of both STIs and human immunodeficiency virus. We examined sexual health screening among a diverse sample of adolescent YMSM living in New York City. METHODS Between 2009 and 2011, cross-sectional data were collected from 590 YMSM in New York City. Separate multivariable logistic regression models were used to assess the relationship between sociodemographic, psychosocial, and health and healthcare related factors and two main outcomes: having sought a recent sexual health screening (past 6 months) and having a rectal sexual health screening (lifetime). RESULTS Overall, 46% reported a sexual health screening in the prior 6 months, but only 16% reported ever having a rectal screening for STIs. Rates were higher among ethnic minority YMSM and men who accessed care at clinics. Multivariable results indicated that gay community affiliation, recent unprotected anal sex, and number of lifetime male partners were also associated with seeking a recent screening. CONCLUSIONS Though half of the sample reported recent general screening, rates of lifetime rectal screening are low. Efforts to increase screening may focus on improving provider knowledge and guideline adherence, and educating and encouraging YMSM to access sexual health check-ups.
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Affiliation(s)
- Daniel E Siconolfi
- Center for Health, Identity, Behavior & Prevention Studies (CHIBPS), Steinhardt School of Culture, Education & Human Development, New York University, New York, NY, USA.
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Abstract
The current study was designed to develop a better understanding of the nature of the relationships between mental health burden, drug use, and unprotected sexual behavior within a sample of emerging adult gay and bisexual men, ages 18-19 (N = 598) and to test a theory of syndemics using structural equation modeling. Participants were actively recruited from community-based settings and the Internet for participation in a seven-wave cohort study. Data for participant characteristics and mental health were collected via computer-assisted survey, while drug use and unprotected sex behaviors for the month prior to assessment were collected via a calendar-based technique. Using the baseline data, we developed and tested structural equation models for mental health burden, drug use, and unprotected sex and also tested a second-order model for a single syndemic. First-order measurement models for each of the three epidemics were successfully identified using observed data. Tests of a second-order model seeking to explain the three epidemics as a single syndemic fit poorly. However, a second-order construct comprised of mental health burden and drug use fit the data well and was highly associated with the first-order construct of unprotected sex. The findings advance a theory of syndemics and suggest that in order to be maximally effective both HIV prevention and HIV care must be delivered holistically such that sexual risk behaviors are addressed in relation to, and in sync with, the drug use and mental health of the individual.
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Affiliation(s)
- Perry N Halkitis
- Center for Health, Identity, Behavior & Prevention Studies, The Steinhardt School of Culture, Education, and Human Development, New York University, NY 10003, USA.
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Kingdon MJ, Storholm ED, Halkitis PN, Jones DC, Moeller RW, Siconolfi D, Solomon TM. Targeting HIV prevention messaging to a new generation of gay, bisexual, and other young men who have sex with men. J Health Commun 2013; 18:325-342. [PMID: 23320963 DOI: 10.1080/10810730.2012.727953] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
HIV prevention messaging has been shown to reduce or delay high-risk sexual behaviors in young men who have sex with men (YMSM). Since the onset of the HIV/AIDS epidemic, a new generation of YMSM has come of age during an evolution in communication modalities. Because both these communication technologies and this new generation remain understudied, the authors investigated the manner in which YMSM interact with HIV prevention messaging. In particular, the authors examined 6 venues in which YMSM are exposed to, pay attention to, and access HIV prevention information: the Internet, bars/dance clubs, print media, clinics/doctors' offices, community centers/agencies, and educational classes. Data were drawn from a community-based sample of 481 racially and ethnically diverse YMSM from New York City. Significant differences in exposure to HIV prevention messaging venues emerged with respect to age, race/ethnicity, and sexual orientation. Attention paid to HIV prevention messages in various venues differed by age and sexual orientation. Across all venues, multivariate modeling indicated YMSM were more likely to access HIV messaging from the same venues at which they paid attention, with some variability explained by person characteristics (age and perceived family socioeconomic status). This suggests that the one-size-fits-all approach does not hold true, and both the venue and person characteristics must be considered when generating and disseminating HIV prevention messaging.
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Affiliation(s)
- Molly J Kingdon
- The Center for Health, Identity, Behavior, and Prevention Studies, The Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA.
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Abstract
The relation of methamphetamine abuse and HIV infection to social cognition (Reading the Mind in the Eyes Task and Faux Pas Recognition Task) was examined in men who have sex with men (N = 56): Of the methamphetamine users (n = 29), 19 were identified as HIV positive, and of the nonusers (n = 27), 13 were identified as HIV positive. Both methamphetamine use and HIV were associated with impaired performance on the Eyes Task (p < .05). Methamphetamine use was also associated with impaired performance on the Faux Pas Task (p < .05). These results link impaired social cognition to methamphetamine abuse and HIV infection.
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Abstract
This study reveals associations between alcohol use and demographic variables, as well as the relation between alcohol use and sexual activity, using episodic data. Data were obtained during summer and fall 2008 from a sample of 558 gay, bisexual, and other young men who have sex with men (YMSM), ages of 13-29 years in New York City. Recruitment strategies targeted potential participants at gay-related venues and public spaces often frequented by YMSM. Alcohol use varied by race/ethnicity, with White YMSM consuming significantly more alcohol than other races/ethnicities. Participants over the age of 21 drank significantly more alcohol than participants ages 13-20. Alcohol use was not found to be associated with sexual risk-taking activity. Our findings are enriched by a large, diverse sample of urban YMSM. Study limitations are noted.
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Affiliation(s)
- James A Pollock
- Department of Applied Psychology, New York University, New York, New York 10003, USA.
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Solomon TM, Halkitis PN, Moeller RM, Siconolfi DE, Kiang MV, Barton SC. Sex parties among young gay, bisexual, and other men who have sex with men in New York City: attendance and behavior. J Urban Health 2011; 88:1063-75. [PMID: 21698548 PMCID: PMC3232420 DOI: 10.1007/s11524-011-9590-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Very little information exists with regard to sex party behaviors in young men who have sex with men (YMSM), often defined as men ranging in age from 13 to 29 years. The current analysis examines sex party attendance and behavior in a sample of 540 emergent adult gay, bisexual, and other YMSM in New York City, ages 18-29 years. Findings indicate that 8.7% (n = 47) of the sample had attended a sex party 3 months prior to assessment. Sex party attendees reported that parties included both HIV-positive and HIV-negative men; attendees also reported unprotected sex and limited access to condoms and lubricant. As compared with those who did not attend sex parties, those who did indicated significantly more lifetime and recent (last 3 months) casual sex partners, drug use (both number of different drugs used and total lifetime use), psychosocial burden (history of partner violence and number of arrests), and total syndemic burden (a composite of unprotected anal sex, drug use and psychosocial burden). These results indicate that while only a small percentage of the overall sample attended sex parties, the intersection of both individual risk factors coupled with risk factors engendered within the sex party environment itself has the potential to be a catalyst in the proliferation of the HIV/AIDS epidemic in urban settings. Lastly, given that sex parties are different than other sex environments, commercial and public, with regard to how they are accessed, public health strategies may need to become more tailored in order to reach this potentially highly risky group.
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Affiliation(s)
- Todd M Solomon
- Center for Health, Identity, Behavior, and Prevention Studies, The Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA.
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35
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Solomon TM, Kiang MV, Halkitis PN, Moeller RW, Pappas MK. Personality traits and mental health states of methamphetamine-dependent and methamphetamine non-using MSM. Addict Behav 2010; 35:161-3. [PMID: 19786324 DOI: 10.1016/j.addbeh.2009.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Revised: 07/30/2009] [Accepted: 09/03/2009] [Indexed: 10/20/2022]
Abstract
This analysis considers the relation between personality traits, mental health states and methamphetamine (MA) use in 60 men who have sex with men (MSM). Thirty MA-dependent and 30 MA non-using MSM were assessed on the Neo Five Factor Inventory, the Brief Symptom Inventory, the Perceived Stress Scale, and the Posttraumatic Stress Disorder Checklist-Civilian Version tests. Our results indicate differences between groups on a variety of measures of personality traits and mental states. Specifically, MA-dependent participants were found to be more Neurotic, less Open, less Agreeable, and less Conscientious. Further, MA-dependent participants were found to have higher levels of Paranoid Ideation and higher levels of Interpersonal Sensitivity. Given the high prevalence of MA use in the MSM community and the association between MA use and sexual risk taking, our findings provided a clearer understanding of how individual personality traits may be a factor in the continued use of this drug among MSM. Further research should seek to incorporate individual personality traits into the development of efficacious MA-specific treatment interventions.
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36
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Halkitis PN, Solomon TM, Moeller RW, Doig SAR, Espinosa LS, Siconolfi D, Homer BD. Methamphetamine use among gay, bisexual and non-identified men-who-have-sex-with-men: an analysis of daily patterns. J Health Psychol 2009; 14:222-31. [PMID: 19237489 DOI: 10.1177/1359105308100206] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study sought to understand the patterns, methods of administration and contexts for methamphetamine use (MA) in a sample of racially diverse men who have sex with men (MSM). Inclusion into the study required participants to be classified as clinically dependent on MA, but indicate no other illicit substance use. Use was assessed using Timeline Followback for a period of 30 days. Of the 900 assessed days, MA use was reported on 217. Participants reported an average of seven days of use, with the majority of use occurring on the weekend. The weekend usage pattern suggests an incorporation of drugs into the lives of gay men as a means of socialization and recreation.
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Homer BD, Solomon TM, Moeller RW, Mascia A, DeRaleau L, Halkitis PN. Methamphetamine abuse and impairment of social functioning: a review of the underlying neurophysiological causes and behavioral implications. Psychol Bull 2008; 134:301-10. [PMID: 18298273 DOI: 10.1037/0033-2909.134.2.301] [Citation(s) in RCA: 165] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The highly addictive drug methamphetamine has been associated with impairments in social cognitions as evidenced by changes in users' behaviors. Physiological changes in brain structure and functioning, particularly in the frontal lobe, have also been identified. The authors propose a biopsychosocial approach to understanding the effects of methamphetamine addiction by relating the physiological effects of the drug to the behaviors and social cognitions of its users, through the application of the theory of mind paradigm. Although onset of methamphetamine use has been linked to the desire for socialization, chronic use has been associated with an increase in depression, aggressiveness, and social isolation, behaviors that also implicate involvement of the frontal lobe. The reviewed literature provides strong circumstantial evidence that social-cognitive functioning is significantly impacted by methamphetamine use and that the social isolation, depression, and aggressiveness associated with chronic use is due to more than just the social withdrawal associated with addiction. Treatment considerations for methamphetamine must therefore consider the role of social cognition, and pharmacological responses must address the documented impact of the drug on frontal lobe functioning.
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Affiliation(s)
- Bruce D Homer
- Department of Applied Psychology, New York University, NY, USA.
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38
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Solomon TM, Halkitis PN. Cognitive executive functioning in relation to HIV medication adherence among gay, bisexual, and other men who have sex with men. AIDS Behav 2008; 12:68-77. [PMID: 17636373 DOI: 10.1007/s10461-007-9273-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2006] [Accepted: 06/20/2007] [Indexed: 11/28/2022]
Abstract
A longitudinal study of 300 HIV-positive gay, bisexual or non-gay-identified men-who-have-sex-with-men was undertaken to consider patterns relating to HIV medication adherence. The purpose of our analyses was to consider the rate of adherence in relation to both age and executive functioning as assessed by the Trail Making Test A and B. Executive functioning was assessed at baseline and month 10. Our analytic sample consisted of 213 men who remained on the same protease inhibitor throughout the assessment timeframe. Adherence rates were relatively high with more than 50% of the sample maintaining a 95%+ adherence rate at both baseline and month 10. Analyses at baseline indicated executive functioning and age were related to rate of adherence. Analyses at month 10 indicated no significant relations. Findings support previous research and suggest that the status of executive functioning as well as age be given consideration when working with HIV-positive individuals.
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Affiliation(s)
- Todd M Solomon
- New York University School of Medicine, New York, NY, USA
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39
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Abstract
Alzheimer's disease (AD) reduces associative effects on false recognition in the Deese-Roediger-McDermott task, either due to impaired memory for gist or impaired use of gist in memory decisions. Gist processes were manipulated by blocking or mixing studied words according to their associations and by varying the associative strength between studied and nonstudied words at test. Both associative blocking and associative strength had smaller effects on false recognition in AD patients than in control participants, consistent with gist memory impairments. However, unlike the case with control participants, blocking influenced true and false recognition equally in AD patients, demonstrating an overdependence on gist when making memory decisions. AD also impaired item-specific recollections, relative to control participants, as true recognition of studied words was reduced even when the two groups were equated on gist-based false recognition. We propose that the overdependence on degraded gist memory in AD is caused by even larger impairments in item-specific recollections.
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Affiliation(s)
- David A Gallo
- Department of Psychology, University of Chicago, Chicago, IL 60637, USA.
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