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Li K, Xu S, Wang R, Zou X, Liu H, Fan C, Li J, Li G, Wu Y, Ma X, Chen Y, Hu C, Liu X, Yuan C, Ye Q, Dai M, Wu L, Wang Z, Wu H. Electroacupuncture for motor dysfunction and constipation in patients with Parkinson's disease: a randomised controlled multi-centre trial. EClinicalMedicine 2023; 56:101814. [PMID: 36691434 PMCID: PMC9860357 DOI: 10.1016/j.eclinm.2022.101814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/09/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Motor disturbances and non-motor disturbances such as constipation are the main factors affecting the quality of life in patients with Parkinson's disease (PD). We investigated the efficacy and safety of electroacupuncture combined with conventional pharmacological treatment on motor dysfunction and constipation in PD. METHODS In this multi-centre randomised controlled trial, we enrolled 166 eligible participants between September 19, 2018 and September 25, 2019 in four hospitals in China. Participants were randomly assigned (1:1) to the electroacupuncture (EA) group and the waitlist control group. Each participant in both groups received the conventional pharmacological treatment, EA group received 3 sessions of electroacupuncture per week for 12 weeks. The primary outcome was the change in the Unified Parkinson's Disease Rating Scale (UPDRS) score from baseline to week 12. The secondary outcomes included the evaluation of functional disability in motor symptoms and constipation, the adherence and adverse events were also recorded. Registered with Chictr.org.cn, ChiCTR1800019517. FINDINGS At week 12, the change in the UPDRS score of the EA group was significantly higher than that of the control group, with a difference of -9.1 points (95% CI, -11.8 to -6.4), and this difference continued into weeks 16 and 24. From baseline to week 12, the 39-item Parkinson Disease Question (PDQ-39) decreased by 10 points (interquartile range, IQR -26.0 to 0.0) in the EA group and 2.5 points (IQR: -11.0 to 4.0) in the control group, the difference was statistically significant. The time and steps for the 20-m walk at week 12, as well as the changes from baseline in the EA group, were comparable with that in the control group. But the EA group had a greater decrease than the control group from baseline in the times for 20-m walks at weeks 16 and 24. From week 4 to week 24, the median values of spontaneous bowel movements (SBMs) per week in the EA group were higher than that in the control group, the differences were all statistically significant. The incidence of EA-related adverse events during treatment was low, and they are mild and transient. INTERPRETATION The findings of our study suggested that compared with conventional pharmacological treatment, conventional pharmacological treatment combined with electroacupuncture significantly enhances motor function and increased bowel movements in patients with PD, electroacupuncture is a safe and effective treatment for PD. FUNDING Shanghai "Science and Technology Innovation Action Plan" Clinical Medicine Field Project (18401970700), Shanghai Special Project on Aging and Women's and Children's Health Research (020YJZX0134), Shanghai Clinical Research Centre for Acupuncture and Moxibustion (20MC1920500).
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Key Words
- CCS, Chronic constipation severity scale
- Constipation
- EA, Electroacupuncture
- Electroacupuncture
- ITT, Intention-to-treat
- LED, Levodopa equivalent dose
- MMSE, Mini-Mental State Examination
- Motor dysfunction
- PAC-QOL, Patient assessment of constipation quality of life
- PD, Parkinson's disease
- PDQ-39, 39-item Parkinson Disease Question
- Parkinson's disease
- SBMs, Spontaneous bowel movements
- UPDRS, Unified Parkinson’s Disease Rating Scale
- VAS, Visual Analogue Scale
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Affiliation(s)
- Kunshan Li
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Shifen Xu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
| | - Ruiping Wang
- Shanghai Skin Disease Hospital, Tongji University, Shanghai 200443, China
| | - Xuan Zou
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Huirong Liu
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Chunhai Fan
- Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jing Li
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Guona Li
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Yiwen Wu
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiaopeng Ma
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Yiyi Chen
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Chenfang Hu
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xiru Liu
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Canxing Yuan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Qing Ye
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Ming Dai
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Luyi Wu
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
- Corresponding author.
| | - Zhaoqin Wang
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
- Corresponding author.
| | - Huangan Wu
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
- Corresponding author.
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Gao M, Zhang C, Gao L, Sun S, Song L, Liu S. Association between C-reactive protein-albumin ratio and overall survival in Parkinson's disease using publicly available data: A retrospective cohort study. Heliyon 2023; 9:e12671. [PMID: 36747520 PMCID: PMC9898616 DOI: 10.1016/j.heliyon.2022.e12671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 11/14/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023] Open
Abstract
Background At present, many studies have confirmed that inflammation plays a central role in Parkinson's disease (PD). The inflammatory index is related to the prognosis of the disease, but a single inflammatory index has some limitations. The C-reactive protein-albumin ratio (CAR) is a better marker of inflammation or nutritional status than C-reactive protein (CRP) or albumin (Alb), but there is limited study on the association between CAR and the overall survival (OS) of PD. Object To study the association between CAR and OS in PD patients. Methods All of these data were obtained from the Dryad Digital Repository, based on which we conducted a secondary analysis. The study was conducted by the Department of Neurology, the National Regional Center for Neurological Disorders, and the National Hospital of Utano study between March 2004 to November 2007. The final analytic sample included 235 PD patients with the outcome of survival or all-cause death from the study registration to the endpoint. In this study, univariate and multivariate COX regression analyses were used to calculate the adjusted hazard ratio (HR), with a 95% confidence interval (CI). In addition, the association between CAR and OS in PD patients was explored by Kaplan-Meier curve and subgroup analysis. Results This study included 235 PD patients with an average age of 62.25 years, including 135 females and 100 males, and 45 died during the follow-up period. CAR was associated with gender, modified Hoehn-Yahr stages (mH-Y), and Mini-Mental State Examination (MMSE) of PD patients. In the COX multivariate regression model, after adjusting the age, gender, PD duration, mH-Y, MMSE, and the non-steroidal anti-inflammatory drugs, CAR was found to be associated with the OS in PD (HR = 1.54, 95% CI = 1.01-2.34, p = 0.044). Subgroup analysis showed that the subgroup did not play an interactive role in the association between the prognosis of patients with CAR and PD (p for interaction >0.05), and the results remained stable. Conclusions The all-cause mortality of PD patients with a high level of CAR is higher, which indicates that the poor overall survival of PD patients is associated with the increase of CAR. The CAR may be a reliable prognostic biomarker for PD patients.
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Key Words
- Alb, albumin
- Biomarker
- C-reactive protein-albumin ratio
- CAR, C-reactive protein
- CI, Confidence interval
- CRP, C-reactive protein-albumin ratio
- HR, Hazard ratio
- IQR, Interquartile range
- MMSE, Mini-Mental State Examination
- NSAIDs, Non-steroidal anti-inflammatory drugs
- Overall survival
- PD, Parkinson's disease
- Parkinson's disease
- Prognosis
- mH-Y, Modified Hoehn-Yahr stages
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Affiliation(s)
- Mengqi Gao
- Department of Nephrology and Endocrinology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chuanlong Zhang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lijie Gao
- Department of Neurology, Sichuan University of West China Hospital, Sichuan, China
| | - Shanmei Sun
- Department of TCM, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Lucheng Song
- Department of TCM, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China,Corresponding author.
| | - Shiwei Liu
- Department of Nephrology and Endocrinology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Corresponding author.
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Imaoka M, Nakao H, Nakamura M, Tazaki F, Hida M, Imai R, Maebuchi M, Ibuki M, Takeda M. Improvement of memory function via a combination of exercise and soy peptide supplementation in community-dwelling older adults: A randomized controlled trial. Contemp Clin Trials Commun 2022; 30:100998. [PMID: 36124312 DOI: 10.1016/j.conctc.2022.100998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/07/2022] [Revised: 07/13/2022] [Accepted: 09/08/2022] [Indexed: 11/21/2022] Open
Abstract
Background Soy peptide, when consumed as a functional food, has been reported to improve cognitive function. This study aimed to verify the combined effect of soy peptide supplementation and exercise on cognitive function among community-dwelling older adults in Japan. Methods In this population-based, non-blinded randomized controlled trial, 72 community-dwelling older adults who were independent in activities of daily living were randomly assigned to an "exercise plus nutrition" program (Ex + Nt group, n = 36) or an exercise program (Ex group, n = 36). For 3 months, both groups participated in an exercise and cognitive training regimen once per week, with the Ex + Nt group receiving soy supplementation once per week. Pre- and post-intervention measurements included grip strength, gait speed, skeletal muscle mass index, and scores on Addenbrooke's Cognitive Examination-Revised, trail-making test A, and the Geriatric Depression Scale. Participant enrollment for this study started in January 2019 and ended in April 2019. Results Exercise training increased the skeletal muscle mass index by 2.0% and 3.0% in the Ex + Nt and Ex groups, respectively. The Ex + Nt group exhibited a significant 0.3-point increase in the memory score. Conclusion A 3-month exercise program combined with soy peptide supplementation may be effective in improving both motor and memory function in community-dwelling older adults.
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Mano T, Kinugawa K, Ozaki M, Kataoka H, Sugie K. Neural synchronization analysis of electroencephalography coherence in patients with Parkinson's disease-related mild cognitive impairment. Clin Park Relat Disord 2022; 6:100140. [PMID: 35308256 PMCID: PMC8928128 DOI: 10.1016/j.prdoa.2022.100140] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/13/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022] Open
Abstract
We studied brain functional connectivity in 20 patients with PD-MCI and 10 MCI patients without Parkinsonism. Cognitive impairment was related to decreased coherence in the alpha range [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19]. Regional coherence in left FP had a higher correlation with cognitive function. Differences in EEG coherence may reflect a compensatory response to PD-MCI.
Introduction The underlying pathophysiology of slight cognitive dysfunction in Parkinson’s disease-related mild cognitive impairment (PD-MCI) is yet to be elucidated. Our study aimed to evaluate the association between cognitive function and brain functional connectivity (FC) in patients with PD-MCI. Methods Twenty patients with sporadic PD-MCI were evaluated for FC in the brain network. Further, electroencephalography (EEG) coherence analysis in the whole-brain and quantified regional coherence using phase coupling were performed for each frequency, and motor and cognitive function were assessed in the whole-brain. Results The degree of cognitive impairment was related to a decrease in the coherence in the alpha ranges. The regional coherence in the left frontal-left parietal region rather than the right frontal-right parietal region showed a higher correlation with the cognitive function scores. Conclusion The differences in EEG coherence across different types of cognitive dysfunction reflect a compensatory response to the heterogeneous and complex clinical presentation of PD-MCI. Our findings indicate decreased brain efficiency and impaired neural synchronization in PD-MCI; these results may be crucial in elucidating the pathological exacerbation of PD-MCI.
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Key Words
- Coherence analysis
- EEG, electroencephalography
- Electroencephalography
- FAB, Frontal Assessment Battery
- FC, functional connectivity
- FF, frontal-frontal
- FP, frontal-parietal
- FPL, left frontal-left parietal
- FPR, right frontal-right parietal
- FT, frontal-temporal
- HDS-R, Revised Hasegawa Dementia Score
- LEDD, levodopa-equivalent daily dose
- MCI, Mild Cognitive Impairment
- MCI, mild cognitive impairment
- MDS-UPDRS, Movement Disorder Society Unified Parkinson's Disease Rating Scale
- MMSE, Mini-Mental State Examination
- Mild cognitive impairment
- PD, Parkinson’s disease
- PO, parietal-occipital
- PT, parietal-temporal
- Parkinson's disease
- RBD, rapid eye movement sleep behavior disorder
- TT, temporal-temporal
- Time–frequency analysis
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Affiliation(s)
- Tomoo Mano
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan.,Department of Rehabilitation Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Kaoru Kinugawa
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Maki Ozaki
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Hiroshi Kataoka
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
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Rajpurohit S, Musunuri B, Basthi Mohan P, Shetty S. Novel Drugs for the Management of Hepatic Encephalopathy: Still a Long Journey to Travel. J Clin Exp Hepatol 2022; 12:1200-1214. [PMID: 35814520 PMCID: PMC9257922 DOI: 10.1016/j.jceh.2022.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/22/2021] [Accepted: 01/24/2022] [Indexed: 12/12/2022] Open
Abstract
Hepatic encephalopathy (HE) is one of the reversible complications of chronic liver disease, associated with a higher mortality rate. In current clinical practice, treatment with rifaximin and lactulose/lactitol is the first line of treatment in HE. With the advance in pathophysiology, a new class of ammonia lowering drugs has been revealed to overcome the hurdle and disease burden. The mechanism of the novel agents differs significantly and includes the alteration in intestinal microbiota, intestinal endothelial integrity, oxidative stress, inflammatory markers, and modulation of neurotoxins. Most of the trials have reported promising results in the treatment and prevention of HE with fecal microbiota transplantation, albumin, probiotics, flumazenil, polyethylene glycol, AST-120, glycerol phenylbutyrate, nitazoxanide, branched-chain amino acid, naloxone, and acetyl-l-carnitine. However, their clinical use is limited due to the presence of major drawbacks in their study design, sample size, safety profile, bias, and heterogenicity. This study will discuss the novel therapeutic targets for HE in liver cirrhosis patients with supporting clinical trial data.
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Key Words
- ALC, acetyl-L-carnitine
- BCAA, branched-chain amino acid
- BD, twice a day
- BDI, Beck Depression Inventory
- BUN, blood urea nitrogen
- CHESS, Clinical Hepatic Encephalopathy Staging Scale
- CLDQ, Chronic Liver Disease Questionnaire
- ECT, estimated completion time
- EEG, electroencephalogram
- FMT, fecal microbiota transplantation
- GPB, glycerol phenylbutyrate
- HESA, Hepatic Encephalopathy Scoring Algorithm
- HRQOL, health-related quality of life
- IV, intravenous
- MED, Modified Encephalopathy Scale
- MELD, Model for End-stage Liver Disease
- MMSE, Mini-Mental State Examination
- NTZ, nitazoxanide
- Nal, naloxone
- OD, once a day
- ORT, object recognition test
- PEG, polyethylene glycol
- QID, four times a day
- QOL, quality of life
- RBNS, Repeatable Battery for the Assessment of Neuropsychological Status
- RCT, randomized control trial
- RT-qPCR, real-time quantitative polymerase chain reaction
- TID, three times a day
- VSL#3, high concentration probiotic preparations
- hepatic encephalopathy
- liver cirrhosis
- novel drugs
- treatment outcome
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Affiliation(s)
| | | | | | - Shiran Shetty
- Address for correspondence: Shiran Shetty, Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
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Singh S, Taneja S, Tandon P, Bansal A, Gorsi U, Roy A, De A, Verma N, Premkumar M, Duseja A, Dhiman RK, Singh V. A Comparison of Different Frailty Scores and Impact of Frailty on Outcome in Patients With Cirrhosis. J Clin Exp Hepatol 2022; 12:398-408. [PMID: 35535083 PMCID: PMC9077184 DOI: 10.1016/j.jceh.2021.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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: 05/10/2021] [Accepted: 07/06/2021] [Indexed: 12/12/2022] Open
Abstract
Background & aims There is no "gold standard" tool for the assessment of frailty in cirrhosis. This study compares Liver Frailty Index (LFI), Short Physical Performance Battery (SPPB), Fried Frailty Criteria (FFC), and Clinical Frailty Scale (CFS) for frailty assessment and ascertains its impact on predicting mortality and hospitalizations in a cohort of outpatients with cirrhosis. Methods 116 patients were enrolled in this prospective observational cohort study. Frailty assessment was done using LFI, SPPB, FFC, and CFS. All patients were followed up for 6 months. The primary outcome was the first of either all-cause unplanned hospitalization or all-cause mortality occurring within 6 months of the study period. Results 100 (86.2%) males and 16 (13.8%) females with a mean age of 50.2 (48.4-51.9, 95% CI) years were included. The most common cause of cirrhosis was alcoholic liver disease (47.4%) followed by hepatitis C (12.9%) and Nonalcoholic steatohepatitis (NASH) (10.3%). There was no significant difference in prevalence of frailty based on LFI (43.1%), FFC (36.2%), CFS (44%), and SPPB (47.4%) (P > 0.05). Frail patients had worse outcomes compared to the Not frail group. At 6 months, the mortality rate in Frail patients was 42% versus 1.5% for the Not frail; hospitalization in Frail patients occurred in 92% versus 6% in the Not frail. On multivariable analysis, independent predictors of mortality were Frailty [OR 14 (1.4-54.2)], alcohol-related cirrhosis [OR 4.2 (1.1-16.3)], Child-Turcotte-Pugh (CTP) [OR 2.1 (1.4-2.9)] and Chronic liver disease questionnaire (CLDQ) [OR 0.1 (0.1-0.4)] scores. Conclusions LFI, SPPB, FFC, and CFS are comparable in frailty assessment in patients with cirrhosis. Importantly, comparability of the commonly used scores for frailty assessment and prediction of hospitalization and mortality allows flexibility for clinical application.
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Key Words
- AKI, Acute Kidney Injury
- ANOVA, Analysis Of Variance
- AUC, Area Under the Curve
- CFS, Clinical Frailty Scale
- CI, Confidence Interval
- CLDQ, Chronic liver disease questionnaire
- CT, Computerized Tomography
- CTP, Child-Turcotte-Pugh
- FFC, Fried Frailty Criteria
- FSS, Fatigue severity scale
- HCC, Hepatocellular Carcinoma
- HE, Hepatic Encephalopathy
- HU, Hounsfield Units
- IBM, International Business Machines
- LFI, Liver Frailty Index
- MELD, Model for End-Stage Liver Disease
- MELDNa, Model for End-Stage Liver Disease with Sodium
- MMSE, Mini-Mental State Examination
- NASH, Nonalcoholic Steatohepatitis
- NPV, Negative Predictive Value
- PGIMER, Post Graduate Institute of Medical Education and Research
- PPV, Positive Predictive Value
- ROC, Receiver Operating Characteristic Curve
- SBP, Spontaneous Bacterial Peritonitis
- SPPB, Short Physical Performance Battery
- SPSS, Statistical Package for Social Sciences
- UTI, Urinary Tract infection
- cirrhosis
- frailty
- hospitalization
- mortality
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Affiliation(s)
- Surender Singh
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sunil Taneja
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India,Address for correspondence: Sunil Taneja, Assistant Professor, Department of Hepatology, PGIMER, Chandigarh, India. Tel.: +919592160444.
| | - Puneeta Tandon
- Division of Gastroenterology, University of Alberta, Edmonton, Canada
| | - Akash Bansal
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ujjwal Gorsi
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Akash Roy
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Arka De
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Nipun Verma
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Madhumita Premkumar
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Radha K. Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Virendra Singh
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Ito D, Kawakami M, Narita Y, Yoshida T, Mori N, Kondo K. Cognitive Function is a Predictor of the Daily Step Count in Patients With Subacute Stroke With Independent Walking Ability: A Prospective Cohort Study. Arch Rehabil Res Clin Transl 2021; 3:100132. [PMID: 34589683 PMCID: PMC8463495 DOI: 10.1016/j.arrct.2021.100132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cognition at admission may predict daily step count. Cognitive impairment may increase risk of poor ambulation after subacute stroke. Ambulation poststroke is influenced by both physical and cognitive factors.
Objectives To investigate the physical, cognitive, and psychological factors related to daily step count in patients with subacute stroke. Design Prospective cohort study. Setting A subacute rehabilitation ward with 160 beds. Participants Patients with subacute stroke who could walk independently (N=101). Among the 101 participants enrolled in this study (mean age, 64.5±13.5y), 64.4% (n=65) were men and 69.3% (n=70) were patients with cerebral infarction. Interventions We assessed ambulatory activity using a pedometer placed in the pants pocket on the nonparalyzed side continuously for 7 consecutive days. We also obtained demographic and clinical information and recorded the following measurement scores: Stroke Impairment Assessment Set, FIM, Mini-Mental State Examination (MMSE), Self-Rating Depression Scale, and Apathy Scale. All measurements were collected at admission and discharge. Main Outcome Measures The outcomes assessed were ambulatory activity, motor and sensory functions, functional disability, cognitive function, depressive symptoms, and motivation. Results The median daily steps ambulated at admission and discharge were 5584 steps (interquartile range, 3763-7096 steps) and 5991 steps (interquartile range, 4329-8204 steps), respectively. In the univariate regression analysis, age, sex, serum albumin level, affected side of the brain, and MMSE score at admission were significantly associated with the daily step count at discharge. Multiple regression analysis using these 5 items as independent variables revealed that the MMSE score at admission (reference, 28-30 points; B, −2.07; 95% confidence interval, −3.89 to −0.35; β, −0.22; P=.027) was significantly associated with the daily step count at discharge. Conclusions Cognitive function at admission had a significant association with the daily step count at discharge in patients with subacute stroke who could walk independently.
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Affiliation(s)
- Daisuke Ito
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
- Corresponding author Daisuke Ito, OT, MSc, Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, 4-1-1, Yatsu, Narashino City, Chiba 275-0026, Japan.
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yuya Narita
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Taiki Yoshida
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Graduate School of Human Sciences, Waseda University, Tokorozawa City, Saitama, Japan
| | - Naoki Mori
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan
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Chen CH, Wu MS, Yang YW, Liu YT, Chiu YF, Hsu CC, Chuang SC, Chung TC, Tsai TL, Huang WH, Huang WL, Juan CC, Lien LM, Hsiung CA, Wu IC. Longitudinal changes in physical and mental health of older adults with chronic hepatitis B infection: Trajectories and predictors. Prev Med Rep 2021; 23:101432. [PMID: 34150482 PMCID: PMC8193133 DOI: 10.1016/j.pmedr.2021.101432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/14/2021] [Accepted: 05/07/2021] [Indexed: 02/06/2023] Open
Abstract
Despite the increasing health burden of chronic hepatitis B (CHB) in aging populations, little is known about the course of health-related quality of life (HRQoL) changes. We aimed to assess individual-level longitudinal HRQoL changes in elderly patients with CHB and to examine their correlates. A prospective 5.1 years-cohort study was conducted in community-dwelling adults aged 55 years with hepatitis B surface antigen-positive. Participants underwent serial measurement of HRQoL using the short-form (12) health survey version 2. Of 503 participants, 82.7% remained in good physical health throughout the study period, whereas 9.1% had declining physical health and 8.2% were in poor physical health. We likewise identified three trajectories of mental health changes ("good mental health" [86.9%], "declining mental health" [6.8%], and "poor mental health" [6.4%]). Three baseline characteristics were independently associated with a lower likelihood of remaining physically or mentally healthy: sarcopenic obesity (odds ratio [OR] with 95% confidence interval [95% CI] of 7.5 [2.8-20.5] for poor physical health, 3.1 [1.1-8.4] for declining physical health, 4.3 [1.4-13.0] for poor mental health), a higher number of metabolic abnormalities (OR [95% CI] of 3.6 [1.6-8.0] for poor physical health) and depressed mood (OR [95% CI] of 21.7 [5.8-81.0] for poor physical health, 5.3 [1.4-19.9] for declining physical health, 83.1 [19.7-350.2] for poor mental health, 13.6 [2.9-64.8] for declining mental health). In conclusion, in a cohort of elderly patients with CHB, we demonstrated the heterogeneity and nonlinearity of HRQoL changes and their associations with variations in specific extrahepatic organs/systems.
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Key Words
- 95% CI, 95% confidence interval
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- Aging
- BIC, Bayesian information criterion
- BMI, body mass index
- BP, blood pressure
- CES-D, Center for Epidemiological Studies Depression
- CHB, chronic hepatitis B
- CV, coefficient of variation
- FIB-4, Fibrosis-4 Index for Liver Fibrosis
- Geriatric assessment
- Group-based trajectory modeling
- HALST, Healthy Aging Longitudinal Study in Taiwan
- HBV, hepatitis B virus
- HBsAg, hepatitis B surface antigen
- HOMA-IR, Homeostasis Model Assessment of Insulin Resistance
- HRQoL, health-related quality of life
- Health-related quality of life
- Healthy Aging Longitudinal Study in Taiwan (HALST)
- MCS, Mental Component Summary
- MMSE, Mini-Mental State Examination
- OR, odds ratio
- PCS, Physical Component Summary
- SF-12v2, the Short Form (12) Health Survey version 2
- hsCRP, high-sensitivity C-reactive protein
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Affiliation(s)
- Chang-Hua Chen
- Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan
- Center for Aging and Health, Changhua Christian Hospital, Changhua City, Taiwan
| | - Ming-Shiang Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Yu-Wen Yang
- Center for Aging and Health, Changhua Christian Hospital, Changhua City, Taiwan
- Department of Family Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Yen-Tze Liu
- Center for Aging and Health, Changhua Christian Hospital, Changhua City, Taiwan
- Department of Family Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Yen-Feng Chiu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Shu-Chun Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | | | - Tsung-Lung Tsai
- Puzi Hospital, Ministry of Health and Welfare, Chiayi County, Taiwan
| | | | | | | | - Li-Ming Lien
- Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chao A. Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - I-Chien Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
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Axelsen TM, Vammen TL, Bak M, Pourhadi N, Stenør CM, Grønborg S. Case report: 'AARS2 leukodystrophy'. Mol Genet Metab Rep 2021; 28:100782. [PMID: 34285876 DOI: 10.1016/j.ymgmr.2021.100782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/18/2021] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 12/17/2022] Open
Abstract
Background Mitochondrial alanyl-tRNA synthetase 2 gene (AARS2) related disease is a rare genetic disorder affecting mitochondrial metabolism, leading to severe cardiac disease in infants or progressive leukodystrophy in young adults. The disease is considered ultra-rare with only 39 cases of AARS2-leukodystrophy previously reported. Case presentation We present the case of a young man of consanguineous heritage suffering from cognitive decline and progressive spasticity as well as weakness of the proximal musculature. Utilizing MRI and whole genome sequencing, the patient was diagnosed with a homozygous AARS2 missense variant (NM_020745.3:c.650C > T; p.(Pro217Leu)) and a homozygous CAPN3 variant (NM_000070.2: c.1469G > A; p.(Arg490Gln)), both variants have previously been identified in patients suffering from AARS2 related leukodystrophy and limb-girdle muscular dystrophy, respectively. Conclusions This case report presents a case of homozygous AARS2 leukodystrophy and serves to highlight the importance of whole genome sequencing in diagnosing rare neurological diseases as well as to add to the awareness of adult onset leukodystrophies.
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Key Words
- AARS2
- AARS2, Mitochondrial alanyl-tRNA synthetase 2 gene
- AARS2-L, Mitochondrial alanyl-tRNA synthetase 2 gene leukodystrophy
- ADLs, activities of daily living
- ALSP, Adult-Onset Leukoencephalopathy With Axonal Spheroids and Pigmented Glia
- Adult onset leukodystrophies
- CSF, Cerebrospinal fluid
- CSF1R, Colony stimulating factor-1 receptor
- Case report
- DARS2, Deficiency of aspartyl-tRNA
- EARS2, Deficiency of glutamate-tRNA synthetase
- HDLS, Hereditary Diffuse Leukodystrophy with axonal Spheroids
- IEM, Inborn errors of metabolism
- Inborn errors of metabolism
- LGMD R1, Limb-girdle muscular dystrophy R1 calpain3-related
- Limb-girdle muscular dystrophy
- MMSE, Mini-Mental State Examination
- Mt-aaRS, Mitochondrial aminoacyl-tRNA synthetase
- Whole genome sequencing
- mtDNA, Mitochondrial DNA
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Yamashita K, Kuwashiro T, Ishikawa K, Furuya K, Harada S, Shin S, Wada N, Hirakawa C, Okada Y, Noguchi T. Identification of predictors for mini-mental state examination and revised Hasegawa's Dementia Scale scores using MR-based brain morphometry. Eur J Radiol Open 2021; 8:100359. [PMID: 34095357 PMCID: PMC8167144 DOI: 10.1016/j.ejro.2021.100359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose The early detection of cognitive function decline is crucial to help manage or slow the progression of symptoms. The Mini-Mental State Examination (MMSE) and revised Hasegawa's Dementia Scale (HDS-R) are widely used in screening for cognitive impairment. The purpose of this study was to explore common predictors of the two different cognitive testing systems using MR-based brain morphometry. Materials and Methods This retrospective study included 200 subjects with clinical suspicion of cognitive impairment who underwent 3D T1-weighted MRI at our institution between February 2019 and August 2020. Variables related to the volume of deep gray matter and 70 cortical thicknesses were obtained from the MR images using voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) and FreeSurfer software. The correlation between each variable including age and MMSE/HDS-R scores was evaluated using uni- and multi-variate logistic regression analyses. Results In univariate analysis, parameters include hippocampal volume and bilateral entorhinal cortex (ERC) thickness showed moderate correlation coefficients with both MMSE and HDS-R scores. Multivariate analysis demonstrated the right ERC thickness was the common parameter which significantly correlates with both MMSE and HDS-R scores (p < 0.05). Conclusion Right ERC thickness appears to offer a useful predictive biomarker for both MMSE and HDS-R scores.
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Key Words
- 3D, 3-dimensional
- AD, Alzheimer’s disease
- ApoE, apolipoprotein E
- Cerebral cortex
- ERC, entorhinal cortex
- GM, gray matter
- HDS-R, revised Hasegawa's Dementia Scale
- MMSE, Mini-Mental State Examination
- MPRAGE, magnetization-prepared rapid gradient-echo
- Magnetic resonance imaging
- Mini-Mental State examination
- VOI, voxel of interest
- VSRAD, Voxel-based specific regional analysis system for Alzheimer’s disease
- WM, white matter
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Affiliation(s)
- Koji Yamashita
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Takahiro Kuwashiro
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Kensuke Ishikawa
- Department of Psychiatry, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Kiyomi Furuya
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Shino Harada
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Seitaro Shin
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Noriaki Wada
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Chika Hirakawa
- Department of Medical Technology, Division of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Yasushi Okada
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Tomoyuki Noguchi
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
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van den Brink H, Kopczak A, Arts T, Onkenhout L, Siero JC, Zwanenburg JJ, Duering M, Blair GW, Doubal FN, Stringer MS, Thrippleton MJ, Kuijf HJ, de Luca A, Hendrikse J, Wardlaw JM, Dichgans M, Biessels GJ. Zooming in on cerebral small vessel function in small vessel diseases with 7T MRI: Rationale and design of the "ZOOM@SVDs" study. Cereb Circ Cogn Behav 2021; 2:100013. [PMID: 36324717 PMCID: PMC9616370 DOI: 10.1016/j.cccb.2021.100013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 06/01/2023]
Abstract
Background Cerebral small vessel diseases (SVDs) are a major cause of stroke and dementia. Yet, specific treatment strategies are lacking in part because of a limited understanding of the underlying disease processes. There is therefore an urgent need to study SVDs at their core, the small vessels themselves. Objective This paper presents the rationale and design of the ZOOM@SVDs study, which aims to establish measures of cerebral small vessel dysfunction on 7T MRI as novel disease markers of SVDs. Methods ZOOM@SVDs is a prospective observational cohort study with two years follow-up. ZOOM@SVDs recruits participants with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL, N = 20), sporadic SVDs (N = 60), and healthy controls (N = 40). Participants undergo 7T brain MRI to assess different aspects of small vessel function including small vessel reactivity, cerebral perforating artery flow, and pulsatility. Extensive work-up at baseline and follow-up further includes clinical and neuropsychological assessment as well as 3T brain MRI to assess conventional SVD imaging markers. Measures of small vessel dysfunction are compared between patients and controls, and related to the severity of clinical and conventional MRI manifestations of SVDs. Discussion ZOOM@SVDs will deliver novel markers of cerebral small vessel function in patients with monogenic and sporadic forms of SVDs, and establish their relation with disease burden and progression. These small vessel markers can support etiological studies in SVDs and may serve as surrogate outcome measures in future clinical trials to show target engagement of drugs directed at the small vessels.
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Key Words
- ASL, Arterial Spin Labeling
- BOLD, Blood Oxygenation Level-Dependent
- CADASIL
- CADASIL, Cerebral Autosomal Dominant Arteriopathy with Leukoencephalopathy and Subcortical Infarcts
- CDR, Clinical Dementia Rating scale
- CERAD+, Consortium to Establish a Disease Registry for Alzheimer's Disease Plus battery
- CES-D, Center for Epidemiologic Studies Depression Scale
- CO2, Carbon Dioxide
- CSF, Cerebrospinal Fluid
- Cerebral small vessel disease
- DTI, Diffusion Tensor Imaging
- EPIC, European Prospective Investigation into Cancer and Nutrition
- EtCO2, End-tidal Carbon Dioxide
- FLAIR, Fluid Attenuated Inversion Recovery
- FOV, Field Of View
- FWHM, Full-Width-at-Half-Maximum
- GE, Gradient Echo
- GM, Grey Matter
- GPRS, General Packet Radio Service
- HRF, Hemodynamic Response Function
- High field strength MRI
- LMU, Ludwig-Maximilians-Universität
- MMSE, Mini-Mental State Examination
- NAWM, Normal Appearing White Matter
- NIHSS, National Institute for Health Stroke Scale
- PI, Pulsatility Index
- ROI, Region Of Interest
- SPPB, Short Physical Performance Battery
- SVDs, Small Vessel Diseases
- SWI, Susceptibility Weighted Imaging
- Small vessel function
- Sporadic SVD
- Stroke
- TE, Echo Time
- TI, Inversion Time
- TR, Repetition Time
- TSE, Turbo Spin Echo
- UMCU, University Medical Center Utrecht
- Vmax, Maximum velocity
- Vmean, Mean velocity
- Vmin, Minimum velocity
- WM, White Matter
- WMH, White Matter Hyperintensity
- fMRI, Functional Magnetic Resonance Imaging
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Affiliation(s)
- Hilde van den Brink
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, the Netherlands
| | - Anna Kopczak
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Tine Arts
- Department of Radiology, Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Laurien Onkenhout
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, the Netherlands
| | - Jeroen C.W. Siero
- Department of Radiology, Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
- Spinoza Centre for Neuroimaging Amsterdam, Amsterdam, the Netherlands
| | - Jaco J.M. Zwanenburg
- Department of Radiology, Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marco Duering
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Disease (DZNE), Munich, Germany
| | - Gordon W. Blair
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, UK Dementia Research Institute Centre at the University of Edinburgh, Edinburgh, United Kingdom
| | - Fergus N. Doubal
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, UK Dementia Research Institute Centre at the University of Edinburgh, Edinburgh, United Kingdom
| | - Michael S. Stringer
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, UK Dementia Research Institute Centre at the University of Edinburgh, Edinburgh, United Kingdom
| | - Michael J. Thrippleton
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, UK Dementia Research Institute Centre at the University of Edinburgh, Edinburgh, United Kingdom
| | - Hugo J. Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alberto de Luca
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, the Netherlands
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, UK Dementia Research Institute Centre at the University of Edinburgh, Edinburgh, United Kingdom
| | - Jeroen Hendrikse
- Department of Radiology, Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Joanna M. Wardlaw
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, UK Dementia Research Institute Centre at the University of Edinburgh, Edinburgh, United Kingdom
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Disease (DZNE), Munich, Germany
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, the Netherlands
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Imaoka M, Nakao H, Nakamura M, Tazaki F, Hida M, Omizu T, Imai R, Takeda M. Associations between depressive symptoms and geriatric syndromes in community-dwelling older adults in Japan: A cross-sectional study. Prev Med Rep 2021; 22:101353. [PMID: 33767949 PMCID: PMC7980056 DOI: 10.1016/j.pmedr.2021.101353] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/05/2021] [Accepted: 02/27/2021] [Indexed: 01/12/2023] Open
Abstract
Depressive symptoms are associated with frailty in community-dwelling older adults. AWGS’s new sarcopenia definition is not associated with depressive symptoms. Depressive symptoms may be associated with J-CHS-defined frailty. Among geriatric syndromes, only frailty may be associated with depressive symptoms.
It is estimated that 7.2% of community-dwelling older adults worldwide have major depression. Therefore, this study aimed to investigate the relationship between geriatric syndromes and depressive symptoms. Data were obtained from the Kaizuka Dementia Prevention Study 2018 and 2019, which was a community-based health check conducted in collaboration with the Osaka Kawasaki Rehabilitation University (Kaizuka City Office) and Cognitive Reserve Research Center in Osaka, Japan. The participants comprised 363 older adults (mean age 73.6 ± 6.6 years; women = 75.8%) who participated in a community-based health check. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15). Depressive symptoms were defined as a GDS-15 score of ≥ 5. Furthermore, geriatric syndromes in participants—such as frailty, sarcopenia, and locomotive syndrome—were assessed. There was a 28.1% prevalence of depressive symptoms. In a logistic regression analysis with depressive symptoms as the dependent variable, both pre-frailty (odds ratio [OR] 1.85, 95% confidence interval [CI] 1.09–3.01) and frailty (OR 5.45, 95% CI 2.23–13.31) were found to be significantly higher in the depressive group. There were no significant differences in sarcopenia and locomotive syndrome between the depressive groups. Our findings suggest that depressive symptoms are associated with frailty and pre-frailty in community-dwelling older adults in Japan. Physical frailty should be evaluated in depressed individuals and may contribute to the prioritization of clinical evaluation of geriatric syndromes.
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Affiliation(s)
- Masakazu Imaoka
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan.,Cognitive Reserve Research Center, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan.,Department of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka 583-8555, Japan.,Department of Preventive Gerontology, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Hidetoshi Nakao
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan.,Cognitive Reserve Research Center, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan
| | - Misa Nakamura
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan.,Cognitive Reserve Research Center, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan
| | - Fumie Tazaki
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan.,Cognitive Reserve Research Center, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan
| | - Mitsumasa Hida
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan.,Cognitive Reserve Research Center, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan
| | - Tomoko Omizu
- Department of Rehabilitation, Kansai University of Welfare Sciences. 3-11-1 Asahigaoka, Kasihara, Osaka 582-0026, Japan
| | - Ryota Imai
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan
| | - Masatoshi Takeda
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan.,Cognitive Reserve Research Center, 158 Mizuma, Kaizuka, Osaka 597-0104, Japan
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Kishimoto T, Takamiya A, Liang KC, Funaki K, Fujita T, Kitazawa M, Yoshimura M, Tazawa Y, Horigome T, Eguchi Y, Kikuchi T, Tomita M, Bun S, Murakami J, Sumali B, Warnita T, Kishi A, Yotsui M, Toyoshiba H, Mitsukura Y, Shinoda K, Sakakibara Y, Mimura M; PROMPT collaborators. The project for objective measures using computational psychiatry technology (PROMPT): Rationale, design, and methodology. Contemp Clin Trials Commun 2020; 19:100649. [PMID: 32913919 DOI: 10.1016/j.conctc.2020.100649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/06/2020] [Accepted: 08/16/2020] [Indexed: 01/08/2023] Open
Abstract
Introduction Depressive and neurocognitive disorders are debilitating conditions that account for the leading causes of years lived with disability worldwide. However, there are no biomarkers that are objective or easy-to-obtain in daily clinical practice, which leads to difficulties in assessing treatment response and developing new drugs. New technology allows quantification of features that clinicians perceive as reflective of disorder severity, such as facial expressions, phonic/speech information, body motion, daily activity, and sleep. Methods Major depressive disorder, bipolar disorder, and major and minor neurocognitive disorders as well as healthy controls are recruited for the study. A psychiatrist/psychologist conducts conversational 10-min interviews with participants ≤10 times within up to five years of follow-up. Interviews are recorded using RGB and infrared cameras, and an array microphone. As an option, participants are asked to wear wrist-band type devices during the observational period. Various software is used to process the raw video, voice, infrared, and wearable device data. A machine learning approach is used to predict the presence of symptoms, severity, and the improvement/deterioration of symptoms. Discussion The overall goal of this proposed study, the Project for Objective Measures Using Computational Psychiatry Technology (PROMPT), is to develop objective, noninvasive, and easy-to-use biomarkers for assessing the severity of depressive and neurocognitive disorders in the hopes of guiding decision-making in clinical settings as well as reducing the risk of clinical trial failure. Challenges may include the large variability of samples, which makes it difficult to extract the features that commonly reflect disorder severity. Trial Registration UMIN000021396, University Hospital Medical Information Network (UMIN).
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Key Words
- AMED, Japan Agency for Medical Research and Development
- Adabag, Adaptive Bagging
- Adaboost, Adaptive Boosting
- BD, Bipolar disorder
- BDI-II, Beck Depression Inventory, Second Edition
- BNN, Bayesian Neural Networks
- CDR, Clinical Dementia Rating
- CDT, Clock Drawing Test
- CNN, Convolutional Neural Networks
- CPP, cepstral peak prominence
- DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
- Depression
- F0, fundamental frequency
- F1, F2, F3, first, second, and third formant frequencies
- FedRAMP, Federal Risk and Authorization Management Program
- GCNN, Gated Convolutional Neural Networks
- GDS, Geriatric Depression Scale
- HAM-D, Hamilton Depression Rating Scale
- IEC, International Electrotechnical Commission
- ISO, International Organization for Standardization
- LM, Wechsler Memory Scale-Revised Logical Memory
- LSTM, Long Short-Term Memory Networks
- M.I.N.I., Mini-International Neuropsychiatric Interview
- MADRS, Montgomery-Asberg Depression Rating Scale
- MARS, Motor Agitation and Retardation Scale
- MCI, mild cognitive impairment
- MDD, Major depressive disorder
- MFCC, mel-frequency cepstrum coefficients
- MMSE, Mini-Mental State Examination
- MRI, magnetic resonance imaging
- Machine learning
- MoCA, Montreal Cognitive Assessment
- NPI, Neuropsychiatric Inventory
- Natural language processing
- Neurocognitive disorder
- PET, positron emission tomography
- PROMPT, Project for Objective Measures Using Computational Psychiatry Technology
- PSQI, Pittsburgh Sleep Quality Index
- RF, Random Forest
- RGB, red, green, blue
- SCID, Structural Clinical Interview for DSM-5
- SVM, Support Vector Machine
- SVR, Support Vector Regression
- Screening
- UI, uncertainty interval
- UMIN, University Hospital Medical Information Network
- UV, ultraviolet
- YLDs, years lived with disability
- YMRS, Young Mania Rating Scale
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14
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Concha-Cisternas Y, Lanuza F, Waddell H, Sillars A, Leiva AM, Troncoso C, Martinez MA, Villagrán M, Mardones L, Martorell M, Nazar G, Ulloa N, Labraña AM, Diaz-Martinez X, Sadarangani K, Alvarez C, Ramirez-Campillo R, Garrido-Mendez A, Luarte C, Ho F, Gray SR, Petermann-Rocha F, Celis-Morales C. Association between adiposity levels and cognitive impairment in the Chilean older adult population. J Nutr Sci 2019; 8:e33. [PMID: 31656624 DOI: 10.1017/jns.2019.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 04/04/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 01/30/2023] Open
Abstract
Although both obesity and ageing are risk factors for cognitive impairment, there is no evidence in Chile on how obesity levels are associated with cognitive function. Therefore, the aim of the present study was to investigate the association between adiposity levels and cognitive impairment in older Chilean adults. This cross-sectional study includes 1384 participants, over 60 years of age, from the Chilean National Health Survey 2009-2010. Cognitive impairment was evaluated using the Mini-Mental State Examination. BMI and waist circumference (WC) were used as measures of adiposity. Compared with people with a normal BMI, the odds of cognitive impairment were higher in participants who were underweight (OR 4·44; 95 % CI 2·43, 6·45; P < 0·0001), overweight (OR 1·86; 95 % CI 1·06, 2·66; P = 0·031) and obese (OR 2·26; 95 % CI 1·31, 3·21; P = 0·003). The associations were robust after adjustment for confounding variables. Similar results were observed for WC. Low and high levels of adiposity are associated with an increased likelihood of cognitive impairment in older adults in Chile.
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Liang Y, Chen YK, Liu YL, Mok VCT, Ungvari GS, Chu WCW, Tang WK, Kim JS, Kim JM. Exploring causal pathways linking cerebral small vessel diseases burden to poststroke depressive symptoms with structural equation model analysis. J Affect Disord 2019; 253:218-223. [PMID: 31054447 DOI: 10.1016/j.jad.2019.04.092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/25/2019] [Accepted: 04/21/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cerebral small vessel diseases (SVD) are associated with poststroke depressive symptoms (PDS). The mechanisms underlying the association between SVD burden and PDS are unclear. This study investigated the clinical pathways linking SVD burden to PDS. METHOD A cohort of 563 patients with acute ischemic stroke were examined at three and fifteen months after stroke. PDS was measured with the 15-item Geriatric Depression Scale (GDS). Cognitive and physical functions were assessed with the Mini-Mental State Examination and the modified Rankin Scale, respectively. All patients received MRI scans at baseline. Infarct volumes and the four SVD markers (lacunae, white matter hyperintensities, cerebral microbleeds, and perivascular spaces) were assessed on magnetic resonance imaging. SVD burden was defined as a latent variable encompassing the information about all four SVD markers in structural equation modeling (SEM). SEM was further employed to examine the direct and indirect linking pathways between SVD burden, infarct volumes, stroke severity, poststroke cognitive and physical dysfunctions, and PDS. RESULTS The latent SVD burden was directly associated with more severe PDS at the 3-month follow-up (path coefficient=0.11), while SVD burden and PDS at the 15-month were mainly linked through PDS at the 3-month follow-up (path coefficient=0.48). The volume of acute infarcts and impaired physical functions predominantly mediated the association between SVD burden and PDS at 3-month follow-up. Physical and cognitive functions 15 months after stroke mainly bridged the link between SVD burden and the PDS at the 15-month follow-up. LIMITATIONS The study included patients with mild stroke, which reduced the generalizability of the findings. CONCLUSIONS SVD burden not only directly determines poststroke depressive symptoms, but also worsens acute stroke lesions, stroke severity, and poststroke neurological deficits, thereby contributing further to the development of PDS over the first 15 months after stroke.
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Key Words
- Abbreviations: CFI, Comparative fit index
- Acute ischemic stroke
- CMB, Cerebral microbleeds
- Cerebral small vessel disease
- Depressive symptoms
- EPVS, Enlarged perivascular spaces
- FLAIR, Fluid attenuated inversion recovery
- GDS, Geriatric Depression Scale
- LSNS, Lubben Social Network Scale
- MMSE, Mini-Mental State Examination
- MRI, Magnetic resonance imaging
- NIHSS, National Institutes of Health Stroke Scale
- PDS, Poststroke depressive symptoms
- RMSEA, Root mean square error of approximation
- SEM, Structural equation modelling
- SVD, Small vessel diseases
- Structural equation modeling
- WMH, White matter hyperintensities
- mRS, Modified Rankin Scale
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Affiliation(s)
- Yan Liang
- Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China; Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yang-Kun Chen
- Department of Neurology, Dongguan People's Hospital, Dongguan, Guangdong, China
| | - Yong-Lin Liu
- Department of Neurology, Dongguan People's Hospital, Dongguan, Guangdong, China
| | - Vincent C T Mok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Crawley, Australia
| | - Winnie C W Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wai-Kwong Tang
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
| | - Jong S Kim
- Department of Neurology, Asian Medical Center, University of Ulsan, Seoul, South Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
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Abstract
Decreases in cognitive function related to increases in oxidative stress and inflammation occur with ageing. Acknowledging the free radical-quenching activity and anti-inflammatory action of the carotenoid lycopene, the aim of the present review was to assess if there is evidence for a protective relationship between lycopene and maintained cognitive function or between lycopene and development or progression of dementia. A systematic literature search identified five cross-sectional and five longitudinal studies examining these outcomes in relation to circulating or dietary lycopene. Among four studies evaluating relationships between lycopene and maintained cognition, three reported significant positive relationships. Neither of the two studies reporting on relationship between lycopene and development of dementia reported significant results. Of four studies investigating circulating lycopene and pre-existing dementia, only one reported significant associations between lower circulating lycopene and higher rates of Alzheimer's disease mortality. Acknowledging heterogeneity among studies, there is insufficient evidence and a paucity of data to draw firm conclusions or tease apart direct effects of lycopene. Nevertheless, as low circulating lycopene is a predictor of all-cause mortality, further investigation into its relationship with cognitive longevity and dementia-related mortality is warranted.
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Thakur J, Rathi S, Grover S, Chopra M, Agrawal S, Taneja S, Duseja A, Bhansali A, Chawla YK, Dhiman RK. Tadalafil, a Phosphodiesterase-5 Inhibitor, Improves Erectile Dysfunction in Patients With Liver Cirrhosis. J Clin Exp Hepatol 2019; 9:312-317. [PMID: 31360023 PMCID: PMC6637079 DOI: 10.1016/j.jceh.2018.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/12/2017] [Accepted: 07/11/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Erectile dysfunction(ED) is common in patients with chronic liver disease(CLD). Although it significantly worsens the quality of life, caregivers and researchers often neglect it. AIM Evaluating the prevalence of ED in patients with CLD, associated factors, and response to therapy with tadalafil, a phosphodiesterase-5 inhibitor. METHODS A total of 60 males with Child-Pugh score between 5 and 10 and no overt hepatic encephalopathy were studied. ED was assessed based on the 15-question International Index of Erectile Function (IIEF) questionnaire. Patients were classified as ED+ if score was <25. Patients with ED were given 10 mg of tadalafil for 4 weeks. RESULTS The mean age was 45.2 he 7.8 years. The mean Child-Turcotte-Pugh (CTP) score was 6.4 sc 1.7, and model for end-stage liver disease (MELD) score was 12.1 sc 4.5. Twenty-seven (45%) patients had compensated cirrhosis, and 45(75%) had alcohol as etiology. Twenty-five (42%) had an IIEF score <25, suggestive of ED. The IIEF score had significant correlation with the presence of ascites(r = -0.27, P 0.04) and serum creatinine (r -0.26, P = 0.05); however, there was no correlation with CTP, MELD, or alcohol as etiology. Among ED group, IIEF scores improved significantly with 4 weeks of tadalafil therapy (15.1 ± 5.6 vs 22.0 ± 3.4, P < 0.001), and 11(44%) had resolution of ED. CONCLUSION ED is common in patients with cirrhosis. Tadalafil administration significantly improves ED in these patients.
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Affiliation(s)
- Jitender Thakur
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sahaj Rathi
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Madhu Chopra
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Swastik Agrawal
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sunil Taneja
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Yogesh K. Chawla
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Radha K. Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India,Address for correspondence. Radha K Dhiman, Professor, Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
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18
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Nomoto M, Nagai M, Nishikawa N, Ando R, Kagamiishi Y, Yano K, Saito S, Takeda A. Pharmacokinetics and safety/efficacy of levodopa pro-drug ONO-2160/carbidopa for Parkinson's disease. eNeurologicalSci 2018; 13:8-13. [PMID: 30294682 PMCID: PMC6171046 DOI: 10.1016/j.ensci.2018.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 09/10/2018] [Accepted: 09/15/2018] [Indexed: 11/23/2022] Open
Abstract
We conducted a phase I study investigating the efficacy, safety, and tolerability of ONO-2160, a newly developed levodopa pro-drug, and carbidopa compared with levodopa and carbidopa to stabilize levodopa plasma concentration fluctuations in Japanese patients with Parkinson's disease. In an open-label two-period design, patients (n = 12) with Parkinson's disease received levodopa and carbidopa for 3 days before 7 days of treatment with ONO-2160 and carbidopa. Patients were primarily evaluated using the Unified Parkinson's Disease Rating Scale Part III, a Parkinson's disease symptom diary, and analysis of adverse events. Pharmacokinetic analysis of plasma levodopa concentration was also performed. ONO-2160 and carbidopa therapy stabilized effective plasma levodopa concentration. No adverse events with safety concerns were observed. The combination of ONO-2160 and carbidopa produced a prolonged and stable plasma levodopa concentration with a reduction in Unified Parkinson's Disease Rating Scale Part III total scores. The combination was well tolerated, with no safety concerns, when administered to Japanese patients with Parkinson's disease.
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Key Words
- ADR, adverse drug reactions
- AE, adverse event
- CD, carbidopa
- COMT, catechol-O-methyltransferase
- DDCI, dopa-decarboxylase inhibitor
- Levodopa
- MMSE, Mini-Mental State Examination
- Motor fluctuations
- ONO-2160
- PD, Parkinson's disease
- Parkinson's disease
- SD, standard deviation
- SE, standard error
- UPDRS, Unified Parkinson's Disease Rating Scale
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Affiliation(s)
- Masahiro Nomoto
- Department of Neurology and Clinical Pharmacology, Clinical Research Trial Center, Phase-I Unit, Ehime University Graduate School of Medicine, Tohon, Ehime, Japan
| | - Masahiro Nagai
- Department of Neurology and Clinical Pharmacology, Clinical Research Trial Center, Phase-I Unit, Ehime University Graduate School of Medicine, Tohon, Ehime, Japan
| | - Noriko Nishikawa
- Department of Neurology and Clinical Pharmacology, Clinical Research Trial Center, Phase-I Unit, Ehime University Graduate School of Medicine, Tohon, Ehime, Japan
| | - Rina Ando
- Department of Neurology and Clinical Pharmacology, Clinical Research Trial Center, Phase-I Unit, Ehime University Graduate School of Medicine, Tohon, Ehime, Japan
| | | | - Koji Yano
- Translational Medicine Center, Ono Pharmaceutical Co., Ltd, Osaka, Japan
| | - Shigeto Saito
- Translational Medicine Center, Ono Pharmaceutical Co., Ltd, Osaka, Japan
| | - Atsushi Takeda
- National Hospital Organization, Sendai-Nishitaga Hospital, Sendai, Japan
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Botha H, Utianski RL, Whitwell JL, Duffy JR, Clark HM, Strand EA, Machulda MM, Tosakulwong N, Knopman DS, Petersen RC, Jack CR, Josephs KA, Jones DT. Disrupted functional connectivity in primary progressive apraxia of speech. Neuroimage Clin 2018; 18:617-629. [PMID: 29845010 PMCID: PMC5964833 DOI: 10.1016/j.nicl.2018.02.036] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 02/13/2018] [Accepted: 02/28/2018] [Indexed: 12/12/2022]
Abstract
Apraxia of speech is a motor speech disorder thought to result from impaired planning or programming of articulatory movements. It can be the initial or only manifestation of a degenerative disease, termed primary progressive apraxia of speech (PPAOS). The aim of this study was to use task-free functional magnetic resonance imaging (fMRI) to assess large-scale brain network pathophysiology in PPAOS. Twenty-two PPAOS participants were identified from a prospective cohort of degenerative speech and language disorders patients. All participants had a comprehensive, standardized evaluation including an evaluation by a speech-language pathologist, examination by a behavioral neurologist and a multimodal imaging protocol which included a task-free fMRI sequence. PPAOS participants were age and sex matched to amyloid-negative, cognitively normal participants with a 1:2 ratio. We chose a set of hypothesis driven, predefined intrinsic connectivity networks (ICNs) from a large, out of sample independent component analysis and then used them to initialize a spatiotemporal dual regression to estimate participant level connectivity within these ICNs. Specifically, we evaluated connectivity within the speech and language, face and hand sensorimotor, left working memory, salience, superior parietal, supramarginal, insular and deep gray ICNs in a multivariate manner. The spatial maps for each ICN were then compared between PPAOS and control participants. We used clinical measures of apraxia of speech severity to assess for clinical-connectivity correlations for regions found to differ between PPAOS and control participants. Compared to controls, PPAOS participants had reduced connectivity of the right supplementary motor area and left posterior temporal gyrus to the rest of the speech and language ICN. The connectivity of the right supplementary motor area correlated negatively with an articulatory error score. PPAOS participants also had reduced connectivity of the left supplementary motor area to the face sensorimotor ICN, between the left lateral prefrontal cortex and the salience ICN and between the left temporal-occipital junction and the left working memory ICN. The latter connectivity correlated with the apraxia of speech severity rating scale, although the finding did not survive correction for multiple comparisons. Increased connectivity was noted in PPAOS participants between the dorsal posterior cingulate and the left working memory ICN. Our results support the importance of the supplementary motor area in the pathophysiology of PPAOS, which appears to be disconnected from speech and language regions. Supplementary motor area connectivity may serve as a biomarker of degenerative apraxia of speech severity.
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Key Words
- AES, Articulatory Error Score
- AOS, Apraxia Of Speech
- AQ, Aphasia Quotient
- ASRS, Apraxia of Speech Severity Rating Scale
- Apraxia of speech
- BNT, Boston Naming Test
- FAB, Frontal Assessment Battery
- FBI, Frontal Behavioral Inventory
- Functional connectivity
- ICN, Intrinsic Connectivity Network
- Intrinsic connectivity networks
- MMSE, Mini-Mental State Examination
- NPI-S, Neuropsychiatric Inventory – Severity
- NVOA, Nonverbal Oral Apraxia
- PCC, Posterior Cingulate Cortex
- PFC, Prefrontal Cortex
- PPA, Primary Progressive Aphasia
- SMA, Supplementary Motor Area
- TOJ, Temporal-Occipital Junction
- TT, Token Test
- UPDRS, Unified Parkinson Disease Rating Scale
- WAB, Western Aphasia Battery
- agPPA, Agrammatic/Nonfluent PPA
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Affiliation(s)
- Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States.
| | - Rene L Utianski
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States.
| | | | - Joseph R Duffy
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States.
| | - Heather M Clark
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States.
| | - Edythe A Strand
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States.
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, United States.
| | - Nirubol Tosakulwong
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, United States.
| | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States.
| | - Ronald C Petersen
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States.
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States.
| | - Keith A Josephs
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States.
| | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, United States; Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States.
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20
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Heller J, Mirzazade S, Romanzetti S, Habel U, Derntl B, Freitag NM, Schulz JB, Dogan I, Reetz K. Impact of gender and genetics on emotion processing in Parkinson's disease - A multimodal study. Neuroimage Clin 2018; 18:305-314. [PMID: 29876251 PMCID: PMC5987844 DOI: 10.1016/j.nicl.2018.01.034] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 01/25/2018] [Accepted: 01/28/2018] [Indexed: 01/07/2023]
Abstract
Understanding of the phenotypic heterogeneity of Parkinson's disease is needed. Gender and genetics determine manifestation and progression of Parkinson's disease. Altered emotion processing in Parkinson's disease is specific to male patients. This is influenced by endocrinal and genetic factors in both genders. This finding may impact the diagnosis and treatment of emerging clinical features.
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Key Words
- BAI, Beck anxiety inventory
- BDI-II, Beck depression inventory version II
- BFRT, Benton facial recognition test
- BOLD, blood‑oxygen-level dependent
- COMT, catechol-O-methyltransferase
- EPI, echo planar imaging
- Emotion
- Functional magnetic resonance imaging (fMRI)
- GM, gray matter
- Gender
- Genetics
- H&Y, Hoehn and Yahr rating scale
- HC, healthy controls
- LEDD, levodopa equivalence daily dose
- MCI, mild cognitive impairment
- MMSE, Mini-Mental State Examination
- MRI, magnetic resonance imaging
- MoCA, Montreal Cognitive Assessment
- NMS, non-motor symptoms
- PD, Parkinson's disease
- Parkinson's disease (PD)
- UPDRS, Unified Parkinson's disease rating scale
- VBM, voxel-based morphometry
- fMRI, functional magnetic resonance imaging
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Affiliation(s)
- Julia Heller
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Shahram Mirzazade
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Sandro Romanzetti
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Brain Structure-Function Relationships: Decoding the Human Brain at Systemic Levels, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, Osianderstraße 24, Tübingen, Germany
| | - Nils M Freitag
- II. Institute of Physics B and JARA-FIT, RWTH Aachen University, Otto-Blumenthal-Straße, Aachen, Germany
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Germany.
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Politis M, Wilson H, Wu K, Brooks DJ, Piccini P. Chronic exposure to dopamine agonists affects the integrity of striatal D 2 receptors in Parkinson's patients. Neuroimage Clin 2017; 16:455-460. [PMID: 28879087 PMCID: PMC5577411 DOI: 10.1016/j.nicl.2017.08.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/06/2017] [Accepted: 08/12/2017] [Indexed: 01/27/2023]
Abstract
We aimed to investigate the integrity and clinical relevance of striatal dopamine receptor type-2 (D2R) availability in Parkinson's disease (PD) patients. We studied 68 PD patients, spanning from early to advanced disease stages, and 12 healthy controls. All participants received one [11C]raclopride PET scan in an OFF medication condition for quantification of striatal D2R availability in vivo. Parametric images of [11C]raclopride non-displaceable binding potential were generated from the dynamic [11C]raclopride scans using implementation of the simplified reference tissue model with cerebellum as the reference tissue. PET data were interrogated for correlations with clinical data related to disease burden and dopaminergic treatment. PD patients showed a mean 16.7% decrease in caudate D2R and a mean 3.5% increase in putaminal D2R availability compared to healthy controls. Lower caudate [11C]raclopride BPND correlated with longer PD duration. PD patients on dopamine agonist treatment had 9.2% reduced D2R availability in the caudate and 12.8% in the putamen compared to PD patients who never received treatment with dopamine agonists. Higher amounts of lifetime dopamine agonist therapy correlated with reduced D2Rs availability in both caudate and putamen. No associations between striatal D2R availability and levodopa treatment and dyskinesias were found. In advancing PD the caudate and putamen D2R availability are differentially affected. Chronic exposure to treatment with dopamine agonists, but no levodopa, suppresses striatal D2R availability, which may have relevance to output signaling to frontal lobes and the occurrence of executive deficits, but not dyskinesias. D2R in caudate and putamen are differentially affected in PD. Loss of D2R in caudate correlates with longer disease duration. Dopamine agonists treatment, but not levodopa, suppresses caudate and putamen D2Rs. No association between striatal D2R availability, levodopa treatment and dyskinesia.
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Key Words
- AIMS, Abnormal Involuntary Movement Scale
- BDI-II, Beck Depression Inventory
- BPND, non-displaceable binding potential
- Basal ganglia
- D2R, dopamine receptor type-2
- Dopamine D2 receptors
- Dopamine agonists
- H&Y, Hoehn and Yahr staging
- LED, levodopa-equivalent-dose
- MMSE, Mini-Mental State Examination
- MRI, magnetic resonance imaging
- PD, Parkinson's disease
- PET
- PET, position emission tomography
- Parkinson's disease
- ROI, region of interest
- UPDRS, Unified Parkinson's Disease Rating Scale
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Affiliation(s)
- Marios Politis
- Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Heather Wilson
- Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Kit Wu
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - David J Brooks
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK.,Positron Emission Tomography Center, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Paola Piccini
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
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Kim NY, Lee SC, Shin JC, Park JE, Kim YW. Voxel-based lesion symptom mapping analysis of depressive mood in patients with isolated cerebellar stroke: A pilot study. Neuroimage Clin 2017; 13:39-45. [PMID: 27942446 DOI: 10.1016/j.nicl.2016.11.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/07/2016] [Accepted: 11/11/2016] [Indexed: 12/27/2022]
Abstract
Post-stroke depression (PSD) is the most common neuropsychological sequela of stroke and occurs in approximately one-third of all stroke survivors. However, there are no well-established predictors of PSD. Depression in stroke patients is correlated with unfavorable outcomes. Meta-analyses of the relationship between PSD and lesion location have yielded contradictory results and have not adequately addressed the impact of cerebellar lesions. Furthermore, other brain regions associated with depression in patients with cerebellar stroke remain a matter of debate. For these reasons, this cross-sectional study investigated the relationship between PSD and lesion location in patients with isolated cerebellar stroke. Twenty-four patients in the subacute rehabilitative period following a first-ever isolated cerebellar stroke were enrolled in the study. Depressive mood were evaluated using the Geriatric Depression Scale. Regions of interest were drawn manually on T1-weighted magnetic resonance images using MRIcron software, and data were normalized to a standard brain template in order to examine the neural correlates of depression using voxel-based lesion-symptom mapping analysis. Voxel-wise subtraction and χ (Ayerbe et al., 2014) analyses indicated that damage to the left posterior cerebellar hemisphere was associated with depression. Significant correlations were also found between the severity of depressive symptoms and lesions in lobules VI, VIIb, VIII, Crus I, and Crus II of the left cerebellar hemisphere (Pcorrected = 0.045). Our results suggest that damage to the left posterior cerebellum is associated with increased depressive mood severity in patients with isolated cerebellar stroke. Post-stroke depression (PSD) could be associated with lesion location. The potential role of the cerebellum in the development of PSD has been underexplored. Relationship between lesion location and PSD was investigated in patients with isolated cerebellar stroke. Damage to the left posterior cerebellar hemisphere was significantly associated with PSD.
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Dopper EGP, Chalos V, Ghariq E, den Heijer T, Hafkemeijer A, Jiskoot LC, de Koning I, Seelaar H, van Minkelen R, van Osch MJP, Rombouts SARB, van Swieten JC. Cerebral blood flow in presymptomatic MAPT and GRN mutation carriers: A longitudinal arterial spin labeling study. Neuroimage Clin 2016; 12:460-5. [PMID: 27625986 PMCID: PMC5011170 DOI: 10.1016/j.nicl.2016.08.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 06/25/2016] [Accepted: 08/01/2016] [Indexed: 12/11/2022]
Abstract
Objective Frontotemporal dementia (FTD) is characterized by behavioral disturbances and language problems. Familial forms can be caused by genetic defects in microtubule-associated protein tau (MAPT), progranulin (GRN), and C9orf72. In light of upcoming clinical trials with potential disease-modifying agents, the development of sensitive biomarkers to evaluate such agents in the earliest stage of FTD is crucial. In the current longitudinal study we used arterial spin labeling MRI (ASL) in presymptomatic carriers of MAPT and GRN mutations to investigate early changes in cerebral blood flow (CBF). Methods Healthy first-degree relatives of patients with a MAPT or GRN mutation underwent ASL at baseline and follow-up after two years. We investigated cross-sectional and longitudinal differences in CBF between mutation carriers (n = 34) and controls without a mutation (n = 31). Results GRN mutation carriers showed significant frontoparietal hypoperfusion compared with controls at follow-up, whereas we found no cross-sectional group differences in the total study group or the MAPT subgroup. Longitudinal analyses revealed a significantly stronger decrease in CBF in frontal, temporal, parietal, and subcortical areas in the total group of mutation carriers and the GRN subgroup, with the strongest decrease in two mutation carriers who converted to clinical FTD during follow-up. Interpretation We demonstrated longitudinal alterations in CBF in presymptomatic FTD independent of grey matter atrophy, with the strongest decrease in individuals that developed symptoms during follow-up. Therefore, ASL could have the potential to serve as a sensitive biomarker of disease progression in the presymptomatic stage of FTD in future clinical trials. Longitudinal alterations in cerebral blood flow in presymptomatic FTD Larger decline in cerebral blood flow during conversion to symptomatic FTD Arterial spin labeling might provide a useful biomarker for therapeutic trials.
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Key Words
- AD, Alzheimer's disease
- ASL, arterial spin labeling
- Arterial spin labeling
- BDI-II, Beck Depression inventory II (BDI-II)
- BNT, Boston Naming Test
- CBF, cerebral blood flow
- Cerebral blood flow
- FDG-PET, positron emission tomography with 18F-fluorodeoxyglucose
- FTD, frontotemporal dementia
- Frontotemporal dementia
- GRN, progranulin
- LDST, Letter Digit Substitution Test
- MAPT, microtubule-associated protein tau
- MMSE, Mini-Mental State Examination
- Presymptomatic
- RAVLT, Rey Auditory Verbal Learning Test
- SAT, Semantic Association Test
- TMT, Trailmaking Test
- VAT, Visual Association Test
- WCST, Wisconsin Card Sorting Test
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Affiliation(s)
- Elise G P Dopper
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, VU Medical Center, Amsterdam, The Netherlands
| | - Vicky Chalos
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eidrees Ghariq
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tom den Heijer
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Neurology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Anne Hafkemeijer
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Methodology and Statistics, Institute of Psychology, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Lize C Jiskoot
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neuropsychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Inge de Koning
- Department of Neuropsychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Harro Seelaar
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rick van Minkelen
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Methodology and Statistics, Institute of Psychology, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Clinical Genetics, VU Medical Center, Amsterdam, The Netherlands
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Arai Y, Martin-Ruiz CM, Takayama M, Abe Y, Takebayashi T, Koyasu S, Suematsu M, Hirose N, von Zglinicki T. Inflammation, But Not Telomere Length, Predicts Successful Ageing at Extreme Old Age: A Longitudinal Study of Semi-supercentenarians. EBioMedicine 2015; 2:1549-58. [PMID: 26629551 PMCID: PMC4634197 DOI: 10.1016/j.ebiom.2015.07.029] [Citation(s) in RCA: 185] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/20/2015] [Accepted: 07/22/2015] [Indexed: 11/22/2022] Open
Abstract
To determine the most important drivers of successful ageing at extreme old age, we combined community-based prospective cohorts: Tokyo Oldest Old Survey on Total Health (TOOTH), Tokyo Centenarians Study (TCS) and Japanese Semi-Supercentenarians Study (JSS) comprising 1554 individuals including 684 centenarians and (semi-)supercentenarians, 167 pairs of centenarian offspring and spouses, and 536 community-living very old (85 to 99 years). We combined z scores from multiple biomarkers to describe haematopoiesis, inflammation, lipid and glucose metabolism, liver function, renal function, and cellular senescence domains. In Cox proportional hazard models, inflammation predicted all-cause mortality with hazard ratios (95% CI) 1.89 (1.21 to 2.95) and 1.36 (1.05 to 1.78) in the very old and (semi-)supercentenarians, respectively. In linear forward stepwise models, inflammation predicted capability (10.8% variance explained) and cognition (8(.)6% variance explained) in (semi-)supercentenarians better than chronologic age or gender. The inflammation score was also lower in centenarian offspring compared to age-matched controls with Δ (95% CI) = - 0.795 (- 1.436 to - 0.154). Centenarians and their offspring were able to maintain long telomeres, but telomere length was not a predictor of successful ageing in centenarians and semi-supercentenarians. We conclude that inflammation is an important malleable driver of ageing up to extreme old age in humans.
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Key Words
- ALT, alanine aminotransferase or alanine transaminase
- ANOVA, analysis of variance
- AST, aspartate aminotransferase or aspartate transaminase
- Ageing
- CD, cluster of differentiation
- CMV, cytomegalovirus
- CRP, C-reactive protein
- CVD, cardiovascular disease
- Centenarian
- ELISA, enzyme-linked immunosorbent assay
- GGTP, gamma-glutamyl-transpeptidase
- IL-6, interleukin 6
- IQR, inter-quartile range
- Inflammation
- JSS, Japanese Semi-Supercentenarians Study
- LTL, leukocyte telomere length
- MMSE, Mini-Mental State Examination
- NK cells, natural killer cells
- PCR, polymerase chain reaction
- SD, standard deviation
- TCS, Tokyo Centenarians Study
- TNF-alpha, tumour necrosis factor-alpha (TNF-alpha)
- TOOTH, Tokyo Oldest Old Survey on Total Health
- Telomere
- eGFR, estimated glomerular filtration rate
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Affiliation(s)
- Yasumichi Arai
- Centre for Supercentenarian Research, Keio University School of Medicine, Tokyo, Japan
| | - Carmen M. Martin-Ruiz
- Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle University, UK
| | - Michiyo Takayama
- Centre for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yukiko Abe
- Centre for Supercentenarian Research, Keio University School of Medicine, Tokyo, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Shigeo Koyasu
- Laboratory for Immune Cell Systems, RIKEN Centre for Integrative Medical Sciences (IMS), Yokohama, Kanagawa, Japan
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Suematsu
- Centre for Supercentenarian Research, Keio University School of Medicine, Tokyo, Japan
- Department of Biochemistry, Keio University School of Medicine, and JST, ERATO, Suematsu Gas Biology Project, Tokyo, Japan
| | - Nobuyoshi Hirose
- Centre for Supercentenarian Research, Keio University School of Medicine, Tokyo, Japan
- Correspondence to: N. Hirose, Centre for Supercentenarian Research, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Thomas von Zglinicki
- Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle University, UK
- Correspondence to: T. von Zglinicki, Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.
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25
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Caminiti SP, Canessa N, Cerami C, Dodich A, Crespi C, Iannaccone S, Marcone A, Falini A, Cappa SF. Affective mentalizing and brain activity at rest in the behavioral variant of frontotemporal dementia. Neuroimage Clin 2015; 9:484-97. [PMID: 26594631 DOI: 10.1016/j.nicl.2015.08.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 08/18/2015] [Accepted: 08/19/2015] [Indexed: 12/13/2022]
Abstract
Background bvFTD patients display an impairment in the attribution of cognitive and affective states to others, reflecting GM atrophy in brain regions associated with social cognition, such as amygdala, superior temporal cortex and posterior insula. Distinctive patterns of abnormal brain functioning at rest have been reported in bvFTD, but their relationship with defective attribution of affective states has not been investigated. Objective To investigate the relationship among resting-state brain activity, gray matter (GM) atrophy and the attribution of mental states in the behavioral variant of fronto-temporal degeneration (bvFTD). Methods We compared 12 bvFTD patients with 30 age- and education-matched healthy controls on a) performance in a task requiring the attribution of affective vs. cognitive mental states; b) metrics of resting-state activity in known functional networks; and c) the relationship between task-performances and resting-state metrics. In addition, we assessed a connection between abnormal resting-state metrics and GM atrophy. Results Compared with controls, bvFTD patients showed a reduction of intra-network coherent activity in several components, as well as decreased strength of activation in networks related to attentional processing. Anomalous resting-state activity involved networks which also displayed a significant reduction of GM density. In patients, compared with controls, higher affective mentalizing performance correlated with stronger functional connectivity between medial prefrontal sectors of the default-mode and attentional/performance monitoring networks, as well as with increased coherent activity in components of the executive, sensorimotor and fronto-limbic networks. Conclusions Some of the observed effects may reflect specific compensatory mechanisms for the atrophic changes involving regions in charge of affective mentalizing. The analysis of specific resting-state networks thus highlights an intermediate level of analysis between abnormal brain structure and impaired behavioral performance in bvFTD, reflecting both dysfunction and compensation mechanisms. bvFTD patients are impaired in the attribution of mental states to others (theory of mind, ToM). bvFTD patients' ToM deficit involves mainly the attribution of affective states. Affective ToM deficits in bvFTD reflect gray matter atrophy in frontolimbic areas. Affective ToM deficits in bvFTD reflect altered frontomedial resting-state activity. Brain activity at rest reflects both dysfunction and compensation mechanisms in bvFTD.
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Key Words
- AD, Alzheimer's disease
- Affective mentalizing
- BOLD, blood-oxygen-level-dependent
- Behavioral variant of frontotemporal dementia
- CI, causal inferences
- Default mode network
- EA, emotion attribution
- Executive functioning network
- FDR, false discovery rate
- FTLD, frontotemporal lobar degeneration
- GM, gray matter
- IA, intention attribution
- MANCOVAN, multivariate analysis of covariance
- MMSE, Mini-Mental State Examination
- PCA, principal component analysis
- RSNs, resting-state networks
- Resting state functional MRI
- SET, story-based empathy task
- SPM, statistical parametric mapping
- ToM, theory of mind
- VBM, voxel based morphometry
- aDMN, anterior default mode network
- bvFTD, behavioral variant of frontotemporal dementia
- gICA, group independent component analysis
- pDMN, posterior default mode network
- rs-fMRI, resting-state fMRI
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Haris M, Yadav SK, Rizwan A, Singh A, Cai K, Kaura D, Wang E, Davatzikos C, Trojanowski JQ, Melhem ER, Marincola FM, Borthakur A. T1rho MRI and CSF biomarkers in diagnosis of Alzheimer's disease. Neuroimage Clin 2015; 7:598-604. [PMID: 25844314 PMCID: PMC4375645 DOI: 10.1016/j.nicl.2015.02.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 02/22/2015] [Accepted: 02/23/2015] [Indexed: 01/14/2023]
Abstract
In the current study, we have evaluated the performance of magnetic resonance (MR) T1rho (T1ρ) imaging and CSF biomarkers (T-tau, P-tau and Aβ-42) in characterization of Alzheimer's disease (AD) patients from mild cognitive impairment (MCI) and control subjects. With informed consent, AD (n = 27), MCI (n = 17) and control (n = 17) subjects underwent a standardized clinical assessment and brain MRI on a 1.5-T clinical-scanner. T1ρ images were obtained at four different spin-lock pulse duration (10, 20, 30 and 40 ms). T1ρ maps were generated by pixel-wise fitting of signal intensity as a function of the spin-lock pulse duration. T1ρ values from gray matter (GM) and white matter (WM) of medial temporal lobe were calculated. The binary logistic regression using T1ρ and CSF biomarkers as variables was performed to classify each group. T1ρ was able to predict 77.3% controls and 40.0% MCI while CSF biomarkers predicted 81.8% controls and 46.7% MCI. T1ρ and CSF biomarkers in combination predicted 86.4% controls and 66.7% MCI. When comparing controls with AD, T1ρ predicted 68.2% controls and 73.9% AD, while CSF biomarkers predicted 77.3% controls and 78.3% for AD. Combination of T1ρ and CSF biomarkers improved the prediction rate to 81.8% for controls and 82.6% for AD. Similarly, on comparing MCI with AD, T1ρ predicted 35.3% MCI and 81.9% AD, whereas CSF biomarkers predicted 53.3% MCI and 83.0% AD. Collectively CSF biomarkers and T1ρ were able to predict 59.3% MCI and 84.6% AD. On receiver operating characteristic analysis T1ρ showed higher sensitivity while CSF biomarkers showed greater specificity in delineating MCI and AD from controls. No significant correlation between T1ρ and CSF biomarkers, between T1ρ and age, and between CSF biomarkers and age was observed. The combined use of T1ρ and CSF biomarkers have promise to improve the early and specific diagnosis of AD. Furthermore, disease progression form MCI to AD might be easily tracked using these two parameters in combination. Increased T1rho was observed in MCI and AD compared to controls. Increased T-tau and P-tau and decreased Aβ1-42 were observed in MCI and AD. Combined biomarkers have promise to improve early and specific diagnosis of AD. MCI to AD progression might be tracked using these two biomarkers in combination.
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Key Words
- AD, Alzheimer's disease
- Alzheimer's disease
- Aβ1-42, amyloid beta 42
- CSF biomarkers
- CSF, cerebrospinal fluid
- FOV, field of view
- GM, gray matter
- MCI, mild cognitive impairment
- MMSE, Mini-Mental State Examination
- MPRAGE, magnetization prepared rapid acquisition gradient-echo
- MRI, magnetic resonance imaging
- MTL, medial temporal lobe
- Medial temporal lobe
- Mild cognitive impairment
- PET, positron emission tomography
- ROC, receiver operating characteristic.
- T-tau, total tau
- T1rho
- T1ρ, T1rho
- TE, echo time
- TI, inversion time
- TR, repetition time
- TSL, total spin lock
- WM, white matter
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Affiliation(s)
- Mohammad Haris
- Research Branch, Sidra Medical and Research Center, Doha, Qatar ; Center for Magnetic Resonance and Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Santosh K Yadav
- Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Arshi Rizwan
- All India Institute of Medical Science, Ansari Nagar East, New Delhi, Delhi 110029, India
| | - Anup Singh
- Center for Magnetic Resonance and Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA ; Center for Biomedical Engineering, Indian institute of Technology, New Delhi, India
| | - Kejia Cai
- Center for Magnetic Resonance and Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA ; Center for Magnetic Resonance Research, Radiology Department, University of Illinois at Chicago, IL, USA
| | - Deepak Kaura
- Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Ena Wang
- Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Christos Davatzikos
- Section of Biomedical Image Analysis, University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology & Lab Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elias R Melhem
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Arijitt Borthakur
- Center for Magnetic Resonance and Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
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Apostolova LG, Hwang KS, Kohannim O, Avila D, Elashoff D, Jack CR, Shaw L, Trojanowski JQ, Weiner MW, Thompson PM. ApoE4 effects on automated diagnostic classifiers for mild cognitive impairment and Alzheimer's disease. Neuroimage Clin 2014; 4:461-72. [PMID: 24634832 PMCID: PMC3952354 DOI: 10.1016/j.nicl.2013.12.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 12/24/2013] [Accepted: 12/24/2013] [Indexed: 01/30/2023]
Abstract
Biomarkers are the only feasible way to detect and monitor presymptomatic Alzheimer's disease (AD). No single biomarker can predict future cognitive decline with an acceptable level of accuracy. In addition to designing powerful multimodal diagnostic platforms, a careful investigation of the major sources of disease heterogeneity and their influence on biomarker changes is needed. Here we investigated the accuracy of a novel multimodal biomarker classifier for differentiating cognitively normal (NC), mild cognitive impairment (MCI) and AD subjects with and without stratification by ApoE4 genotype. 111 NC, 182 MCI and 95 AD ADNI participants provided both structural MRI and CSF data at baseline. We used an automated machine-learning classifier to test the ability of hippocampal volume and CSF Aβ, t-tau and p-tau levels, both separately and in combination, to differentiate NC, MCI and AD subjects, and predict conversion. We hypothesized that the combined hippocampal/CSF biomarker classifier model would achieve the highest accuracy in differentiating between the three diagnostic groups and that ApoE4 genotype will affect both diagnostic accuracy and biomarker selection. The combined hippocampal/CSF classifier performed better than hippocampus-only classifier in differentiating NC from MCI and NC from AD. It also outperformed the CSF-only classifier in differentiating NC vs. AD. Our amyloid marker played a role in discriminating NC from MCI or AD but not for MCI vs. AD. Neurodegenerative markers contributed to accurate discrimination of AD from NC and MCI but not NC from MCI. Classifiers predicting MCI conversion performed well only after ApoE4 stratification. Hippocampal volume and sex achieved AUC = 0.68 for predicting conversion in the ApoE4-positive MCI, while CSF p-tau, education and sex achieved AUC = 0.89 for predicting conversion in ApoE4-negative MCI. These observations support the proposed biomarker trajectory in AD, which postulates that amyloid markers become abnormal early in the disease course while markers of neurodegeneration become abnormal later in the disease course and suggests that ApoE4 could be at least partially responsible for some of the observed disease heterogeneity. Multimodal classifiers have better predictive power than unimodal classifier. ApoE4 significantly affects diagnostic discriminability in the MCI and dementia stages. Our data supports the hypothesized biomarker trajectory in AD.
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Key Words
- AD, Alzheimer's disease
- ADNI
- ADNI, Alzheimer's Disease Neuroimaging Initiative
- AUC, area under the curve
- Abeta
- Alzheimer's disease
- ApoE, apolipoprotein E
- Aβ, Amyloid beta
- Aβ42, Amyloid beta with 42 amino acid residues
- CSF, cerebrospinal fluid
- Diagnosis
- Hippocampus atrophy
- ICBM, International Consortium for Brain Mapping
- MCI, mild cognitive impairment
- MCIc, MCI converters
- MCInc, MCI nonconverters
- MMSE, Mini-Mental State Examination
- NC, normal control
- ROC, receiver operating curve
- SVM, support vector machine
- Tau
- p-tau, phosphorylated tau protein
- t-tau, total tau protein
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Affiliation(s)
- Liana G Apostolova
- Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Kristy S Hwang
- Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Omid Kohannim
- Imaging genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, USA
| | - David Avila
- Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - David Elashoff
- Department of Medicine Statistics Core, UCLA, Los Angeles, CA, USA
| | - Clifford R Jack
- Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN, USA
| | - Leslie Shaw
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Michael W Weiner
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA ; Department of Veteran's Affairs Medical Center, San Francisco, CA, USA
| | - Paul M Thompson
- Imaging genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, USA
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28
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Woost TB, Dukart J, Frisch S, Barthel H, Sabri O, Mueller K, Schroeter ML. Neural correlates of the DemTect in Alzheimer's disease and frontotemporal lobar degeneration - A combined MRI & FDG-PET study. Neuroimage Clin 2013; 2:746-58. [PMID: 24179826 PMCID: PMC3777755 DOI: 10.1016/j.nicl.2013.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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: 12/12/2012] [Revised: 05/08/2013] [Accepted: 05/14/2013] [Indexed: 11/21/2022]
Abstract
Valid screening devices are critical for an early diagnosis of dementia. The DemTect is such an internationally accepted tool. We aimed to characterize the neural networks associated with performance on the DemTect's subtests in two frequent dementia syndromes: early Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD). Voxel-based group comparisons of cerebral glucose utilization (as measured by F-18-fluorodeoxyglucose positron emission tomography) and gray matter atrophy (as measured by structural magnetic resonance imaging) were performed on data from 48 subjects with AD (n = 21), FTLD (n = 14) or subjective cognitive impairment (n = 13) as a control group. We performed group comparisons and correlation analyses between multimodal imaging data and performance on the DemTect's subtests. Group comparisons showed regional patterns consistent with previous findings for AD and FTLD. Interestingly, atrophy dominated in FTLD, whereas hypometabolism in AD. Across diagnostic groups performance on the "wordlist" subtest was positively correlated with glucose metabolism in the left temporal lobe. The "number transcoding" subtest was significantly associated with glucose metabolism in both a predominantly left lateralized frontotemporal network and a parietooccipital network including parts of the basal ganglia. Moreover, this subtest was associated with gray matter density in an extensive network including frontal, temporal, parietal and occipital areas. No significant correlates were observed for the "supermarket task" subtest. Scores on the "digit span reverse" subtest correlated with glucose metabolism in the left frontal cortex, the bilateral putamen, the head of caudate nucleus and the anterior insula. Disease-specific correlation analyses could partly verify or extend the correlates shown in the analyses across diagnostic groups. Correlates of gray matter density were found in FTLD for the "number transcoding" subtest and the "digit span reverse" subtest. Correlates of glucose metabolism were found in AD for the "wordlist" subtest and in FTLD for the "digit span reverse" subtest. Our study contributes to the understanding of the neural correlates of cognitive deficits in AD and FTLD and supports an external validation of the DemTect providing preliminary conclusions about disease-specific correlates.
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Key Words
- AD, Alzheimer's disease
- ANOVA, Analysis of variance
- Alzheimer's disease
- BA, Brodmann area
- CDR, Clinical dementia rating scale
- DARTEL, Diffeomorphic anatomical registration through exponentiated lie algebra
- DemTect
- FDG-PET
- FDG-PET, F-18-fluorodeoxyglucose positron emission tomography
- FTLD, Frontotemporal lobar degeneration
- Frontotemporal lobar degeneration
- MMSE, Mini-Mental State Examination
- MNI, Montreal Neurological Institute
- MRI
- MRI, Magnetic resonance imaging
- PVE, Partial volume effects
- SPM, Statistical parametric mapping
- Voxel based morphometry
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Affiliation(s)
- Timo B. Woost
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, University Hospital of Leipzig, Leipzig, Germany
| | - Juergen Dukart
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- LIFE — Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
- LREN, Département des Neurosciences Cliniques, CHUV, Université de Lausanne, Lausanne, Switzerland
| | - Stefan Frisch
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Henryk Barthel
- LIFE — Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Osama Sabri
- LIFE — Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Karsten Mueller
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Matthias L. Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- LIFE — Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
- Clinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany
- German Consortium for Frontotemporal Lobar Degeneration
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