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Sabaei M, Rahimian S, Haj Mohamad Ebrahim Ketabforoush A, Rasoolijazi H, Zamani B, Hajiakhoundi F, Soleimani M, Shahidi G, Faramarzi M. Salivary levels of disease-related biomarkers in the early stages of Parkinson's and Alzheimer's disease: A cross-sectional study. IBRO Neurosci Rep 2023; 14:285-292. [PMID: 36942319 PMCID: PMC10023984 DOI: 10.1016/j.ibneur.2023.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/06/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction Finding a non-invasive and repeatable tool has been recommended to make an accurate diagnosis of Alzheimer's disease (AD) and Parkinson's disease (PD). Methods 70 volunteers participated in three groups: 24 with mild dementia of AD, 24 in the first and second stages of PD, and 22 healthy controls. After valuing the scores of cognitive tests, the salivary levels of phosphorylated tau (p-tau), total alpha-synuclein (α-syn), and beta-amyloid 1-42 (Aβ) proteins have been evaluated. Finally, the cutoff points, receiver operating characteristic (ROC), sensitivity, and specificity have been calculated to find accurate and detectable biomarkers. Results Findings showed that the salivary level of Aβ was higher in both PD (p < 0.01) and AD (p < 0.001) patients than in controls. Moreover, the level of α-syn in both PD and AD patients was similarly lower than in controls (p < 0.05). However, the level of p-tau was only higher in the AD group than in the control (p < 0.01). Salivary Aβ 1-42 level at a 60.3 pg/ml cutoff point revealed an excellent performance for diagnosing AD (AUC: 0.81). Conclusion Evaluation of p-tau, α-syn, and Aβ 1-42 levels in the saliva of AD and PD patients could help the early diagnosis. The p-tau level might be valuable for differentiation between AD and PD. Therefore, these hopeful investigations could be done to reduce the usage of invasive diagnostic methods, which alone is a success in alleviating the suffering of AD and PD patients. Moreover, introducing accurate salivary biomarkers according to the pathophysiology of AD and PD should be encouraged.
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Key Words
- AD, Alzheimer's disease
- Alzheimer's disease
- Aβ, Beta-amyloid 1–42
- BDRS, Blessed Dementia Rating Scale
- Beta-amyloid
- CSF, Cerebrospinal fluid
- CT scan, Computed tomography scan
- ELISA, Enzyme-linked immunosorbent assay
- MDS-UPDRS, MDS-Unified Parkinson’s Disease Rating Scale
- MMSE, MCI (mild cognitive impairment mini-mental state examination
- MRI, Magnetic resonance imaging
- MoCA, Montreal Cognitive Assessment
- NFTs, Neurofibrillary Tangles
- NIA-AA, National Institute on Aging-Alzheimer’s Association
- PD, Parkinson's disease
- Parkinson's disease
- Phosphorylated tau
- ROC, Receiver operating characteristic
- Total alpha-synuclein
- p-tau, Phosphorylated tau
- α-syn, Total alpha-synuclein
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Affiliation(s)
- Masoomeh Sabaei
- Anatomy Department, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Cellular & Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saba Rahimian
- Dentistry School, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Homa Rasoolijazi
- Anatomy Department, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Cellular & Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Babak Zamani
- Neurology Department, Rasool Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Fahime Hajiakhoundi
- Neurology Department, Rasool Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mansoureh Soleimani
- Anatomy Department, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Cellular & Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Gholamali Shahidi
- Neurology Department, Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mahmood Faramarzi
- Research center of pediatric infectious diseases, institute of immunology and infectious diseases, Rasool Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
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Wei HL, Ao MQ, Wang MY, Zhou GP, Yu YS, Tao Q, Zhang H. Disrupted resting-state functional connectivity of the thalamus in patients with coronary heart disease. Heliyon 2023; 9:e13423. [PMID: 36814614 PMCID: PMC9939614 DOI: 10.1016/j.heliyon.2023.e13423] [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: 08/26/2022] [Revised: 12/17/2022] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Background Although homeostasis of the cardiovascular system is regulated by the cerebral cortex via the autonomic nervous system, the role of abnormal brain functional connectivity (FC) networks in patients with cardiac dysfunction remains unclear. Here, we report thalamus-based FC alterations and their relationship with clinical characteristics in patients with coronary heart disease (CHD). Methods We employed resting-state functional magnetic resonance imaging (rs-fMRI) to acquire imaging data in twenty-six patients with CHD alongside sixteen healthy controls (HCs). Next, we performed a thalamus-based FC analysis to profile abnormal FC patterns in the whole brain. Subsequently, the mean time series of the brain regions that survived in the FC analysis were used to determine correlations with clinical parameters in patients with CHD. Results We found no statistically significant differences in demographic and clinical data between patients with CHD and HCs. Patients with CHD showed decreased FC patterns between bilateral thalami and left hemisphere, encompassing supplementary motor area, superior frontal gyrus, superior parietal gyrus, inferior parietal gyrus, middle cingulate cortex, lingual gyrus and calcarine sulcus. Conclusions These findings not only have implications in clarifying the relationship between cerebral functional imbalance and cardiovascular system, but also provide valuable insights to guide future evaluation and management of cardiac autonomic regulation via the brain-heart axis.
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Key Words
- ANS, autonomic nervous system
- CHD, coronary heart disease
- CNS, central nervous system
- CVD, cardiovascular disease
- Coronary heart disease
- DMN, default mode network
- ECN, executive control network
- FC, functional connectivity
- Functional connectivity analysis
- Functional magnetic resonance imaging
- IPG, inferior parietal gyrus
- MCC, middle cingulate cortex
- MCI, myocardial ischemia
- MoCA, Montreal Cognitive Assessment
- Resting-state
- Rs-fMRI, resting-state functional magnetic resonance imaging
- SFG, superior frontal gyrus
- SMA, supplementary motor area
- SMN, sensorimotor network
- SN, salient network
- SNS, sympathetic nervous system
- SPG, superior parietal gyrus
- Thalamus
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Affiliation(s)
- Heng-Le Wei
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu 211100, China
| | - Ming-Qiang Ao
- Department of Cardiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu 211100, China
| | - Meng-Yao Wang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu 211100, China
| | - Gang-Ping Zhou
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu 211100, China
| | - Yu-Sheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu 211100, China
| | - Qin Tao
- Department of Cardiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu 211100, China,Corresponding author.
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu 211100, China,Corresponding author. Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No. 169, Hushan Road, Nanjing, Jiangsu Province, 211100, China.
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Hartung TJ, Neumann C, Bahmer T, Chaplinskaya-Sobol I, Endres M, Geritz J, Haeusler KG, Heuschmann PU, Hildesheim H, Hinz A, Hopff S, Horn A, Krawczak M, Krist L, Kudelka J, Lieb W, Maetzler C, Mehnert-Theuerkauf A, Montellano FA, Morbach C, Schmidt S, Schreiber S, Steigerwald F, Störk S, Maetzler W, Finke C. Fatigue and cognitive impairment after COVID-19: A prospective multicentre study. EClinicalMedicine 2022; 53:101651. [PMID: 36133318 PMCID: PMC9482331 DOI: 10.1016/j.eclinm.2022.101651] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/16/2022] [Accepted: 08/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Reliable estimates of frequency, severity and associated factors of both fatigue and cognitive impairment after COVID-19 are needed. Also, it is not clear whether the two are distinct sequelae of COVID-19 or part of the same syndrome." METHODS In this prospective multicentre study, frequency of post-COVID fatigue and cognitive impairment were assessed in n = 969 patients (535 [55%] female) ≥6 months after SARS-CoV-2 infection with the FACIT-Fatigue scale (cut-off ≤30) and Montreal Cognitive Assessment (≤25 mild, ≤17 moderate impairment) between November 15, 2020 and September 29, 2021 at University Medical Center Schleswig-Holstein, Campus Kiel and University Hospital Würzburg in Germany. 969 matched non-COVID controls were drawn from a pre-pandemic, randomised, Germany-wide population survey which also included the FACIT-Fatigue scale. Associated sociodemographic, comorbid, clinical, psychosocial factors and laboratory markers were identified with univariate and multivariable linear regression models. FINDINGS On average 9 months after infection, 19% of patients had clinically relevant fatigue, compared to 8% of matched non-COVID controls (p < 0.001). Factors associated with fatigue were female gender, younger age, history of depression and the number of acute COVID symptoms. Among acute COVID symptoms, altered consciousness, dizziness and myalgia were most strongly associated with long-term fatigue. Moreover, 26% of patients had mild and 1% had moderate cognitive impairment. Factors associated with cognitive impairment were older age, male gender, shorter education and a history of neuropsychiatric disease. There was no significant correlation between fatigue and cognitive impairment and only 5% of patients suffered from both conditions. INTERPRETATION Fatigue and cognitive impairment are two common, but distinct sequelae of COVID-19 with potentially separate pathophysiological pathways. FUNDING German Federal Ministry of Education and Research (BMBF).
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Key Words
- CI, confidence interval
- COVID-19
- COVID-19, Coronavirus Disease 2019
- CRP, C-reactive protein
- CSF, cerebrospinal fluid
- Cognitive dysfunction
- Fatigue
- GAD-7, 7-item anxiety screening questionnaire
- MoCA, Montreal Cognitive Assessment
- NAPKON, National Pandemic Cohort Network
- PCR, polymerase chain reaction
- PHQ-8, 8-item depression module of the Patient Health Questionnaire
- PSQI, Pittsburgh Sleep Quality Index
- Post-acute COVID-19 syndrome
- SARS-CoV-2
- SARS-CoV-2, Severe Acute Respiratory Distress Syndrome caused by Corona Virus 2
- VIF, variance inflation factor
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Affiliation(s)
- Tim J. Hartung
- Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Christian Neumann
- Neurology Department, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Thomas Bahmer
- Internal Medicine Department I, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
- Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
| | | | - Matthias Endres
- Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Center for Stroke Research Berlin, Berlin, Germany
- Excellence Cluster NeuroCure, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Germany
| | - Johanna Geritz
- Neurology Department, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - Peter U. Heuschmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Clinical Trial Center, University Hospital Würzburg, Würzburg, Germany
| | - Hanna Hildesheim
- Neurology Department, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Sina Hopff
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne, Duesseldorf, Germany
| | - Anna Horn
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Michael Krawczak
- Institute of Medical Informatics and Statistics, Kiel University, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jennifer Kudelka
- Neurology Department, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Kiel University, Kiel, Germany
| | - Corina Maetzler
- Neurology Department, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Felipe A. Montellano
- Department of Neurology, Universitätsklinikum Würzburg, Würzburg, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany
| | - Caroline Morbach
- University Hospital Würzburg, Department for Medicine I and Comprehensive Heart Failure Center, Würzburg, Germany
| | - Sein Schmidt
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Clinical Study Center, Berlin, Germany
| | - Stefan Schreiber
- Universitätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Klinik für Innere Medizin I, Kiel, Germany
| | - Flo Steigerwald
- Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Störk
- Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Walter Maetzler
- Neurology Department, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Carsten Finke
- Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Corresponding author at: Department of Neurology, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
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Ferini G, Viola A, Valenti V, Tripoli A, Molino L, Marchese VA, Illari SI, Rita Borzì G, Prestifilippo A, Umana GE, Martorana E, Mortellaro G, Ferrera G, Cacciola A, Lillo S, Pontoriero A, Pergolizzi S, Parisi S. Whole Brain Irradiation or Stereotactic RadioSurgery for five or more brain metastases (WHOBI-STER): A prospective comparative study of neurocognitive outcomes, level of autonomy in daily activities and quality of life. Clin Transl Radiat Oncol 2021; 32:52-58. [PMID: 34926839 PMCID: PMC8649107 DOI: 10.1016/j.ctro.2021.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 02/07/2023] Open
Abstract
The main aim of MBM treatment is to palliate neurological symptoms and to maintain an adequate QoL. SRT could be the “new standard” over WBI in the management of MBM patients. Neurocognitive functions could deteriorate more after WBI than after SRT.
Aims To evaluate neurocognitive performance, daily activity and quality of life (QoL), other than usual oncologic outcomes, among patients with brain metastasis ≥5 (MBM) from solid tumors treated with Stereotactic Brain Irradiation (SBI) or Whole Brain Irradiation (WBI). Methods This multicentric randomized controlled trial will involve the enrollment of 100 patients (50 for each arm) with MBM ≥ 5, age ≥ 18 years, Karnofsky Performance Status (KPS) ≥ 70, life expectancy > 3 months, known primary tumor, with controlled or controllable extracranial disease, baseline Montreal Cognitive Assessment (MoCA) score ≥ 20/30, Barthel Activities of Daily Living score ≥ 90/100, to be submitted to SBI by LINAC with monoisocentric technique and non-coplanar arcs (experimental arm) or to WBI (control arm). The primary endpoints are neurocognitive performance, QoL and autonomy in daily-life activities variations, the first one assessed by MoCa Score and Hopkins Verbal Learning Test-Revised, the second one through the EORTC QLQ-C15-PAL and QLQ-BN-20 questionnaires, the third one through the Barthel Index, respectively. The secondary endpoints are time to intracranial failure, overall survival, retreatment rate, acute and late toxicities, changing of KPS. It will be considered significant a statistical difference of at least 30% between the two arms (statistical power of 80% with a significance level of 95%). Discussion Several studies debate what is the decisive factor accountable for the development of neurocognitive decay among patients undergoing brain irradiation for MBM: radiation effect on clinically healthy brain tissue or intracranial tumor burden? The answer to this question may come from the recent technological advancement that allows, in a context of a significant time saving, improved patient comfort and minimizing radiation dose to off-target brain, a selective treatment of MBM simultaneously, otherwise attackable only by WBI. The achievement of a local control rate comparable to that obtained with WBI remains the fundamental prerequisite. Trial registration NCT number: NCT04891471.
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Key Words
- 3D-CRT, 3Dimensional-ConformalRadioTherapy
- Autonomy in daily activities
- BSC, Best Supportive Care
- Brain metastases
- CRF, Case Report Form
- CT, Computerized Tomography
- CTV, Clinical Target Volume
- EORTC QLQ-C15-PAL, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 for Palliative Care
- FSRT, Fractionated Stereotactic Radiation Therapy
- GTV, Gross Tumor Volume
- KPS, Karnofsky Performance Status
- LINAC, Linear Accelerator
- MBM, Multiple Brain Metastastes
- MRI, Magnetic Resonance Imaging
- MoCA, Montreal Cognitive Assessment
- NCCN, National Comprehensive Cancer Network
- Neurocognitive decay
- Neurocognitive performance
- Neurocognitive tests
- OAR, Organ At Risk
- OS, Overall Survival
- PTV, Planning Target Volume
- Palliative care
- QLQ-BN20, Quality of Life Questionnaire - Brain Neoplasm 20
- QoL, Quality of Life
- Quality of life
- RT, Radiation Therapy
- RTOG, Radiation Therapy Oncology Group
- Radiotherapy for multiple brain metastases
- SBI, Stereotactic Brain Irradiation
- SRS, Stereotactic RadioSurgery
- SRT, Stereotactic Radiation Therapy
- Stereotactic Brain RadioSurgery
- Stereotactic Brain Radiotherapy
- Supportive care in cancer patients
- VEGF, Vascular Endothelial Growth Factor
- Whole Brain Radiotherapy
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Affiliation(s)
| | - Anna Viola
- Fondazione IOM, Viagrande, I-95029 Catania, Italy
| | - Vito Valenti
- REM Radioterapia srl, Viagrande, I-95029 Catania, Italy
| | | | - Laura Molino
- Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali Università di Messina, I-98100 Messina, Italy
| | | | | | | | - Angela Prestifilippo
- Medical Oncology Unit, Mediterranean Institute of Oncology, Viagrande, I-95029 Catania, Italy
| | - Giuseppe Emmanuele Umana
- Trauma Center, Gamma Knife Center, Department of Neurosurgery, Cannizzaro Hospital, I-95125 Catania, Italy
| | | | - Gianluca Mortellaro
- Department of Radiation Oncology, ARNAS Ospedale Civico, I-90127 Palermo, Italy
| | - Giuseppe Ferrera
- Department of Radiation Oncology, ARNAS Ospedale Civico, I-90127 Palermo, Italy
| | - Alberto Cacciola
- Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali Università di Messina, I-98100 Messina, Italy
| | - Sara Lillo
- Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali Università di Messina, I-98100 Messina, Italy
| | - Antonio Pontoriero
- Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali Università di Messina, I-98100 Messina, Italy
| | - Stefano Pergolizzi
- Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali Università di Messina, I-98100 Messina, Italy
| | - Silvana Parisi
- Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali Università di Messina, I-98100 Messina, Italy
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Ogura H, Hatip-Al-Khatib I, Suenaga M, Hatip FB, Mishima T, Fujioka S, Ouma S, Matsunaga Y, Tsuboi Y. Circulatory 25(OH)D and 1,25(OH) 2D as differential biomarkers between multiple system atrophy and Parkinson's disease patients. eNeurologicalSci 2021; 25:100369. [PMID: 34611554 PMCID: PMC8477135 DOI: 10.1016/j.ensci.2021.100369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/24/2021] [Accepted: 09/17/2021] [Indexed: 02/07/2023] Open
Abstract
Background and purpose There is sufficient evidence to support vitamin D's noncalcemic effects and the role of vitamin D deficiency in the development of a wide range of neurological disorders. This study aimed to evaluate whether serum 25(OH)D and 1,25(OH) 2 D could be used as biomarkers to differentiate between healthy subjects (HS), multiple system atrophy (MSA) and Parkinson's disease (PD) patients of both genders. Methods A total of 107 subjects were included in this study, divided into three groups: 1- HS (n = 61), 2- MSA patients (n = 19), and 3- PD patients (n = 27). The patients were assessed using UMSARS II, UPDRS III, H&Y, MMSE and MoCA rating scales. The levels of 25(OH)D and 1,25(OH) 2 D in serum were determined using the radioimmunoassay technique. Results The levels of 25(OH)D and 1,25(OH) 2 D in HS were 26.85 +/- 7.62 ng/mL and 53.63 +/- 13.66 pg/mL respectively. 25(OH)D levels were lower in both MSA and PD by 61% and 50%, respectively (P = 0.0001 vs. HS). 1,25(OH) 2 D levels were lower in MSA by 29%(P = 0.001 vs HS). There was a correlation between 25(OH)D and 1,25(OH) 2 D in MSA and PD, but not in HS. 1,25(OH) 2 D regressed with MMSE (β = 0.476, P = 0.04, R 2 = 0.226) in MSA, and with UPDRS III (β = -0.432, P = 0.024, R 2 = 0.187) and MoCA (β = 0.582, P = 0.005,R 2 = 0.279) in PD. 25(OH)D displayed considerable differentiative strength between HS and MSA (Wald = 17.123, OR = 0.586, P = 0.0001; AUC = 0.982, sensitivity and Youden index = 0.882, P = 0.0001) and PD (Wald = 18.552, OR = 0.700, P = 0.0001; AUC = 0.943, sensitivity = 0.889, YI = 0.791, P = 0.0001). 1,25(OH) 2 D distinguished MSA from PD (Wald 16.178, OR = 1.117, P = 0.0001; AUC = 0.868, sensitivity = 0.926, Youden index =0.632, P = 0.0001). H&Y exhibited the highest sensitivity, AUC, and significant distinguishing power between MSA and PD. Conclusions Serum 25(OH)D and 1,25(OH) 2 D could be useful biomarkers for MSA and PD. 25(OH)D and H&Y provided the highest sensitivity and group classification characteristics.
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Key Words
- 1,25(OH)2D, 1,25-dihydroxyvitamin D3 (Calcitriol)
- 25(OH)D, 25-hydroxyvitamin D3
- H&Y, Hoehn &Yahr rating scale
- Hoehn & Yahr staging scale
- MMSE, Mini mental state examination
- MSA, Multiple system atrophy
- MoCA, Montreal Cognitive Assessment
- Multiple system atrophy
- PD, Parkinson's disease
- Parkinson's disease
- UMSARS, Unified MSA Rating Scale
- UPDRS, Unified PD Rating Scale.
- Unified MSA rating scale
- Unified PD rating scale
- Vitamin D
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Affiliation(s)
- Hiromu Ogura
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | | | - Midori Suenaga
- Department of Medical Pharmacology, Faculty of Pharmaceutical Sciences, Tokushima-Bunri University, Tokushima, Japan
| | - Funda Bolukbasi Hatip
- Department of Medical Pharmacology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Takayasu Mishima
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shinji Ouma
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yoichi Matsunaga
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Deri Y, Clouston SAP, DeLorenzo C, Gardus JD, Bartlett EA, Santiago-Michels S, Bangiyev L, Kreisl WC, Kotov R, Huang C, Slifstein M, Parsey RV, Luft BJ. Neuroinflammation in World Trade Center responders at midlife: A pilot study using [ 18F]-FEPPA PET imaging. Brain Behav Immun Health 2021; 16:100287. [PMID: 34589784 PMCID: PMC8474562 DOI: 10.1016/j.bbih.2021.100287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 02/08/2023] Open
Abstract
Background Neuroinflammation has long been theorized to arise from exposures to fine particulate matter and to be modulated when individuals experience chronic stress, both of which are also though to cause cognitive decline in part as a result of neuroinflammation. Objectives Hypothesizing that neuroinflammation might be linked to experiences at the World Trade Center (WTC) events, this study explored associations between glial activation and neuropsychological measures including post-traumatic stress disorder (PTSD) symptom severity and WTC exposure duration. Methods Translocator protein 18-kDa (TSPO) is overexpressed by activated glial cells, predominantly microglia and astrocytes, making TSPO distribution a putative biomarker for neuroinflammation. Twenty WTC responders completed neuropsychological assessments and in vivo PET brain scan with [18F]-FEPPA. Generalized linear modeling was used to test associations between PTSD, and WTC exposure duratiioni as the predictor and both global and regional [18F]-FEPPA total distribution volumes as the outcomes. Result Responders were 56.0 ± 4.7 years-old, and 75% were police officers on 9/11/2001, and all had at least a high school education. Higher PTSD symptom severity was associated with global and regional elevations in [18F]-FEPPA binding predominantly in the hippocampus (d = 0.72, P = 0.001) and frontal cortex (d = 0.64, P = 0.004). Longer exposure duration to WTC sites was associated with higher [18F]-FEPPA binding in the parietal cortex. Conclusion Findings from this study of WTC responders at midlife suggest that glial activation is associated with PTSD symptoms, and WTC exposure duration. Future investigation is needed to understand the important role of neuroinflammation in highly exposed WTC responders. We examined the theory that glial activation is associated with 9/11 exposures. TSPO-Vt was examined using PET in 20 responders adjusting for TSPO genotype. Responders with PTSD had increased TSPO distribution volume in the hippocampus. Heavily exposed responders had increased TSPO distribution in the parietal cortex.
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Affiliation(s)
- Yael Deri
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Sean A P Clouston
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - John D Gardus
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Elizabeth A Bartlett
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA.,Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Stephanie Santiago-Michels
- Stony Brook World Trade Center Wellness Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Lev Bangiyev
- Department of Radiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - William C Kreisl
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Roman Kotov
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Chuan Huang
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.,Department of Radiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Mark Slifstein
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Ramin V Parsey
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Benjamin J Luft
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Stony Brook World Trade Center Wellness Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
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7
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Marks TS, Giles GM, Al-Heizan MO, Edwards DF. How Well Does the Brief Interview for Mental Status Identify Risk for Cognition Mediated Functional Impairment in a Community Sample? Arch Rehabil Res Clin Transl 2021; 3:100102. [PMID: 33778475 PMCID: PMC7984985 DOI: 10.1016/j.arrct.2021.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To determine the adequacy of the Brief Interview for Mental Status (BIMS) compared with other screening tools in identifying individuals with limitations in functional cognition and instrumental activities of daily living (IADL). DESIGN Cross-sectional observational study. SETTING Midsized midwestern city. PARTICIPANTS We assessed a convenience sample of community dwelling individuals (N=197) aged 55 years and older who were living independently. MAIN OUTCOME MEASURES Participant scores on the BIMS, Mini-Cog, Menu Task, and Montreal Cognitive Assessment (MoCA) were compared with the Performance Assessment of Self-Care Skills Checkbook Balancing and Shopping tasks (PCST), which are known to predict impairment in complex IADLs associated with a diagnosis of mild cognitive impairment. Multiple logistic regression analyses controlling for participant demographics, as well as sensitivity and specificity, were computed for each screening measure using the PCST as the criterion measure. RESULTS The Mini-Cog, Menu Task, and MoCA identified 25.89%, 32.49%, and 47.21% more individuals, respectively, as impaired than the BIMS. In multiple logistical regression analyses, the BIMS correctly identified 58% of those impaired on the PCST. However, each of the alternate screening measures correctly identified at least 70% of individuals as impaired on the PCST. CONCLUSIONS In this community sample, the BIMS was insensitive to subtle impairments with the potential to compromise community living, suggesting that the BIMS may be inappropriate for use outside nursing home settings.
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Affiliation(s)
- Timothy S. Marks
- University of Wisconsin–Madison, Department of Kinesiology–Occupational Therapy, Madison, WI
| | - Gordon M. Giles
- Department of Occupational Therapy, Samuel Merritt University, Oakland, CA
- Neurobehavioral Services, Crestwood Behavioral Health, Inc, Sacramento, CA
| | | | - Dorothy F. Edwards
- University of Wisconsin–Madison, Department of Kinesiology–Occupational Therapy, Madison, WI
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8
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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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9
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Zanaty M, Roa JA, Jabbour PM, Samaniego EA, Hasan DM. Recanalization of the Chronically Occluded Internal Carotid Artery: Review of the Literature. World Neurosurg X 2019; 5:100067. [PMID: 31872191 PMCID: PMC6920090 DOI: 10.1016/j.wnsx.2019.100067] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/13/2019] [Indexed: 12/01/2022] Open
Abstract
Introduction We reviewed the literature on interventions for patients with medically refractory chronically occluded internal carotid artery (COICA) to assess the risks and/or benefits after recanalization via an endovascular technique (ET) or hybrid surgery (HS, i.e., ET plus carotid endarterectomy). Methods A systematic search of the electronic databases was performed. Patients with COICA were classified into 4 different categories according to Hasan et al classification. Results Eighteen studies satisfied the inclusion criteria. Only 6 studies involved an HS procedure. We identified 389 patients with COICA who underwent ET or HS; 91% were males. The overall perioperative complication rate was 10.1% (95% confidence interval [CI]: 7.4%-13.1%). For types A and B, the successful recanalization rate was 95.4% (95% CI: 86.5%-100%), with a 13.7% (95% CI: 2.3%-27.4%) complication rate. For type C, the success rate for ET was 45.7% (95% CI: 17.8%-70.7%), with a complication rate of 46.0% (95% CI: 20.0%-71.4%) for ET and for the HS technique 87.6% (95% CI: 80.9%-94.4%), with a complication rate of 14.0% (95% CI: 7.0%-21.8%). For type D, the success rate of recanalization was 29.8% (95% CI: 7.8%-52.8%), with a 29.8% (95% CI: 6.1%-56.3%) complication rate. Successful recanalization resulted in a symmetrical perfusion between both cerebral hemispheres, resolution of penumbra, normalization of the mean transit time, and improvement in Montreal Cognitive Assessment (MoCA) score (ΔMoCA = 9.80 points; P = 0.004). Conclusions Type A and B occlusions benefit from ET, especially in the presence of a large penumbra. Type C occlusions can benefit from HS. Unfortunately, we did not identify an intervention to help patients with type D occlusions. A phase 2b randomized controlled trial is needed to confirm these findings.
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Affiliation(s)
- Mario Zanaty
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Jorge A Roa
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.,Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Pascal M Jabbour
- Department of Neurosurgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA
| | - Edgar A Samaniego
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.,Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.,Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - David M Hasan
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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10
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Hufstedler HC, Dorsman KA, Rivera EJ, Lanata SC, Bogner JA, Corrigan JD, Fuller SM, Borja XR, Wilson F, Gardner RC. Linguistic and Cultural Acceptability of a Spanish Translation of the Ohio State University Traumatic Brain Injury Identification Method Among Community-Dwelling Spanish-Dominant Older Adults. Arch Rehabil Res Clin Transl 2019; 1:100020. [PMID: 33543051 PMCID: PMC7853324 DOI: 10.1016/j.arrct.2019.100020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 11/29/2022] Open
Abstract
Objective Our objective was to (1) evaluate the linguistic and cultural acceptability of a Spanish translation of the Ohio State University traumatic brain injury identification method (OSU TBI-ID) and (2) to assess the usability and acceptability of a tablet-based version of this instrument in a cohort of Spanish-dominant older adults. Setting University clinical research center and local community center. Participants Community-dwelling Spanish-dominant adults age 50 years or older without dementia residing in the Bay Area of California (N=22). Design Cross-sectional cohort study. Main Outcome Measures Qualitative assessment of linguistic or cultural acceptability of a Spanish translation of the OSU TBI-ID as well as usability or acceptability of a tablet-based self-administered version of this instrument. Results The Spanish translation had high linguistic and cultural acceptability and was further optimized based on participant feedback. Cognitive interviews to review survey wording revealed high levels of homogeneity in the clinical definitions and synonyms given by participants—for example, results for the clinical term “Quedó Inconsciente/Pérdida (temporal) de la conciencia” (To be unconscious/[Temporary] loss of consciousness) used in the survey included “perder el conocimiento” (loss of consciousness), “knockeado” (knocked out), “No es que esté dormida, porque está inconsciente, pero su corazón está todavía palpitando” (it’s not that they’re sleeping, because they’re unconscious, but their heart is still palpitating). The tablet interface had low observer-based usability, revealing that participants with <13 years of education (n=6) had more difficulty using the tablet which could be improved with minor changes to the coding of the application and minimal in-person technology support. Acceptability of the tool was low among all but 1 participant. Conclusion This linguistically optimized Spanish translation of the OSU TBI-ID is recommended for use as a semistructured interview among Spanish-dominant older adults. Although the tablet-based instrument may be used by interviewers as an efficient electronic case report form among older adults, further research is needed, particularly among older adults with varying levels of education, to validate this instrument as a self-administered survey.
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Affiliation(s)
- Heather C Hufstedler
- Institute for Global Health Sciences, University of California, San Francisco, California
| | - Karen A Dorsman
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California.,Global Brain Health Institute, San Francisco, California
| | - Ernesto J Rivera
- Department of Neurosurgery, University of California, San Francisco, California
| | - Serggio C Lanata
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California.,Global Brain Health Institute, San Francisco, California
| | - Jennifer A Bogner
- Department of Physical Medicine and Rehabilitation, College of Medicine, Ohio State University, Columbus, Ohio
| | - John D Corrigan
- Department of Physical Medicine and Rehabilitation, College of Medicine, Ohio State University, Columbus, Ohio
| | - Shannon M Fuller
- Institute for Global Health Sciences, University of California, San Francisco, California
| | - Xochilt R Borja
- Institute for Global Health Sciences, University of California, San Francisco, California
| | - Fiona Wilson
- Discipline of Physiotherapy, School of Medicine Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Raquel C Gardner
- Institute for Global Health Sciences, University of California, San Francisco, California.,San Francisco Veterans Affairs Medical Center, San Francisco, California
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11
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Chung JW, Burciu RG, Ofori E, Coombes SA, Christou EA, Okun MS, Hess CW, Vaillancourt DE. Beta-band oscillations in the supplementary motor cortex are modulated by levodopa and associated with functional activity in the basal ganglia. Neuroimage Clin 2018; 19:559-571. [PMID: 29984164 PMCID: PMC6029579 DOI: 10.1016/j.nicl.2018.05.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 03/02/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 12/15/2022]
Abstract
We investigated the effect of acute levodopa administration on movement-related cortical oscillations and movement velocity in Parkinson's disease (PD). Patients with PD on and off medication and age- and sex-matched healthy controls performed a ballistic upper limb flexion movement as fast and accurately as possible while cortical oscillations were recorded with high-density electroencephalography. Patients off medication were also studied using task-based functional magnetic resonance imaging (fMRI) using a force control paradigm. Percent signal change of functional activity during the force control task was calculated for the putamen and subthalamic nucleus (STN) contralateral to the hand tested. We found that patients with PD off medication had an exaggerated movement-related beta-band (13–30 Hz) desynchronization in the supplementary motor area (SMA) compared to controls. In PD, spectral power in the beta-band was correlated with movement velocity. Following an acute dose of levodopa, we observed that the beta-band desynchronization in the SMA was reduced in PD, and was associated with increased movement velocity and increased voltage of agonist muscle activity. Further, using fMRI we found that the functional activity in the putamen and STN in the off medication state, was related to how responsive that cortical oscillations in the SMA of PD were to levodopa. Collectively, these findings provide the first direct evaluation of how movement-related cortical oscillations relate to movement velocity during the ballistic phase of movement in PD and demonstrate that functional brain activity in the basal ganglia pathways relate to the effects of dopaminergic medication on cortical neuronal oscillations during movement. Acute levodopa decreased beta-band desynchronization in the SMA, while improving movement velocity and muscle activity. Beta-band cortical activity during movement is positively correlated with upper limb movement velocity. fMRI in basal ganglia predicted the response of beta-band cortical activity to levodopa.
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Key Words
- BOLD, blood oxygen level dependent
- Ballistic movements
- DBS, deep brain stimulation
- ECoG, electrocorticography
- EEG
- EEG, electroencephalography
- EMG, electromyography
- ERSP, event-related power spectral perturbation
- FDR, false discovery rate
- HC, healthy control
- ICA, independent component analysis
- LFP, local field potential
- Levodopa
- M1, primary motor cortex
- MDS-UPDRS, Movement Disorder Society Unified Parkinson's Disease Rating Scale
- MEG, magnetoencephalography
- MPA, measure projection analysis
- MVC, maximum voluntary contraction
- MoCA, Montreal Cognitive Assessment
- PD, Parkinson's disease
- PD-OFF, off medication (levodopa) day
- PD-ON, on medication (levodopa) day
- PET, positron emission tomography
- Parkinson's disease
- ROI, regions of interest
- S1, primary somatosensory cortex
- SMA, supplementary motor area
- SNc, substantia nigra pars compacta
- STN, subthalamic nucleus
- Supplementary motor area
- fMRI
- fMRI, functional magnetic resonance imaging
- iEMG, integrated electromyography
- rCBF, regional cerebral blood flow
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Affiliation(s)
- Jae Woo Chung
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Roxana G Burciu
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Edward Ofori
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Stephen A Coombes
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Evangelos A Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Michael S Okun
- Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA
| | - Christopher W Hess
- Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA; Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
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12
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Stark AJ, Smith CT, Petersen KJ, Trujillo P, van Wouwe NC, Donahue MJ, Kessler RM, Deutch AY, Zald DH, Claassen DO. [ 18F]fallypride characterization of striatal and extrastriatal D 2/3 receptors in Parkinson's disease. Neuroimage Clin 2018; 18:433-442. [PMID: 29541577 PMCID: PMC5849871 DOI: 10.1016/j.nicl.2018.02.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 10/04/2017] [Revised: 01/15/2018] [Accepted: 02/07/2018] [Indexed: 12/11/2022]
Abstract
Parkinson's disease (PD) is characterized by widespread degeneration of monoaminergic (especially dopaminergic) networks, manifesting with a number of both motor and non-motor symptoms. Regional alterations to dopamine D2/3 receptors in PD patients are documented in striatal and some extrastriatal areas, and medications that target D2/3 receptors can improve motor and non-motor symptoms. However, data regarding the combined pattern of D2/3 receptor binding in both striatal and extrastriatal regions in PD are limited. We studied 35 PD patients off-medication and 31 age- and sex-matched healthy controls (HCs) using PET imaging with [18F]fallypride, a high affinity D2/3 receptor ligand, to measure striatal and extrastriatal D2/3 nondisplaceable binding potential (BPND). PD patients completed PET imaging in the off medication state, and motor severity was concurrently assessed. Voxel-wise evaluation between groups revealed significant BPND reductions in PD patients in striatal and several extrastriatal regions, including the locus coeruleus and mesotemporal cortex. A region-of-interest (ROI) based approach quantified differences in dopamine D2/3 receptors, where reduced BPND was noted in the globus pallidus, caudate, amygdala, hippocampus, ventral midbrain, and thalamus of PD patients relative to HC subjects. Motor severity positively correlated with D2/3 receptor density in the putamen and globus pallidus. These findings support the hypothesis that abnormal D2/3 expression occurs in regions related to both the motor and non-motor symptoms of PD, including areas richly invested with noradrenergic neurons.
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Affiliation(s)
- Adam J Stark
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | | | - Kalen J Petersen
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Paula Trujillo
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Nelleke C van Wouwe
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Manus J Donahue
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Robert M Kessler
- Radiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ariel Y Deutch
- Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Pharmacology, Vanderbilt University, Nashville, TN, United States
| | - David H Zald
- Psychology, Vanderbilt University, Nashville, TN, United States; Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Daniel O Claassen
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.
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13
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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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Adamczyk P, Wyczesany M, Domagalik A, Daren A, Cepuch K, Błądziński P, Cechnicki A, Marek T. Neural circuit of verbal humor comprehension in schizophrenia - an fMRI study. Neuroimage Clin 2017; 15:525-540. [PMID: 28652967 PMCID: PMC5473647 DOI: 10.1016/j.nicl.2017.06.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/03/2017] [Accepted: 06/01/2017] [Indexed: 11/17/2022]
Abstract
Individuals with schizophrenia exhibit problems with understanding the figurative meaning of language. This study evaluates neural correlates of diminished humor comprehension observed in schizophrenia. The study included chronic schizophrenia (SCH) outpatients (n = 20), and sex, age and education level matched healthy controls (n = 20). The fMRI punchline based humor comprehension task consisted of 60 stories of which 20 had funny, 20 nonsensical and 20 neutral (not funny) punchlines. After the punchlines were presented, the participants were asked to indicate whether the story was comprehensible and how funny it was. Three contrasts were analyzed in both groups reflecting stages of humor processing: abstract vs neutral stories - incongruity detection; funny vs abstract - incongruity resolution and elaboration; and funny vs neutral - complete humor processing. Additionally, parametric modulation analysis was performed using both subjective ratings separately. Between-group comparisons revealed that the SCH subjects had attenuated activation in the right posterior superior temporal gyrus (BA 41) in case of irresolvable incongruity processing of nonsensical puns; in the left dorsomedial middle and superior frontal gyri (BA 8/9) in case of incongruity resolution and elaboration processing of funny puns; and in the interhemispheric dorsal anterior cingulate cortex (BA 24) in case of complete processing of funny puns. Additionally, during comprehensibility ratings the SCH group showed a suppressed activity in the left dorsomedial middle and superior frontal gyri (BA 8/9) and revealed weaker activation during funniness ratings in the left dorsal anterior cingulate cortex (BA 24). Interestingly, these differences in the SCH group were accompanied behaviorally by a protraction of time in both types of rating responses and by indicating funny punchlines less comprehensible. Summarizing, our results indicate neural substrates of humor comprehension processing impairments in schizophrenia, which is accompanied by fronto-temporal hypoactivation.
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Key Words
- ABS, absurd/nonsensical punchline
- ACC, anterior cingulate cortex
- BA, Brodmann's area
- CON, healthy controls/control group
- Communication skills
- EEG, electroencephalography
- ERPs, EEG event-related potentials
- FDR, False Discovery Rate
- FUN, funny punchline
- FWHM, full-width-at-half-maximum
- Figurative meaning
- Functional magnetic resonance imaging
- GLM, general linear model
- Humor
- IFG, inferior frontal gyrus
- IPL, Inferior Parietal Lobule
- ISI, interstimulus-interval
- L, left hemisphere
- MFG, medial frontal gyrus
- MNI, Montreal Neurological Institute coordinates
- MOG, middle occipital gyrus
- MRI, magnetic resonance imaging
- MTG, middle temporal gyrus
- MoCA, Montreal Cognitive Assessment
- NEU, neutral/unfunny punchline
- PANSS, Positive and Negative Syndrome Scale
- PFC, prefrontal cortex
- R, right hemisphere
- RHLB, Right Hemisphere Language Battery
- RT, reaction time
- SCH, schizophrenia outpatients/clinical group
- SD, standard deviations
- SEM, standard error of the mean
- SFG, Superior Frontal Gyrus
- SOA, stimulus onset asynchrony
- STG, superior temporal gyrus
- Schizophrenia
- TP, temporal pole
- TPJ, temporoparietal junction
- ToM, theory of mind.
- dACC, dorsal anterior cingulate cortex
- dlPFC, dorsolateral prefrontal cortex
- dmMFG, dorsomedial Middle Frontal Gyrus
- fMRI, functional magnetic resonance imaging
- fNIRS, functional near-infrared spectroscopy
- k, number of voxels in analyzed cluster size
- ns, non-significant group difference
- pSTG, posterior Superior Temporal Gyrus
- sLORETA, standardized low resolution brain electromagnetic tomography analysis
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Affiliation(s)
- Przemysław Adamczyk
- Department of Community Psychiatry, Medical College, Jagiellonian University, Krakow, Poland; Psychosis Research and Psychotherapy Unit, Association for the Development of Psychiatry and Community Care, Krakow, Poland.
| | - Miroslaw Wyczesany
- Psychophysiology Laboratory, Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Aleksandra Domagalik
- Neurobiology Department, The Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Artur Daren
- Department of Community Psychiatry, Medical College, Jagiellonian University, Krakow, Poland; Psychosis Research and Psychotherapy Unit, Association for the Development of Psychiatry and Community Care, Krakow, Poland
| | - Kamil Cepuch
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Piotr Błądziński
- Department of Community Psychiatry, Medical College, Jagiellonian University, Krakow, Poland
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Medical College, Jagiellonian University, Krakow, Poland; Psychosis Research and Psychotherapy Unit, Association for the Development of Psychiatry and Community Care, Krakow, Poland
| | - Tadeusz Marek
- Neurobiology Department, The Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland; Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
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Anazodo UC, Shoemaker JK, Suskin N, St Lawrence KS. An investigation of changes in regional gray matter volume in cardiovascular disease patients, pre and post cardiovascular rehabilitation. Neuroimage Clin 2013; 3:388-95. [PMID: 24273722 DOI: 10.1016/j.nicl.2013.09.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 09/14/2013] [Accepted: 09/29/2013] [Indexed: 12/21/2022]
Abstract
Cognitive function decline secondary to cardiovascular disease has been reported. However, little is known about the impact of coronary artery disease (CAD) on the aging brain macrostructure or whether exercise training, in the context of cardiovascular rehabilitation, can affect brain structure following a coronary event. This study employed voxel-based morphometry of high resolution structural MRI images to investigate; 1) changes in regional gray matter volume (GMV) in CAD patients compared to age-matched controls, and 2) the effects of a six-month exercise-based cardiovascular rehabilitation program on CAD-related GMV decline. Compared to controls, significant decreases in regional GMV were found in the superior, medial and inferior frontal gyrus; superior and inferior parietal gyrus; middle and superior temporal gyrus and in the posterior cerebellum of CAD patients. Cardiovascular rehabilitation was associated with the recovery of regional GMV in the superior frontal gyrus, superior temporal gyrus and posterior cerebellum of the CAD patients as well as the increase in GMV in the supplementary motor area. Total and regional GMV correlated with fitness level, defined by the maximal oxygen consumption (VO2max), at baseline but not after cardiovascular rehabilitation. This study demonstrates that cardiovascular disease can adversely affect age-related decline in GMV; and that these disease-related effects could be mitigated by moderate levels of exercise training as part of cardiovascular rehabilitation.
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