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Caminiti SP, De Francesco S, Tondo G, Galli A, Redolfi A, Perani D. FDG-PET markers of heterogeneity and different risk of progression in amnestic MCI. Alzheimers Dement 2024; 20:159-172. [PMID: 37505996 PMCID: PMC10962797 DOI: 10.1002/alz.13385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/19/2023] [Accepted: 06/12/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Amnestic mild cognitive impairment (aMCI) is emerging as a heterogeneous condition. METHODS We looked at a cohort of N = 207 aMCI subjects, with baseline fluorodeoxyglucose positron emission tomography (FDG-PET), T1 magnetic resonance imaging, cerebrospinal fluid (CSF), apolipoprotein E (APOE), and neuropsychological assessment. An algorithm based on FDG-PET hypometabolism classified each subject into subtypes, then compared biomarker measures and clinical progression. RESULTS Three subtypes emerged: hippocampal sparing-cortical hypometabolism, associated with younger age and the highest level of Alzheimer's disease (AD)-CSF pathology; hippocampal/cortical hypometabolism, associated with a high percentage of APOE ε3/ε4 or ε4/ε4 carriers; medial-temporal hypometabolism, characterized by older age, the lowest AD-CSF pathology, the most severe hippocampal atrophy, and a benign course. Within the whole cohort, the severity of temporo-parietal hypometabolism, correlated with AD-CSF pathology and marked the rate of progression of cognitive decline. DISCUSSION FDG-PET can distinguish clinically comparable aMCI at single-subject level with different risk of progression to AD dementia or stability. The obtained results can be useful for the optimization of pharmacological trials and automated-classification models. HIGHLIGHTS Algorithm based on FDG-PET hypometabolism demonstrates distinct subtypes across aMCI; Three different subtypes show heterogeneous biological profiles and risk of progression; The cortical hypometabolism is associated with AD pathology and cognitive decline; MTL hypometabolism is associated with the lowest conversion rate and CSF-AD pathology.
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Affiliation(s)
- Silvia Paola Caminiti
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Silvia De Francesco
- Laboratory of NeuroinformaticsIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Giacomo Tondo
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Alice Galli
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Alberto Redolfi
- Laboratory of NeuroinformaticsIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Daniela Perani
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
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Hammers DB, Eloyan A, Taurone A, Thangarajah M, Beckett L, Gao S, Kirby K, Aisen P, Dage JL, Foroud T, Griffin P, Grinberg LT, Jack CR, Kramer J, Koeppe R, Kukull WA, Mundada NS, Joie RL, Soleimani-Meigooni DN, Iaccarino L, Murray ME, Nudelman K, Polsinelli AJ, Rumbaugh M, Toga A, Touroutoglou A, Vemuri P, Atri A, Day GS, Duara R, Graff-Radford NR, Honig LS, Jones DT, Masdeu J, Mendez MF, Womack K, Musiek E, Onyike CU, Riddle M, Rogalski E, Salloway S, Sha SJ, Turner RS, Wingo TS, Wolk DA, Carrillo MC, Dickerson BC, Rabinovici GD, Apostolova LG. Profiling baseline performance on the Longitudinal Early-Onset Alzheimer's Disease Study (LEADS) cohort near the midpoint of data collection. Alzheimers Dement 2023; 19 Suppl 9:S8-S18. [PMID: 37256497 PMCID: PMC10806768 DOI: 10.1002/alz.13160] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The Longitudinal Early-Onset Alzheimer's Disease Study (LEADS) seeks to provide comprehensive understanding of early-onset Alzheimer's disease (EOAD; onset <65 years), with the current study profiling baseline clinical, cognitive, biomarker, and genetic characteristics of the cohort nearing the data-collection mid-point. METHODS Data from 371 LEADS participants were compared based on diagnostic group classification (cognitively normal [n = 89], amyloid-positive EOAD [n = 212], and amyloid-negative early-onset non-Alzheimer's disease [EOnonAD; n = 70]). RESULTS Cognitive performance was worse for EOAD than other groups, and EOAD participants were apolipoprotein E (APOE) ε4 homozygotes at higher rates. An amnestic presentation was common among impaired participants (81%), with several clinical phenotypes present. LEADS participants generally consented at high rates to optional trial procedures. CONCLUSIONS We present the most comprehensive baseline characterization of sporadic EOAD in the United States to date. EOAD presents with widespread cognitive impairment within and across clinical phenotypes, with differences in APOE ε4 allele carrier status appearing to be relevant. HIGHLIGHTS Findings represent the most comprehensive baseline characterization of sporadic early-onset Alzheimer's disease (EOAD) to date. Cognitive impairment was widespread for EOAD participants and more severe than other groups. EOAD participants were homozygous apolipoprotein E (APOE) ε4 carriers at higher rates than the EOnonAD group. Amnestic presentation predominated in EOAD and EOnonAD participants, but other clinical phenotypes were present.
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Affiliation(s)
- Dustin B. Hammers
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ani Eloyan
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA
| | - Alexander Taurone
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA
| | - Maryanne Thangarajah
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA
| | - Laurel Beckett
- Department of Public Health Sciences, University of California – Davis, Davis, California, USA
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kala Kirby
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Paul Aisen
- Alzheimer’s Therapeutic Research Institute, University of Southern California, San Diego, California, USA
| | - Jeffrey L. Dage
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Percy Griffin
- Medical & Scientific Relations Division, Alzheimer’s Association, Chicago, Illinois, USA
| | - Lea T. Grinberg
- Department of Pathology, University of California – San Francisco, San Francisco, California, USA
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | | | - Joel Kramer
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Robert Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Walter A. Kukull
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Nidhi S Mundada
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Renaud La Joie
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | | | - Leonardo Iaccarino
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | | | - Kelly Nudelman
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Angelina J. Polsinelli
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Malia Rumbaugh
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Arthur Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami, Florida, USA
| | | | - Lawrence S. Honig
- Taub Institute and Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - David T. Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph Masdeu
- Nantz National Alzheimer Center, Houston Methodist and Weill Cornell Medicine, Houston, Texas, USA
| | - Mario F. Mendez
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Kyle Womack
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Erik Musiek
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Chiadi U. Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Meghan Riddle
- Department of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Emily Rogalski
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Steven Salloway
- Department of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Sharon J. Sha
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, California, USA
| | | | - Thomas S. Wingo
- Department of Neurology and Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David A. Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maria C. Carrillo
- Medical & Scientific Relations Division, Alzheimer’s Association, Chicago, Illinois, USA
| | - Bradford C. Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Gil D. Rabinovici
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Liana G. Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine Indianapolis, Indianapolis, Indiana, USA
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Bushnell J, Hammers DB, Aisen P, Dage JL, Eloyan A, Foroud T, Grinberg LT, Iaccarino L, Jack CR, Kirby K, Kramer J, Koeppe R, Kukull WA, La Joie R, Mundada NS, Murray ME, Nudelman K, Rumbaugh M, Soleimani-Meigooni DN, Toga A, Touroutoglou A, Vemuri P, Atri A, Day GS, Duara R, Graff-Radford NR, Honig LS, Jones DT, Masdeu J, Mendez M, Musiek E, Onyike CU, Riddle M, Rogalski E, Salloway S, Sha S, Turner RS, Wingo TS, Wolk DA, Carrillo MC, Dickerson BC, Rabinovici GD, Apostolova LG, Clark DG. Influence of amyloid and diagnostic syndrome on non-traditional memory scores in early-onset Alzheimer's disease. Alzheimers Dement 2023; 19 Suppl 9:S29-S41. [PMID: 37653686 PMCID: PMC10855009 DOI: 10.1002/alz.13434] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION The Rey Auditory Verbal Learning Test (RAVLT) is a useful neuropsychological test for describing episodic memory impairment in dementia. However, there is limited research on its utility in early-onset Alzheimer's disease (EOAD). We assess the influence of amyloid and diagnostic syndrome on several memory scores in EOAD. METHODS We transcribed RAVLT recordings from 303 subjects in the Longitudinal Early-Onset Alzheimer's Disease Study. Subjects were grouped by amyloid status and syndrome. Primacy, recency, J-curve, duration, stopping time, and speed score were calculated and entered into linear mixed effects models as dependent variables. RESULTS Compared with amyloid negative subjects, positive subjects exhibited effects on raw score, primacy, recency, and stopping time. Inter-syndromic differences were noted with raw score, primacy, recency, J-curve, and stopping time. DISCUSSION RAVLT measures are sensitive to the effects of amyloid and syndrome in EOAD. Future work is needed to quantify the predictive value of these scores. HIGHLIGHTS RAVLT patterns characterize various presentations of EOAD and EOnonAD Amyloid impacts raw score, primacy, recency, and stopping time Timing-based scores add value over traditional count-based scores.
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Affiliation(s)
- Justin Bushnell
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Dustin B. Hammers
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Paul Aisen
- Alzheimer’s Therapeutic Research Institute, University of Southern California, San Diego, California, USA
| | - Jeffrey L. Dage
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ani Eloyan
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lea T. Grinberg
- Department of Pathology, University of California – San Francisco, San Francisco, California, USA
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Leonardo Iaccarino
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | | | - Kala Kirby
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Joel Kramer
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Robert Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Walter A. Kukull
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Renaud La Joie
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Nidhi S. Mundada
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | | | - Kelly Nudelman
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Malia Rumbaugh
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Arthur Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami, Florida, USA
| | | | - Lawrence S. Honig
- Taub Institute and Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - David T. Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph Masdeu
- Nantz National Alzheimer Center, Houston Methodist and Weill Cornell Medicine, Houston, Texas, USA
| | - Mario Mendez
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Erik Musiek
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Chiadi U. Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Meghan Riddle
- Department of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Emily Rogalski
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Steven Salloway
- Department of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Sharon Sha
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, California, USA
| | - Raymond S. Turner
- Department of Neurology, Georgetown University, Washington D.C., USA
| | - Thomas S. Wingo
- Department of Neurology and Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David A. Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maria C. Carrillo
- Medical & Scientific Relations Division, Alzheimer’s Association, Chicago, Illinois, USA
| | - Bradford C. Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Gil D. Rabinovici
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Liana G. Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - David G. Clark
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Wang R, Zhang H, Li H, Ren H, Sun T, Xu L, Liu Y, Hou X. The influence of exercise interventions on cognitive functions in patients with amnestic mild cognitive impairment: A systematic review and meta-analysis. Front Public Health 2022; 10:1046841. [PMID: 36457329 PMCID: PMC9706097 DOI: 10.3389/fpubh.2022.1046841] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Patients with amnestic mild cognitive impairment (aMCI) are more likely to develop dementia compared to patients with non-aMCI (naMCI). Among the mixed samples of aMCI and naMCI, exercise interventions are effective for patients with MCI to improve cognitive functions. However, the influence of exercise interventions on patients with aMCI is still unclear. Objective The objective of this systematic review and meta-analysis is to evaluate the influence of exercise interventions on cognitive functions in patients with aMCI. Methods Four literature databases (PubMed, Web of Science, EBSCO, and Cochrane Library) and three Chinese databases (China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Database) were searched from their inception to August 31, 2022. Based on the preliminary search of seven databases and their cited references, a total of 2,290 records were identified. Finally, 10 studies with a total of 28 data points involving 575 participants with aMCI were included in this meta-analysis. If the measurements of outcomes were different among studies, the effect size was synthesized using the standardized mean difference (SMD) with a 95% confidence interval (CI). If the measurements were the same, the weight mean difference (WMD) with a 95% CI was used to integrate the effect size. Data synthesis The results showed that exercise interventions had no significant effects on improving several specific domains of cognitive functions including working memory (WMD = -0.05; 95% CI = -0.74 to 0.63; p = 0.88; I 2 = 78%) and attention (SMD = 0.20; 95% CI = -0.31 to 0.72; p = 0.44; I 2 = 60%). Additionally, exercise interventions had a significant effect on global cognitive function (SMD = 0.70; 95% CI = 0.50-0.90; p < 0.00001; I 2 = 29%) and some specific cognitive domains including immediate recall (SMD = 0.55; 95% CI = 0.28-0.81; p < 0.0001; I 2 = 0%), delayed recall (SMD = 0.66; 95% CI = 0.45-0.87; p < 0.00001; I 2 = 37%), and executive function (SMD = 0.38; 95% CI = 0.16-0.60; p= 0.0006; I 2 = 4%). Furthermore, subgroup analysis based on the intervention forms indicated that multi-component interventions (SMD = 0.44; 95% CI = 0.11-0.77; p = 0.009; I 2 = 0%) appeared to be less effective than the single-component intervention (SMD = 0.85; 95% CI = 0.60-1.10; p < 0.00001; I 2 = 10%) in terms of boosting global cognitive function. Conclusion This meta-analysis suggests that the exercise can help patients with aMCI improve global cognitive function. And exercise interventions have positive influence on enhancing several specific cognitive domains such as immediate recall, delayed recall, and executive function.Systematic review registration: http://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022354235.
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Affiliation(s)
- Rong Wang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Hanyue Zhang
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China.,School of Physical Education, Northeast Normal University, Changchun, China
| | - Hongjuan Li
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Hong Ren
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China
| | - Tingting Sun
- Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
| | - Liya Xu
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
| | - Yang Liu
- Department of Physical Education, Shandong Jianzhu University, Jinan, China
| | - Xiao Hou
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China
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Payne S, Shofer JB, Shutes-David A, Li G, Jankowski A, Dean P, Tsuang D. Correlates of Conversion from Mild Cognitive Impairment to Dementia with Lewy Bodies: Data from the National Alzheimer's Coordinating Center. J Alzheimers Dis 2022; 86:1643-1654. [PMID: 35213374 PMCID: PMC9536845 DOI: 10.3233/jad-215428] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many patients with dementia with Lewy bodies (DLB) miss out on the best standards of care and psychosocial support due to diagnostic delays or inaccuracies following symptom onset. OBJECTIVE This study seeks to identify baseline characteristics in individuals with mild cognitive impairment (MCI) that correlate with eventual conversion to DLB or Alzheimer's disease (AD). METHODS Baseline neuropsychological and neuropsychiatric data were analyzed in National Alzheimer's Coordinating Center participants who completed the Uniform Data Set between 2006 and 2020 and subsequently converted from MCI to DLB or AD (n = 1632). RESULTS Only 6% of participants with MCI converted to DLB. Among those who converted to DLB, multidomain amnestic MCI (aMCI) was the most common subtype at study entry. As part of logistic regression analyses, odds ratios (ORs) were estimated for conversion to DLB versus AD based on study-entry characteristics, adjusting for age, sex, education, and years to diagnosis. The strongest predictors of conversion to DLB (p≤0.0001) were nonamnestic MCI versus aMCI (OR 8.2, CI [5.0, 14]), multidomain MCI versus single-domain MCI (OR 2.7, CI [1.7. 4.2]), male sex (OR 4.2, CI [2.5, 7.1]), and presence of nighttime behaviors (OR 4.4 CI [2.8, 6.9]). CONCLUSION A diagnosis of prodromal DLB should be considered in individuals with MCI who present with prominent executive/visuospatial deficits, neuropsychiatric symptoms, and less memory impairment. Early diagnosis of DLB may guide treatment planning, including the avoidance of antipsychotic medications in patients who develop psychotic symptoms, caregiver support, and initiation of early treatment(s) once medications become available.
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Affiliation(s)
- Sarah Payne
- Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
| | - Jane B. Shofer
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
| | - Andrew Shutes-David
- Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
| | - Ge Li
- Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
| | - Adrienne Jankowski
- Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
| | - Pamela Dean
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
- Mental Health Service, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Debby Tsuang
- Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
- Correspondence to: Debby Tsuang, MD, MS, VA Puget Sound, Health Care System, 1660 S Columbian Way, MS-182, Seattle WA, 98108, USA. Tel.: +1 206 277 1333;
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Suo WZ. GRK5 Deficiency Causes Mild Cognitive Impairment due to Alzheimer's Disease. J Alzheimers Dis 2021; 85:1399-1410. [PMID: 34958040 DOI: 10.3233/jad-215379] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Prevention of Alzheimer's disease (AD) is a high priority mission while searching for a disease modifying therapy for AD, a devastating major public health crisis. Clinical observations have identified a prodromal stage of AD for which the patients have mild cognitive impairment (MCI) though do not yet meet AD diagnostic criteria. As an identifiable transitional stage before the onset of AD, MCI should become the high priority target for AD prevention, assuming successful prevention of MCI and/or its conversion to AD also prevents the subsequent AD. By pulling this string, one demonstrated cause of amnestic MCI appears to be the deficiency of G protein-coupled receptor-5 (GRK5). The most compelling evidence is that GRK5 knockout (GRK5KO) mice naturally develop into aMCI during aging. Moreover, GRK5 deficiency was reported to occur during prodromal stage of AD in CRND8 transgenic mice. When a GRK5KO mouse was crossbred with Tg2576 Swedish amyloid precursor protein transgenic mouse, the resulted double transgenic GAP mice displayed exaggerated behavioral and pathological changes across the spectrum of AD pathogenesis. Therefore, the GRK5 deficiency possesses unique features and advantage to serve as a prophylactic therapeutic target for MCI due to AD.
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Affiliation(s)
- William Z Suo
- Laboratory for Alzheimer's Disease & Aging Research, VA Medical Center, Kansas City, MO, USA.,Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA.,The University of Kansas Alzheimer's Disease Center, Kansas City, KS, USA
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7
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Shang S, Wu J, Chen YC, Chen H, Zhang H, Dou W, Wang P, Cao X, Yin X. Aberrant cerebral perfusion pattern in amnestic mild cognitive impairment and Parkinson's disease with mild cognitive impairment: a comparative arterial spin labeling study. Quant Imaging Med Surg 2021; 11:3082-3097. [PMID: 34249637 DOI: 10.21037/qims-20-1259] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/12/2020] [Accepted: 03/15/2021] [Indexed: 11/06/2022]
Abstract
Background Mild cognitive impairment (MCI) has been defined as the prodromal stage of Alzheimer's disease and Parkinson's disease (PD) with dementia. We investigated the differences in regional perfusion properties among MCI subtypes and healthy control (HC) subjects by using arterial spin labeling (ASL). Methods Regional normalized CBF (z-CBF) and CBF-connectivity were analyzed from ASL data in 44 amnestic MCI (aMCI) patients, 42 PD-MCI patients, and 50 matched HC participants. The correlations between these significant regions and clinical performance were investigated separately using Spearman correlation analysis. Receiver operating characteristic analysis was generated to determine the differentiating ability of z-CBF values. z-CBF values in disease-related specific regions were extracted for group comparison. Results MCI subgroups showed overlapped impaired regions, aMCI group seemed more extensive than the PD-MCI group. PD-MCI patients had reduced z-CBF in the bilateral putamen, left precentral gyrus, left middle cingulate gyrus, and right middle frontal gyrus compared to aMCI group. Correlations to executive performance and motor severity were found in PD-MCI group, and correlations were to memory performance found in aMCI group. CBF-connectivity in left precentral gyrus, left middle cingulate gyrus, and right middle frontal gyrus were significantly altered. All of the significant clusters had good discriminatory ability. Conclusions Normalized CBF as measured by ASL revealed different patterns of perfusion between aMCI and PD-MCI, which were probably linked to distinct neural mechanisms. The present study indicates that z-CBF can provide specific perfusion information for further pathological and neuropsychological studies.
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Affiliation(s)
- Song'an Shang
- Department of Radiology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Jingtao Wu
- Department of Radiology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Hongri Chen
- Department of Radiology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Hongying Zhang
- Department of Radiology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Weiqiang Dou
- MR Research China, GE Healthcare, Beijing, China
| | - Peng Wang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xin Cao
- Department of Medical Genetics, School of Basic Medical Science, Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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8
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Welstead M, Luciano M, Muniz-Terrera G, Taylor AM, Russ TC. Prevalence of Mild Cognitive Impairment in the Lothian Birth Cohort 1936. Alzheimer Dis Assoc Disord 2021; 35:230-236. [PMID: 33480611 PMCID: PMC8386587 DOI: 10.1097/wad.0000000000000433] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Lothian Birth Cohort 1936 (LBC1936) is a highly phenotyped longitudinal study of cognitive and brain ageing. Given its substantial clinical importance, we derived an indicator of mild cognitive impairment (MCI) and amnestic and nonamnestic subtypes at 3 time points. METHODS MCI status was derived at 3 waves of the LBC1936 at ages 76 (n=567), 79 (n=441), and 82 years (n=341). A general MCI category was derived as well as amnestic MCI (aMCI) and nonamnestic MCI (naMCI). A comparison was made between MCI derivations using normative data from the LBC1936 cohort versus the general UK population. RESULTS MCI rates showed a proportional increase at each wave between 76 and 82 years from 15% to 18%. Rates of MCI subtypes also showed a proportional increase over time: aMCI 4% to 6%; naMCI 12% to 16%. Higher rates of MCI were found when using the LBC1936 normative data to derive MCI classification rather than UK-wide norms. CONCLUSIONS We found that MCI and aMCI rates in the LBC1936 were consistent with previous research. However, naMCI rates were higher than expected. Future LBC1936 research should assess the predictive factors associated with MCI prevalence to validate previous findings and identify novel risk factors.
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Affiliation(s)
| | | | | | | | - Tom C. Russ
- Lothian Birth Cohorts, Department of Psychology
- Edinburgh Dementia Prevention
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
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9
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Michels L, Riese F, Meyer R, Kälin AM, Leh SE, Unschuld PG, Luechinger R, Hock C, O'Gorman R, Kollias S, Gietl A. EEG-fMRI Signal Coupling Is Modulated in Subjects With Mild Cognitive Impairment and Amyloid Deposition. Front Aging Neurosci 2021; 13:631172. [PMID: 33967737 PMCID: PMC8104007 DOI: 10.3389/fnagi.2021.631172] [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: 11/19/2020] [Accepted: 03/10/2021] [Indexed: 12/13/2022] Open
Abstract
Cognitive impairment indicates disturbed brain physiology which can be due to various mechanisms including Alzheimer's pathology. Combined functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) recordings (EEG-fMRI) can assess the interplay between complementary measures of brain activity and EEG changes to be localized to specific brain regions. We used a two-step approach, where we first examined changes related to a syndrome of mild cognitive impairment irrespective of pathology and then studied the specific impact of amyloid pathology. After detailed clinical and neuropsychological characterization as well as a positron emission tomography (PET) scans with the tracer 11-[C]-Pittsburgh Compound B to estimate cerebral amyloid deposition, 14 subjects with mild cognitive impairment (MCI) (mean age 75.6 SD: 8.9) according to standard criteria and 21 cognitively healthy controls (HCS) (mean age 71.8 SD: 4.2) were assessed with EEG-fMRI. Thalamo-cortical alpha-fMRI signal coupling was only observed in HCS. Additional EEG-fMRI signal coupling differences between HCS and MCI were observed in parts of the default mode network, salience network, fronto-parietal network, and thalamus. Individuals with significant cerebral amyloid deposition (amyloid-positive MCI and HCS combined compared to amyloid-negative HCS) displayed abnormal EEG-fMRI signal coupling in visual, fronto-parietal regions but also in the parahippocampus, brain stem, and cerebellum. This finding was paralleled by stronger absolute fMRI signal in the parahippocampus and weaker absolute fMRI signal in the inferior frontal gyrus in amyloid-positive subjects. We conclude that the thalamocortical coupling in the alpha band in HCS more closely reflects previous findings observed in younger adults, while in MCI there is a clearly aberrant coupling in several networks dominated by an anticorrelation in the posterior cingulate cortex. While these findings may broadly indicate physiological changes in MCI, amyloid pathology was specifically associated with abnormal fMRI signal responses and disrupted coupling between brain oscillations and fMRI signal responses, which especially involve core regions of memory: the hippocampus, para-hippocampus, and lateral prefrontal cortex.
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Affiliation(s)
- Lars Michels
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
| | - Florian Riese
- Department of Geriatric Psychiatry, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland.,University Research Priority Programs (URPP) ≪Dynamics of Healthy Aging≫, University of Zurich, Zurich, Switzerland
| | - Rafael Meyer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Andrea M Kälin
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Sandra E Leh
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Paul G Unschuld
- Department of Geriatric Psychiatry, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland.,Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland.,Geriatric Psychiatry, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Roger Luechinger
- Institute of Biomedical Engineering, University and Eidgenössische Technische Hochschule (ETH) Zurich, Zurich, Switzerland
| | - Christoph Hock
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland.,Neurimmune AG, Schlieren, Switzerland
| | - Ruth O'Gorman
- Center for Magnetic Resonance Research, University Children's Hospital Zurich, Zurich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
| | - Anton Gietl
- Department of Geriatric Psychiatry, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland.,Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
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10
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Chaikittisilpa S, Orprayoon N, Santibenchakul S, Hemrungrojn S, Phutrakool P, Kengsakul M, Jaisamrarn U. Prevalence of mild cognitive impairment in surgical menopause: subtypes and associated factors. Climacteric 2021; 24:394-400. [PMID: 33688775 DOI: 10.1080/13697137.2021.1889499] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The aim of this study was to determine the prevalence and associated factors of mild cognitive impairment (MCI) and subtypes, amnestic MCI (aMCI) and non-amnestic MCI (naMCI), in women with surgical menopause. METHODS We obtained the database containing information for 200 women with surgical menopause from our previous study. The Montreal Cognitive Assessment - total score, the Montreal Cognitive Assessment - memory index score (MoCA-MIS) and their age, years since menopause, education, medical and surgical history, hormone therapy use, exercise, sleep duration, alcohol use, smoking and family history of dementia were obtained. All participants without the MoCA-MIS were excluded. RESULT The average age of the 164 participants was 56.3 ± 6.9 years. The prevalence of MCI, aMCI and naMCI was 43.3%, 9.8% and 33.5%, respectively. The duration of education reduced MCI for 93% (95% confidence interval 0.03-0.20) of the women. In late postmenopause, hormone therapy >10 years showed 47% lower prevalence of MCI (age-adjusted odds ratio = 0.53, 95% confidence interval 0.22-1.28). Finally, length of education was the only independent factor associated with MCI and its subtypes. CONCLUSION We found a high prevalence of MCI and the non-amnestic subtype in women with surgical menopause. Further study is needed to clarify the long-term effects of surgical menopause on cognitive function.
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Affiliation(s)
- S Chaikittisilpa
- Menopause Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - N Orprayoon
- Menopause Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - S Santibenchakul
- Family Planning and Reproductive Health Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - S Hemrungrojn
- Cognitive Fitness Research Group, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - P Phutrakool
- Chula Data Management Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - M Kengsakul
- Department of Obstetrics and Gynecology, Faculty of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Bangkok, Thailand
| | - U Jaisamrarn
- Menopause Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Family Planning and Reproductive Health Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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11
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Vonk JMJ, Bouteloup V, Mangin J, Dubois B, Blanc F, Gabelle A, Ceccaldi M, Annweiler C, Krolak‐Salmon P, Belin C, Rivasseau‐Jonveaux T, Julian A, Sellal F, Magnin E, Chupin M, Habert M, Chêne G, Dufouil C. Semantic loss marks early Alzheimer's disease-related neurodegeneration in older adults without dementia. Alzheimers Dement (Amst) 2020; 12:e12066. [PMID: 32775598 PMCID: PMC7403823 DOI: 10.1002/dad2.12066] [Citation(s) in RCA: 8] [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: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To assess progression of semantic loss in early stages of cognitive decline using semantic and letter fluency performance, and its relation with Alzheimer's disease (AD)-specific neurodegeneration using longitudinal multimodal neuroimaging measures. METHODS Change in verbal fluency was analyzed among 2261 non-demented individuals with a follow-up diagnosis of no mild cognitive impairment (MCI), amnestic MCI (aMCI), non-amnestic MCI (naMCI), or incident dementia, using linear mixed models across 4 years of follow-up, and relations with magnetic resonance imaging (MRI; n = 1536) and 18F-fluorodeoxyglucose brain positron emission tomography (18F-FDG-PET) imaging (n = 756) using linear regression models across 2 years of follow-up. RESULTS Semantic fluency declined-fastest in those at higher risk for AD (apolipoprotein E [APOE] e4 carriers, Clinical Dementia Rating score of .5, aMCI, or incident dementia)-while letter fluency did not except for those with incident dementia. Lower baseline semantic fluency was associated with an increase in white matter hyperintensities and total mean cortical thinning over time, and regionally with less hippocampal volume as well as more cortical thinning and reduced 18F-FDG-PET uptake in the inferior parietal lobule, entorhinal cortex, isthmus cingulate, and precuneus-posterior cingulate area. In contrast, baseline letter fluency was not associated with change in total nor regional neurodegeneration. Whole-brain neurodegeneration over time was associated with faster decline in both fluencies, while AD-specific regions were associated with a faster rate of decline in semantic but not letter fluency. INTERPRETATION This study provides strong evidence of distinctive degeneration of semantic abilities early on in relation to both cognitive decline and AD-specific neurodegeneration.
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Affiliation(s)
- Jet M. J. Vonk
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainDepartment of NeurologyCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
- Julius Center for Health Sciences and Primary Care, Department of EpidemiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Vincent Bouteloup
- Centre Inserm U1219d'Epidémiologie et de Développement (ISPED)Bordeaux School of Public HealthInstitut de Santé PubliqueUniversité de BordeauxBordeauxFrance
- Pole de sante publiqueCentre Hospitalier Universitaire (CHU) de BordeauxBordeauxFrance
| | - Jean‐François Mangin
- CATI Multicenter Neuroimaging PlatformParisFrance
- NeurospinCEAParis Saclay UniversityGif‐sur‐YvetteFrance
| | - Bruno Dubois
- IM2AAP‐HPINSERMUMR‐S975Groupe Hospitalier Pitié‐SalpêtrièreInstitut de la Mémoire et de la Maladie d'AlzheimerInstitut du Cerveau et de la Moelle épinièreSorbonne UniversitéParisFrance
| | - Frédéric Blanc
- Hôpitaux Universitaire de StrasbourgCM2R (Centre Mémoire de Ressource et de Recherche)Hôpital de jourpôle de Gériatrieet CNRSlaboratoire ICube UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMISStrasbourgFrance
| | - Audrey Gabelle
- Centre Mémoire Ressources RechercheDépartement de NeurologieCHU Gui de ChauliacMontpellierFrance
- Inserm U1061La ColombièreUniversité de MontpellierMontpellierFrance
| | - Mathieu Ceccaldi
- CMMR PACA OuestCHU TimoneAPHM & Aix Marseille UnivINSERMINSInst Neurosci SystMarseilleFrance
| | - Cédric Annweiler
- Department of Geriatric MedicineAngers University HospitalAngersFrance
- Angers University Memory ClinicAngersFrance
- Research Center on Autonomy and LongevityAngersFrance
- UPRES EA 4638University of AngersAngersFrance
- Robarts Research InstituteDepartment of Medical BiophysicsSchulich School of Medicine and Dentistrythe University of Western Ontario, OntarioLondonCanada
| | - Pierre Krolak‐Salmon
- Institut du VieillissementCentre Mémoire Ressources Recherche de LyonHospices civils de LyonUniversité Lyon 1, Inserm U1048LyonFrance
| | | | - Thérèse Rivasseau‐Jonveaux
- Centre Mémoire de Ressources et de Recherche de Lorraine Unité Cognitivo Comportementale CHRU NancyLaboratoire Lorrain de Psychologie et de Neurosciences de la dynamique des comportements 2LPN EA 7489 Université de LorraineNancyFrance
| | - Adrien Julian
- Service de NeurologieCHU La MilétrieCentre Mémoire de Ressources et de RecherchePoitiersFrance
| | - François Sellal
- CMRR Département de NeurologieHôpitaux CivilsColmarFrance
- INSERM U‐1118Université de Strasbourg. Faculté de MédecineStrasbourgFrance
| | - Eloi Magnin
- Centre Mémoire Ressources et Recherche (CMRR)service de NeurologieCHRU BesançonBesançonFrance
- Neurosciences intégratives et cliniques EA481Univ. Bourgogne Franche‐ComtéBesançonFrance
| | - Marie Chupin
- CATI Multicenter Neuroimaging PlatformParisFrance
| | - Marie‐Odile Habert
- CATI Multicenter Neuroimaging PlatformParisFrance
- CNRSINSERMLaboratoire d'Imagerie BiomédicaleLIBSorbonne UniversitéParisFrance
- AP‐HPHôpital Pitié‐SalpêtrièreMédecine NucléaireParisFrance
| | - Geneviève Chêne
- Centre Inserm U1219d'Epidémiologie et de Développement (ISPED)Bordeaux School of Public HealthInstitut de Santé PubliqueUniversité de BordeauxBordeauxFrance
- Pole de sante publiqueCentre Hospitalier Universitaire (CHU) de BordeauxBordeauxFrance
| | - Carole Dufouil
- Centre Inserm U1219d'Epidémiologie et de Développement (ISPED)Bordeaux School of Public HealthInstitut de Santé PubliqueUniversité de BordeauxBordeauxFrance
- Pole de sante publiqueCentre Hospitalier Universitaire (CHU) de BordeauxBordeauxFrance
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12
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Alves L, Cardoso S, Silva D, Mendes T, Marôco J, Nogueira J, Lima M, Tábuas-Pereira M, Baldeiras I, Santana I, de Mendonça A, Guerreiro M. Neuropsychological profile of amyloid-positive versus amyloid-negative amnestic Mild Cognitive Impairment. J Neuropsychol 2020; 15 Suppl 1:41-52. [PMID: 32588984 DOI: 10.1111/jnp.12218] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/19/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Patients diagnosed with amnestic mild cognitive impairment (aMCI) are at high risk of progressing to dementia. It became possible, through the use of biomarkers, to diagnose those patients with aMCI who have Alzheimer's disease. However, it is presently unfeasible that all patients undergo biomarker testing. Since neuropsychological testing is required to make a formal diagnosis of aMCI, it would be interesting if it could be used to predict the amyloid status of patients with aMCI. METHODS Participants with aMCI, known amyloid status (Aβ+ or Aβ-) and a comprehensive neuropsychological evaluation, were selected from the Cognitive Complaints Cohort database for this study. Neuropsychological tests were compared in Aβ+ and Aβ- aMCI patients. A binary logistic regression analysis was conducted to model the probability of being amyloid positive. RESULTS Of the 216 aMCI patients studied, 117 were Aβ+ and 99 were Aβ-. Aβ+ aMCI patients performed worse on several memory tests, namely Word Total Recall, Logical Memory Immediate and Delayed Free Recall, and Verbal Paired Associate Learning, as well as on Trail Making Test B, an executive function test. In a binary logistic regression model, only Logical Memory Delayed Free Recall retained significance, so that for each additional score point in this test, the probability of being amyloid positive decreased by 30.6%. The resulting model correctly classified 64.6% of the aMCI cases regarding their amyloid status. CONCLUSIONS The neuropsychological assessment remains an essential step to diagnose and characterize patients with aMCI; however, neuropsychological tests have limited value to distinguish the aMCI patients who have amyloid pathology from those who might suffer from other clinical conditions.
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Affiliation(s)
- Luísa Alves
- Chronic Diseases Research Centre, NOVA Medical School, NOVA University of Lisbon, Portugal
| | | | - Dina Silva
- Faculty of Medicine, University of Lisbon, Portugal.,Cognitive Neuroscience Research Group, Department of Psychology and Educational Sciences and Center for Biomedical Research (CBMR), Universidade do Algarve, Faro, Portugal
| | - Tiago Mendes
- Faculty of Medicine, University of Lisbon, Portugal.,Psychiatry and Mental Health Department, Santa Maria Hospital, Lisbon, Portugal
| | - João Marôco
- Instituto Superior de Psicologia Aplicada, Lisbon, Portugal
| | - Joana Nogueira
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Portugal
| | - Marisa Lima
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Portugal
| | - Miguel Tábuas-Pereira
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Portugal
| | - Inês Baldeiras
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Portugal
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Portugal
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13
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Wams EJ, Wilcock GK, Foster RG, Wulff K. Sleep-Wake Patterns and Cognition of Older Adults with Amnestic Mild Cognitive Impairment (aMCI): A Comparison with Cognitively Healthy Adults and Moderate Alzheimer's Disease Patients. Curr Alzheimer Res 2018; 14:1030-1041. [PMID: 28545363 DOI: 10.2174/1567205014666170523095634] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/29/2017] [Accepted: 05/16/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Age-related cognitive impairment and the prevalence of neurodegenerative disease contribute to decreasing quality of life in affected individuals and their families as well as demand considerable societal responsibility. Sleep supports overall brain activity and contributes to both physical and mental health. As a result, sleep is an attractive target for exploring ways to promote health in accelerated cognitive aging. The aims of this study were to characterise cognitive performance and sleepwake behaviour in older adults with different degrees of cognitive impairment. METHODS Cognitive ability in a variety of domains of amnestic mild cognitive impairment (aMCI) individuals, moderate AD patients and cognitively healthy adults was assessed with the Mini-Mental-State- Examination and five computerised tests (CANTABeclipse™). It was imperative to exclude mixed diagnosis, comorbidities (psychiatric, neurological, sleep disorders), anti-dementia medication, institutionalised subjects, and to study participants within their home to minimise confounders. Sleep profiles were assessed with the Jupiter Sleep Questionnaire and Pittsburgh Sleep Quality Index completed by participants and carers. Participants' sleep-wake activity was monitored for three weeks using a wrist-worn actigraph and a semi-standardised diary. Groups were compared according to their diagnostic category and then pooled to correlate sleep data with cognitive performance. RESULTS Mild cognitive impairment in aMCI individuals was reflected in domains of verbal and visuospatial memory but not attentional capacity or episodic memory. All self-reported and objective measures of sleep quality and sleep quantity of the aMCIs were within the normal range and comparable to those of cognitively healthy controls. Moderate AD patients scored significantly lower on all cognitive tests and had lower rest-activity amplitudes and distinctively longer nightly sleep periods that were not associated with sleep disorders, sleep medication or poor sleep efficiency. Self-rated and actigraphic quality of sleep was equally good (i.e. 90% sleep efficiency) in all groups. CONCLUSION This investigation is of clinical importance, because major confounding variables were excluded. The lack of comorbidities might be responsible for the absence of sundown syndrome and sleep disturbances commonly reported in AD patients. Whether there is interdependence between progressive decline in cognition and long sleep duration remains elusive. Future studies should address whether prolonged sleep at night and decreased day-time activity can be altered to delay the progression of cognitive decline.
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Affiliation(s)
- Emma J Wams
- Nuffield Department of Clinical Neurosciences, Oxford Molecular Pathology Institute (OMPI), South Parks Road, Oxford, OX1 3RE. United Kingdom
| | - Gordon K Wilcock
- Nuffield Department of Clinical Neurosciences, West Wing, University of Oxford, John Radcliffe Hospital, Headington, Oxford OX3 9DU. United Kingdom
| | - Russell G Foster
- Nuffield Department of Clinical Neurosciences, Oxford Molecular Pathology Institute (OMPI), South Parks Road, Oxford, OX1 3RE. United Kingdom
| | - Katharina Wulff
- University of Oxford, Sleep and Circadian Neuroscience Institute, Sir William Dunn School of Pathology (OMPI), South Parks Road, Oxford OX1 3RE. United Kingdom
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14
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Wakefield SJ, Blackburn DJ, Harkness K, Khan A, Reuber M, Venneri A. Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment. Acta Neuropsychiatr 2018; 30:90-6. [PMID: 28714423 DOI: 10.1017/neu.2017.21] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Patients with functional memory disorder (FMD) report significant memory failures in everyday life. Differentiating these patients from those with memory difficulties due to early stage neurodegenerative conditions is clinically challenging. The current study explored whether distinctive neuropsychological profiles could be established, suitable to differentiate patients with FMD from healthy individuals and those experiencing amnestic mild cognitive impairment (a-MCI). METHODS Patients with a clinical diagnosis of FMD were compared with patients with a-MCI, and healthy matched controls on several tests assessing different cognitive functions. Patients with clinically established mood disorders were excluded. Patients with FMD and a-MCI were broadly comparable on the level of their subjective memory complaints as assessed by clinical interview. RESULTS The neuropsychological profile of the FMD patients, although they expressed subjective memory and attention concerns during their clinical interview was distinct from patients with a-MCI on tests of memory [semantic fluency, age of acquisition (AoA) analysis of semantic fluency, verbal and non-verbal memory]. FMD patients did not differ significantly from healthy controls, but their scores on the letter fluency and digit cancellation tasks were not significantly different from those of the a-MCI patients indicating a possible sub-threshold deficit on these tasks. CONCLUSION Whilst subjective complaints are common within the FMD population, no objective impairment could be detected, even on a sensitive battery of tasks designed to detect subtle deficits caused by an early neurodegenerative brain disease. This study indicates that FMD patients can be successfully differentiated from patients with neurodegenerative memory decline by characterising their neuropsychological profile.
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15
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Csukly G, Sirály E, Fodor Z, Horváth A, Salacz P, Hidasi Z, Csibri É, Rudas G, Szabó Á. The Differentiation of Amnestic Type MCI from the Non-Amnestic Types by Structural MRI. Front Aging Neurosci 2016; 8:52. [PMID: 27065855 PMCID: PMC4811920 DOI: 10.3389/fnagi.2016.00052] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [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: 12/09/2015] [Accepted: 02/29/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction: While amnestic mild cognitive impairment (aMCI) and non-amnestic mild cognitive impairment (naMCI) are theoretically different entities, only a few investigations studied the structural brain differences between these subtypes of mild cognitive impairment. The aim of the study was to find the structural differences between aMCI and naMCI, and to replicate previous findings on the differentiation between aMCI and healthy controls. Methods: Altogether 62 aMCI, naMCI, and healthy control subjects were included into the study based on the Petersen criteria. All patients underwent a routine brain MR examination, and a detailed neuropsychological examination. Results: The sizes of the hippocampus, the entorhinal cortex and the amygdala were decreased in aMCI relative to naMCI and to controls. Furthermore the cortical thickness of the entorhinal cortex, the fusiform gyrus, the precuneus and the isthmus of the cingulate gyrus were significantly decreased in aMCI relative to naMCI and healthy controls. The largest differences relative to controls were detected for the volume of the hippocampus (18% decrease vs. controls) and the cortical thickness (20% decrease vs. controls) of the entorhinal cortex: 1.6 and 1.4 in terms of Cohen's d. Only the volume of the precuneus were decreased in the naMCI group (5% decrease) compared to the control subjects: 0.9 in terms of Cohen's d. Significant between group differences were also found in the neuropsychological test results: a decreased anterograde, retrograde memory, and category fluency performance was detected in the aMCI group relative to controls and naMCI subjects. Subjects with naMCI showed decreased letter fluency relative to controls, while both MCI groups showed decreased executive functioning relative to controls as measured by the Trail Making test part B. Memory performance in the aMCI group and in the entire sample correlated with the thickness of the entorhinal cortex and with the volume of the amygdala. Conclusion: The amnestic mild cognitive impairment/non-amnestic mild cognitive impairment separation is not only theoretical but backed by structural imaging methods and neuropsychological tests. A better knowledge of the MCI subtypes can help to predict the direction of progression and create targeted prevention.
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Affiliation(s)
- Gábor Csukly
- Department of Psychiatry and Psychotherapy, Semmelweis University Budapest, Hungary
| | - Enikő Sirály
- Department of Psychiatry and Psychotherapy, Semmelweis University Budapest, Hungary
| | - Zsuzsanna Fodor
- Department of Psychiatry and Psychotherapy, Semmelweis University Budapest, Hungary
| | - András Horváth
- Department of Neurology, National Institute of Clinical Neurosciences Budapest, Hungary
| | - Pál Salacz
- Department of Psychiatry and Psychotherapy, Semmelweis UniversityBudapest, Hungary; Department of Neurology, Hospital at Péterfy Sándor StreetBudapest, Hungary
| | - Zoltán Hidasi
- Department of Psychiatry and Psychotherapy, Semmelweis University Budapest, Hungary
| | - Éva Csibri
- Department of Psychiatry and Psychotherapy, Semmelweis University Budapest, Hungary
| | - Gábor Rudas
- Magnetic Resonance Imaging Research Center, Semmelweis University Budapest, Hungary
| | - Ádám Szabó
- Magnetic Resonance Imaging Research Center, Semmelweis University Budapest, Hungary
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16
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Michels L, Warnock G, Buck A, Macauda G, Leh SE, Kaelin AM, Riese F, Meyer R, O'Gorman R, Hock C, Kollias S, Gietl AF. Arterial spin labeling imaging reveals widespread and Aβ-independent reductions in cerebral blood flow in elderly apolipoprotein epsilon-4 carriers. J Cereb Blood Flow Metab 2016; 36:581-95. [PMID: 26661143 PMCID: PMC4794091 DOI: 10.1177/0271678x15605847] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 10/07/2015] [Indexed: 12/11/2022]
Abstract
Changes in cerebral blood flow are an essential feature of Alzheimer's disease and have been linked to apolipoprotein E-genotype and cerebral amyloid-deposition. These factors could be interdependent or influence cerebral blood flow via different mechanisms. We examined apolipoprotein E-genotype, amyloid beta-deposition, and cerebral blood flow in amnestic mild cognitive impairment using pseudo-continuous arterial spin labeling MRI in 27 cognitively normal elderly and 16 amnestic mild cognitive impairment participants. Subjects underwent Pittsburgh Compound B (PiB) positron emission tomography and apolipoprotein E-genotyping. Global cerebral blood flow was lower in apolipoprotein E ɛ4-allele carriers (apolipoprotein E4+) than in apolipoprotein E4- across all subjects (including cognitively normal participants) and within the group of cognitively normal elderly. Global cerebral blood flow was lower in subjects with mild cognitive impairment compared with cognitively normal. Subjects with elevated cerebral amyloid-deposition (PiB+) showed a trend for lower global cerebral blood flow. Apolipoprotein E-status exerted the strongest effect on global cerebral blood flow. Regional analysis indicated that local cerebral blood flow reductions were more widespread for the contrasts apolipoprotein E4+ versus apolipoprotein E4- compared with the contrasts PiB+ versus PiB- or mild cognitive impairment versus cognitively normal. These findings suggest that apolipoprotein E-genotype exerts its impact on cerebral blood flow at least partly independently from amyloid beta-deposition, suggesting that apolipoprotein E also contributes to cerebral blood flow changes outside the context of Alzheimer's disease.
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Affiliation(s)
- Lars Michels
- Institute of Neuroradiology, University Hospital Zurich, Zurich, Switzerland Center of MR-Research, University Children's Hospital Zurich, Zurich, Switzerland
| | - Geoffrey Warnock
- Clinic of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Alfred Buck
- Clinic of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Gianluca Macauda
- Institute of Neuroradiology, University Hospital Zurich, Zurich, Switzerland Neuropsychology Unit, Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Sandra E Leh
- Division of Psychiatry Research and Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Andrea M Kaelin
- Division of Psychiatry Research and Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Florian Riese
- Division of Psychiatry Research and Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Rafael Meyer
- Division of Psychiatry Research and Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Ruth O'Gorman
- Center of MR-Research, University Children's Hospital Zurich, Zurich, Switzerland
| | - Christoph Hock
- Division of Psychiatry Research and Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
| | - Spyros Kollias
- Institute of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Anton F Gietl
- Division of Psychiatry Research and Psychogeriatric Medicine, University of Zurich, Zurich, Switzerland
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17
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Goldman JG, Aggarwal NT, Schroeder CD. Mild cognitive impairment: an update in Parkinson's disease and lessons learned from Alzheimer's disease. Neurodegener Dis Manag 2015; 5:425-43. [PMID: 26517759 DOI: 10.2217/nmt.15.34] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Cognitive dysfunction is an important focus of research in Parkinson's disease (PD) and Alzheimer's disease (AD). While the concept of amnestic mild cognitive impairment (MCI) as a prodrome to AD has been recognized for many years, the construct of MCI in PD is a relative newcomer with recent development of diagnostic criteria, biomarker research programs and treatment trials. Controversies and challenges, however, regarding PD-MCI's definition, application, heterogeneity and different trajectories have arisen. This review will highlight current research advances and challenges in PD-MCI. Furthermore, lessons from the AD field, which has witnessed an evolution in MCI/AD definitions, relevant advances in biomarker research and development of disease-modifying and targeted therapeutic trials will be discussed.
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Affiliation(s)
- Jennifer G Goldman
- Rush University Medical Center, Department of Neurological Sciences, Section of Parkinson Disease & Movement Disorders, 1725 W. Harrison Street, Suite 755, Chicago, IL 60612, USA
| | - Neelum T Aggarwal
- Rush University Medical Center, Department of Neurological Sciences & Rush Alzheimer's Disease Center, 600 South Paulina, Suite 1038, Chicago, IL 60612, USA
| | - Cynthia D Schroeder
- Rush University Medical Center, Department of Neurological Sciences, 1735 W. Harrison Street, Suite 306, Chicago, IL 60612, USA
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18
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Neufeld KJ, Nelliot A, Inouye SK, Ely EW, Bienvenu OJ, Lee HB, Needham DM. Delirium diagnosis methodology used in research: a survey-based study. Am J Geriatr Psychiatry 2014; 22:1513-21. [PMID: 24745562 PMCID: PMC4164600 DOI: 10.1016/j.jagp.2014.03.003] [Citation(s) in RCA: 37] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 03/05/2014] [Accepted: 03/06/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe methodology used to diagnose delirium in research studies evaluating delirium detection tools. METHODS The authors used a survey to address reference rater methodology for delirium diagnosis, including rater characteristics, sources of patient information, and diagnostic process, completed via web or telephone interview according to respondent preference. Participants were authors of 39 studies included in three recent systematic reviews of delirium detection instruments in hospitalized patients. RESULTS Authors from 85% (N = 33) of the 39 eligible studies responded to the survey. The median number of raters per study was 2.5 (interquartile range: 2-3); 79% were physicians. The raters' median duration of clinical experience with delirium diagnosis was 7 years (interquartile range: 4-10), with 5% having no prior clinical experience. Inter-rater reliability was evaluated in 70% of studies. Cognitive tests and delirium detection tools were used in the delirium reference rating process in 61% (N = 21) and 45% (N = 15) of studies, respectively, with 33% (N = 11) using both and 27% (N = 9) using neither. When patients were too drowsy or declined to participate in delirium evaluation, 70% of studies (N = 23) used all available information for delirium diagnosis, whereas 15% excluded such patients. CONCLUSION Significant variability exists in reference standard methods for delirium diagnosis in published research. Increasing standardization by documenting inter-rater reliability, using standardized cognitive and delirium detection tools, incorporating diagnostic expert consensus panels, and using all available information in patients declining or unable to participate with formal testing may help advance delirium research by increasing consistency of case detection and improving generalizability of research results.
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Affiliation(s)
- KJ Neufeld
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland USA
| | - A Nelliot
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland USA
| | - SK Inouye
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts USA,Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts USA
| | - EW Ely
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Center for Health Services Research, Vanderbilt School of Medicine, Nashville, Tennessee USA,Geriatric Research, Education and Clinical Center, (GRECC) Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee USA
| | - OJ Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland USA
| | - HB Lee
- Psychological Medicine Service, Yale-New Haven Hospital, New Haven, Connecticut USA
| | - DM Needham
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland USA,Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland USA
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19
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Román GC, Jackson RE, Longoria EM, Fisher RE. Scopolamine-induced "cholinergic stress test" in the elderly. Front Pharmacol 2014; 5:182. [PMID: 25165458 PMCID: PMC4131233 DOI: 10.3389/fphar.2014.00182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/17/2014] [Indexed: 11/19/2022] Open
Affiliation(s)
- Gustavo C Román
- Department of Neurology, Methodist Neurological Institute, Houston Methodist Hospital Houston, TX, USA ; Department of Neurology, Professor of Neurology, Weill Cornell Medical College of Cornell University New York, NY, USA
| | - Robert E Jackson
- Department of Medicine, Houston Methodist Hospital Houston, TX, USA ; Department of Medicine, Clinical Professor of Internal Medicine, Weill Cornell Medical College of Cornell University New York, NY, USA
| | - E Mariana Longoria
- Division of Cognitive Aging and Geriatric Psychiatry, Mexican National Institute of Neurology and Neurosurgery México DF, México
| | - Ronald E Fisher
- Departments of Radiology and Neuroscience, Assistant Professor in Radiology and Neuroscience, Baylor College of Medicine Houston, TX, USA ; Director of Nuclear Medicine, Houston Methodist Hospital Houston, TX, USA
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20
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Abstract
Mild cognitive impairment (MCI) is a dynamic state between normal cognition and dementia, where interventions can be taken to stop or delay the progression to dementia. It is broadly of 2 types-amnestic, where memory loss is the chief concern and nonamnestic, where it is not. One variant of nonamnestic, dysexecutive, being more prevalent is sometimes known as a separate subtype by itself. Diagnosis of MCI is mostly clinical and is aided by various scales and neuropsychological testing. Functional imaging studies help in early detection and is superior to biomarkers or structural magnetic resonance imaging. Although there is no evidence supporting any pharmacological intervention, cognitive rehabilitation, memory training, and caregiver support play a strong role in limiting and sometimes reversing the ongoing cognitive decline. As the spectrum of MCI is heterogeneous, making the right diagnosis can be a challenging; hence, we need a systematic yet cost-effective algorithm for the timely management of MCI.
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Affiliation(s)
- Sayantani Ghosh
- Department of Neurology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - David Libon
- Department of Neurology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Carol Lippa
- Department of Neurology, Drexel University College of Medicine, Philadelphia, PA, USA
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21
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Raamana PR, Wen W, Kochan NA, Brodaty H, Sachdev PS, Wang L, Beg MF. The Sub-Classification of Amnestic Mild Cognitive Impairment Using MRI-Based Cortical Thickness Measures. Front Neurol 2014; 5:76. [PMID: 24904520 PMCID: PMC4033252 DOI: 10.3389/fneur.2014.00076] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 02/14/2014] [Accepted: 05/02/2014] [Indexed: 11/13/2022] Open
Abstract
Background: Amnestic mild cognitive impairment (aMCI) is considered to be the transitional stage between healthy aging and Alzheimer’s disease (AD). Moreover, aMCI individuals with additional impairment in one or more non-memory cognitive domains are at higher risk of conversion to AD. Hence accurate identification of the sub-types of aMCI would enable earlier detection of individuals progressing to AD. Methods: We examine the group differences in cortical thickness between single-domain and multiple-domain sub-types of aMCI, and as well as with respect to age-matched controls in a well-balanced cohort from the Sydney Memory and Aging Study. In addition, the diagnostic value of cortical thickness in the sub-classification of aMCI as well as from normal controls using support vector machine (SVM) classifier is evaluated, using a novel cross-validation technique that can handle class-imbalance. Results: This study revealed an increased, as well as a wider spread, of cortical thinning in multiple-domain aMCI compared to single-domain aMCI. The best performances of the classifier for the pairs (1) single-domain aMCI and normal controls, (2) multiple-domain aMCI and normal controls, and (3) single and multiple-domain aMCI were AUC = 0.52, 0.66, and 0.54, respectively. The accuracy of the classifier for the three pairs was just over 50% exhibiting low specificity (44–60%) and similar sensitivity (53–68%). Conclusion: Analysis of group differences added evidence to the hypothesis that multiple-domain aMCI is a later stage of AD compared to single-domain aMCI. The classification results show that discrimination among single, multiple-domain sub-types of aMCI and normal controls is limited using baseline cortical thickness measures.
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Affiliation(s)
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales , Sydney, NSW , Australia ; Neuropsychiatric Institute, Prince of Wales Hospital , Randwick, NSW , Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales , Sydney, NSW , Australia ; Neuropsychiatric Institute, Prince of Wales Hospital , Randwick, NSW , Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales , Sydney, NSW , Australia ; Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales , Sydney, NSW , Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales , Sydney, NSW , Australia ; Neuropsychiatric Institute, Prince of Wales Hospital , Randwick, NSW , Australia
| | - Lei Wang
- Feinberg School of Medicine, Northwestern University , Chicago, IL , USA
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University , Burnaby, BC , Canada
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22
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Oudman E, Van der Stigchel S, Postma A, Wijnia JW, Nijboer TCW. A Case of Chronic Wernicke's Encephalopathy: A Neuropsychological Study. Front Psychiatry 2014; 5:59. [PMID: 24904442 PMCID: PMC4034510 DOI: 10.3389/fpsyt.2014.00059] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 05/12/2014] [Indexed: 11/13/2022] Open
Abstract
A 54-year-old woman was referred to our Korsakoff Center because of extensive cognitive problems following acute Wernicke's encephalopathy (WE). She had a relatively short history of alcohol abuse and was found lying on the floor in her home by her son. After 5 days without treatment, she was diagnosed with WE in a general hospital. During the course of the disease, minimal change to the acute situation occurred, with chronic confusion, attention deficits, and incoherent behavior symptoms most notable unlike classical Korsakoff's syndrome. Neuropsychological assessment after 4 and 16 months after admission to the hospital revealed global cognitive decline, with striking impairments in attentional, executive, and memory functions. The present case study suggests that the state of confusion and the neuropsychological symptoms in WE can become chronic in case of very late treatment. We therefore recommend that confused alcoholics should receive appropriate parenteral thiamine according to the current clinical standards.
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Affiliation(s)
- Erik Oudman
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University , Utrecht , Netherlands ; Slingedael Korsakoff Center , Rotterdam , Netherlands
| | - Stefan Van der Stigchel
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University , Utrecht , Netherlands
| | - Albert Postma
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University , Utrecht , Netherlands ; Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht , Netherlands
| | - Jan W Wijnia
- Slingedael Korsakoff Center , Rotterdam , Netherlands
| | - Tanja C W Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University , Utrecht , Netherlands ; Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht , Utrecht , Netherlands ; Brain Center Rudolf Magnus, Center of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, University Medical Center Utrecht , Utrecht , Netherlands
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23
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Abstract
BACKGROUND Cerebral white matter lesions (WML), evident on CT and MRI brain scans, are histopathologically heterogeneous but associated with vascular risk factors and thought mainly to indicate ischemic damage. There has been disagreement over their clinical prognostic value in predicting conversion from mild cognitive impairment (MCI) to dementia. METHODS We scrutinised and rated CT and MRI brain scans for degree of WML in a memory clinic cohort of 129 patients with at least 1 year of follow-up. We examined the relationship between WML severity and time until conversion to dementia for all MCI patients and for amnestic (aMCI) and non-amnestic (naMCI) subgroups separately. RESULTS Five-year outcome data were available for 87 (67%) of the 129 patients. The proportion of patients converting to dementia was 25% at 1 year and 76% at 5 years. Patients with aMCI converted to dementia significantly earlier than those with naMCI. WML severity was not associated with time to conversion to dementia for either MCI patients in general or aMCI patients in particular. Among naMCI patients, there was a tendency for those with a low degree of WML to survive without dementia for longer than those with a high degree of WML. However, this was not statistically significant. CONCLUSIONS MCI subtype is a significant independent predictor of conversion to dementia, with aMCI patients having higher risk than naMCI for conversion throughout the 5-year follow-up period. WML severity does not influence conversion to dementia for aMCI but might accelerate progression in naMCI.
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24
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Bangen KJ, Jak AJ, Schiehser DM, Delano-Wood L, Tuminello E, Han SD, Delis DC, Bondi MW. Complex activities of daily living vary by mild cognitive impairment subtype. J Int Neuropsychol Soc 2010; 16:630-9. [PMID: 20374675 DOI: 10.1017/S1355617710000330] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
There is increasing consensus regarding the importance of operationally defining and measuring functional decline in mild cognitive impairment (MCI). However, few studies have directly examined functional abilities in MCI or its presumed subtypes and, to date, reported findings have been discrepant. Nondemented older adults (n = 120) were administered a comprehensive cognitive battery measuring multiple domains as well as a performance-based functional ability measure. Participants were characterized as either cognitively normal, amnestic MCI, or non-amnestic MCI. MCI individuals demonstrated decrements in instrumental activities of daily living (IADL) relative to their cognitively normal counterparts. Specifically, participants with amnestic MCI demonstrated significant decrements in financial management, whereas those with non-amnestic MCI showed poorer performance in abilities related to health and safety. Moreover, decreased functional abilities were associated with decrements in global cognitive functioning but not memory or executive functions in the MCI participants. Finally, logistic regression demonstrated that functional abilities accurately predicted MCI subtype. Results support the need for better delineation of functional decline in MCI. Given the implications of functional status for MCI diagnosis and treatment, the direct assessment of functional abilities is recommended. Results further suggest performance-based IADL assessment may have utility in distinguishing MCI subtypes.
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25
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Jak AJ, Urban S, McCauley A, Bangen KJ, Delano-Wood L, Corey-Bloom J, Bondi MW. Profile of hippocampal volumes and stroke risk varies by neuropsychological definition of mild cognitive impairment. J Int Neuropsychol Soc 2009; 15:890-7. [PMID: 19570306 DOI: 10.1017/S1355617709090638] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Wide-ranging conceptual and diagnostic approaches to defining mild cognitive impairment (MCI) have led to highly variable prevalence and progression rates. We sought to examine whether bilateral hippocampal volumes and cerebrovascular risk factors in individuals characterized by two different neuropsychological definitions of MCI subtypes would also differ. Participants were 65 nondemented, community-dwelling, older adults, ages 62-91 years, drawn from a larger group of individuals enrolled in a longitudinal study of normal aging. A comprehensive neuropsychological definition of MCI that required the presence of more than one impaired score in a cognitive domain resulted in expected anatomical results; hippocampal volumes were significantly smaller in the aMCI group as compared to cognitively normal or nonamnestic MCI participants. However, a typical definitional scheme for classifying MCI based only on the presence of one impaired score within a cognitive domain did not result in hippocampal differences between groups. Global stroke risk factors did not differ between the two definitional schemes, although the relationship between stroke risk variables and neuropsychological performance did vary by diagnostic approach. The comprehensive approach demonstrated associations between stroke risk and cognition, whereas the typical approach did not. Use of more sophisticated clinical decision-making and diagnostic approaches that incorporate comprehensive neuropsychological assessment techniques is supported by this convergence of neuropsychological, neuropathological, and stroke risk findings.
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26
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Huckans M, Seelye A, Parcel T, Mull L, Woodhouse J, Bjornson D, Fuller BE, Loftis JM, Morasco BJ, Sasaki AW, Storzbach D, Hauser P. The cognitive effects of hepatitis C in the presence and absence of a history of substance use disorder. J Int Neuropsychol Soc 2009; 15:69-82. [PMID: 19128530 DOI: 10.1017/S1355617708090085] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of the study was to determine whether infection with the hepatitis C virus (HCV) is associated with cognitive impairment beyond the effects of prevalent comorbidities and a history of substance use disorder (SUD). Adult veterans were recruited from the Portland Veterans Affairs Medical Center into three groups: (1) HCV+/SUD+ (n = 39), (2) HCV+/SUD- (n = 24), and (3) HCV-/SUD- (n = 56). SUD+ participants were in remission for > or =90 days, while SUD- participants had no history of SUD. Groups did not significantly differ in terms of rates of psychiatric or medical comorbidities. Procedures included clinical interviews, medical record reviews, and neuropsychological testing. Significant group differences were found in the domains of Verbal Memory, Auditory Attention, Speeded Visual Information Processing, and Reasoning/Mental Flexibility (p <or = .05). Post hoc comparisons indicated that HCV+/SUD- patients performed significantly worse than HCV-/SUD- controls on tests measuring verbal learning, auditory attention, and reasoning/mental flexibility, but only HCV+/SUD+ patients did worse than HCV-/SUD- controls on tests of speeded visual information processing. Results indicate that chronic HCV is associated with cognitive impairment in the absence of a history of SUD. The most robust deficits appear to be in verbal learning and reasoning/mental flexibility. (JINS, 2009, 15, 69-82.).
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27
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Abstract
Mild cognitive impairment (MCI) is the transitional stage between normal aging
and Alzheimer’s disease (AD). Impairments in semantic memory have been
demonstrated to be a critical factor in early AD. The Boston Naming Test (BNT)
is a straightforward method of examining semantic or visuo-perceptual processing
and therefore represents a potential diagnostic tool. The objective of this
study was to examine naming ability and identify error types in patients with
amnestic mild cognitive impairment (aMCI).
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Affiliation(s)
- Indra F Willers
- Utrecht University, the Netherlands.,Department of Neuropsychology (SIREN), CEMIC School of Medicine & Research Institute, Buenos Aires, Argentina
| | - Mónica L Feldman
- Department of Neuropsychology (SIREN), CEMIC School of Medicine & Research Institute, Buenos Aires, Argentina
| | - Ricardo F Allegri
- Department of Neuropsychology (SIREN), CEMIC School of Medicine & Research Institute, Buenos Aires, Argentina.,CONICET
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Morice E, Billard JM, Denis C, Mathieu F, Betancur C, Epelbaum J, Giros B, Nosten-Bertrand M. Parallel loss of hippocampal LTD and cognitive flexibility in a genetic model of hyperdopaminergia. Neuropsychopharmacology 2007; 32:2108-16. [PMID: 17342172 PMCID: PMC2547847 DOI: 10.1038/sj.npp.1301354] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Dopamine-mediated neurotransmission has been implicated in the modulation of synaptic plasticity and in the mechanisms underlying learning and memory. In the present study, we tested different forms of activity-dependent neuronal and behavioral plasticity in knockout mice for the dopamine transporter (DAT-KO), which constitute a unique genetic model of constitutive hyperdopaminergia. We report that DAT-KO mice exhibit slightly increased long-term potentiation and severely decreased long-term depression at hippocampal CA3-CA1 excitatory synapses. Mutant mice also show impaired adaptation to environmental changes in the Morris watermaze. Both the electrophysiological and behavioral phenotypes are reversed by the dopamine antagonist haloperidol, suggesting that hyperdopaminergia is involved in these deficits. These findings support the modulation by dopamine of synaptic plasticity and cognitive flexibility. The behavioral deficits seen in DAT-KO mice are reminiscent of the deficits in executive functions observed in dopamine-related neuropsychiatric disorders, suggesting that the study of DAT-KO mice can contribute to the understanding of the molecular basis of these disorders.
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Affiliation(s)
- Elise Morice
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de MarneFaculte de Medecine PARIS XII
8, Rue du General Sarrail
94010 CRETEIL CEDEX,FR
| | - Jean-Marie Billard
- Neurobiologie de la Croissance et de la Senescence
INSERM : U549Université Paris Descartes - Paris VCentre Paul Broca
2 Ter, Rue D'Alesia
75014 PARIS ,FR
| | - Cécile Denis
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de MarneFaculte de Medecine PARIS XII
8, Rue du General Sarrail
94010 CRETEIL CEDEX,FR
| | - Flavie Mathieu
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de MarneFaculte de Medecine PARIS XII
8, Rue du General Sarrail
94010 CRETEIL CEDEX,FR
| | - Catalina Betancur
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de MarneFaculte de Medecine PARIS XII
8, Rue du General Sarrail
94010 CRETEIL CEDEX,FR
| | - Jacques Epelbaum
- Neurobiologie de la Croissance et de la Senescence
INSERM : U549Université Paris Descartes - Paris VCentre Paul Broca
2 Ter, Rue D'Alesia
75014 PARIS ,FR
| | - Bruno Giros
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de MarneFaculte de Medecine PARIS XII
8, Rue du General Sarrail
94010 CRETEIL CEDEX,FR
| | - Marika Nosten-Bertrand
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de MarneFaculte de Medecine PARIS XII
8, Rue du General Sarrail
94010 CRETEIL CEDEX,FR
- * Correspondence should be adressed to: Marika Nosten-Bertrand
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