1
|
Eraslan Boz H, Koçoğlu K, Akkoyun M, Tüfekci IY, Ekin M, Özçelik P, Akdal G. Uncorrected errors and correct saccades in the antisaccade task distinguish between early-stage Alzheimer's disease dementia, amnestic mild cognitive impairment, and normal aging. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2024; 31:457-478. [PMID: 37004192 DOI: 10.1080/13825585.2023.2198191] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/29/2023] [Indexed: 04/03/2023]
Abstract
Alzheimer's disease (AD) dementia is a degenerative illness that is characterized by a gradual decline in cognitive abilities. Amnestic mild cognitive impairment (aMCI) is seen as a precursor to AD. The changes in antisaccade performance that can be seen in MCI may provide important clues in the early detection of AD. Therefore, the antisaccade deficits in AD and aMCI remain a research question. This study aimed to examine antisaccade responses and the relationship between antisaccade and cognitive function in AD, aMCI, and healthy controls (HC). This study included 30 patients with early-stage AD, 34 with aMCI, and 32 HC. Patients with AD showed higher rates of uncorrected error, anticipatory saccades and corrected errors, as well as decreased correct saccade rates, and shortened saccade latency compared to aMCI and HC in this study. Patients with aMCI exhibited increased rates of express saccades relative to HC. The antisaccade task and cognitive domains were found to be significantly related. Our study showed that the rate of correct saccades has the capacity to distinguish AD from HC with 87% sensitivity and 86% specificity (AUC = 0.93, p < 0.001). In addition, the rate of uncorrected errors was found to be capable of distinguishing AD from HC with 84% sensitivity and 83% specificity (AUC = 0.91, p < 0.001). This study presented promising findings that these parameters can be used clinically to differentiate AD and aMCI from healthy older individuals.
Collapse
Affiliation(s)
- Hatice Eraslan Boz
- Institute of Health Sciences, Department of Neuroscience, Dokuz Eylül University, Izmir, Türkiye
- Department of Neurology, Unit of Neuropsychology, Dokuz Eylül University, Izmir, Türkiye
| | - Koray Koçoğlu
- Institute of Health Sciences, Department of Neuroscience, Dokuz Eylül University, Izmir, Türkiye
| | - Müge Akkoyun
- Institute of Health Sciences, Department of Neuroscience, Dokuz Eylül University, Izmir, Türkiye
| | - Işıl Yağmur Tüfekci
- Institute of Health Sciences, Department of Neuroscience, Dokuz Eylül University, Izmir, Türkiye
| | - Merve Ekin
- Institute of Health Sciences, Department of Neuroscience, Dokuz Eylül University, Izmir, Türkiye
| | - Pınar Özçelik
- Institute of Health Sciences, Department of Neuroscience, Dokuz Eylül University, Izmir, Türkiye
| | - Gülden Akdal
- Institute of Health Sciences, Department of Neuroscience, Dokuz Eylül University, Izmir, Türkiye
- Department of Neurology, Dokuz Eylül University, Izmir, Türkiye
| |
Collapse
|
2
|
Wang H, Shi L, Luo S, Luo Y, Xu C, Qiu G, Guo Q, Chen C, Lu T, Liu K, Zhu F. Associations of apolipoprotein E ε4 allele, regional cerebral blood flow, and serum liver function markers in patients with cognitive impairment. Front Neurol 2024; 15:1345705. [PMID: 38628697 PMCID: PMC11018914 DOI: 10.3389/fneur.2024.1345705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/04/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction The ε4 allele of the apolipoprotein E gene (APOE4) is expressed abundantly in both the brain and peripheral circulation as a genetic risk factor for Alzheimer's disease (AD). Cerebral blood flow (CBF) dysfunction is an essential feature of AD, and the liver plays an important role in the pathogenesis of dementia. However, the associations of APOE4 with CBF and liver function markers in patients with cognitive impairment remains unclear. We aimed to evaluate the associations of APOE4 with CBF measured by arterial spin labeling (ASL) magnetic resonance imaging (MRI) and serum liver function markers in participants who were diagnosed with cognitive impairment. Methods Fourteen participants with AD and sixteen with amnestic mild cognitive impairment (MCI) were recruited. In addition to providing comprehensive clinical information, all patients underwent laboratory tests and MRI. All participants were divided into carriers and noncarriers of the ε4 allele, and T-tests and Mann-Whitney U tests were used to observe the differences between APOE4 carriers and noncarriers in CBF and liver function markers. Results Regarding regional cerebral blood flow (rCBF), APOE4 carriers showed hyperperfusion in the bilateral occipital cortex, bilateral thalamus, and left precuneus and hypoperfusion in the right lateral temporal cortex when compared with noncarriers. Regarding serum liver function markers, bilirubin levels (including total, direct, and indirect) were lower in APOE4 carriers than in noncarriers. Conclusion APOE4 exerts a strong effect on CBF dysfunction by inheritance, representing a risk factor for AD. APOE4 may be related to bilirubin metabolism, potentially providing specific neural targets for the diagnosis and treatment of AD.
Collapse
Affiliation(s)
- Hao Wang
- Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Lin Shi
- BrainNow Research Institute, Guangdong, China
| | - Shimei Luo
- Department of Nuclear Magnetic Resonance, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, China
| | - Yishan Luo
- BrainNow Research Institute, Guangdong, China
| | - Chunyan Xu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, China
| | - Guozhen Qiu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, China
| | - Qiwen Guo
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, China
| | - Chunchun Chen
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, China
| | - Taikun Lu
- Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Kangding Liu
- Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Feiqi Zhu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, China
| |
Collapse
|
3
|
Hu H, Wang L, Abdul S, Tang X, Feng Q, Mu Y, Ge X, Liao Z, Ding Z. Frequency-dependent alterations in functional connectivity in patients with Alzheimer's Disease spectrum disorders. Front Aging Neurosci 2024; 16:1375836. [PMID: 38605859 PMCID: PMC11007178 DOI: 10.3389/fnagi.2024.1375836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/04/2024] [Indexed: 04/13/2024] Open
Abstract
Background In the spectrum of Alzheimer's Disease (AD) and related disorders, the resting-state functional magnetic resonance imaging (rs-fMRI) signals within the cerebral cortex may exhibit distinct characteristics across various frequency ranges. Nevertheless, this hypothesis has not yet been substantiated within the broader context of whole-brain functional connectivity. This study aims to explore potential modifications in degree centrality (DC) and voxel-mirrored homotopic connectivity (VMHC) among individuals with amnestic mild cognitive impairment (aMCI) and AD, while assessing whether these alterations differ across distinct frequency bands. Methods This investigation encompassed a total of 53 AD patients, 40 aMCI patients, and 40 healthy controls (HCs). DC and VMHC values were computed within three distinct frequency bands: classical (0.01-0.08 Hz), slow-4 (0.027-0.073 Hz), and slow-5 (0.01-0.027 Hz) for the three respective groups. To discern differences among these groups, ANOVA and subsequent post hoc two-sample t-tests were employed. Cognitive function assessment utilized the mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA). Pearson correlation analysis was applied to investigate the associations between MMSE and MoCA scores with DC and VMHC. Results Significant variations in degree centrality (DC) were observed among different groups across diverse frequency bands. The most notable differences were identified in the bilateral caudate nucleus (CN), bilateral medial superior frontal gyrus (mSFG), bilateral Lobule VIII of the cerebellar hemisphere (Lobule VIII), left precuneus (PCu), right Lobule VI of the cerebellar hemisphere (Lobule VI), and right Lobule IV and V of the cerebellar hemisphere (Lobule IV, V). Likewise, disparities in voxel-mirrored homotopic connectivity (VMHC) among groups were predominantly localized to the posterior cingulate gyrus (PCG) and Crus II of the cerebellar hemisphere (Crus II). Across the three frequency bands, the brain regions exhibiting significant differences in various parameters were most abundant in the slow-5 frequency band. Conclusion This study enhances our understanding of the pathological and physiological mechanisms associated with AD continuum. Moreover, it underscores the importance of researchers considering various frequency bands in their investigations of brain function.
Collapse
Affiliation(s)
- Hanjun Hu
- The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
- School of Biomedical Engineering, Shanghai Tech University, Shanghai, China
| | - Sammad Abdul
- International Education College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xue Tang
- School of Medical Imaging, Hangzhou Medical College, Hangzhou, China
| | - Qi Feng
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Yuzhu Mu
- The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Zhengluan Liao
- Department of Psychiatry, Zhejiang Provincial People’s Hospital/People’s Hospital of Hangzhou Medical College, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| |
Collapse
|
4
|
Liang X, Xue C, Zheng D, Yuan Q, Qi W, Ruan Y, Chen S, Song Y, Wu H, Lu X, Xiao C, Chen J. Repetitive transcranial magnetic stimulation regulates effective connectivity patterns of brain networks in the spectrum of preclinical Alzheimer's disease. Front Aging Neurosci 2024; 16:1343926. [PMID: 38410745 PMCID: PMC10894951 DOI: 10.3389/fnagi.2024.1343926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
Objectives Subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI) are considered as the spectrum of preclinical Alzheimer's disease (AD), with abnormal brain network connectivity as the main neuroimaging feature. Repetitive transcranial magnetic stimulation (rTMS) has been proven to be an effective non-invasive technique for addressing neuropsychiatric disorders. This study aims to explore the potential of targeted rTMS to regulate effective connectivity within the default mode network (DMN) and the executive control network (CEN), thereby improving cognitive function. Methods This study included 86 healthy controls (HCs), 72 SCDs, and 86 aMCIs. Among them, 10 SCDs and 11 aMCIs received a 2-week rTMS course of 5-day, once-daily. Cross-sectional analysis with the spectral dynamic causal model (spDCM) was used to analyze the DMN and CEN effective connectivity patterns of the three groups. Afterwards, longitudinal analysis was conducted on the changes in effective connectivity patterns and cognitive function before and after rTMS for SCD and aMCI, and the correlation between them was analyzed. Results Cross-sectional analysis showed different effective connectivity patterns in the DMN and CEN among the three groups. Longitudinal analysis showed that the effective connectivity pattern of the SCD had changed, accompanied by improvements in episodic memory. Correlation analysis indicated a negative relationship between effective connectivity from the left angular gyrus (ANG) to the anterior cingulate gyrus and the ANG.R to the right middle frontal gyrus, with visuospatial and executive function, respectively. In patients with aMCI, episodic memory and executive function improved, while the effective connectivity pattern remained unchanged. Conclusion This study demonstrates that PCUN-targeted rTMS in SCD regulates the abnormal effective connectivity patterns in DMN and CEN, thereby improving cognition function. Conversely, in aMCI, the mechanism of improvement may differ. Our findings further suggest that rTMS is more effective in preventing or delaying disease progression in the earlier stages of the AD spectrum. Clinical Trial Registration http://www.chictr.org.cn, ChiCTR2000034533.
Collapse
Affiliation(s)
- Xuhong Liang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Darui Zheng
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qianqian Yuan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yiming Ruan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shanshan Chen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Song
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Huimin Wu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiang Lu
- Department of Neurology, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Chaoyong Xiao
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| |
Collapse
|
5
|
Ai Y, Zhou C, Wang M, Yang C, Zhou S, Dong X, Ye N, Li Y, Wang L, Ren H, Gao X, Xu M, Hu H, Wang Y. Higher remnant cholesterol is associated with an increased risk of amnestic mild cognitive impairment: a community-based cross-sectional study. Front Aging Neurosci 2024; 16:1332767. [PMID: 38410746 PMCID: PMC10894954 DOI: 10.3389/fnagi.2024.1332767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
Background and aims Amnestic mild cognitive impairment (aMCI) is the most common subtype of MCI, which carries a significantly high risk of transitioning to Alzheimer's disease. Recently, increasing attention has been given to remnant cholesterol (RC), a non-traditional and previously overlooked risk factor. The aim of this study was to explore the association between plasma RC levels and aMCI. Methods Data were obtained from Brain Health Cognitive Management Team in Wuhan (https://hbtcm.66nao.com/admin/). A total of 1,007 community-dwelling elders were recruited for this project. Based on ten tools including general demographic data, cognitive screening and some exclusion scales, these participants were divided into the aMCI (n = 401) and normal cognitive groups (n = 606). Physical examinations were conducted on all participants, with clinical indicators such as blood pressure, blood sugar, and blood lipids collected. Results The aMCI group had significantly higher RC levels compared to the normal cognitive group (0.64 ± 0.431 vs. 0.52 ± 0.447 mmol/L, p < 0.05). Binary logistics regression revealed that occupation (P<0.001, OR = 0.533, 95%CI: 0.423-0.673) and RC (p = 0.014, OR = 1.477, 95% CI:1.081-2.018) were associated factors for aMCI. Partial correlation analysis, after controlling for occupation, showed a significant negative correlation between RC levels and MoCA scores (r = 0.059, p = 0.046), as well as Naming scores (r = 0.070, p = 0.026). ROC curve analysis demonstrated that RC levels had an independent predictive efficacy in predicting aMCI (AUC = 0.580, 95%CI: 0.544 ~ 0.615, P < 0.001). Conclusion Higher RC levels were identified as an independent indicator for aMCI, particularly in the naming cognitive domain among older individuals. Further longitudinal studies are necessary to validate the predictive efficacy of RC.
Collapse
Affiliation(s)
- Yating Ai
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Shizhen Laboratory, Hubei University of Chinese Medicine, Wuhan, China
- Engineering Research Center of TCM Protection Technology and New Product Development for the Elderly Brain Health, Ministry of Education, Hubei University of Chinese Medicine, Wuhan, China
| | - Chunyi Zhou
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ming Wang
- Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Chongming Yang
- Research Support Center, Brigham Young University, Provo, UT, United States
| | - Shi Zhou
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xinxiu Dong
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Niansi Ye
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yucan Li
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ling Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Hairong Ren
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xiaolian Gao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Man Xu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Shizhen Laboratory, Hubei University of Chinese Medicine, Wuhan, China
- Engineering Research Center of TCM Protection Technology and New Product Development for the Elderly Brain Health, Ministry of Education, Hubei University of Chinese Medicine, Wuhan, China
| | - Yuncui Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Shizhen Laboratory, Hubei University of Chinese Medicine, Wuhan, China
- Engineering Research Center of TCM Protection Technology and New Product Development for the Elderly Brain Health, Ministry of Education, Hubei University of Chinese Medicine, Wuhan, China
| |
Collapse
|
6
|
Eraslan Boz H, Koçoğlu K, Akkoyun M, Tüfekci IY, Ekin M, Akdal G. Visual search in Alzheimer's disease and amnestic mild cognitive impairment: An eye-tracking study. Alzheimers Dement 2024; 20:759-768. [PMID: 37774122 PMCID: PMC10917020 DOI: 10.1002/alz.13478] [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: 06/23/2023] [Revised: 08/01/2023] [Accepted: 08/21/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION Visual search impairment is a potential cognitive marker for Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI). The aim of this study is to compare eye movements during visual tracking in AD and aMCI patients versus healthy controls (HCs). METHODS A prospective cohort study included 32 AD and 37 aMCI patients, and 33 HCs. Each participant was asked to look at the target object in a visual stimulus containing one target and eight distractors, and eye movements were recorded with EyeLink 1000 Plus. RESULTS AD patients had fewer fixations and shorter target fixation duration than aMCI patients and HCs. Fixation durations were also shorter in aMCI patients compared to HCs. Also, AD patients were more fixated on distractors than HCs. DISCUSSION Our findings revealed that visual search is impaired in the early stages of AD and even aMCI, highlighting the importance of addressing visual processes in the Alzheimer's continuum. HIGHLIGHTS AD patients looked to distractors more and longer than the target compared to aMCI patients and older healthy individuals. aMCI patients had an impaired visual search pattern compared to healthy controls, just like patients with AD. The visual search task differentiated AD and aMCI patients from healthy individuals without dementia.
Collapse
Affiliation(s)
- Hatice Eraslan Boz
- Department of NeurosciencesInstitute of Health Sciences, Dokuz Eylül UniversityIzmirTurkey
- Department of NeurologyUnit of NeuropsychologyDokuz Eylül UniversityIzmirTurkey
| | - Koray Koçoğlu
- Department of NeurosciencesInstitute of Health Sciences, Dokuz Eylül UniversityIzmirTurkey
| | - Müge Akkoyun
- Department of NeurosciencesInstitute of Health Sciences, Dokuz Eylül UniversityIzmirTurkey
| | - Işıl Yağmur Tüfekci
- Department of NeurosciencesInstitute of Health Sciences, Dokuz Eylül UniversityIzmirTurkey
| | - Merve Ekin
- Department of NeurosciencesInstitute of Health Sciences, Dokuz Eylül UniversityIzmirTurkey
| | - Gülden Akdal
- Department of NeurosciencesInstitute of Health Sciences, Dokuz Eylül UniversityIzmirTurkey
- Department of NeurologyDokuz Eylül UniversityIzmirTurkey
| |
Collapse
|
7
|
Rao S, Cai Y, Zhong Z, Gou T, Wang Y, Liao S, Qiu P, Kuang W. Prevalence, cognitive characteristics, and influencing factors of amnestic mild cognitive impairment among older adults residing in an urban community in Chengdu, China. Front Neurol 2024; 15:1336385. [PMID: 38356893 PMCID: PMC10864602 DOI: 10.3389/fneur.2024.1336385] [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] [Received: 11/10/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Objective Dementia is a significant public health concern, and mild cognitive impairment (MCI) serves as a transitional stage between normal aging and dementia. Among the various types of MCI, amnestic MCI (aMCI) has been identified as having a higher likelihood of progressing to Alzheimer's dimension. However, limited research has been conducted on the prevalence of aMCI in China. Therefore, the objective of this study is to investigate the prevalence of aMCI, examine its cognitive characteristics, and identify associated risk factors. Methods In this cross-sectional study, we investigated a sample of 368 older adults aged 60 years and above in the urban communities of Chengdu, China. The participants underwent a battery of neuropsychological assessments, including the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating (CDR), Auditory Verbal Learning Test (AVLT), Wechsler's Logical Memory Task (LMT), Boston Naming Test (BNT) and Trail Making Test Part A (TMT-A). Social information was collected by standard questionnaire. Multiple logistic regression analysis was utilized to screen for the risk and protective factors of aMCI. Results The data analysis included 309 subjects with normal cognitive function and 59 with aMCI, resulting in a prevalence of 16.0% for aMCI. The average age of participants was 69.06 ± 7.30 years, with 56.0% being females. After controlling for age, gender and education, the Spearman partial correlation coefficient between various cognitive assessments and aMCI ranged from -0.52 for the long-term delayed recall scores in AVLT to 0.19 for the time-usage scores in TMT-A. The results indicated that all cognitive domains, except for naming scores (after semantic cue of BNT) and error quantity (in TMT-A), showed statistically significant associations with aMCI. Furthermore, the multiple logistic regression analysis revealed that older age (OR = 1.044, 95%CI: 1.002~1.087), lower educational level, and diabetes (OR = 2.450, 95%CI: 1.246~4.818) were risk factors of aMCI. Conclusion This study found a high prevalence of aMCI among older adults in Chengdu, China. Individuals with aMCI exhibited lower cognitive function in memory, language, and executive domains, with long-term delayed recall showing the strongest association. Clinicians should prioritize individuals with verbal learning and memory difficulties, especially long-term delayed recall, in clinical practice.
Collapse
Affiliation(s)
- Shan Rao
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, Sichuan, China
| | - Yan Cai
- Evidence-Based Nursing Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhujun Zhong
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Tianyuan Gou
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, Sichuan, China
| | - Yangyang Wang
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Shiyi Liao
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Peiyuan Qiu
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Weihong Kuang
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
8
|
Tuena C, Pupillo C, Stramba-Badiale C, Stramba-Badiale M, Riva G. Predictive power of gait and gait-related cognitive measures in amnestic mild cognitive impairment: a machine learning analysis. Front Hum Neurosci 2024; 17:1328713. [PMID: 38348371 PMCID: PMC10859484 DOI: 10.3389/fnhum.2023.1328713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/20/2023] [Indexed: 02/15/2024] Open
Abstract
Introduction Gait disorders and gait-related cognitive tests were recently linked to future Alzheimer's Disease (AD) dementia diagnosis in amnestic Mild Cognitive Impairment (aMCI). This study aimed to evaluate the predictive power of gait disorders and gait-related neuropsychological performances for future AD diagnosis in aMCI through machine learning (ML). Methods A sample of 253 aMCI (stable, converter) individuals were included. We explored the predictive accuracy of four predictors (gait profile plus MMSE, DSST, and TMT-B) previously identified as critical for the conversion from aMCI to AD within a 36-month follow-up. Supervised ML algorithms (Support Vector Machine [SVM], Logistic Regression, and k-Nearest Neighbors) were trained on 70% of the dataset, and feature importance was evaluated for the best algorithm. Results The SVM algorithm achieved the best performance. The optimized training set performance achieved an accuracy of 0.67 (sensitivity = 0.72; specificity = 0.60), improving to 0.70 on the test set (sensitivity = 0.79; specificity = 0.52). Feature importance revealed MMSE as the most important predictor in both training and testing, while gait type was important in the testing phase. Discussion We created a predictive ML model that is capable of identifying aMCI at high risk of AD dementia within 36 months. Our ML model could be used to quickly identify individuals at higher risk of AD, facilitating secondary prevention (e.g., cognitive and/or physical training), and serving as screening for more expansive and invasive tests. Lastly, our results point toward theoretically and practically sound evidence of mind and body interaction in AD.
Collapse
Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Chiara Pupillo
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| |
Collapse
|
9
|
Du Y, Zhang Y, Diao J, Fu P, Jiang R, Wang P, Yang H, Zheng X, Zhang L, Bi J, Zhou Q. Decoding the diagnostic potential of T cell repertoires in peripheral blood of patients from amnestic mild cognitive impairment to Alzheimer's disease. FASEB J 2024; 38:e23317. [PMID: 38095240 DOI: 10.1096/fj.202301485r] [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: 07/20/2023] [Revised: 10/13/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023]
Abstract
Alzheimer's disease (AD) is currently an incurable neurodegenerative disorder and is the most common etiological cause of dementia. Consequently, it has severe burden on its patients and on their caregivers and represents a global health concern. Clinical investigations have indicated that a dysregulation of peripheral T cell immune homeostasis may be involved in the pathogenesis of AD, as well as in the early stages of AD, characterized by mild cognitive impairment (MCI). However, the characteristics and concomitant feasibility of the use of T-cell receptor (TCR) typing for disease diagnosis remains largely unknown. We employed a high-throughput sequencing and multidimensional bioinformatics analyses for the identification of TCR repertoires present in peripheral blood samples of 10 patients with amnestic MCI (aMCI), 10 patients with AD, and 10 healthy controls (HCs). Based on the characteristics of the TCR repertoires in the amount and diversity of combinations of V-J, the spectrum of immune defense, and differentially expressed genes (DEGs), single and specific TCR profiles were observed in the patient samples of aMCI and AD compared to profiles of HCs. In particular, the diversity of TCR clonotypes manifested a pattern of "decreased first and then increased" pattern during the progression from aMCI to AD, a pattern that was not observed in HC samples. Additionally, a total of 46 and 35 amino acid CDR3 sequences with consistent and reverse expressive abundance with diversity of TCR clonotypes were identified, respectively. Taken together, we provide novel and essential preliminary evidence demonstrating the presence of diversity of T cell repertoires from differentially expressed V-J gene segments and amino acid clonotypes using peripheral blood samples from patients with AD, aMCI, and from HC. Such findings have the potential to reveal potential mechanisms through which aMCI progresses to AD and provide a reference for the future development of immune-related diagnoses and therapies for AD.
Collapse
Affiliation(s)
- Yansheng Du
- Department of Neurology Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yichen Zhang
- Department of Critical Care Medicine, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jiuzhou Diao
- Department of Neurology Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Pengrui Fu
- Department of Neurology Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Runze Jiang
- Department of Translational Medicine Research Institute, Shandong Jingwei Biotechnology Co. Ltd, Jinan, China
| | - Ping Wang
- Department of Neurology Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hui Yang
- Department of Neurology Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaolei Zheng
- Department of Neurology Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Leisheng Zhang
- Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province & NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, China
- Key Laboratory of Radiation Technology and Biophysics, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Jianzhong Bi
- Department of Neurology Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qingbo Zhou
- Department of Neurology Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| |
Collapse
|
10
|
Feng Q, Wang L, Tang X, Ge X, Hu H, Liao Z, Ding Z. Machine learning classifiers and associations of cognitive performance with hippocampal subfields in amnestic mild cognitive impairment. Front Aging Neurosci 2023; 15:1273658. [PMID: 38099266 PMCID: PMC10719844 DOI: 10.3389/fnagi.2023.1273658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/10/2023] [Indexed: 12/17/2023] Open
Abstract
Background Neuroimaging studies have demonstrated alterations in hippocampal volume and hippocampal subfields among individuals with amnestic mild cognitive impairment (aMCI). However, research on using hippocampal subfield volume modeling to differentiate aMCI from normal controls (NCs) is limited, and the relationship between hippocampal volume and overall cognitive scores remains unclear. Methods We enrolled 50 subjects with aMCI and 44 NCs for this study. Initially, a univariate general linear model was employed to analyze differences in the volumes of hippocampal subfields. Subsequently, two sets of dimensionality reduction methods and four machine learning techniques were applied to distinguish aMCI from NCs based on hippocampal subfield volumes. Finally, we assessed the correlation between the relative volumes of hippocampal subfields and cognitive test variables (Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA)). Results Significant volume differences were observed in several hippocampal subfields, notably in the left hippocampus. Specifically, the volumes of the hippocampal tail, subiculum, CA1, presubiculum, molecular layer, GC-ML-DG, CA3, CA4, and fimbria differed significantly between the two groups. The highest area under the curve (AUC) values for left and right hippocampal machine learning classifiers were 0.678 and 0.701, respectively. Moreover, the volumes of the left subiculum, left molecular layer, right subiculum, right CA1, right molecular layer, right GC-ML-DG, and right CA4 exhibited the strongest and most consistent correlations with MoCA scores. Conclusion Hippocampal subfield volume may serve as a predictive marker for aMCI. These findings underscore the sensitivity of hippocampal subfield volume to overall cognitive performance.
Collapse
Affiliation(s)
- Qi Feng
- Department of Radiology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Xue Tang
- School of Medical Imaging, Hangzhou Medical College, Hangzhou, China
| | - Xiuhong Ge
- Department of Radiology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Hanjun Hu
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhengluan Liao
- Department of Psychiatry, Zhejiang Provincial People’s Hospital/People’s Hospital of Hangzhou Medical College, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People’s Hospital, Hangzhou, China
| |
Collapse
|
11
|
Feng Q, Wang L, Tang X, Hu H, Ge X, Liao Z, Ding Z. Static and dynamic functional connectivity combined with the triple network model in amnestic mild cognitive impairment and Alzheimer's disease. Front Neurol 2023; 14:1284227. [PMID: 38107647 PMCID: PMC10723161 DOI: 10.3389/fneur.2023.1284227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/31/2023] [Indexed: 12/19/2023] Open
Abstract
Background Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) are characterized by abnormal functional connectivity (FC) of default-mode network (DMN), salience network (SN), and central executive network (CEN). Static FC (sFC) and dynamic FC (dFC) combined with triple network model can better study the dynamic and static changes of brain networks, and improve its potential diagnostic value in the diagnosis of AD spectrum disorders. Methods Differences in sFC values and dFC variability patterns among the three brain networks of the three groups (53 AD patients, 40 aMCI patients, and 40 NCs) were computed by ANOVA using Gaussian Random Field theory (GRF) correction. The correlation between FC values (sFC values and dFC variability) in the three networks and cognitive scores (MMSE and MoCA) in AD and aMCI groups was analyzed separately. Results Within the DMN network, there were significant differences of sFC values in right/left medial superior frontal gyrus and dFC variability in left opercular part inferior frontal gyrus and right dorsolateral superior frontal gyrus among the three groups. Within the CEN network, there were significant differences of sFC values in left superior parietal gyrus. Within the SN network, there were significant differences of dFC variability in right Cerebelum_7b and left opercular part inferior frontal gyrus. In addition, there was a significant negative correlation between FC values (sFC values of CEN and dFC variability of SN) and MMSE and MoCA scores. Conclusion It suggests that sFC, dFC combined with triple network model can be considered as potential biomarkers for AD and aMCI.
Collapse
Affiliation(s)
- Qi Feng
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Xue Tang
- School of Medical Imaging, Hangzhou Medical College, Hangzhou, China
| | - Hanjun Hu
- Fourth Clinical School, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Zhengluan Liao
- Department of Psychiatry, Zhejiang Provincial People's Hospital/People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| |
Collapse
|
12
|
Zheng W, Mu R, Liu F, Qin X, Li X, Yang P, Li X, Liang Y, Zhu X. Textural features of the frontal white matter could be used to discriminate amnestic mild cognitive impairment patients from the normal population. Brain Behav 2023; 13:e3222. [PMID: 37587901 PMCID: PMC10636424 DOI: 10.1002/brb3.3222] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVE We aim to develop a radiomics model based on 3-dimensional (3D)-T1WI images to discriminate amnestic mild cognitive impairment (aMCI) patients from the normal population by measuring changes in frontal white matter. METHODS In this study, 126 patients with aMCI and 174 normal controls (NC) were recruited from the local community. All subjects underwent routine magnetic resonance imaging examination (including 3D-T1WI ). Participants were randomly divided into a training set (n = 242, aMCI:102, NC:140) and a testing set (n = 58, aMCI:24, NC:34). Texture features of the frontal lobe were extracted from 3D-T1WI images. The least absolute shrinkage and selection operator (LASSO) was used to reduce feature dimensions and develop a radiomics signature model. Diagnostic performance was assessed in the training and testing sets using the receiver operating characteristic (ROC) curve analysis. The area under the ROC curve (AUC), sensitivity, and specificity were also calculated. The efficacy of the radiomics model in discriminating aMCI patients from the normal population was assessed by decision curve analysis (DCA). RESULTS A total of 108 frontal lobe texture features were extracted from 3D-T1WI images. LASSO selected 58 radiomic features for the final model, including log-sigma (n = 18), original (n = 8), and wavelet (n = 32) features. The performance of radiomic features extracted from 3D T1 imaging for distinguishing aMCI patients from controls was: in the training set, AUC was 1.00, and the accuracy, sensitivity, and specificity were 100%, 98%, and 100%, respectively. In the testing set, AUC was 0.82 (95% CI:0.69-0.95), and the accuracy, sensitivity, and specificity were 69%, 92%, and 55%, respectively. The DCA demonstrated that the model had favorable clinical predictive value. CONCLUSIONS Textural features of white matter in the frontal lobe showed potential for distinguishing aMCI from the normal population, which could be a surrogate protocol to aid aMCI screening in clinical setting.
Collapse
Affiliation(s)
- Wei Zheng
- Department of Clinical MedicineGuilin Medical universityGuilinChina
- Department of Medical ImagingNanxishan Hospital of Guangxi ZhuangAutonomous RegionGuilinChina
| | - Ronghua Mu
- Department of Medical ImagingNanxishan Hospital of Guangxi ZhuangAutonomous RegionGuilinChina
| | - Fuzhen Liu
- Department of Medical ImagingNanxishan Hospital of Guangxi ZhuangAutonomous RegionGuilinChina
| | - Xiaoyan Qin
- Department of Medical ImagingNanxishan Hospital of Guangxi ZhuangAutonomous RegionGuilinChina
| | - Xin Li
- Department of Medical ImagingNanxishan Hospital of Guangxi ZhuangAutonomous RegionGuilinChina
| | - Peng Yang
- Department of Medical ImagingNanxishan Hospital of Guangxi ZhuangAutonomous RegionGuilinChina
| | - Xin Li
- Department of Medical ImagingNanxishan Hospital of Guangxi ZhuangAutonomous RegionGuilinChina
| | | | - Xiqi Zhu
- Department of Medical ImagingNanxishan Hospital of Guangxi ZhuangAutonomous RegionGuilinChina
| |
Collapse
|
13
|
Eraslan Boz H, Koçoğlu K, Akkoyun M, Tüfekci IY, Ekin M, Akdal G. Eye movement patterns during viewing face images with neutral expressions in patients with early-stage Alzheimer's disease and amnestic mild cognitive impairment. Brain Behav 2023; 13:e3232. [PMID: 37605291 PMCID: PMC10636417 DOI: 10.1002/brb3.3232] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) neuropathology affects the brain regions responsible for visuospatial skills. Accumulating evidence points to visual difficulties involving face processing in AD and amnestic mild cognitive impairment (aMCI). No study has so far examined eye movement patterns when viewing faces with neutral expressions in patients with AD. AIM The objective of this study aimed to examine the eye movements of patients with early-stage AD, aMCI, and healthy controls (HC) during viewing face images. MATERIALS&METHODS Thirty-one AD, 37 aMCI, and 33 HC were included in the study. Eye movements in facial stimuli were recorded with the EyeLink 1000 Plus eye-tracker. RESULTS Our findings showed that AD patients looked less at the eye area of interest than the nose and mouth areas of interest compared to aMCI and HC. Regardless of the group, all participants looked at the eye and nose areas of interest more and longer in the mouth area of interest. In addition, the first fixation duration to the eye area of interest of all participants was shorter than that of the nose and mouth. DISCUSSION Consistent with our study, studies in healthy adults revealed eye movement patterns that focused more on the eyes and nose. AD patients are unable to pay attention to the salient parts of faces, tending to focus instead on the non-informative parts. CONCLUSION Our study is the first to reveal eye movement differences in face processing in AD.
Collapse
Affiliation(s)
- Hatice Eraslan Boz
- Department of Neurosciences, Institute of Health SciencesDokuz Eylül UniversityIzmirTürkiye
- Department of Neurology, Unit of NeuropsychologyDokuz Eylül UniversityIzmirTürkiye
| | - Koray Koçoğlu
- Department of Neurosciences, Institute of Health SciencesDokuz Eylül UniversityIzmirTürkiye
| | - Müge Akkoyun
- Department of Neurosciences, Institute of Health SciencesDokuz Eylül UniversityIzmirTürkiye
| | - Işıl Yağmur Tüfekci
- Department of Neurosciences, Institute of Health SciencesDokuz Eylül UniversityIzmirTürkiye
| | - Merve Ekin
- Department of Neurosciences, Institute of Health SciencesDokuz Eylül UniversityIzmirTürkiye
| | - Gülden Akdal
- Department of Neurosciences, Institute of Health SciencesDokuz Eylül UniversityIzmirTürkiye
- Department of NeurologyDokuz Eylül UniversityIzmirTürkiye
| |
Collapse
|
14
|
He Y, Li Q, Fu Z, Zeng D, Han Y, Li S. Functional gradients reveal altered functional segregation in patients with amnestic mild cognitive impairment and Alzheimer's disease. Cereb Cortex 2023; 33:10836-10847. [PMID: 37718155 DOI: 10.1093/cercor/bhad328] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/26/2023] [Accepted: 08/23/2023] [Indexed: 09/19/2023] Open
Abstract
Alzheimer's disease and amnestic mild cognitive impairment are associated with disrupted functional organization in brain networks, involved with alteration of functional segregation. Connectome gradients are a new tool representing brain functional topological organization to smoothly capture the human macroscale hierarchy. Here, we examined altered topological organization in amnestic mild cognitive impairment and Alzheimer's disease by connectome gradient mapping. We further quantified functional segregation by gradient dispersion. Then, we systematically compared the alterations observed in amnestic mild cognitive impairment and Alzheimer's disease patients with those in normal controls in a two-dimensional functional gradient space from both the whole-brain level and module level. Compared with normal controls, the first gradient, which described the neocortical hierarchy from unimodal to transmodal regions, showed a more distributed and significant suppression in Alzheimer's disease than amnestic mild cognitive impairment patients. Furthermore, gradient dispersion showed significant decreases in Alzheimer's disease at both the global level and module level, whereas this alteration was limited only to limbic areas in amnestic mild cognitive impairment. Notably, we demonstrated that suppressed gradient dispersion in amnestic mild cognitive impairment and Alzheimer's disease was associated with cognitive scores. These findings provide new evidence for altered brain hierarchy in amnestic mild cognitive impairment and Alzheimer's disease, which strengthens our understanding of the progressive mechanism of cognitive decline.
Collapse
Affiliation(s)
- Yirong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Qiongling Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
- Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Zhenrong Fu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science & Medical Engineering, Beihang University, Beijing 100083, China
| | - Debin Zeng
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science & Medical Engineering, Beihang University, Beijing 100083, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
- Biomedical Engineering Institute, Hainan University, Haikou 570228, China
- Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing 100050, China
- National Clinical Research Center for Geriatric Disorders, Beijing 100053, China
| | - Shuyu Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| |
Collapse
|
15
|
Waschkies KF, Soch J, Darna M, Richter A, Altenstein S, Beyle A, Brosseron F, Buchholz F, Butryn M, Dobisch L, Ewers M, Fliessbach K, Gabelin T, Glanz W, Goerss D, Gref D, Janowitz D, Kilimann I, Lohse A, Munk MH, Rauchmann BS, Rostamzadeh A, Roy N, Spruth EJ, Dechent P, Heneka MT, Hetzer S, Ramirez A, Scheffler K, Buerger K, Laske C, Perneczky R, Peters O, Priller J, Schneider A, Spottke A, Teipel S, Düzel E, Jessen F, Wiltfang J, Schott BH, Kizilirmak JM. Machine learning-based classification of Alzheimer's disease and its at-risk states using personality traits, anxiety, and depression. Int J Geriatr Psychiatry 2023; 38:e6007. [PMID: 37800601 DOI: 10.1002/gps.6007] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/07/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is often preceded by stages of cognitive impairment, namely subjective cognitive decline (SCD) and mild cognitive impairment (MCI). While cerebrospinal fluid (CSF) biomarkers are established predictors of AD, other non-invasive candidate predictors include personality traits, anxiety, and depression, among others. These predictors offer non-invasive assessment and exhibit changes during AD development and preclinical stages. METHODS In a cross-sectional design, we comparatively evaluated the predictive value of personality traits (Big Five), geriatric anxiety and depression scores, resting-state functional magnetic resonance imaging activity of the default mode network, apoliprotein E (ApoE) genotype, and CSF biomarkers (tTau, pTau181, Aβ42/40 ratio) in a multi-class support vector machine classification. Participants included 189 healthy controls (HC), 338 individuals with SCD, 132 with amnestic MCI, and 74 with mild AD from the multicenter DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE). RESULTS Mean predictive accuracy across all participant groups was highest when utilizing a combination of personality, depression, and anxiety scores. HC were best predicted by a feature set comprised of depression and anxiety scores and participants with AD were best predicted by a feature set containing CSF biomarkers. Classification of participants with SCD or aMCI was near chance level for all assessed feature sets. CONCLUSION Our results demonstrate predictive value of personality trait and state scores for AD. Importantly, CSF biomarkers, personality, depression, anxiety, and ApoE genotype show complementary value for classification of AD and its at-risk stages.
Collapse
Affiliation(s)
- Konrad F Waschkies
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Joram Soch
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Margarita Darna
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Anni Richter
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- German Center for Mental Health (DZPG), Munich, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Aline Beyle
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University of Bonn, Bonn, Germany
| | | | - Friederike Buchholz
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Michaela Butryn
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Tatjana Gabelin
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Doreen Goerss
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Daria Gref
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Andrea Lohse
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Matthias H Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
- Department of Neuroradiology, University Hospital LMU, Munich, Germany
| | - Ayda Rostamzadeh
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Peter Dechent
- MR-Research in Neurosciences, Department of Cognitive Neurology, Georg-August-University Goettingen, Göttingen, Germany
| | - Michael T Heneka
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Stefan Hetzer
- Berlin Center for Advanced Neuroimaging, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Psychiatry & Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, Texas, USA
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
- Munich Cluster for Systems Neurology (SyNergy) Munich, Munich, Germany
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, UK
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
- School of Medicine, Technical University of Munich, Department of Psychiatry and Psychotherapy, Munich, Germany
- University of Edinburgh and UK DRI, Edinburgh, UK
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Björn H Schott
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Jasmin M Kizilirmak
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Neurodidactics and NeuroLab, Institute for Psychology, University of Hildesheim, Hildesheim, Germany
| |
Collapse
|
16
|
Gao SL, Yue J, Li XL, Li A, Cao DN, Han SW, Wei ZY, Yang G, Zhang Q. Multimodal magnetic resonance imaging on brain network in amnestic mild cognitive impairment: A mini-review. Medicine (Baltimore) 2023; 102:e34994. [PMID: 37653770 PMCID: PMC10470781 DOI: 10.1097/md.0000000000034994] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 09/02/2023] Open
Abstract
Amnestic mild cognitive impairment (aMCI) is a stage between normal aging and Alzheimer disease (AD) where individuals experience a noticeable decline in memory that is greater than what is expected with normal aging, but dose not meet the clinical criteria for AD. This stage is considered a transitional phase that puts individuals at a high risk for developing AD. It is crucial to intervene during this stage to reduce the changes of AD development. Recently, advanced multimodal magnetic resonance imaging techniques have been used to study the brain structure and functional networks in individuals with aMCI. Through the use of structural magnetic resonance imaging, diffusion tensor imaging, and functional magnetic resonance imaging, abnormalities in certain brain regions have been observed in individuals with aMCI. Specifically, the default mode network, salience network, and executive control network have been found to show abnormalities in both structure and function. This review aims to provide a comprehensive understanding of the brain structure and functional networks associated with aMCI. By analyzing the existing literature on multimodal magnetic resonance imaging and aMCI, this study seeks to uncover potential biomarkers and gain insight into the underlying pathogenesis of aMCI. This knowledge can then guide the development of future treatments and interventions to delay or prevent the progression of aMCI to AD.
Collapse
Affiliation(s)
- Sheng-Lan Gao
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jinhuan Yue
- Shenzhen Frontiers in Chinese Medicine Research Co., Ltd., Shenzhen, China
| | - Xiao-Ling Li
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ang Li
- Sanofi-Aventis China Investment Co., Ltd, Beijing, China
| | - Dan-Na Cao
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Sheng-Wang Han
- Third Ward of Rehabilitation Department, Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ze-Yi Wei
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Guanhu Yang
- Department of Specialty Medicine, Ohio University, Athens, OH
| | - Qinhong Zhang
- Shenzhen Frontiers in Chinese Medicine Research Co., Ltd., Shenzhen, China
| |
Collapse
|
17
|
Yue J, Han SW, Liu X, Wang S, Zhao WW, Cai LN, Cao DN, Mah JZ, Hou Y, Cui X, Wang Y, Chen L, Li A, Li XL, Yang G, Zhang Q. Functional brain activity in patients with amnestic mild cognitive impairment: an rs-fMRI study. Front Neurol 2023; 14:1244696. [PMID: 37674874 PMCID: PMC10477362 DOI: 10.3389/fneur.2023.1244696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
Background Amnestic mild cognitive impairment (aMCI) is an early stage of Alzheimer's disease (AD). Regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) are employed to explore spontaneous brain function in patients with aMCI. This study applied ALFF and ReHo indicators to analyze the neural mechanism of aMCI by resting-state functional magnetic resonance imaging (rs-fMRI). Methods Twenty-six patients with aMCI were included and assigned to the aMCI group. The other 26 healthy subjects were included as a healthy control (HC) group. Rs-fMRI was performed for all participants in both groups. Between-group comparisons of demographic data and neuropsychological scores were analyzed using SPSS 25.0. Functional imaging data were analyzed using DPARSF and SPM12 software based on MATLAB 2017a. Gender, age, and years of education were used as covariates to obtain ALFF and ReHo indices. Results Compared with HC group, ALFF decreased in the left fusiform gyrus, left superior temporal gyrus, and increased in the left cerebellum 8, left inferior temporal gyrus, left superior frontal gyrus (BA11), and right inferior temporal gyrus (BA20) in the aMCI group (p < 0.05, FWE correction). In addition, ReHo decreased in the right middle temporal gyrus and right anterior cuneiform lobe, while it increased in the left middle temporal gyrus, left inferior temporal gyrus, cerebellar vermis, right parahippocampal gyrus, left caudate nucleus, right thalamus, and left superior frontal gyrus (BA6) (p < 0.05, FWE correction). In the aMCI group, the ALFF of the left superior frontal gyrus was negatively correlated with Montreal Cognitive Assessment (MoCA) score (r = -0.437, p = 0.026), and the ALFF of the left superior temporal gyrus was positively correlated with the MoCA score (r = 0.550, p = 0.004). The ReHo of the right hippocampus was negatively correlated with the Mini-Mental State Examination (MMSE) score (r = -0.434, p = 0.027), and the ReHo of the right middle temporal gyrus was positively correlated with MMSE score (r = 0.392, p = 0.048). Conclusion Functional changes in multiple brain regions rather than in a single brain region have been observed in patients with aMCI. The abnormal activity of multiple specific brain regions may be a manifestation of impaired central function in patients with aMCI.
Collapse
Affiliation(s)
- Jinhuan Yue
- Shenzhen Frontiers in Chinese Medicine Research Co., Ltd., Shenzhen, China
- Department of Acupuncture and Moxibustion, Vitality University, Hayward, CA, United States
| | - Sheng-wang Han
- Department of Third Rehabilitation Medicine, Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiao Liu
- Department of Pediatrics, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Song Wang
- Department of Radiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | | | - Li-na Cai
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Dan-na Cao
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jeffrey Zhongxue Mah
- Department of Acupuncture and Moxibustion, Vitality University, Hayward, CA, United States
| | - Yu Hou
- Department of Gynecology, Harbin Traditional Chinese Medicine Hospital, Harbin, China
| | - Xuan Cui
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yang Wang
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Li Chen
- Confucius Institute for TCM, London South Bank University, London, United Kingdom
| | - Ang Li
- Sanofi-Aventis China Investment Co., Ltd., Beijing, China
| | - Xiao-ling Li
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Guanhu Yang
- Department of Specialty Medicine, Ohio University, Athens, OH, United States
| | - Qinhong Zhang
- Shenzhen Frontiers in Chinese Medicine Research Co., Ltd., Shenzhen, China
- Department of Acupuncture and Moxibustion, Heilongjiang University of Chinese Medicine, Harbin, China
| |
Collapse
|
18
|
Liang Y, Liu W, Wang M. Characteristics of macroscopic sleep structure in patients with mild cognitive impairment: a systematic review. Front Psychiatry 2023; 14:1212514. [PMID: 37547222 PMCID: PMC10399242 DOI: 10.3389/fpsyt.2023.1212514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/27/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives Conducting a systematic analysis of objective measurement tools to assess the characteristics of macroscopic sleep architecture in patients with mild cognitive impairment (MCI), amnestic MCI (aMCI), and non-amnestic MCI (naMCI) in order to provide sleep disorder guidance for MCI patients. Methods PubMed, EMbase, Web of Science, Cochrane Library, CNKI, SinoMed, Wanfang Data, and VIP Data were examined to find literature relating to sleep in patients with MCI, aMCI, and naMCI, with a search time frame of build to April 2023. Following independent literature screening, data extraction, and quality evaluation by two researchers, statistical analysis was performed using RevMan 5.4 software. Results Twenty-five papers with 1,165 study subjects were included. Patients with MCI and aMCI were found to have altered total sleep time (TST), reduced sleep efficiency (SE), more wake-time after sleep onset (WASO), longer sleep latency (SL), a higher proportion of N1 stage and a lower proportion of N2 and N3 stage. naMCI was only found to have statistically significant differences in WASO. Conclusions The results of this study provide evidence for macroscopic sleep architecture abnormalities among MCI patients with sleep disorders. Maintaining a normal sleep time, improving SE, and reducing sleep fragmentation may have an association with a slowed development of cognitive impairment. Further exploration is required of the effects each component of macroscopic sleep structure after the intervention has on altered sleep disturbance and cognition in MCI, aMCI, and naMCI. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023401937, identifier: CRD42023401937.
Collapse
Affiliation(s)
- Yahui Liang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Weihua Liu
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Meizi Wang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| |
Collapse
|
19
|
Strijkert F, Huitema RB, van Munster BC, Spikman JM. Impaired Emotion Recognition: A Potential Marker for Social Behavioral Problems in Patients With Amnestic Mild Cognitive Impairment and Early Alzheimer Disease? Alzheimer Dis Assoc Disord 2023; 37:189-194. [PMID: 37561955 PMCID: PMC10443627 DOI: 10.1097/wad.0000000000000567] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/19/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Emotion recognition, an important aspect of social cognition, can be impaired already in early Alzheimer disease dementia and amnestic mild cognitive impairment (aMCI) and may underly social behavioral changes, which can increase caregiver burden. However, social behavior is difficult to assess in outpatient settings. We evaluated whether impaired emotion recognition is related to proxy-rated social behavioral problems and thus can serve as a marker of these changes. PATIENTS AND METHOD Emotion recognition was assessed with Ekman 60 Faces Test (EFT-total, 6 separate emotions) in patients (n = 31 AD; n = 37 aMCI) and healthy controls (n = 60 HCs). Social behavioral problems were rated by proxies with the neuropsychiatric inventory (agitation, apathy, irritability, disinhibition, and a sum score). It tested whether EFT scores differed between patients with and without behavioral problems. RESULTS AD had worse EFT-total ( P <0.001), disgust ( P = 0.02), and fear ( P = 0.001) than HC, but not than aMCI, who did not differ from HC. AD displayed more disinhibition ( P < 0.05). EFT and neuropsychiatric inventory sum scores were not significantly correlated. Patients with apathy had lower EFT-total ( P = 0.02). CONCLUSIONS Measuring emotion recognition adds value: it is impaired in early neurodegeneration and associated with apathy but not necessarily related to overall changes in social behavior in this population.
Collapse
|
20
|
Bao Q, Liu Y, Zhang X, Li Y, Wang Z, Ye F, He X, Xia M, Chen Z, Yao J, Zhong W, Wu K, Wang Z, Sun M, Chen J, Hong X, Zhao L, Yin Z, Liang F. Clinical observation and mechanism of acupuncture on amnestic mild cognitive impairment based on the gut-brain axis: study protocol for a randomized controlled trial. Front Med (Lausanne) 2023; 10:1198579. [PMID: 37415772 PMCID: PMC10321407 DOI: 10.3389/fmed.2023.1198579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023] Open
Abstract
Background Amnestic mild cognitive impairment (aMCI) is a pre-dementia condition associated with declined cognitive function dominated by memory impairment. The occurrence of aMCI is associated with the gut-brain axis. Previous studies have shown cognitive improvements in MCI after acupuncture treatment. This study evaluates whether acupuncture can produce a therapeutic effect in patients with aMCI by modulating the gut-brain axis. Methods and design This is a prospective, parallel, multicenter randomized controlled trial. A total of 40 patients with aMCI will be randomly assigned to an acupuncture group (AG) or a waiting-list group (WG), participants in both groups will receive health education on improving cognitive function at each visit, and acupuncture will be conducted twice a week for 12 weeks in the AG. Another 20 matched healthy volunteers will be enrolled as normal control. The primary outcome will be the change in Alzheimer's Disease Assessment Scale-cognitive scale score before and after treatment. Additionally, functional magnetic resonance imaging data, faeces, and blood will be collected from each participant to characterize the brain function, gut microbiota, and inflammatory cytokines, respectively. The differences between patients with aMCI and healthy participants, and the changes in the AG and WG groups before and after treatment will be observed. Ultimately, the correlation among brain function, gut microbiota, inflammatory cytokines, and clinical efficacy evaluation in patients with aMCI will be analyzed. Discussion This study will identify the efficacy and provide preliminary data on the possible mechanism of acupuncture in treating aMCI. Furthermore, it will also identify biomarkers of the gut microbiota, inflammatory cytokines, and brain function correlated with therapeutic effects. The results of this study will be published in peer-reviewed journals. Clinical trial registration http://www.chictr.org.cn, identifier ChiCTR2200062084.
Collapse
Affiliation(s)
- Qiongnan Bao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Yiwei Liu
- The West China Hospital, Chengdu, China
| | - Xinyue Zhang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Yaqin Li
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ziqi Wang
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Fang Ye
- The Sichuan Province People's Hospital, Chengdu, China
| | - Xia He
- The Rehabilitation Hospital of Sichuan Province, Chengdu, China
| | - Manze Xia
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Zhenghong Chen
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Jin Yao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Wanqi Zhong
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Kexin Wu
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Ziwen Wang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Mingsheng Sun
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Jiao Chen
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Xiaojuan Hong
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Ling Zhao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Zihan Yin
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Fanrong Liang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| |
Collapse
|
21
|
Ma J, Zheng MX, Wu JJ, Xing XX, Xiang YT, Wei D, Xue X, Zhang H, Hua XY, Guo QH, Xu JG. Mapping the long-term delayed recall-based cortex-hippocampus network constrained by the structural and functional connectome: a case-control multimodal MRI study. Alzheimers Res Ther 2023; 15:61. [PMID: 36964589 PMCID: PMC10037827 DOI: 10.1186/s13195-023-01197-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/23/2023] [Indexed: 03/26/2023]
Abstract
Background Connectome mapping may reveal new treatment targets for patients with neurological and psychiatric diseases. However, the long-term delayed recall based-network with structural and functional connectome is still largely unknown. Our objectives were to (1) identify the long-term delayed recall-based cortex-hippocampus network with structural and functional connectome and (2) investigate its relationships with various cognitive functions, age, and activities of daily living. Methods This case-control study enrolled 131 subjects (73 amnestic mild cognitive impairment [aMCI] patients and 58 age- and education-matched healthy controls [HCs]). All subjects completed a neuropsychological battery, activities of daily living assessment, and multimodal magnetic resonance imaging. Nodes of the cortical-hippocampal network related to long-term delayed recall were identified by probabilistic fiber tracking and functional connectivity (FC) analysis. Then, the main and interaction effects of the network on cognitive functions were assessed by a generalized linear model. Finally, the moderating effects of the network on the relationships between long-term delayed recall and clinical features were analyzed by multiple regression and Hayes’ bootstrap method. All the effects of cortex-hippocampus network were analyzed at the connectivity and network levels. Results The result of a generalized linear model showed that the bilateral hippocampus, left dorsolateral superior frontal gyrus, right supplementary motor area, left lingual gyrus, left superior occipital gyrus, left superior parietal gyrus, left precuneus, and right temporal pole (superior temporal gyrus) are the left and right cortex-hippocampus network nodes related to long-term delayed recall (P < 0.05). Significant interaction effects were found between the Auditory Verbal Learning Test Part 5 (AVLT 5) scores and global properties of the left cortex-hippocampus network [hierarchy, clustering coefficient, characteristic path length, global efficiency, local efficiency, Sigma and synchronization (P < 0.05 Bonferroni corrected)]. Significant interaction effects were found between the general cognitive function/executive function/language and global properties of the left cortex-hippocampus network [Sigma and synchronization (P < 0.05 Bonferroni corrected)]. Conclusion This study introduces a novel symptom-based network and describes relationships among cognitive functions, brain function, and age. The cortex–hippocampus network constrained by the structural and functional connectome is closely related to long-term delayed recall. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-023-01197-7.
Collapse
Affiliation(s)
- Jie Ma
- grid.412540.60000 0001 2372 7462Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
- grid.412540.60000 0001 2372 7462School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203 China
| | - Mou-Xiong Zheng
- grid.412540.60000 0001 2372 7462Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
| | - Jia-Jia Wu
- grid.412540.60000 0001 2372 7462Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
| | - Xiang-Xin Xing
- grid.412540.60000 0001 2372 7462Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
| | - Yun-Ting Xiang
- grid.412540.60000 0001 2372 7462School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203 China
| | - Dong Wei
- grid.412540.60000 0001 2372 7462School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203 China
| | - Xin Xue
- grid.412540.60000 0001 2372 7462School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203 China
| | - Han Zhang
- grid.440637.20000 0004 4657 8879School of Biomedical Engineering, ShanghaiTech University, Shanghai, 201210 China
| | - Xu-Yun Hua
- grid.412540.60000 0001 2372 7462Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
| | - Qi-Hao Guo
- grid.412528.80000 0004 1798 5117Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 China
| | - Jian-Guang Xu
- grid.412540.60000 0001 2372 7462Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
- grid.412540.60000 0001 2372 7462School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203 China
- grid.419897.a0000 0004 0369 313XEngineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, 201203 China
| |
Collapse
|
22
|
Wu H, Song Y, Yang X, Chen S, Ge H, Yan Z, Qi W, Yuan Q, Liang X, Lin X, Chen J. Functional and structural alterations of dorsal attention network in preclinical and early-stage Alzheimer's disease. CNS Neurosci Ther 2023; 29:1512-1524. [PMID: 36942514 PMCID: PMC10173716 DOI: 10.1111/cns.14092] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES Subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI) are known as the preclinical and early stage of Alzheimer's disease (AD). The dorsal attention network (DAN) is mainly responsible for the "top-down" attention process. However, previous studies mainly focused on single functional modality and limited structure. This study aimed to investigate the multimodal alterations of DAN in SCD and aMCI to assess their diagnostic value in preclinical and early-stage AD. METHODS Resting-state functional magnetic resonance imaging (MRI) was carried out to measure the fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and functional connectivity (FC). Structural MRI was used to calculate the gray matter volume (GMV) and cortical thickness. Moreover, receiver-operating characteristic (ROC) analysis was used to distinguish these alterations in SCD and aMCI. RESULTS The SCD and aMCI groups showed both decreased ReHo in the right middle temporal gyrus (MTG) and decreased GMV compared to healthy controls (HCs). Especially in the SCD group, there were increased fALFF and increased ReHo in the left inferior occipital gyrus (IOG), decreased fALFF and increased FC in the left inferior parietal lobule (IPL), and reduced cortical thickness in the right inferior temporal gyrus (ITG). Furthermore, functional and structural alterations in the SCD and aMCI groups were closely related to episodic memory (EM), executive function (EF), and information processing speed (IPS). The combination of multiple indicators of DAN had a high accuracy in differentiating clinical stages. CONCLUSIONS Our current study demonstrated functional and structural alterations of DAN in SCD and aMCI, especially in the MTG, IPL, and SPL. Furthermore, cognitive performance was closely related to these significant alterations. Our study further suggested that the combined multiple indicators of DAN could be acted as the latent neuroimaging markers of preclinical and early-stage AD for their high diagnostic value.
Collapse
Affiliation(s)
- Huimin Wu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Song
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xinyi Yang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shanshan Chen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Honglin Ge
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Zheng Yan
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qianqian Yuan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xuhong Liang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xingjian Lin
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Department of Radiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| |
Collapse
|
23
|
Hao SW, Li TR, Han C, Han Y, Cai YN. Associations Between Levels of Peripheral NCAPH2 Promoter Methylation and Different Stages of Alzheimer's Disease: A Cross-Sectional Study. J Alzheimers Dis 2023; 92:899-909. [PMID: 36806511 DOI: 10.3233/jad-221211] [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: 02/19/2023]
Abstract
BACKGROUND Several studies have examined NCAPH2 methylation in amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD), but little is known of NCAPH2 methylation in subjective cognitive decline (SCD). OBJECTIVE To examine whether methylation of peripheral NCAPH2 are differentially changed at various phases of AD, and whether it could serve as a diagnostic biomarker for SCD. METHODS A total of 40 AD patients, 52 aMCI patients, 148 SCD patients, and 193 cognitively normal controls (NCs) were recruited in the current case-control study. Besides, 54 cognitively normal individuals have received amyloid positron emission tomography (amyloid PET) scans. Using bisulfite pyrosequencing method, we measured blood DNA methylation in the NCAPH2 gene promoter. RESULTS The main outcomes were: 1) For SCD, there was no significant difference between SCD and NC regarding NCAPH2 methylation; 2) For aMCI, NCAPH2 methylation at CpG2 were significantly lower in aMCI compared with NC and SCD in the entire population and male subgroup; 3) For AD, NCAPH2 methylation at CpG1 were significantly lower in AD compared with NC among females; 4) A relationship with apolipoprotein E (APOE) ɛ4 status was shown. Receiver operating characteristic (ROC) analysis by combining NCAPH2 methylation, age, education, and APOEɛ4 status could distinguish between patients with aMCI (area under the curve (AUC): 0.742) and AD (AUC: 0.873) from NCs. CONCLUSION NCAPH2 methylation levels were altered at the aMCI and AD stage and may be convenient and cost-effective biomarkers of AD and aMCI.
Collapse
Affiliation(s)
- Shu-Wen Hao
- Department of Neurobiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China.,Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, China
| | - Tao-Ran Li
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Chao Han
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yan-Ning Cai
- Department of Neurobiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Biobank, Xuanwu Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
24
|
Mohammadian F, Noroozian M, Sadeghi AZ, Malekian V, Saffar A, Talebi M, Hashemi H, Mobarak Salari H, Samadi F, Sodaei F, Rad HS. Effective Connectivity Evaluation of Resting-State Brain Networks in Alzheimer's Disease, Amnestic Mild Cognitive Impairment, and Normal Aging: An Exploratory Study. Brain Sci 2023; 13. [PMID: 36831808 DOI: 10.3390/brainsci13020265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
(1) Background: Alzheimer's disease (AD) is a neurodegenerative disease with a high prevalence. Despite the cognitive tests to diagnose AD, there are pitfalls in early diagnosis. Brain deposition of pathological markers of AD can affect the direction and intensity of the signaling. The study of effective connectivity allows the evaluation of intensity flow and signaling pathways in functional regions, even in the early stage, known as amnestic mild cognitive impairment (aMCI). (2) Methods: 16 aMCI, 13 AD, and 14 normal subjects were scanned using resting-state fMRI and T1-weighted protocols. After data pre-processing, the signal of the predefined nodes was extracted, and spectral dynamic causal modeling analysis (spDCM) was constructed. Afterward, the mean and standard deviation of the Jacobin matrix of each subject describing effective connectivity was calculated and compared. (3) Results: The maps of effective connectivity in the brain networks of the three groups were different, and the direction and strength of the causal effect with the progression of the disease showed substantial changes. (4) Conclusions: Impaired information flow in the resting-state networks of the aMCI and AD groups was found versus normal groups. Effective connectivity can serve as a potential marker of Alzheimer's pathophysiology, even in the early stages of the disease.
Collapse
|
25
|
Chen X, Gong T, Chen T, Xu C, Li Y, Song Q, Lin L, Oeltzschner G, Edden RAE, Xia Z, Wang G. Altered glutamate-glutamine and amide proton transfer-weighted values in the hippocampus of patients with amnestic mild cognitive impairment: A novel combined imaging diagnostic marker. Front Neurosci 2023; 17:1089300. [PMID: 36908797 PMCID: PMC9995585 DOI: 10.3389/fnins.2023.1089300] [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] [Received: 11/04/2022] [Accepted: 01/30/2023] [Indexed: 02/25/2023] Open
Abstract
Background and purpose Early diagnosis of amnestic mild cognitive impairment (aMCI) and timely management to delay the onset of Alzheimer's disease (AD) would benefit patients. Pathological metabolic changes of excitatory/inhibitory neurotransmitters and abnormal protein deposition in the hippocampus of aMCI may provide a new clue to imaging diagnosis. However, the diagnostic performance using these hippocampal metabolite measurements is still unclear. We aimed to quantify right hippocampal glutamate-glutamine (Glx) and gamma-aminobutyric acid (GABA) levels as well as protein-based amide proton transfer-weighted (APTw) signals of patients with aMCI and investigate the diagnostic performance of these metabolites. Methods In this cross-sectional study, 20 patients with aMCI and 20 age- and gender-matched healthy controls (HCs) underwent MEGA Point Resolved Spectroscopy (MEGA-PRESS) and APTw MR imaging at 3 T. GABA+, Glx, and APTw signals were measured in the right hippocampus. The GABA+ levels, Glx levels, Glx/GABA+ ratios, and APTw values were compared between the HCs and aMCI groups using the Mann-Whitney U test. Binary logistic regression and receiver operating characteristic (ROC) curve analyses were used to evaluate MEGA-PRESS and APTw parameters' diagnostic performance. Results Compared with HCs, patients with aMCI had significantly lower Glx levels in the right hippocampus (7.02 ± 1.41 i.u. vs. 5.81 ± 1.33 i.u., P = 0.018). No significant changes in the GABA+ levels were observed in patients with aMCI (HCs vs. aMCI: 2.54 ± 0.28 i.u. vs. 2.47 ± 0.36 i.u., P = 0.620). In addition, Glx/GABA+ ratios between the two groups (HCs vs. aMCI: 2.79 ± 0.60 vs. 2.37 ± 0.55, P = 0.035) were significantly different. Compared with HCs, patients with aMCI showed higher APTw values in the right hippocampus (0.99 ± 0.26% vs. 1.26% ± 0.28, P = 0.006). The ROC curve analysis showed that Glx, GABA+, Glx/GABA+, and APTw values had an area under the curve (AUC) of 0.72, 0.55, 0.70, and 0.75, respectively, for diagnosing aMCI. In the ROC curve analysis, the AUC of the combination of the parameters increased to 0.88, which is much higher than that observed in the univariate analysis (P < 0.05). Conclusion The combination of right hippocampal Glx levels and APTw values improved the diagnostic performance for aMCI, indicating it as a promising combined imaging diagnostic marker. Our study provided a potential imaging diagnostic strategy of aMCI, which may promote early detection of aMCI and facilitate timely intervention to delay the pathological progress toward AD.
Collapse
Affiliation(s)
- Xin Chen
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Department of Neurology, Liaocheng People's Hospital, Liaocheng, China.,Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tao Gong
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tong Chen
- Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Changyuan Xu
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yuchao Li
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Qingxu Song
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, China
| | | | - Georg Oeltzschner
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Richard A E Edden
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Zhangyong Xia
- Department of Neurology, Liaocheng People's Hospital, Liaocheng, China.,Department of Neurology, Liaocheng Clinical School of Shandong First Medical University, Liaocheng, China
| | - Guangbin Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| |
Collapse
|
26
|
Sunderland KM, Beaton D, Arnott SR, Kleinstiver P, Kwan D, Lawrence-Dewar JM, Ramirez J, Tan B, Bartha R, Black SE, Borrie M, Brien D, Casaubon LK, Coe BC, Cornish B, Dilliott AA, Dowlatshahi D, Finger E, Fischer C, Frank A, Fraser J, Freedman M, Greenberg B, Grimes DA, Hassan A, Hatch W, Hegele RA, Hudson C, Jog M, Kumar S, Lang A, Levine B, Lou W, Mandzia J, Marras C, McIlroy W, Montero-Odasso M, Munoz DG, Munoz DP, Orange JB, Park DS, Pasternak SH, Pieruccini-Faria F, Rajji TK, Roberts AC, Robinson JF, Rogaeva E, Sahlas DJ, Saposnik G, Scott CJM, Seitz D, Shoesmith C, Steeves TDL, Strong MJ, Strother SC, Swartz RH, Symons S, Tang-Wai DF, Tartaglia MC, Troyer AK, Turnbull J, Zinman L, McLaughlin PM, Masellis M, Binns MA, Adamo S, Berezuk C, Black A, Breen DP, Bulman D, Chen Y, El‐Defrawy S, Farhan S, Ghani M, Gonder J, Haddad SMH, Holmes M, Huang J, Leontieva E, Mandelcorn E, Margolin E, Nanayakkara N, Ozzoude M, Peltsch AJ, Pollock B, Raamana P, Rashkovan N, Yanina, Southwell A, Sujanthan S, Tayyari F, Van Ooteghem K, Woulfe J, Zamyadi M, Zou G. Characteristics of the Ontario Neurodegenerative Disease Research Initiative cohort. Alzheimers Dement 2023; 19:226-243. [PMID: 36318754 DOI: 10.1002/alz.12632] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 12/01/2021] [Accepted: 12/17/2021] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Understanding synergies between neurodegenerative and cerebrovascular pathologies that modify dementia presentation represents an important knowledge gap. METHODS This multi-site, longitudinal, observational cohort study recruited participants across prevalent neurodegenerative diseases and cerebrovascular disease and assessed participants comprehensively across modalities. We describe univariate and multivariate baseline features of the cohort and summarize recruitment, data collection, and curation processes. RESULTS We enrolled 520 participants across five neurodegenerative and cerebrovascular diseases. Median age was 69 years, median Montreal Cognitive Assessment score was 25, median independence in activities of daily living was 100% for basic and 93% for instrumental activities. Spousal study partners predominated; participants were often male, White, and more educated. Milder disease stages predominated, yet cohorts reflect clinical presentation. DISCUSSION Data will be shared with the global scientific community. Within-disease and disease-agnostic approaches are expected to identify markers of severity, progression, and therapy targets. Sampling characteristics also provide guidance for future study design.
Collapse
Affiliation(s)
- Kelly M Sunderland
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Derek Beaton
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Stephen R Arnott
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Peter Kleinstiver
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | | | - Joel Ramirez
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Robert Bartha
- Robarts Research Institute, Western University, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Sandra E Black
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Michael Borrie
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,St. Joseph's Healthcare Centre, London, Ontario, Canada
| | - Donald Brien
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Leanne K Casaubon
- Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,Toronto Western Hospital, Toronto, Ontario, Canada
| | - Brian C Coe
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Benjamin Cornish
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Allison A Dilliott
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Robarts Research Institute, Western University, London, Ontario, Canada
| | - Dar Dowlatshahi
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Elizabeth Finger
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Corinne Fischer
- Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Andrew Frank
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Julia Fraser
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,Division of Neurology, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Barry Greenberg
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David A Grimes
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ayman Hassan
- Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada
| | - Wendy Hatch
- Kensington Eye Institute, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Robert A Hegele
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Robarts Research Institute, Western University, London, Ontario, Canada
| | - Christopher Hudson
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Mandar Jog
- London Health Sciences Centre, London, Ontario, Canada
| | - Sanjeev Kumar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anthony Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Mandzia
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Clinical Neurological Sciences, London Health Sciences Centre, London, Ontario, Canada
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, Toronto, Ontario, Canada
| | - William McIlroy
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Manuel Montero-Odasso
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Gait and Brain Lab, Parkwood Institute, London, Ontario, Canada
| | - David G Munoz
- Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Joseph B Orange
- School of Communication Sciences and Disorders, Elborn College, Western University, London, Ontario, Canada
| | - David S Park
- Hotchkiss Brain Institute, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Stephen H Pasternak
- St. Joseph's Healthcare Centre, London, Ontario, Canada.,Cognitive Neurology and Alzheimer's Disease Research Centre, Parkwood Institute, London, Ontario, Canada
| | - Frederico Pieruccini-Faria
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Gait and Brain Lab, Parkwood Institute, London, Ontario, Canada
| | - Tarek K Rajji
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Angela C Roberts
- School of Communication Sciences and Disorders, Elborn College, Western University, London, Ontario, Canada.,Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - John F Robinson
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Robarts Research Institute, Western University, London, Ontario, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | | | - Gustavo Saposnik
- Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Christopher J M Scott
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Dallas Seitz
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Michael J Strong
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Canadian Institutes for Health Research, Ottawa, Ontario, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Richard H Swartz
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Sean Symons
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - David F Tang-Wai
- Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Angela K Troyer
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Neuropsychology and Cognitive Health, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - John Turnbull
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lorne Zinman
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Paula M McLaughlin
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Mario Masellis
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Zheng Y, Li T, Xie T, Zhang Y, Liu Y, Zeng X, Wang Z, Wang L, Li H, Xie Y, Lv X, Wang J, Yu X, Wang H. Characteristics and Potential Neural Substrates of Encoding and Retrieval During Memory Binding in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2023; 94:1405-1415. [PMID: 37424465 DOI: 10.3233/jad-230154] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND Whether encoding or retrieval failure contributes to memory binding deficit in amnestic mild cognitive impairment (aMCI) has not been elucidated. Also, the potential brain structural substrates of memory binding remained undiscovered. OBJECTIVE To investigate the characteristics and brain atrophy pattern of encoding and retrieval performance during memory binding in aMCI. METHODS Forty-three individuals with aMCI and 37 cognitively normal controls were recruited. The Memory Binding Test (MBT) was used to measure memory binding performance. The immediate and delayed memory binding indices were computed by using the free and cued paired recall scores. Partial correlation analysis was performed to map the relationship between regional gray matter volume and memory binding performance. RESULTS The memory binding performance in the learning and retrieval phases was worse in the aMCI group than in the control group (F = 22.33 to 52.16, all p < 0.001). The immediate and delayed memory binding index in the aMCI group was lower than that in the control group (p < 0.05). The gray matter volume of the left inferior temporal gyrus was positively correlated with memory binding test scores (r = 0.49 to 0.61, p < 0.05) as well as the immediate (r = 0.39, p < 0.05) and delayed memory binding index (r = 0.42, p < 0.05) in the aMCI group. CONCLUSION aMCI may be primarily characterized by a deficit in encoding phase during the controlled learning process. Volumetric losses in the left inferior temporal gyrus may contribute to encoding failure.
Collapse
Affiliation(s)
- Yaonan Zheng
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| | - Tao Li
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| | - Teng Xie
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| | - Ying Zhang
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Ying Liu
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Xiangzhu Zeng
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Zhijiang Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| | - Luchun Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| | - Huizi Li
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| | - Yuhan Xie
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| | - Xiaozhen Lv
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| | - Jing Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| | - Xin Yu
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| | - Huali Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders (Peking University), NHC Key Laboratory for Mental Health, Beijing, China
| |
Collapse
|
28
|
Beck JS, Madaj Z, Cheema CT, Kara B, Bennett DA, Schneider JA, Gordon MN, Ginsberg SD, Mufson EJ, Counts SE. Co-expression network analysis of frontal cortex during the progression of Alzheimer's disease. Cereb Cortex 2022; 32:5108-5120. [PMID: 35076713 PMCID: PMC9667180 DOI: 10.1093/cercor/bhac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 01/29/2023] Open
Abstract
Mechanisms of Alzheimer's disease (AD) and its putative prodromal stage, amnestic mild cognitive impairment (aMCI), involve the dysregulation of multiple candidate molecular pathways that drive selective cellular vulnerability in cognitive brain regions. However, the spatiotemporal overlap of markers for pathway dysregulation in different brain regions and cell types presents a challenge for pinpointing causal versus epiphenomenal changes characterizing disease progression. To approach this problem, we performed Weighted Gene Co-expression Network Analysis and STRING interactome analysis of gene expression patterns quantified in frontal cortex samples (Brodmann area 10) from subjects who died with a clinical diagnosis of no cognitive impairment, aMCI, or mild/moderate AD. Frontal cortex was chosen due to the relatively protracted involvement of this region in AD, which might reveal pathways associated with disease onset. A co-expressed network correlating with clinical diagnosis was functionally associated with insulin signaling, with insulin (INS) being the most highly connected gene within the network. Co-expressed networks correlating with neuropathological diagnostic criteria (e.g., NIA-Reagan Likelihood of AD) were associated with platelet-endothelium-leucocyte cell adhesion pathways and hypoxia-oxidative stress. Dysregulation of these functional pathways may represent incipient alterations impacting disease progression and the clinical presentation of aMCI and AD.
Collapse
Affiliation(s)
- John S Beck
- Department of Translational Neuroscience, Michigan State University, Grand Rapids, MI 49503, USA
| | - Zachary Madaj
- Bioinformatics and Biostatistics Core, Van Andel Research Institute, Grand Rapids, MI 49503, USA
| | - Calvin T Cheema
- Department of Mathematics and Computer Science, Kalamazoo College, Kalamazoo, MI 49006, USA
| | - Betul Kara
- Department of Translational Neuroscience, Michigan State University, Grand Rapids, MI 49503, USA
- Cell and Molecular Biology Program, Michigan State University, East Lansing, MI 48824, USA
| | - David A Bennett
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
- Rush Alzheimer’s Disease Research Center, Chicago, IL 60612, USA
| | - Julie A Schneider
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
- Rush Alzheimer’s Disease Research Center, Chicago, IL 60612, USA
| | - Marcia N Gordon
- Department of Translational Neuroscience, Michigan State University, Grand Rapids, MI 49503, USA
| | - Stephen D Ginsberg
- Center for Dementia Research, Nathan Kline Institute, Orangeburg, NY 10962, USA
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Neuroscience and Physiology, New York University Grossman School of Medicine, New York, NY 10016, USA
- NYU Neuroscience Institute, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Elliott J Mufson
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ 85013, USA
| | - Scott E Counts
- Department of Translational Neuroscience, Michigan State University, Grand Rapids, MI 49503, USA
- Cell and Molecular Biology Program, Michigan State University, East Lansing, MI 48824, USA
- Department of Family Medicine, Michigan State University, Grand Rapids, MI 49503, USA
- Hauenstein Neurosciences Center, Mercy Health Saint Mary’s Hospital, Grand Rapids, MI 49503, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI 48109, USA
| |
Collapse
|
29
|
Stamovlasis D, Giannouli V, Vaiopoulou J, Tsolaki M. Catastrophe Theory Applied to Neuropsychological Data: Nonlinear Effects of Depression on Financial Capacity in Amnestic Mild Cognitive Impairment and Dementia. Entropy (Basel) 2022; 24:1089. [PMID: 36010753 PMCID: PMC9407425 DOI: 10.3390/e24081089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
Financial incapacity is one of the cognitive deficits observed in amnestic mild cognitive impairment and dementia, while the combined interference of depression remains unexplored. The objective of this research is to investigate and propose a nonlinear model that explains empirical data better than ordinary linear ones and elucidates the role of depression. Four hundred eighteen (418) participants with a diagnosis of amnestic MCI with varying levels of depression were examined with the Geriatric Depression Scale (GDS-15), the Functional Rating Scale for Symptoms of Dementia (FRSSD), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). Cusp catastrophe analysis was applied to the data, which suggested that the nonlinear model was superior to the linear and logistic alternatives, demonstrating depression contributes to a bifurcation effect. Depressive symptomatology induces nonlinear effects, that is, beyond a threshold value sudden decline in financial capacity is observed. Implications for theory and practice are discussed.
Collapse
Affiliation(s)
- Dimitrios Stamovlasis
- School of Philosophy and Education, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Vaitsa Giannouli
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Julie Vaiopoulou
- Department of Education, University of Nicosia, Nicosia 2417, Cyprus
- School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Magda Tsolaki
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
- Alzheimer Hellas, 54643 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Buildings A & B, Thessaloniki, Aristotle University of Thessaloniki, 10th km Thessaloniki-Thermi Rd, P.O. Box 8318, 54124 Thessaloniki, Greece
| |
Collapse
|
30
|
Li X, Liu Y, Kang J, Sun Y, Xu Y, Yuan Y, Han Y, Xie P. Identifying Amnestic Mild Cognitive Impairment With Convolutional Neural Network Adapted to the Spectral Entropy Heat Map of the Electroencephalogram. Front Hum Neurosci 2022; 16:924222. [PMID: 35874151 PMCID: PMC9298556 DOI: 10.3389/fnhum.2022.924222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Mild cognitive impairment (MCI) is a preclinical stage of Alzheimer's disease (AD), and early diagnosis and intervention may delay its deterioration. However, the electroencephalogram (EEG) differences between patients with amnestic mild cognitive impairment (aMCI) and healthy controls (HC) subjects are not as significant compared to those with AD. This study addresses this situation by proposing a computer-aided diagnostic method that also aims to improve model performance and assess the sensitive areas of the subject's brain. The EEG data of 46 subjects (20HC/26aMCI) were enhanced with windowed moving segmentation and transformed from 1D temporal data to 2D spectral entropy images to measure the efficient information in the time-frequency domain from the point of view of information entropy; A novel convolution module is devised, which considerably reduces the number of model learning parameters and saves computing resources on the premise of ensuring diagnostic performance; One more thing, the cognitive diagnostic contribution of the corresponding channels in each brain region was measured by the weight coefficient of the input and convolution unit. Our results showed that when the segmental window overlap rate was increased from 0 to 75%, the corresponding generalization accuracy increased from 91.673 ± 0.9578% to 94.642 ± 0.4035%; Approximately 35% reduction in model learnable parameters by optimizing the network structure while maintaining accuracy; The top four channels were FP1, F7, T5, and F4, corresponding to the frontal and temporal lobes, in descending order of the mean value of the weight coefficients. This paper proposes a novel method based on spectral entropy image and convolutional neural network (CNN), which provides a new perspective for the identifying of aMCI based on EEG.
Collapse
Affiliation(s)
- Xin Li
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, Institute of Electric Engineering, Yanshan University, Qinhuangdao, China
| | - Yi Liu
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, Institute of Electric Engineering, Yanshan University, Qinhuangdao, China
| | - Jiannan Kang
- College of Electronic and Information Engineering, Hebei University, Baoding, China
| | - Yu Sun
- China-Japan Friendship Hospital, Beijing, China
| | - Yonghong Xu
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, Institute of Electric Engineering, Yanshan University, Qinhuangdao, China
| | - Yi Yuan
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, Institute of Electric Engineering, Yanshan University, Qinhuangdao, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Ping Xie
- Key Laboratory of Measurement Technology and Instrumentation of Hebei Province, Institute of Electric Engineering, Yanshan University, Qinhuangdao, China
| |
Collapse
|
31
|
Mertens N, Michiels L, Vanderlinden G, Vandenbulcke M, Lemmens R, Van Laere K, Koole M. Impact of meningeal uptake and partial volume correction techniques on [ 18F]MK-6240 binding in aMCI patients and healthy controls. J Cereb Blood Flow Metab 2022; 42:1236-1246. [PMID: 35062837 PMCID: PMC9207493 DOI: 10.1177/0271678x221076023] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
[18F]MK-6240 is a second-generation tau PET-tracer to quantify neurofibrillary tangles in-vivo. However, individually variable levels of meningeal uptake induce spill-in-effects into the cortex, complicating [18F]MK-6240 PET quantification. Group SUVR differences between age-matched HC subgroups with varying extracerebral uptake (EC-low/mixed/high), and between aMCI and each HC subgroup were assessed without and with partial volume correction (PVC). Both Müller-Gartner (MG-)PVC and region-based voxelwise (RBV-)PVC, with the latter also correcting for extracerebral spill-in-effects, were implemented. Between HC groups, where no differences are to be expected, HC EC-high showed spill-in differences compared to HC EC-low when no PVC was applied while for MG-PVC, differences were reduced and, for RBV-PVC, no statistically significant differences were observed. Between aMCI and HC, cortical SUVR differences were statistically significant, both without and with PVC, but modulated by the varying meningeal uptake in HC subgroups when no PVC was applied. After applying PVC, correlations to clinical parameters improved and effect sizes between HC and aMCI increased, independent of the HC-subgroup. Therefore, appropriate PVC with correction for extracerebral spill-in-effects is recommended to minimize the impact of varying meningeal uptake on cortical differences between HC and aMCI.
Collapse
Affiliation(s)
- Nathalie Mertens
- Nuclear Medicine and Molecular Imaging, University Hospital and KU Leuven, Leuven, Belgium
| | - Laura Michiels
- Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.,VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Greet Vanderlinden
- Nuclear Medicine and Molecular Imaging, University Hospital and KU Leuven, Leuven, Belgium
| | - Mathieu Vandenbulcke
- Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.,Old-Age Psychiatry, University Hospital and KU Leuven, Leuven, Belgium
| | - Robin Lemmens
- Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.,VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Koen Van Laere
- Nuclear Medicine and Molecular Imaging, University Hospital and KU Leuven, Leuven, Belgium.,Division of Nuclear Medicine, University Hospitals Leuven, Belgium
| | - Michel Koole
- Nuclear Medicine and Molecular Imaging, University Hospital and KU Leuven, Leuven, Belgium
| |
Collapse
|
32
|
Huang S, Zhou X, Liu Y, Luo J, Lv Z, Shang P, Zhang W, Lin B, Huang Q, Feng Y, Wang W, Tao S, Wang Y, Zhang C, Chen L, Shi L, Luo Y, Mok VCT, Pan S, Xie H. High Fall Risk Associated With Memory Deficit and Brain Lobes Atrophy Among Elderly With Amnestic Mild Cognitive Impairment and Mild Alzheimer's Disease. Front Neurosci 2022; 16:896437. [PMID: 35757554 PMCID: PMC9213689 DOI: 10.3389/fnins.2022.896437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives This study aimed to primarily examine the association between memory deficit and increased fall risk, second, explore the underlying neuroanatomical linkage of this association in the elderly with aMCI and mild AD. Methods In this cross-sectional study, a total of 103 older adults were included (55 cognitively normal, CN; 48 cognitive impairment, CI, elderly with aMCI, and mild AD). Memory was assessed by the Auditory Verbal Learning Test (AVLT). Fall risk was evaluated by the Timed Up and Go (TUG) Test, heel strike angles, and stride speed, which were collected by an inertial-sensor-based wearable instrument (the JiBuEn™ gait analysis system). Brain volumes were full-automatic segmented and quantified using AccuBrain® v1.2 from three-dimensional T1-weighted (3D T1W) MR images. Multivariable regression analysis was used to examine the extent of the association between memory deficit and fall risk, the association of brain volumes with memory, and fall risk. Age, sex, education, BMI, and HAMD scores were adjusted. Sensitivity analysis was conducted. Results Compared to CN, participants with aMCI and mild AD had poorer cognitive performance (p < 0.001), longer TUG time (p = 0.018), and smaller hippocampus and medial temporal volumes (p = 0.037 and 0.029). In the CI group, compared to good short delayed memory (SDM) performance (AVLT > 5), the elderly with bad SDM performance (AVLT ≤ 3) had longer TUG time, smaller heel strike angles, and slower stride speed. Multivariable regression analysis showed that elderly with poor memory had higher fall risk than relative good memory performance among cognitive impairment elderly. The TUG time increased by 2.1 s, 95% CI, 0.54∼3.67; left heel strike angle reduced by 3.22°, 95% CI, −6.05 to −0.39; and stride speed reduced by 0.09 m/s, 95% CI, −0.19 to −0.00 for the poor memory elderly among the CI group, but not found the association in CN group. In addition, serious medial temporal atrophy (MTA), small volumes of the frontal lobe and occipital lobe were associated with long TUG time and small heel strike angles; small volumes of the temporal lobe, frontal lobe, and parietal lobe were associated with slow stride speed. Conclusion Our findings suggested that memory deficit was associated with increased fall risk in the elderly with aMCI and mild AD. The association might be mediated by the atrophy of medial temporal, frontal, and parietal lobes. Additionally, increased fall risk, tested by TUG time, heel stride angles, and stride speed, might be objective and convenient kinematics markers for dynamic monitoring of both memory function and fall risk.
Collapse
Affiliation(s)
- Shuyun Huang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China.,Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xinhan Zhou
- Department of Imaging, First People's Hospital of Foshan, Foshan, China
| | - Yajing Liu
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Jiali Luo
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Zeping Lv
- National Research Center for Rehabilitation Technical Aids, Rehabilitation Hospital, Beijing, China
| | - Pan Shang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Weiping Zhang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Biqing Lin
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Qiulan Huang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - YanYun Feng
- Department of Imaging, First People's Hospital of Foshan, Foshan, China
| | - Wei Wang
- Department of Imaging, First People's Hospital of Foshan, Foshan, China
| | - Shuai Tao
- Dalian Key Laboratory of Smart Medical and Health, Dalian University, Dalian, China
| | - Yukai Wang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Chengguo Zhang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Lushi Chen
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,BrainNow Research Institute, Shenzhen, China
| | - Yishan Luo
- BrainNow Research Institute, Shenzhen, China
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Suyue Pan
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Haiqun Xie
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| |
Collapse
|
33
|
Kunieda Y, Arakawa C, Yamada T, Koyama S, Suzuki M, Ishiyama D, Yamada M, Hirokawa R, Matsuda T, Nio S, Adachi T, Hoshino H, Fujiwara T. Effect of simultaneous dual-task training on regional cerebral blood flow in older adults with amnestic mild cognitive impairment. Curr Alzheimer Res 2022; 19:458-468. [PMID: 35761496 DOI: 10.2174/1567205019666220627091246] [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] [Received: 12/13/2021] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND No previous study has examined the effect of dual-task training using changes in regional cerebral blood flow (rCBF) using single-photon emission computed tomography (SPECT) as an outcome. OBJECTIVE This study aimed to examine the effects of simultaneous dual-task training of exercise and cognitive tasks on rCBF using SPECT in older adults with amnestic mild cognitive impairment (aMCI). METHODS In this non-randomized control trial, 40 older adults with aMCI participated from May 2016 to April 2018. Outpatients in the intervention group (n = 22) underwent 24 sessions (12 months) of dual-task training twice a month for 60 mins per session. Participants in the control group (n = 18) continued to have regular outpatient visits. The primary outcome was rCBF at baseline and after 12 months, which was compared in each group using the two-sample t-test. The secondary outcomes were the rate of reversion and conversion from aMCI after 12 months. RESULTS Of the 22 participants in the intervention group, six dropped out; therefore, 16 were included in the analysis. The intervention group showed more significant increases in rCBF in multiple regions, including the bilateral frontal lobes, compared with the control group. However, the rates of reversion or conversion from mild cognitive impairment (MCI) were not significantly different. CONCLUSION Dual-task training for older adults with aMCI increased rCBF in the frontal gyrus but did not promote reversion from MCI to normal cognition. Future intervention studies, such as follow-up examinations after the intervention, are warranted to consider long-term prognosis.
Collapse
Affiliation(s)
- Yota Kunieda
- Department of Rehabilitation, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.,Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Chiaki Arakawa
- Department of Internal Medicine, Musubiha Clinic Shibuya, Tokyo, Japan
| | - Takumi Yamada
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Shingo Koyama
- Department of Rehabilitation, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Mizue Suzuki
- Department of Rehabilitation, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Daisuke Ishiyama
- Department of Rehabilitation, Nippon Medical School Hospital, Tokyo, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Ryuto Hirokawa
- Department of Radiology and Nuclear Medicine, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan
| | - Tadamitsu Matsuda
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Shintaro Nio
- Dementia-related Disease Medical Center, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Tomohide Adachi
- Dementia-related Disease Medical Center, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Haruhiko Hoshino
- Dementia-related Disease Medical Center, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Toshiyuki Fujiwara
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan.,Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
34
|
Liu L, Wang T, Du X, Zhang X, Xue C, Ma Y, Wang D. Concurrent Structural and Functional Patterns in Patients With Amnestic Mild Cognitive Impairment. Front Aging Neurosci 2022; 14:838161. [PMID: 35663572 PMCID: PMC9161636 DOI: 10.3389/fnagi.2022.838161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
Amnestic mild cognitive impairment (aMCI) is a clinical subtype of MCI, which is known to have a high risk of developing Alzheimer's disease (AD). Although neuroimaging studies have reported brain abnormalities in patients with aMCI, concurrent structural and functional patterns in patients with aMCI were still unclear. In this study, we combined voxel-based morphometry (VBM), amplitude of low-frequency fluctuations (ALFFs), regional homogeneity (Reho), and resting-state functional connectivity (RSFC) approaches to explore concurrent structural and functional alterations in patients with aMCI. We found that, compared with healthy controls (HCs), both ALFF and Reho were decreased in the right superior frontal gyrus (SFG_R) and right middle frontal gyrus (MFG_R) of patients with aMCI, and both gray matter volume (GMV) and Reho were decreased in the left inferior frontal gyrus (IFG_L) of patients with aMCI. Furthermore, we took these overlapping clusters from VBM, ALFF, and Reho analyses as seed regions to analyze RSFC. We found that, compared with HCs, patients with aMCI had decreased RSFC between SFG_R and the right temporal lobe (subgyral) (TL_R), the MFG_R seed and left superior temporal gyrus (STG_L), left inferior parietal lobule (IPL_L), and right anterior cingulate cortex (ACC_R), the IFG_L seed and left precentral gyrus (PRG_L), left cingulate gyrus (CG_L), and IPL_L. These findings highlighted shared imaging features in structural and functional magnetic resonance imaging (MRI), suggesting that SFG_R, MFG_R, and IFG_L may play a major role in the pathophysiology of aMCI, which might be useful to better understand the underlying neural mechanisms of aMCI and AD.
Collapse
Affiliation(s)
- Li Liu
- Affiliated Mental Health Center, Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tenglong Wang
- School of Humanities and Management, Graduate School of Wannan Medical College, Wuhu, China
| | - Xiangdong Du
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiaobin Zhang
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Chuang Xue
- Affiliated Mental Health Center, Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu Ma
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Dong Wang
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| |
Collapse
|
35
|
Zhang L, Wang D, Dai Y, Wang X, Cao Y, Liu W, Tao Z. Machine Learning Reveals a Multipredictor Nomogram for Diagnosing the Alzheimer's Disease Based on Chemiluminescence Immunoassay for Total Tau in Plasma. Front Aging Neurosci 2022; 14:863673. [PMID: 35645782 PMCID: PMC9136081 DOI: 10.3389/fnagi.2022.863673] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Predicting amnestic mild cognitive impairment (aMCI) in conversion and Alzheimer's disease (AD) remains a daunting task. Standard diagnostic procedures for AD population are reliant on neuroimaging features (positron emission tomography, PET), cerebrospinal fluid (CSF) biomarkers (Aβ1-42, T-tau, P-tau), which are expensive or require invasive sampling. The blood-based biomarkers offer the opportunity to provide an alternative approach for easy diagnosis of AD, which would be a less invasive and cost-effective screening tool than currently approved CSF or amyloid β positron emission tomography (PET) biomarkers. Methods We developed and validated a sensitive and selective immunoassay for total Tau in plasma. Robust signatures were obtained based on several clinical features selected by multiple machine learning algorithms between the three participant groups. Subsequently, a well-fitted nomogram was constructed and validated, integrating clinical factors and total Tau concentration. The predictive performance was evaluated according to the receiver operating characteristic (ROC) curves and area under the curve (AUC) statistics. Decision curve analysis and calibration curves are used to evaluate the net benefit of nomograms in clinical decision-making. Results Under optimum conditions, chemiluminescence analysis (CLIA) displays a desirable dynamic range within Tau concentration from 7.80 to 250 pg/mL with readily achieved higher performances (LOD: 5.16 pg/mL). In the discovery cohort, the discrimination between the three well-defined participant groups according to Tau concentration was in consistent agreement with clinical diagnosis (AD vs. non-MCI: AUC = 0.799; aMCI vs. non-MCI: AUC = 0.691; AD vs. aMCI: AUC = 0.670). Multiple machine learning algorithms identified Age, Gender, EMPG, Tau, ALB, HCY, VB12, and/or Glu as robust signatures. A nomogram integrated total Tau concentration and clinical factors provided better predictive performance (AD vs. non-MCI: AUC = 0.960, AD vs. aMCI: AUC = 0.813 in discovery cohort; AD vs. non-MCI: AUC = 0.938, AD vs. aMCI: AUC = 0.754 in validation cohort). Conclusion The developed assay and a satisfactory nomogram model hold promising clinical potential for early diagnosis of aMCI and AD participants.
Collapse
|
36
|
Abstract
OBJECTIVES Amnestic mild cognitive impairment (aMCI) among other cognitive deficits also includes impairments in financial capacity, but so far the role of depression in time has not been examined. We aimed to examine the hypothesis that individuals with aMCI and comorbid worsening depression levels would demonstrate greater deficits in financial capacity atone year in relation to multiple-domain aMCI patients with stable levels of depression, aMCI patients without depression and healthy individuals. METHODS Ninety-six Greek women and 24 men aged 54 and older (multiple-domain aMCI with, stable and increased levels of depression at one year, aMCI without depressive symptoms, and cognitively intact elders with and without depression) were examined with the Mini-mental State Examination (MMSE), the Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). RESULTS Bootstrapped ANCOVA was implemented. Multiple-domain aMCI patients' performance regarding financial capacity is severely impaired when depression co-exists, resembling the performance of patients with mild Alzheimer's disease, and it declines further when depression deteriorates. CONCLUSIONS Findings contribute to the limited evidence in financial capacity assessment when depression co-exists showing that higher depressive symptom scores are associated with reduced financial capacity scores and deterioration of depressive symptomatology worsens not only general cognitive outcome, but financial capacity in particular. CLINICAL IMPLICATIONS Proactive care for individuals with depression is needed as this condition severely influences financial capacity in aMCI.
Collapse
Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Stamovlasis
- School of Philosophy and Education, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
37
|
Imai A, Matsuoka T, Kato Y, Narumoto J. Diagnostic performance and neural basis of the combination of free- and pre-drawn Clock Drawing Test. Int J Geriatr Psychiatry 2022; 37. [PMID: 35278001 DOI: 10.1002/gps.5699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/01/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES This study aimed to clarify the diagnostic performance and neural basis of the Clock Drawing Test (CDT) combining free- and pre-drawn methods. METHODS This retrospective study included 165 participants (91 with Alzheimer disease [AD], 52 with amnestic mild cognitive impairment [aMCI], and 22 healthy controls [HC]), who were divided into four groups according to their free- and pre-drawn CDT scores: group 1, could do both; group 2, impaired in both; group 3, impaired in pre-drawn CDT; and group 4, impaired in free-drawn CDT. The diagnostic performances of the free-drawn, pre-drawn, and combination methods were compared using receiver operating characteristics analysis; in voxel-based morphometry analysis, the gray matter (GM) volume of groups 2-4 were compared with that of group 1. RESULTS The area under the curve of the combination method was greater than that of the free- or pre-drawn method alone when comparing AD with HC or aMCI. Group 2 had a significantly smaller GM volume in the bilateral temporal lobes than group 1. Group 3 had a trend toward smaller GM volumes in the right temporal lobe when a liberal threshold was applied. Group 4 had significantly smaller GM volumes in the left temporal lobe than group 1. CONCLUSIONS This study suggests that the combination method may be able to screen for a wider range of brain dysfunction. Combined use of free- and pre-drawn CDT may be useful for screening for AD and its early detection and treatment.
Collapse
Affiliation(s)
- Ayu Imai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuka Kato
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
38
|
Zhao C, Huang WJ, Feng F, Zhou B, Yao HX, Guo YE, Wang P, Wang LN, Shu N, Zhang X. Abnormal characterization of dynamic functional connectivity in Alzheimer's disease. Neural Regen Res 2022; 17:2014-2021. [PMID: 35142691 PMCID: PMC8848607 DOI: 10.4103/1673-5374.332161] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Numerous studies have shown abnormal brain functional connectivity in individuals with Alzheimer's disease (AD) or amnestic mild cognitive impairment (aMCI). However, most studies examined traditional resting state functional connections, ignoring the instantaneous connection mode of the whole brain. In this case-control study, we used a new method called dynamic functional connectivity (DFC) to look for abnormalities in patients with AD and aMCI. We calculated dynamic functional connectivity strength from functional magnetic resonance imaging data for each participant, and then used a support vector machine to classify AD patients and normal controls. Finally, we highlighted brain regions and brain networks that made the largest contributions to the classification. We found differences in dynamic function connectivity strength in the left precuneus, default mode network, and dorsal attention network among normal controls, aMCI patients, and AD patients. These abnormalities are potential imaging markers for the early diagnosis of AD.
Collapse
Affiliation(s)
- Cui Zhao
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing; Department of Geriatrics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, China
| | - Wei-Jie Huang
- State Key Laboratory of Cognitive Neuroscience and Learning; Center for Collaboration and Innovation in Brain and Learning Sciences; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
| | - Feng Feng
- Department of Neurology, First Medical Center, Chinese PLA General Hospital; Department of Neurology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Bo Zhou
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China
| | - Hong-Xiang Yao
- Department of Radiology, Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yan-E Guo
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China
| | - Pan Wang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Lu-Ning Wang
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China
| | - Ni Shu
- State Key Laboratory of Cognitive Neuroscience and Learning; Center for Collaboration and Innovation in Brain and Learning Sciences; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
| | - Xi Zhang
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
39
|
Nie J, Fang Y, Chen Y, Aidina A, Qiu Q, Zhao L, Liu X, Sun L, Li Y, Zhong C, Li Y, Li X. Characteristics of Dysregulated Proinflammatory Cytokines and Cognitive Dysfunction in Late-Life Depression and Amnestic Mild Cognitive Impairment. Front Immunol 2022; 12:803633. [PMID: 35069588 PMCID: PMC8767092 DOI: 10.3389/fimmu.2021.803633] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 10/28/2021] [Accepted: 11/30/2021] [Indexed: 12/25/2022] Open
Abstract
Background Late-life depression (LLD) and amnestic mild cognitive impairment (aMCI) are two different diseases associated with a high risk of developing Alzheimer's disease (AD). Both diseases are accompanied by dysregulation of inflammation. However, the differences and similarities of peripheral inflammatory parameters in these two diseases are not well understood. Methods We used Luminex assays to measure 29 cytokines simultaneously in the plasma of two large cohorts of subjects at high risk for AD (23 LLD and 23 aMCI) and 23 normal controls (NCs) in the community. Demographics and lifestyle factors were also collected. Cognitive function was evaluated with the Chinese versions of the Montreal Cognitive Assessment (C-MoCA) and neuropsychological test battery (NTB). Results We observed a remarkably increased level of IL-6 in the plasma and reduced levels of chemokines (CXCL11 and CCL13) in the LLD group compared with the aMCI group. The LLD group also showed lower levels of CXCL16 than the NC group. Furthermore, altered cytokine levels were associated with abnormal results in neuropsychological testing and Geriatric Depression Scale scores in both the LLD and aMCI groups. Notably, combinations of cytokines (IL-6 and CCL13) and two subitems of C-MoCA (orientation and short-term memory) generated the best area under the receiver operating characteristic curve (AUROC = 0.974). Conclusion A novel model based on proinflammatory cytokines and brief screening tests performs with fair accuracy in the discrimination between LLD and aMCI. These findings will give clues to provide new therapeutic targets for interventions or markers for two diseases with similar predementia syndromes.
Collapse
Affiliation(s)
- Jing Nie
- Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Yuan Fang
- Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Ying Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Aisikeer Aidina
- Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Qi Qiu
- Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Lu Zhao
- Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Xiang Liu
- Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Lin Sun
- Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Yun Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, China
| | - Chuwen Zhong
- Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Yuan Li
- Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Xia Li
- Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| |
Collapse
|
40
|
Bubu OM, Williams ET, Umasabor-Bubu OQ, Kaur SS, Turner AD, Blanc J, Cejudo JR, Mullins AE, Parekh A, Kam K, Osakwe ZT, Nguyen AW, Trammell AR, Mbah AK, de Leon M, Rapoport DM, Ayappa I, Ogedegbe G, Jean-Louis G, Masurkar AV, Varga AW, Osorio RS. Interactive Associations of Neuropsychiatry Inventory-Questionnaire Assessed Sleep Disturbance and Vascular Risk on Alzheimer's Disease Stage Progression in Clinically Normal Older Adults. Front Aging Neurosci 2021; 13:763264. [PMID: 34955813 PMCID: PMC8704133 DOI: 10.3389/fnagi.2021.763264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/23/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: To determine whether sleep disturbance (SD) and vascular-risk interact to promote Alzheimer's disease (AD) stage-progression in normal, community-dwelling older adults and evaluate their combined risk beyond that of established AD biomarkers. Methods: Longitudinal data from the National Alzheimer's Coordinating Center Uniform-Dataset. SD data (i.e., SD+ vs. SD-), as characterized by the Neuropsychiatric Inventory-Questionnaire, were derived from 10,600 participants at baseline, with at-least one follow-up visit. A subset (n = 361) had baseline cerebrospinal fluid (CSF) biomarkers and MRI data. The Framingham heart study general cardiovascular disease (FHS-CVD) risk-score was used to quantify vascular risk. Amnestic mild cognitive impairment (aMCI) diagnosis during follow-up characterized AD stage-progression. Logistic mixed-effects models with random intercept and slope examined the interaction of SD and vascular risk on prospective aMCI diagnosis. Results: Of the 10,600 participants, 1,017 (9.6%) reported SD and 6,572 (62%) were female. The overall mean (SD) age was 70.5 (6.5), and follow-up time was 5.1 (2.7) years. SD and the FHS-CVD risk-score were each associated with incident aMCI (aOR: 1.42 and aOR: 2.11, p < 0.01 for both). The interaction of SD and FHS-CVD risk-score with time was significant (aOR: 2.87, p < 0.01), suggesting a synergistic effect. SD and FHS-CVD risk-score estimates remained significantly associated with incident aMCI even after adjusting for CSF (Aβ, T-tau, P-tau) and hippocampal volume (n = 361) (aOR: 2.55, p < 0.01), and approximated risk-estimates of each biomarker in the sample where data was available. Conclusions: Clinical measures of sleep and vascular risk may complement current AD biomarkers in assessing risk of cognitive decline in older adults.
Collapse
Affiliation(s)
- Omonigho M Bubu
- Department of Psychiatry, Center for Sleep and Brain Health, NYU Grossman School of Medicine, New York, NY, United States.,Department of Population Health, Center for Healthful Behavior Change, NYU Grossman School of Medicine, New York, NY, United States
| | - Ellita T Williams
- Department of Population Health, Center for Healthful Behavior Change, NYU Grossman School of Medicine, New York, NY, United States
| | - Ogie Q Umasabor-Bubu
- Division of Epidemiology and Infection Control, State University New York (SUNY) Downstate Medical Center, Brooklyn, NY, United States
| | - Sonya S Kaur
- Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Arlener D Turner
- Department of Psychiatry and Behavioral Sciences, Center for Translational Sleep and Circadian Sciences (TSCS), University of Miami Miller School of Medicine, Miami, FL, United States
| | - Judite Blanc
- Department of Psychiatry and Behavioral Sciences, Center for Translational Sleep and Circadian Sciences (TSCS), University of Miami Miller School of Medicine, Miami, FL, United States
| | - Jaime Ramos Cejudo
- Department of Psychiatry, Center for Sleep and Brain Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Anna E Mullins
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ankit Parekh
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Korey Kam
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Zainab T Osakwe
- College of Nursing and Public Health, Adelphi University, Garden City, NY, United States
| | - Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Antoine R Trammell
- Division of General Medicine and Geriatrics, Department of Medicine, Emory Brain Health Center, Emory University School of Medicine, Atlanta, GA, United States
| | - Alfred K Mbah
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Mony de Leon
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - David M Rapoport
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Indu Ayappa
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Gbenga Ogedegbe
- Department of Population Health, Center for Healthful Behavior Change, NYU Grossman School of Medicine, New York, NY, United States
| | - Girardin Jean-Louis
- Department of Psychiatry, Center for Sleep and Brain Health, NYU Grossman School of Medicine, New York, NY, United States.,Department of Psychiatry and Behavioral Sciences, Center for Translational Sleep and Circadian Sciences (TSCS), University of Miami Miller School of Medicine, Miami, FL, United States
| | - Arjun V Masurkar
- Department of Neurology, Center for Cognitive Neurology, New York University School of Medicine, New York, NY, United States
| | - Andrew W Varga
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ricardo S Osorio
- Department of Psychiatry, Center for Sleep and Brain Health, NYU Grossman School of Medicine, New York, NY, United States.,Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| |
Collapse
|
41
|
You M, Zhou X, Yin W, Wan K, Zhang W, Li C, Li M, Zhu W, Zhu X, Sun Z. The Influence of MTHFR Polymorphism on Gray Matter Volume in Patients With Amnestic Mild Cognitive Impairment. Front Neurosci 2021; 15:778123. [PMID: 34916904 PMCID: PMC8670096 DOI: 10.3389/fnins.2021.778123] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/05/2021] [Indexed: 12/17/2022] Open
Abstract
The methylenetetrahydrofolate reductase (MTHFR) gene has been associated with Alzheimer's disease (AD) pathogenesis. Amnestic mild cognitive impairment (aMCI) represents a prodromal stage of dementia and involves a high risk of progression into AD. Although the effects of the apolipoprotein E (APOE) gene on structural alterations in aMCI have been widely investigated, the effects of MTHFR C677T and interaction effects of MTHFR × APOE genotypes on gray matter atrophy in aMCI remain largely unknown. In the present study, 60 aMCI patients and 30 healthy controls were enrolled, and voxel-based morphometry analysis was performed to inspect the effects of diagnosis, different genotypes, and their interactions on gray matter atrophy. The results showed that aMCI patients had significant gray matter atrophy involving the bilateral hippocampus, the right parahippocampal gyrus, and the left superior temporal gyrus compared with healthy controls. Besides, a substantial reduction in gray matter volume was observed in the right hippocampus region in APOE ε4 carriers from the aMCI group, compared with APOE ε4 non-carriers. A significant interaction was found between diagnosis and MTHFR C677T genotype on the right precuneus in healthy controls and aMCI patients not carrying APOE ε4 allele. Our findings may provide new evidence substantiating the genetic effects of MTHFR C677T on brain structural alternation in patients with aMCI.
Collapse
Affiliation(s)
- Mengzhe You
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xia Zhou
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wenwen Yin
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ke Wan
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wei Zhang
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chenchen Li
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mingxu Li
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wenhao Zhu
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoqun Zhu
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhongwu Sun
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| |
Collapse
|
42
|
Zhang J, Kuang X, Tang C, Xu N, Xiao S, Xiao L, Wang S, Dong Y, Lu L, Zhang L. Acupuncture for amnestic mild cognitive impairment: A pilot multicenter, randomized, parallel controlled trial. Medicine (Baltimore) 2021; 100:e27686. [PMID: 34797294 PMCID: PMC8601273 DOI: 10.1097/md.0000000000027686] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Patients with amnesic mild cognitive impairment (aMCI) are more likely to develop Alzheimer disease than corresponding age normal population. Because Alzheimer disease is irreversible, early intervention for aMCI patients seems important and urgent. We have designed a pilot multicenter, randomized, parallel controlled trial to assess the efficacy and safety of acupuncture on aMCI, explore the feasibility of acupuncture in the treatment of aMCI, so as to provide a reference for large-sample clinical trials in the next stage. METHOD We designed a pilot multicenter, randomized, parallel controlled trial. This trial aims to test the feasibility of carrying out a large-sample clinical trial. In this trial, 50 eligible patients with aMCI will be included and allocated to acupuncture group (n = 25) or sham acupuncture group (n = 25) at random. Subjects will accept treatment 2 times a week for 12 weeks continuously, with a total of 24 treatment sessions. We will select 6 acupoints (GV20, GV14, bilateral BL18, bilateral BL23). For the clinical outcomes, the primary outcome is Montreal cognitive assessment, which will be assessed from baseline to the end of this trial. And the secondary outcomes are Mini-mental State Examination, Delayed Story Recall, Clinical Dementia Rating scale, Global Deterioration Scale, Activity of Daily Life, Alzheimer Disease Assessment Scale-Cognitive Section, brain magnetic resonance imaging, brain functional magnetic resonance imaging, and event-related potential P300, which will be assessed before and after treatment. In addition, we will assess the safety outcomes from baseline to the end of this trial and feasibility outcome after treatment. We will evaluate neuropsychological assessment scale (Montreal cognitive assessment, Mini-mental State Examination, Alzheimer Disease Assessment Scale-Cognitive Section) at 3 months and 6 months after treatment. DISCUSSION This pilot trial aims to explore the feasibility of the trial, verify essential information of its efficacy and safety. This pilot study will provide a preliminary basis for carrying out a larger clinical trial of acupuncture on aMCI in near future.
Collapse
Affiliation(s)
- Jiayu Zhang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangzhou Health Science College, Guangzhou, China
| | - Xu Kuang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunzhi Tang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Nenggui Xu
- Clinical Research Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Songhua Xiao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lingjun Xiao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shengwen Wang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu Dong
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liming Lu
- Clinical Research and Data Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liang Zhang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| |
Collapse
|
43
|
Zhao H, Cheng J, Liu T, Jiang J, Koch F, Sachdev PS, Basser PJ, Wen W. Orientational changes of white matter fibers in Alzheimer's disease and amnestic mild cognitive impairment. Hum Brain Mapp 2021; 42:5397-5408. [PMID: 34412149 PMCID: PMC8519856 DOI: 10.1002/hbm.25628] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/07/2021] [Indexed: 12/13/2022] Open
Abstract
White matter abnormalities represent early neuropathological events in neurodegenerative diseases such as Alzheimer's disease (AD), investigating these white matter alterations would likely provide valuable insights into pathological changes over the course of AD. Using a novel mathematical framework called "Director Field Analysis" (DFA), we investigated the geometric microstructural properties (i.e., splay, bend, twist, and total distortion) in the orientation of white matter fibers in AD, amnestic mild cognitive impairment (aMCI), and cognitively normal (CN) individuals from the Alzheimer's Disease Neuroimaging Initiative 2 database. Results revealed that AD patients had extensive orientational changes in the bilateral anterior thalamic radiation, corticospinal tract, inferior and superior longitudinal fasciculus, inferior fronto-occipital fasciculus, and uncinate fasciculus in comparison with CN. We postulate that these orientational changes of white matter fibers may be partially caused by the expansion of lateral ventricle, white matter atrophy, and gray matter atrophy in AD. In contrast, aMCI individuals showed subtle orientational changes in the left inferior longitudinal fasciculus and right uncinate fasciculus, which showed a significant association with the cognitive performance, suggesting that these regions may be preferential vulnerable to breakdown by neurodegenerative brain disorders, thereby resulting in the patients' cognitive impairment. To our knowledge, this article is the first to examine geometric microstructural changes in the orientation of white matter fibers in AD and aMCI. Our findings demonstrate that the orientational information of white matter fibers could provide novel insight into the underlying biological and pathological changes in AD and aMCI.
Collapse
Affiliation(s)
- Haichao Zhao
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
| | - Jian Cheng
- Beijing Advanced Innovation Center for Big Data‐Based Precision MedicineBeihang UniversityBeijingChina
| | - Tao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
- Beijing Advanced Innovation Center for Big Data‐Based Precision MedicineBeihang UniversityBeijingChina
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA)University of New South WalesSydneyNew South WalesAustralia
| | - Forrest Koch
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA)University of New South WalesSydneyNew South WalesAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA)University of New South WalesSydneyNew South WalesAustralia
| | - Peter J. Basser
- Section on Quantitative Imaging and Tissue SciencesNIBIB, NICHD, National Institutes of HealthBethesdaMaryland
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA)University of New South WalesSydneyNew South WalesAustralia
| | | |
Collapse
|
44
|
Guo Z, Jiang Y, Qin X, Mu R, Meng Z, Zhuang Z, Liu F, Zhu X. Amide Proton Transfer-Weighted MRI Might Help Distinguish Amnestic Mild Cognitive Impairment From a Normal Elderly Population. Front Neurol 2021; 12:707030. [PMID: 34712196 PMCID: PMC8545995 DOI: 10.3389/fneur.2021.707030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate whether 3D amide proton transfer weighted (APTw) imaging based on magnetization transfer analysis can be used as a novel imaging marker to distinguish amnestic mild cognitive impairment (aMCI) patients from the normal elderly population by measuring changes in APTw signal intensity in the hippocampus and amygdala. Materials and Methods: Seventy patients with aMCI and 74 age- and sex-matched healthy volunteers were recruited for routine MRI and APT imaging examinations. Magnetic transfer ratio asymmetry (MTRasym) of the amide protons (at 3.5 ppm), or APTw values, were measured in the bilateral hippocampus and amygdala on three consecutive cross-sectional APT images and were compared between the aMCI and control groups. The independent sample t-test was used to evaluate the difference in APTw values of the bilateral hippocampus and amygdala between the aMCI and control groups. Receiver operator characteristic analysis was used to assess the diagnostic performance of the APTw. The paired t-test was used to assess the difference in APTw values between the left and right hippocampus and amygdala, in both the aMCI and control groups. Results: The APTw values of the bilateral hippocampus and amygdala in the aMCI group were significantly higher than those in the control group (left hippocampus 1.01 vs. 0.77% p < 0.001; right hippocampus 1.02 vs. 0.74%, p < 0.001; left amygdala 0.98 vs. 0.70% p < 0.001; right amygdala 0.94 vs. 0.71%, p < 0.001). The APTw values of the left amygdala had the largest AUC (0.875) at diagnosis of aMCI. There was no significant difference in APTw values between the left and right hippocampus and amygdala, in either group. (aMCI group left hippocampus 1.01 vs. right hippocampus 1.02%, p = 0.652; healthy control group left hippocampus 0.77 vs. right hippocampus 0.74%, p = 0.314; aMCI group left amygdala 0.98 vs. right amygdala 0.94%, p = 0.171; healthy control group left amygdala 0.70 vs. right amygdala 0.71%, p = 0.726). Conclusion: APTw can be used as a new imaging marker to distinguish aMCI patients from the normal elderly population by indirectly reflecting the changes in protein content in the hippocampus and amygdala.
Collapse
Affiliation(s)
- Zixuan Guo
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Yanchun Jiang
- Department of Neurology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Xiaoyan Qin
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Ronghua Mu
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Zhuoni Meng
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Zeyu Zhuang
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Fuzhen Liu
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Xiqi Zhu
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| |
Collapse
|
45
|
Feng F, Huang W, Meng Q, Hao W, Yao H, Zhou B, Guo Y, Zhao C, An N, Wang L, Huang X, Zhang X, Shu N. Altered Volume and Structural Connectivity of the Hippocampus in Alzheimer's Disease and Amnestic Mild Cognitive Impairment. Front Aging Neurosci 2021; 13:705030. [PMID: 34675796 PMCID: PMC8524052 DOI: 10.3389/fnagi.2021.705030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/10/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Hippocampal atrophy is a characteristic of Alzheimer’s disease (AD). However, alterations in structural connectivity (number of connecting fibers) between the hippocampus and whole brain regions due to hippocampal atrophy remain largely unknown in AD and its prodromal stage, amnestic mild cognitive impairment (aMCI). Methods: We collected high-resolution structural MRI (sMRI) and diffusion tensor imaging (DTI) data from 36 AD patients, 30 aMCI patients, and 41 normal control (NC) subjects. First, the volume and structural connectivity of the bilateral hippocampi were compared among the three groups. Second, correlations between volume and structural connectivity in the ipsilateral hippocampus were further analyzed. Finally, classification ability by hippocampal volume, its structural connectivity, and their combination were evaluated. Results: Although the volume and structural connectivity of the bilateral hippocampi were decreased in patients with AD and aMCI, only hippocampal volume correlated with neuropsychological test scores. However, positive correlations between hippocampal volume and ipsilateral structural connectivity were displayed in patients with AD and aMCI. Furthermore, classification accuracy (ACC) was higher in AD vs. aMCI and aMCI vs. NC by the combination of hippocampal volume and structural connectivity than by a single parameter. The highest values of the area under the receiver operating characteristic (ROC) curve (AUC) in every two groups were all obtained by combining hippocampal volume and structural connectivity. Conclusions: Our results showed that the combination of hippocampal volume and structural connectivity (number of connecting fibers) is a new perspective for the discrimination of AD and aMCI.
Collapse
Affiliation(s)
- Feng Feng
- Department of Neurology, First Medical Center, Chinese PLA General Hospital, Beijing, China.,Department of Neurology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Weijie Huang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
| | - Qingqing Meng
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.,Health Care Office of the Service Bureau of Agency for Offices Administration of the Central Military Commission, Beijing, China
| | - Weijun Hao
- Department of Healthcare, Bureau of Guard, General Office of the Communist Party of China, Beijing, China
| | - Hongxiang Yao
- Department of Radiology, Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bo Zhou
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yan'e Guo
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Cui Zhao
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.,Department of Geriatrics, Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Ningyu An
- Department of Radiology, Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Luning Wang
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xusheng Huang
- Department of Neurology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xi Zhang
- Department of Neurology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ni Shu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
| |
Collapse
|
46
|
Xue C, Qi W, Yuan Q, Hu G, Ge H, Rao J, Xiao C, Chen J. Disrupted Dynamic Functional Connectivity in Distinguishing Subjective Cognitive Decline and Amnestic Mild Cognitive Impairment Based on the Triple-Network Model. Front Aging Neurosci 2021; 13:711009. [PMID: 34603006 PMCID: PMC8484524 DOI: 10.3389/fnagi.2021.711009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/16/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Subjective cognitive decline and amnestic mild cognitive impairment (aMCI) were widely thought to be preclinical AD spectrum disorders, characterized by aberrant functional connectivity (FC) within the triple networks of the default mode network (DMN), the salience network (SN), and the executive control network (ECN). Dynamic FC (DFC) analysis can capture temporal fluctuations in brain FC during the scan, which static FC analysis cannot. The purpose of the current study was to explore the changes in dynamic FC within the triple networks of the preclinical AD spectrum and further reveal their potential diagnostic value in diagnosing preclinical AD spectrum disorders. Methods: We collected resting-state functional magnetic resonance imaging data from 44 patients with subjective cognitive decline (SCD), 49 with aMCI, and 58 healthy controls (HCs). DFC analysis based on the sliding time-window correlation method was used to analyze DFC variability within the triple networks in the three groups. Then, correlation analysis was conducted to reveal the relationship between altered DFC variability within the triple networks and a decline in cognitive function. Furthermore, logistic regression analysis was used to assess the diagnostic accuracy of altered DFC variability within the triple networks in patients with SCD and aMCI. Results: Compared with the HC group, the groups with SCD and aMCI both showed altered DFC variability within the triple networks. DFC variability in the right middle temporal gyrus and left inferior frontal gyrus (IFG) within the ECN were significantly different between patients with SCD and aMCI. Moreover, the altered DFC variability in the left IFG within the ECN was obviously associated with a decline in episodic memory and executive function. The logistic regression analysis showed that multivariable analysis had high sensitivity and specificity for diagnosing SCD and aMCI. Conclusions: Subjective cognitive decline and aMCI showed varying degrees of change in DFC variability within the triple networks and altered DFC variability within the ECN involved episodic memory and executive function. More importantly, altered DFC variability and the triple-network model proved to be important biomarkers for diagnosing and identifying patients with preclinical AD spectrum disorders.
Collapse
Affiliation(s)
- Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qianqian Yuan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Guanjie Hu
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Honglin Ge
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Jiang Rao
- Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chaoyong Xiao
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China.,Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
47
|
Wang Y, Lou F, Li Y, Liu F, Wang Y, Cai L, Gordon ML, Zhang Y, Zhang N. Clinical, Neuropsychological, and Neuroimaging Characteristics of Amyloid- positive vs. Amyloid-negative Patients with Clinically Diagnosed Alzheimer's Disease and Amnestic Mild Cognitive Impairment. Curr Alzheimer Res 2021; 18:523-532. [PMID: 34598664 DOI: 10.2174/1567205018666211001113349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/14/2021] [Accepted: 07/24/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND A significant proportion of patients with clinically diagnosed Alzheimer's Disease (AD) and an even higher proportion of patients with amnestic mild cognitive impairment (aMCI) do not show evidence of amyloid deposition on Positron Emission Tomography (PET) with amyloid-binding tracers such as 11C-labeled Pittsburgh Compound B (PiB). OBJECTIVE This study aimed to identify clinical, neuropsychological and neuroimaging factors that might suggest amyloid neuropathology in patients with clinically suspected AD or aMCI. METHODS Forty patients with mild to moderate AD and 23 patients with aMCI who were clinically diagnosed in our memory clinic and had PiB PET scans were included. Clinical, neuropsychological, and imaging characteristics, such as Medial Temporal lobe Atrophy (MTA) and White Matter Hyperintensities (WMH) on MRI and metabolic pattern on 18F-labeled fluorodeoxyglucose (FDG) PET, were compared between patients with PiB positive and negative PET results for AD, aMCI, and all subjects combined, respectively. RESULTS Compared with PiB positive patients, PiB negative patients had a higher prevalence of hypertension history, better performance on the Mini-Mental State Examination, the Rey Auditory Verbal Learning Test, and the Judgement of Line Orientation, lower score of MTA, and were less likely to have temporoparietal-predominant hypometabolism on FDG PET. Affective symptoms were less common in PiB negative patients diagnosed with AD, and the Animal Fluency Test score was higher in PiB negative patients diagnosed with aMCI. CONCLUSION In patients with clinically diagnosed AD or aMCI, absence of a history of hypertension, deficits in verbal learning and memory, visuospatial function, semantic verbal fluency, presence of affective symptoms, MTA on MRI, and temporoparietal hypometabolism on FDG PET suggested amyloid deposition in the brain.
Collapse
Affiliation(s)
- Yue Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, 154, Anshan Road, Tianjin, China
| | - Fanghua Lou
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, 154, Anshan Road, Tianjin, China
| | - Yonggang Li
- Department of Neurosurgery, Tianjin Medical University General Hospital, 154, Anshan Road, Tianjin 300052, China
| | - Fang Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, 154, Anshan Road, Tianjin, China
| | - Ying Wang
- PET/CT Center, Tianjin Medical University General Hospital, 154, Anshan Road, Tianjin, China
| | - Li Cai
- PET/CT Center, Tianjin Medical University General Hospital, 154, Anshan Road, Tianjin, China
| | - Marc L Gordon
- The Litwin-Zucker Research Center, The Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, United States
| | - Yuanyuan Zhang
- Department of Radiology, Tianjin Medical University General Hospital, 154, Anshan Road, Tianjin, China
| | - Nan Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, 154, Anshan Road, Tianjin, China
| |
Collapse
|
48
|
Zhang X, Xue C, Cao X, Yuan Q, Qi W, Xu W, Zhang S, Huang Q. Altered Patterns of Amplitude of Low-Frequency Fluctuations and Fractional Amplitude of Low-Frequency Fluctuations Between Amnestic and Vascular Mild Cognitive Impairment: An ALE-Based Comparative Meta-Analysis. Front Aging Neurosci 2021; 13:711023. [PMID: 34531735 PMCID: PMC8438295 DOI: 10.3389/fnagi.2021.711023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 05/17/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Changes in the amplitude of low-frequency fluctuations (ALFF) and the fractional amplitude of low-frequency fluctuations (fALFF) have provided stronger evidence for the pathophysiology of cognitive impairment. Whether the altered patterns of ALFF and fALFF differ in amnestic cognitive impairment (aMCI) and vascular mild cognitive impairment (vMCI) is largely unknown. The purpose of this study was to explore the ALFF/fALFF changes in the two diseases and to further explore whether they contribute to the diagnosis and differentiation of these diseases. Methods: We searched PubMed, Ovid, and Web of Science databases for articles on studies using the ALFF/fALFF method in patients with aMCI and vMCI. Based on the activation likelihood estimation (ALE) method, connectivity modeling based on coordinate meta-analysis and functional meta-analysis was carried out. Results: Compared with healthy controls (HCs), patients with aMCI showed increased ALFF/fALFF in the bilateral parahippocampal gyrus/hippocampus (PHG/HG), right amygdala, right cerebellum anterior lobe (CAL), left middle temporal gyrus (MTG), left cerebrum temporal lobe sub-gyral, left inferior temporal gyrus (ITG), and left cerebrum limbic lobe uncus. Meanwhile, decreased ALFF/fALFF values were also revealed in the bilateral precuneus (PCUN), bilateral cuneus (CUN), and bilateral posterior cingulate (PC) in patients with aMCI. Compared with HCs, patients with vMCI predominantly showed decreased ALFF/fALFF in the bilateral CUN, left PCUN, left PC, and right cingulate gyrus (CG). Conclusions: The present findings suggest that ALFF and fALFF displayed remarkable altered patterns between aMCI and vMCI when compared with HCs. Thus, the findings of this study may serve as a reliable tool for distinguishing aMCI from vMCI, which may help understand the pathophysiological mechanisms of these diseases.
Collapse
Affiliation(s)
- Xulian Zhang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xuan Cao
- Division of Statistics and Data Science, Department of Mathematical Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Qianqian Yuan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenwen Xu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shaojun Zhang
- Department of Statistics, University of Florida, Gainesville, FL, United States
| | - Qingling Huang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
49
|
Chuang YC, Chiu MJ, Chen TF, Chang YL, Lai YM, Cheng TW, Hua MS. An Exploration of the Own-Age Effect on Facial Emotion Recognition in Normal Elderly People and Individuals with the Preclinical and Demented Alzheimer's Disease. J Alzheimers Dis 2021; 80:259-269. [PMID: 33522998 DOI: 10.3233/jad-200916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The issue of whether there exists an own-effect on facial recognition in the elderly remains equivocal. Moreover, currently the literature of this issue in pathological aging is little. OBJECTIVE Our study was thus to explore the issue in both of healthy older people and patients with ADMethods:In study 1, 27 older and 31 younger healthy adults were recruited; in study 2, 27 healthy older adults and 80 patients (including subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer's disease (AD) groups) were recruited. Participants received the Taiwan Facial Emotion Recognition Task (FER Task), and a clinical neuropsychological assessment. RESULTS No significant differences on the FER test were found among our groups, except for sadness recognition in which our MCI and AD patients' scores were remarkably lower than their healthy counterparts. The own-age effect was not significantly evident in healthy younger and older adults, except for recognizing neutral photos. Our patients with MCI and AD tended to have the effect, particularly for the sad recognition in which the effect was significantly evident in terms of error features (mislabeling it as anger in younger-face and neutral in older-face photos). CONCLUSION Our results displayed no remarkable own-age effect on facial emotional recognition in the healthy elderly (including SCD). However, it did not appear the case for MCI and AD patients, especially their recognizing those sadness items, suggesting that an inclusion of the FER task particularly involving those items of low-intensity emotion in clinical neuropsychological assessment might be contributory to the early detection of AD-related pathological individuals.
Collapse
Affiliation(s)
- Yu-Chen Chuang
- Department of Psychology, College of Science, National Taiwan University, Taiwan
| | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taiwan.,Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taiwan.,Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Ya-Mei Lai
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ting-Wen Cheng
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taiwan
| | - Mau-Sun Hua
- Department of Psychology, College of Science, National Taiwan University, Taiwan.,Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Psychology, Asia University, Taichung, Taiwan
| |
Collapse
|
50
|
Kang SH, Cheon BK, Kim JS, Jang H, Kim HJ, Park KW, Noh Y, Lee JS, Ye BS, Na DL, Lee H, Seo SW. Machine Learning for the Prediction of Amyloid Positivity in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2021; 80:143-157. [PMID: 33523003 DOI: 10.3233/jad-201092] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Amyloid-β (Aβ) evaluation in amnestic mild cognitive impairment (aMCI) patients is important for predicting conversion to Alzheimer's disease. However, Aβ evaluation through Aβ positron emission tomography (PET) is limited due to high cost and safety issues. OBJECTIVE We therefore aimed to develop and validate prediction models of Aβ positivity for aMCI using optimal interpretable machine learning (ML) approaches utilizing multimodal markers. METHODS We recruited 529 aMCI patients from multiple centers who underwent Aβ PET. We trained ML algorithms using a training cohort (324 aMCI from Samsung medical center) with two-phase modelling: model 1 included age, gender, education, diabetes, hypertension, apolipoprotein E genotype, and neuropsychological test scores; model 2 included the same variables as model 1 with additional MRI features. We used four-fold cross-validation during the modelling and evaluated the models on an external validation cohort (187 aMCI from the other centers). RESULTS Model 1 showed good accuracy (area under the receiver operating characteristic curve [AUROC] 0.837) in cross-validation, and fair accuracy (AUROC 0.765) in external validation. Model 2 led to improvement in the prediction performance with good accuracy (AUROC 0.892) in cross validation compared to model 1. Apolipoprotein E genotype, delayed recall task scores, and interaction between cortical thickness in the temporal region and hippocampal volume were the most important predictors of Aβ positivity. CONCLUSION Our results suggest that ML models are effective in predicting Aβ positivity at the individual level and could help the biomarker-guided diagnosis of prodromal AD.
Collapse
Affiliation(s)
- Sung Hoon Kang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Bo Kyoung Cheon
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Ji-Sun Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hyemin Jang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hee Jin Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Young Noh
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Seoul, Korea
| | - Byoung Seok Ye
- Department of Neurology, Severance hospital, Yonsei University School of Medicine, Seoul, Korea
| | - Duk L Na
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hyejoo Lee
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Sang Won Seo
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea.,Samsung Alzheimer Research Center and Center for Clinical Epidemiology Medical Center, Seoul, Korea.,Department of Intelligent Precision Healthcare Convergence, SAIHST, Sungkyunkwan University, Seoul, Korea
| |
Collapse
|