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Kapoor A, Gaubert A, Yew B, Jang JY, Dutt S, Li Y, Alitin JPM, Nguyen A, Ho JK, Blanken AE, Sible IJ, Marshall A, Shenasa F, Rodgers KE, Martini AC, Head E, Nation DA. Enlarged perivascular spaces and plasma Aβ42/Aβ40 ratio in older adults without dementia. Neurobiol Aging 2023; 128:43-48. [PMID: 37156179 PMCID: PMC10852216 DOI: 10.1016/j.neurobiolaging.2023.04.004] [Citation(s) in RCA: 1] [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: 09/15/2022] [Revised: 03/30/2023] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
Dilation of perivascular spaces (PVS) in the brain may indicate poor fluid drainage due to the accumulation of perivascular cell debris, waste, and proteins, including amyloid-beta (Aβ). No prior study has assessed whether plasma Aβ levels are related to PVS in older adults without dementia. Independently living older adults (N = 56, mean age = 68.2 years; Standard deviation (SD) = 6.5; 30.4% male) free of dementia or clinical stroke were recruited from the community and underwent brain MRI and venipuncture. PVS were qualitatively scored and dichotomized to low PVS burden (scores 0-1,) or high PVS burden (score>1). Plasma was assayed using a Quanterix Simoa Kit to quantify Aβ42 and Aβ40 levels. A significant difference was observed in plasma Aβ42/Aβ40 ratio between low and high PVS burden, controlling for age (F[1, 53] = 5.59, p = 0.022, η2 = 0.10), with lower Aβ42/Aβ40 ratio in the high PVS burden group. Dilation of PVS is associated with a lower plasma Aβ42/Aβ40 ratio, which may indicate higher cortical amyloid deposition. Future longitudinal studies examining PVS changes, and the pathogenesis of AD are warranted.
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Affiliation(s)
- Arunima Kapoor
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Aimée Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - John Paul M Alitin
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Amy Nguyen
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Jean K Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Anna E Blanken
- San Francisco Veterans Affairs Health Care System & Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Anisa Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Fatemah Shenasa
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Kathleen E Rodgers
- Center for Innovations in Brain Science, Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Alessandra C Martini
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, USA
| | - Daniel A Nation
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA.
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Marshall AJ, Gaubert A, Kapoor A, Tan A, McIntosh E, Jang JY, Yew B, Ho JK, Blanken AE, Dutt S, Sible IJ, Li Y, Rodgers K, Nation DA. Blood-Derived Progenitor Cells Are Depleted in Older Adults with Cognitive Impairment: A Role for Vascular Resilience? J Alzheimers Dis 2023; 93:1041-1050. [PMID: 37154177 PMCID: PMC10258882 DOI: 10.3233/jad-220269] [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] [Accepted: 03/23/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Depletion of blood-derived progenitor cells, including so called "early endothelial progenitor cells", has been observed in individuals with early stage Alzheimer's disease relative to matched older control subjects. These findings could implicate the loss of angiogenic support from hematopoietic progenitors or endothelial progenitors in cognitive dysfunction. OBJECTIVE To investigate links between progenitor cell proliferation and mild levels of cognitive dysfunction. METHODS We conducted in vitro studies of blood-derived progenitor cells using blood samples from sixty-five older adults who were free of stroke or dementia. Peripheral blood mononuclear cells from venous blood samples were cultured in CFU-Hill media and the number of colony forming units were counted after 5 days in vitro. Neuropsychological testing was administered to all participants. RESULTS Fewer colony forming units were observed in samples from older adults with a Clinical Dementia Rating global score of 0.5 versus 0. Older adults whose samples developed fewer colony forming units exhibited worse performance on neuropsychological measures of memory, executive functioning, and language ability. CONCLUSION These data suggest blood progenitors may represent a vascular resilience marker related to cognitive dysfunction in older adults.
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Affiliation(s)
- Anisa J. Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Aimee Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Arunima Kapoor
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Alick Tan
- Department of Clinical Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Elissa McIntosh
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Belinda Yew
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jean K. Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Anna E. Blanken
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Isabel J. Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Kathleen Rodgers
- Center for Innovations in Brain Science, Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Daniel A. Nation
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
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Sible IJ, Jang JY, Dutt S, Yew B, Alitin JPM, Li Y, Blanken AE, Ho JK, Marshall AJ, Kapoor A, Shenasa F, Gaubert A, Nguyen A, Sturm VE, Mather M, Rodgers KE, Shao X, Wang DJ, Nation DA. Older Adults With Higher Blood Pressure Variability Exhibit Cerebrovascular Reactivity Deficits. Am J Hypertens 2023; 36:63-68. [PMID: 36149821 PMCID: PMC9793985 DOI: 10.1093/ajh/hpac108] [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: 08/10/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Elevated blood pressure (BP) variability is predictive of increased risk for stroke, cerebrovascular disease, and other vascular brain injuries, independent of traditionally studied average BP levels. However, no studies to date have evaluated whether BP variability is related to diminished cerebrovascular reactivity, which may represent an early marker of cerebrovascular dysfunction presaging vascular brain injury. METHODS The present study investigated BP variability and cerebrovascular reactivity in a sample of 41 community-dwelling older adults (mean age 69.6 [SD 8.7] years) without a history of dementia or stroke. Short-term BP variability was determined from BP measurements collected continuously during a 5-minute resting period followed by cerebrovascular reactivity during 5-minute hypocapnia and hypercapnia challenge induced by visually guided breathing conditions. Cerebrovascular reactivity was quantified as percent change in cerebral perfusion by pseudo-continuous arterial spin labeling (pCASL)-MRI per unit change in end-tidal CO2. RESULTS Elevated systolic BP variability was related to lower whole brain cerebrovascular reactivity during hypocapnia (ß = -0.43 [95% CI -0.73, -0.12]; P = 0.008; adjusted R2 =.11) and hypercapnia (ß = -0.42 [95% CI -0.77, -0.06]; P = 0.02; adjusted R2 = 0.19). CONCLUSIONS Findings add to prior work linking BP variability and cerebrovascular disease burden and suggest BP variability may also be related to prodromal markers of cerebrovascular dysfunction and disease, with potential therapeutic implications.
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Affiliation(s)
- Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - John Paul M Alitin
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Anna E Blanken
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Jean K Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Anisa J Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Arunima Kapoor
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
| | - Fatemah Shenasa
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
| | - Aimée Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Amy Nguyen
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Virginia E Sturm
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA, 94158, USA
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Mara Mather
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Kathleen E Rodgers
- Center for Innovation in Brain Science, Department of Pharmacology, The University of Arizona, Tucson, AZ, 85721, USA
| | - Xingfeng Shao
- Laboratory of Functional MRI Technology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, 90033, USA
| | - Danny J Wang
- Laboratory of Functional MRI Technology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, 90033, USA
| | - Daniel A Nation
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
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Kapoor A, Jang JY, Yew B, Dutt S, Li Y, Sible IJ, Gaubert A, Ho JK, Blanken AE, Marshall AJ, Shao X, Soto M, Bradford DR, Rodgers KE, Wang DJJ, Nation DA. Cerebrovascular reactivity deficits in older adults with elevated levels of plasma vascular injury markers. Alzheimers Dement 2022. [DOI: 10.1002/alz.065221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | - Belinda Yew
- University of Southern California Los Angeles CA USA
| | - Shubir Dutt
- University of Southern California Los Angeles CA USA
| | - Yanrong Li
- University of California, Irvine Irvine CA USA
| | | | | | - Jean K Ho
- University of California, Irvine Irvine CA USA
| | | | | | - Xingfeng Shao
- Keck School of Medicine, University of Southern California Los Angeles CA USA
| | | | | | | | - Danny JJ Wang
- University of Southern California Los Angeles CA USA
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Kapoor A, Yew B, Jang JY, Dutt S, Li Y, Alitin JPM, Gaubert A, Ho JK, Blanken AE, Sible IJ, Marshall A, Shao X, Mather M, Wang DJJ, Nation DA. Older adults with perivascular spaces exhibit cerebrovascular reactivity deficits. Neuroimage 2022; 264:119746. [PMID: 36370956 PMCID: PMC10033456 DOI: 10.1016/j.neuroimage.2022.119746] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/12/2022] [Accepted: 11/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perivascular spaces on brain magnetic resonance imaging (MRI) may indicate poor fluid drainage in the brain and have been associated with numerous neurological conditions. Cerebrovascular reactivity (CVR) is a marker of cerebrovascular function and represents the ability of cerebral blood vessels to regulate cerebral blood flow in response to vasodilatory or vasoconstrictive stimuli. We aimed to examine whether pathological widening of the perivascular space in older adults may be associated with deficits in CVR. METHODS Independently living older adults free of dementia or clinical stroke were recruited from the community and underwent brain MRI. Pseudo-continuous arterial spin labeling MRI quantified whole brain cerebral perfusion at rest and during CVR to hypercapnia and hypocapnia induced by visually guided breathing exercises. Perivascular spaces were visually scored using existing scales. RESULTS Thirty-seven independently living older adults (mean age = 66.3 years; SD = 6.8; age range 55-84 years; 29.7% male) were included in the current analysis. Multiple linear regression analysis revealed a significant negative association between burden of perivascular spaces and global CVR to hypercapnia (B = -2.0, 95% CI (-3.6, -0.4), p = .015), adjusting for age and sex. Perivascular spaces were not related to CVR to hypocapnia. DISCUSSION Perivascular spaces are associated with deficits in cerebrovascular vasodilatory response, but not vasoconstrictive response. Enlargement of perivascular spaces could contribute to, or be influenced by, deficits in CVR. Additional longitudinal studies are warranted to improve our understanding of the relationship between cerebrovascular function and perivascular space enlargement.
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Affiliation(s)
- Arunima Kapoor
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - John Paul M Alitin
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Aimee Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Jean K Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Anna E Blanken
- San Francisco Veterans Affairs Health Care System & Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Anisa Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Xingfeng Shao
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Mara Mather
- Davis School of Gerontology and Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Danny J J Wang
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Daniel A Nation
- Department of Psychological Science, University of California, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.
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Yew B, Jang JY, Dutt S, Li Y, Sible IJ, Gaubert A, Ho JK, Blanken AE, Marshall A, Shao X, Wang DJJ, Nation DA. Cerebrovascular reactivity deficits in cognitively unimpaired older adults: vasodilatory versus vasoconstrictive responses. Neurobiol Aging 2022; 113:55-62. [PMID: 35325813 PMCID: PMC10958374 DOI: 10.1016/j.neurobiolaging.2022.02.006] [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: 10/14/2021] [Revised: 01/27/2022] [Accepted: 02/16/2022] [Indexed: 01/16/2023]
Abstract
Cerebrovascular reactivity (CVR) deficits may index vulnerability to vascular brain injury and cognitive impairment, but findings on age-related changes in CVR have been mixed, and no studies to date have directly compared age-related changes in CVR to hypercapnia versus hypocapnia. The present study compared CVR in 31 cognitively unimpaired older adults (ages 55-87) and 30 healthy younger adults (ages 18-28). Breath control tasks induced CVR to hypocapnia (0.1 Hz paced breathing) and hypercapnia (15s breath holds) during pseudo-continuous arterial spin labeling MRI. Relative to younger adults, cognitively unimpaired older adults displayed lower levels of global CVR under both hypocapnia and hypercapnia. In region-of-interest analyses, older adults exhibited attenuated CVR to hypocapnia in select frontal and temporal regions, and lower CVR to hypercapnia in all cortical, limbic, and subcortical regions examined, relative to younger adults. Results indicate age-related deficits in CVR are detectible even in cognitively unimpaired older adults and are disproportionately related to vasodilatory (hypercapnia) responses relative to vasoconstrictive (hypocapnia) responses. Findings may offer means for early detection of cerebrovascular dysfunction.
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Affiliation(s)
- Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Aimée Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Jean K Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Anna E Blanken
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Anisa Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Xingfeng Shao
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Danny J J Wang
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Daniel A Nation
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA; Department of Psychological Science, University of California, Irvine, Irvine, CA, USA.
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Kumar RG, Esterov D, Adams RS, Corrigan JD, Juengst SB, Chiaravalloti ND, Yew B, Dreer LE, Dams-O’Connor K. Changes in alcohol use and mood during the COVID-19 pandemic among individuals with traumatic brain injury: A difference-in-difference study. PLoS One 2022; 17:e0266422. [PMID: 35390043 PMCID: PMC8989351 DOI: 10.1371/journal.pone.0266422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/18/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To evaluate the impact of COVID-19 pandemic exposure on changes in alcohol use and mood from years 1 to 2 after traumatic brain injury (TBI). Methods We used a difference-in-difference (DiD) study design to analyze data from 1,059 individuals with moderate-to-severe TBI enrolled in the TBI Model Systems (TBIMS) National Database. We defined COVID-19 pandemic exposure as participants who received their year 1 post-injury interviews prior to January 1, 2020, and their year 2 interview between April 1, 2020 and January 15, 2021. Pandemic-unexposed participants had both year 1 and 2 follow-up interviews before January 1, 2020. We measured current alcohol use as any past month alcohol use, average number of drinks per drinking occasion, and past month binge drinking. We measured depression symptoms using Patient Health Questionnaire-9, and anxiety symptoms using the Generalized Anxiety Disorder-7. Results We found persons with TBI exposed to the pandemic had greater increases in the average number of drinks per occasion from year 1 to 2 post-injury compared to pandemic-unexposed individuals (β = 0.36, 95% CI: 0.16, 0.57, p = 0.001), with males, adults <65 years old, and Black and Hispanic subgroups showing the greatest increases in consumption. Though average consumption was elevated, changes in rates of any alcohol use or binge drinking by pandemic exposure were not observed. Overall, there were no significant changes in depressive and anxiety symptoms over time between pandemic exposed and unexposed groups; however, pandemic-exposed Hispanics with TBI reported significant increases in anxiety symptoms from year-1 to year-2 post-injury compared to pandemic-unexposed Hispanics (β = 2.35, 95% CI: 0.25, 4.47, p = 0.028). Conclusion Among persons living with TBI, those exposed to the pandemic had significant increases in average alcohol consumption. Pandemic-exposed Hispanics with TBI had large elevations in anxiety symptoms, perhaps reflecting health inequities exacerbated by the pandemic, and suggesting a need for targeted monitoring of psychosocial distress.
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Affiliation(s)
- Raj G. Kumar
- Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- * E-mail:
| | - Dmitry Esterov
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America
| | - Rachel Sayko Adams
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, United States of America
- VHA Rocky Mountain Mental Illness Research Education and Clinical Center, Aurora, Colorado, United States of America
| | - John D. Corrigan
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH, United States of America
| | - Shannon B. Juengst
- TIRR Memorial Hermann, Houston TX, United States of America
- Department of Physical Medicine & Rehabilitation, UT Southwestern, Dallas, TX, United States of America
| | - Nancy D. Chiaravalloti
- Kessler Foundation, East Hanover, NJ, United States of America
- Department of Physical Medicine and Rehabilitation, Rutgers University/The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Belinda Yew
- Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Laura E. Dreer
- Department of Ophthalmology & Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, United States of America
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Kristen Dams-O’Connor
- Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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8
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Sible IJ, Yew B, Dutt S, Li Y, Blanken AE, Jang JY, Ho JK, Marshall AJ, Kapoor A, Gaubert A, Bangen KJ, Sturm VE, Shao X, Wang DJ, Nation DA. Selective vulnerability of medial temporal regions to short-term blood pressure variability and cerebral hypoperfusion in older adults. Neuroimage Rep 2022; 2:100080. [PMID: 35784272 PMCID: PMC9249026 DOI: 10.1016/j.ynirp.2022.100080] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Blood pressure variability is an emerging risk factor for stroke, cognitive impairment, and dementia, possibly through links with cerebral hypoperfusion. Recent evidence suggests visit-to-visit (e.g., over months, years) blood pressure variability is related to cerebral perfusion decline in brain regions vulnerable to Alzheimer's disease. However, less is known about relationships between short-term (e.g., < 24 hours) blood pressure variability and regional cerebral perfusion, and whether these relationships may differ by age. We investigated short-term blood pressure variability and concurrent regional cerebral microvascular perfusion in a sample of community-dwelling older adults without history of dementia or stroke and healthy younger adults. Blood pressure was collected continuously during perfusion MRI. Cerebral blood flow was determined for several brain regions implicated in cerebrovascular dysfunction in Alzheimer's disease. Elevated systolic blood pressure variability was related to lower levels of concurrent cerebral perfusion in medial temporal regions: hippocampus (β = -.60 [95% CI -.90, -.30]; p < .001), parahippocampal gyrus (β = -.57 [95% CI -.89, -.25]; p = .001), entorhinal cortex (β = -.42 [95% CI -.73, -.12]; p = .009), and perirhinal cortex (β = -.37 [95% CI -.72, -.03]; p = .04), and not in other regions, and in older adults only. Findings suggest a possible age-related selective vulnerability of the medial temporal lobes to hypoperfusion in the context of short-term blood pressure fluctuations, independent of average blood pressure, white matter hyperintensities, and gray matter volume, which may underpin the increased risk for dementia associated with elevated BPV.
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Affiliation(s)
- Isabel J. Sible
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA,Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Anna E. Blanken
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Jean K. Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Anisa J. Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Arunima Kapoor
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
| | - Aimée Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Katherine J. Bangen
- Research Service, Veteran Affairs San Diego Healthcare System, San Diego, CA 92161, USA,Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA
| | - Virginia E. Sturm
- Department of Neurology, University of California, San Francisco, San Francisco, CA, 94158, USA,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, 94158, USA,Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Xingfeng Shao
- Laboratory of Functional MRI Technology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, 90033, USA
| | - Danny J. Wang
- Laboratory of Functional MRI Technology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, 90033, USA
| | - Daniel A. Nation
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA,Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA,Corresponding Author: Daniel A. Nation, Ph.D., Associate Professor, University of California Irvine, Department of Psychological Science, 4201 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, Phone: (949) 824-9339,
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9
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Dutt S, Yew B, Li Y, Gaubert A, Ho JK, Jang JY, Blanken AE, Sible IJ, Marshall AJ, Kapoor A, Shao X, Wang DJJ, Nation DA. Memory and executive function are associated with distinct patterns of regional cerebral perfusion in dementia‐free APOE‐ε4 carriers and non‐carriers. Alzheimers Dement 2021. [DOI: 10.1002/alz.056524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Shubir Dutt
- University of Southern California Los Angeles CA USA
| | - Belinda Yew
- University of Southern California Los Angeles CA USA
| | - Yanrong Li
- University of California Irvine Irvine CA USA
| | | | - Jean K Ho
- University of California Irvine Irvine CA USA
| | | | | | | | | | | | - Xingfeng Shao
- University of Southern California Los Angeles CA USA
| | - Danny JJ Wang
- University of Southern California Los Angeles CA USA
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10
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Kapoor A, Gaubert A, Marshall A, Meier IB, Yew B, Ho JK, Blanken AE, Dutt S, Sible IJ, Li Y, Jang JY, Brickman AM, Rodgers K, Nation DA. Increased Levels of Circulating Angiogenic Cells and Signaling Proteins in Older Adults With Cerebral Small Vessel Disease. Front Aging Neurosci 2021; 13:711784. [PMID: 34650423 PMCID: PMC8510558 DOI: 10.3389/fnagi.2021.711784] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/14/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Cerebral small vessel disease (SVD) is associated with increased risk of stroke and dementia. Progressive damage to the cerebral microvasculature may also trigger angiogenic processes to promote vessel repair. Elevated levels of circulating endothelial progenitor cells (EPCs) and pro-angiogenic signaling proteins are observed in response to vascular injury. We aimed to examine circulating levels of EPCs and proangiogenic proteins in older adults with evidence of SVD. Methods: Older adults (ages 55–90) free of dementia or stroke underwent venipuncture and brain magnetic resonance imaging (MRI). Flow cytometry quantified circulating EPCs as the number of cells in the lymphocyte gate positively expressing EPC surface markers (CD34+CD133+CD309+). Plasma was assayed for proangiogenic factors (VEGF-A, VEGF-C, VEGF-D, Tie-2, and Flt-1). Total SVD burden score was determined based on MRI markers, including white matter hyperintensities, cerebral microbleeds and lacunes. Results: Sixty-four older adults were included. Linear regression revealed that older adults with higher circulating EPC levels exhibited greater total SVD burden [β = 1.0 × 105, 95% CI (0.2, 1.9), p = 0.019], after accounting for age and sex. Similarly, a positive relationship between circulating VEGF-D and total SVD score was observed, controlling for age and sex [β = 0.001, 95% CI (0.000, 0.001), p = 0.048]. Conclusion: These findings suggest that elevated levels of circulating EPCs and VEGF-D correspond with greater cerebral SVD burden in older adults. Additional studies are warranted to determine whether activation of systemic angiogenic growth factors and EPCs represents an early attempt to rescue the vascular endothelium and repair damage in SVD.
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Affiliation(s)
- Arunima Kapoor
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Aimée Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Anisa Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Irene B Meier
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States.,Chione GmbH, Binz, Switzerland
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Jean K Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Anna E Blanken
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Adam M Brickman
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States
| | - Kathleen Rodgers
- Center for Innovation in Brain Science, Department of Pharmacology, The University of Arizona, Tucson, AZ, United States
| | - Daniel A Nation
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States.,Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
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11
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Jang JY, Han SD, Yew B, Blanken AE, Dutt S, Li Y, Ho JK, Gaubert A, Nation DA. Resting-State Functional Connectivity Signatures of Apathy in Community-Living Older Adults. Front Aging Neurosci 2021; 13:691710. [PMID: 34248608 PMCID: PMC8267862 DOI: 10.3389/fnagi.2021.691710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/01/2021] [Indexed: 11/15/2022] Open
Abstract
Apathy predicts poor outcomes in older adults, and its underlying neural mechanism needs further investigation. We examined the association between symptoms of apathy and functional connectivity (FC) in older adults without stroke or dementia. Participants included 48 individuals (mean age = 70.90) living independently in the community, who underwent resting-state fMRI and completed the Apathy Evaluation Scale (AES). Seed-to-voxel analysis (cluster-level p-FDR <0.05, voxel threshold p < 0.001) tested the association between AES scores and the whole-brain FC of brain regions involved in reward- and salience-related processing. We found that AES scores were negatively associated with FC of the right insula cortex and right anterior temporal regions (124 voxels, t = −5.10) and FC of the left orbitofrontal cortex and anterior cingulate regions (160 voxels, t = −5.45), and were positively associated with FC of the left orbitofrontal cortex and left lateral prefrontal (282 voxels, t = 4.99) and anterior prefrontal (123 voxels, t = 4.52) regions. These findings suggest that apathy in older adults may reflect disruptions in neural connectivity involved in reward- and salience-related processing.
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Affiliation(s)
- Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - S Duke Han
- Department of Family Medicine, University of Southern California, Los Angeles, CA, United States.,Department of Psychology, University of Southern California, Los Angeles, CA, United States.,Department of Neurology, University of Southern California, Los Angeles, CA, United States.,School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Anna E Blanken
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Jean K Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Aimée Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Daniel A Nation
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States.,Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
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12
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Sible IJ, Yew B, Dutt S, Bangen KJ, Li Y, Nation DA. Visit-to-visit blood pressure variability and regional cerebral perfusion decline in older adults. Neurobiol Aging 2021; 105:57-63. [PMID: 34034215 DOI: 10.1016/j.neurobiolaging.2021.04.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 12/12/2022]
Abstract
Blood pressure variability (BPV) is linked to dementia risk, possibly through cerebral hypoperfusion. We investigated BPV over 1 year and concurrent regional cerebral perfusion decline in older adults without dementia. Participants underwent 4 blood pressure measurements across 12 months, ASL-MRI at baseline and 12-months, and baseline FDG-PET. Regional perfusion was normalized to precentral gyrus. A subset had cerebral spinal fluid Alzheimer's disease biomarker abnormalities. For every SD increase in BPV, perfusion decreased in medial orbitofrontal cortex (ß = -.36; p = 0.008), hippocampus (ß = -.37; p = 0.005), entorhinal cortex (ß = -.48; p < 0.001), precuneus (ß = -.31; p = 0.02), inferior parietal cortex (ß = -.44; p < 0.001), and inferior temporal cortex (ß = -.46; p < 0.001). Similar patterns emerged in subsets with biomarker abnormalities. Older adults with elevated BPV exhibit concurrent regional perfusion decline in areas vulnerable to Alzheimer's disease, independent of cerebral hypometabolism. BPV may be an early marker of vascular dysfunction in aging.
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Affiliation(s)
- Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, USA; Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Katherine J Bangen
- Research Service, Veteran Affairs San Diego Health Care System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Daniel A Nation
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Psychological Science, University of California, Irvine, CA, USA.
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Kapoor A, Gaubert A, Marshall A, Yew B, Ho JK, Blanken AE, Dutt S, Sible IJ, Li Y, Jang JY, Rodgers K, Soto M, Tan A, Nation DA. Abstract P62: Older Adults With Cerebral Small Vessel Disease Show Increased Levels of Circulating Vascular Endothelial Growth Factor D. Stroke 2021. [DOI: 10.1161/str.52.suppl_1.p62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Cerebral small vessel disease (SVD) resulting from pathological changes in cerebral microvessels is a common precursor of stroke and dementia. Progressive and insidious damage to the cerebral microvasculature may trigger angiogenic processes to promote vessel repair. However, few previous studies have explored the angiogenic response to SVD. In a cohort of older adults with early evidence of SVD, we aimed to examine circulating levels of vascular endothelial growth factor D (VEGF-D)—a secreted glycoprotein with high angiogenic and lymphangiogenic potential—which has previously been linked to heart failure, atrial fibrillation, and ischemic stroke.
Methods:
Sixty independently living older adults (mean age = 69.7 years; SD = 7.5; age range 55-90 years; 38.3% male) free of dementia or clinical stroke were recruited from the community and underwent venipuncture and brain MRI. Plasma was assayed for proangiogenic factors (VEGF-A, VEGF-C, VEGF-D, Tie-2, Flt-1). MRI changes thought to represent microvascular pathologies (white matter hyperintensities, microbleeds and lacunes) were evaluated and total SVD load was determined using a previously validated score. Multiple linear regression examined the relationship between circulating proangiogenic proteins levels and total SVD load.
Results:
Moderate/severe white matter hyperintensity burden was identified by Fazekas scale in 40.0% of participants, small lacunes were identified in 13.3% and microbleeds in 6.7%. Simple linear regression revealed a positive relationship between circulating VEGF-D and total SVD score (p = .019), which remained significant in multiple regression controlling for age, sex and Framingham stroke score (p = .017). VEGF-D was significantly positively correlated with VEGF-C (r = .37), Flt-1 (r = .31) and Tie-2 (r = .42).
Conclusions:
These findings suggest that elevated levels of circulating VEGF-D correspond with greater damage to the cerebral microvasculature in older adults with no history of clinical stroke or dementia. Additional studies are warranted to determine whether activation of systemic proangiogenic growth factors represents an early attempt to rescue the vascular endothelium and repair damage in cerebral SVD.
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Affiliation(s)
- Arunima Kapoor
- Dept of Psychological Science, Univ of California, Irvine, Irvine, CA
| | | | | | - Belinda Yew
- Univ of Southern California, Los Angeles, CA
| | - Jean K Ho
- Univ of California, Irvine, Irvine, CA
| | | | - Shubir Dutt
- Univ of Southern California, Los Angeles, CA
| | | | | | | | | | | | - Alick Tan
- Univ of Southern California, Los Angeles, CA
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Yew B, Dutt S, Li Y, Ho JK, Jang JY, Blanken AE, Sible IJ, Marshall AJ, Gaubert A, Shao X, Wang DJJ, Nation DA. Detection of attenuated dynamic cerebrovascular function in aging and cognitive decline using a novel neuroimaging approach. Alzheimers Dement 2020. [DOI: 10.1002/alz.045968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Belinda Yew
- University of Southern California Los Angeles CA USA
| | - Shubir Dutt
- University of Southern California Los Angeles CA USA
| | - Yanrong Li
- University of California, Irvine Irvine CA USA
| | - Jean K Ho
- University of Southern California Los Angeles CA USA
| | | | | | | | | | | | - Xingfeng Shao
- University of Southern California Los Angeles CA USA
| | - Danny JJ Wang
- University of Southern California Los Angeles CA USA
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15
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Sible IJ, Yew B, Dutt S, Li Y, Ho JK, Jang JY, Blanken AE, Gaubert A, Marshall AJ, Kapoor A, Shao X, Wang DJ, Nation DA. Mean arterial pressure during cerebral perfusion MRI: An arterial spin‐labeling study in younger and older adults. Alzheimers Dement 2020. [DOI: 10.1002/alz.043623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Belinda Yew
- University of Southern California Los Angeles CA USA
| | - Shubir Dutt
- University of Southern California Los Angeles CA USA
| | | | - Jean K. Ho
- University of Southern California Los Angeles CA USA
| | | | | | | | | | | | - Xingfeng Shao
- University of Southern California Los Angeles CA USA
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Marshall AJ, Gaubert A, Yew B, Ho JK, Jang JY, Blanken AE, Dutt S, Sible IJ, Kapoor A, Li Y, McIntosh EC, Rodgers KE, Nation DA. Endothelial progenitor cells are depleted in older adults with cognitive impairment and white matter volume loss. Alzheimers Dement 2020. [DOI: 10.1002/alz.046352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - Belinda Yew
- University of Southern California Los Angeles CA USA
| | - Jean K. Ho
- University of Southern California Los Angeles CA USA
| | | | | | - Shubir Dutt
- University of Southern California Los Angeles CA USA
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17
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Kapoor A, Gaubert A, Marshall AJ, Meier IB, Yew B, Ho JK, Blanken AE, Dutt S, Sible IJ, Li Y, Jang JY, Brickman AM, Rodgers KE, Nation DA. Increased circulating endothelial progenitor cells as a biomarker for cerebral microvascular pathology in cognitively normal older adults. Alzheimers Dement 2020. [DOI: 10.1002/alz.045527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | - Belinda Yew
- University of Southern California Los Angeles CA USA
| | - Jean K. Ho
- University of Southern California Los Angeles CA USA
| | | | - Shubir Dutt
- University of Southern California Los Angeles CA USA
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Nation DA, Han D, Jang J, Dutt S, Ho JK, Yew B, Tan A, McIntosh EC, Blanken AE, Gaubert A, Marshall A, Sible IJ, Rodgers KE, Li Y. P4-167: PROGENITOR CELL SENESCENCE IS LINKED TO NEUROVASCULAR DYSFUNCTION AND LOSS OF BRAIN NETWORK CONNECTIVITY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Duke Han
- University of Southern California; Alhambra CA USA
| | - Jung Jang
- University of Southern California; Los Angeles CA USA
| | - Shubir Dutt
- University of Southern California; Los Angeles CA USA
| | - Jean K. Ho
- University of Southern California; Los Angeles CA USA
| | - Belinda Yew
- University of Southern California; Los Angeles CA USA
| | - Alick Tan
- University of Southern California; Los Angeles CA USA
| | | | | | - Aimee Gaubert
- University of Southern California; Los Angeles CA USA
| | | | | | | | - Yanrong Li
- University of Southern California; Los Angeles CA USA
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Nation DA, Tan A, McIntosh EC, Dutt S, Ho JK, Jang J, Yew B, Rodgers KE, Brickman AM, Meier I, Chang K, Blanken AE, Gaubert A. P3‐160: PROGENITOR RESERVE HYPOTHESIS: A MODEL FOR DISCOVERING PROTECTIVE FACTORS IN OLDER ADULTS AT RISK FOR DEMENTIA. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Alick Tan
- University of Southern CaliforniaLos AngelesCAUSA
| | | | - Shubir Dutt
- University of Southern CaliforniaLos AngelesCAUSA
| | - Jean K. Ho
- University of Southern CaliforniaLos AngelesCAUSA
| | - Jung Jang
- University of Southern CaliforniaLos AngelesCAUSA
| | - Belinda Yew
- University of Southern CaliforniaLos AngelesCAUSA
| | | | - Adam M. Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainColumbia UniversityNew YorkNYUSA
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Nation DA, Tan A, Dutt S, McIntosh EC, Yew B, Ho JK, Blanken AE, Jang JY, Rodgers KE, Gaubert A. Circulating Progenitor Cells Correlate with Memory, Posterior Cortical Thickness, and Hippocampal Perfusion. J Alzheimers Dis 2018; 61:91-101. [PMID: 29103037 PMCID: PMC5924766 DOI: 10.3233/jad-170587] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Bone marrow-derived progenitor cells survey the vasculature and home to sites of tissue injury where they can promote repair and regeneration. It has been hypothesized that these cells may play a protective role neurodegenerative and vascular cognitive impairment. OBJECTIVE To evaluate progenitor cell levels in older adults with and without mild cognitive impairment (MCI), and to relate circulating levels to memory, brain volume, white matter lesion volume, and cerebral perfusion. METHOD Thirty-two older adults, free of stroke and cardiovascular disease, were recruited from the community and evaluated for diagnosis of MCI versus cognitively normal (CN). Participants underwent brain MRI and blood samples were taken to quantify progenitor reserve using flow cytometry (CD34+, CD34+CD133+, and CD34+CD133+CD309+ cells). RESULTS Participants with MCI (n = 10) exhibited depletion of all CPC markers relative to those who were CN (n = 22), after controlling for age, sex, and education. Post-hoc age, sex, and education matched comparisons (n = 10 MCI, n = 10 CN) also revealed the same pattern of results. Depletion of CD34+ cells correlated with memory performance, left posterior cortical thickness, and bilateral hippocampal perfusion. Participants exhibited low levels of vascular risk and white matter lesion burden that did not correlate with progenitor levels. CONCLUSIONS Circulating progenitor cells are associated with cognitive impairment, memory, cortical atrophy, and hippocampal perfusion. We hypothesize that progenitor depletion contributes to, or is triggered by, cognitive decline and cortical atrophy. Further study of progenitor cell depletion in older adults may benefit efforts to prevent or delay dementia.
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Affiliation(s)
- Daniel A. Nation
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Alick Tan
- Department of Clinical Pharmacy, University of Southern California, Los Angeles CA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Elissa C. McIntosh
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Jean K. Ho
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Anna E. Blanken
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Jung Yun Jang
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Kathleen E. Rodgers
- Department of Clinical Pharmacy, University of Southern California, Los Angeles CA
| | - Aimée Gaubert
- Department of Psychology, University of Southern California, Los Angeles, CA
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Yew B, Nation DA. Cerebrovascular resistance: effects on cognitive decline, cortical atrophy, and progression to dementia. Brain 2017; 140:1987-2001. [PMID: 28575149 DOI: 10.1093/brain/awx112] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [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: 09/05/2016] [Accepted: 03/15/2017] [Indexed: 01/06/2023] Open
Abstract
See Markus (doi:10.1093/awx161) for a scientific commentary on this article.Evidence for vascular contributions to Alzheimer's disease has been increasingly identified, with increased blood pressure and decreased cerebral blood flow both linked to in vivo biomarkers and clinical progression of Alzheimer's disease. We therefore hypothesized that an elevated ratio of blood pressure to cerebral blood flow, indicative of cerebrovascular resistance, would exhibit earlier and more widespread associations with Alzheimer's disease than cerebral blood flow alone. Further, we predicted that increased cerebrovascular resistance and amyloid retention would synergistically influence cognitive performance trajectories, independent of neuronal metabolism. Lastly, we anticipated associations between cerebrovascular resistance and later brain atrophy, prior to amyloid accumulation. To evaluate these hypotheses, we investigated associations between cerebrovascular resistance and amyloid retention, cognitive decline, and brain atrophy, controlling for neuronal metabolism. North American older adults (n = 232) underwent arterial spin labelling magnetic resonance imaging to measure regional cerebral blood flow in brain regions susceptible to ageing and Alzheimer's disease. An estimated cerebrovascular resistance index was then calculated as the ratio of mean arterial pressure to regional cerebral blood flow. Positron emission tomography with 18F-florbetapir and fludeoxyglucose was used to quantify amyloid retention and neuronal metabolism, respectively. Cognitive performance was evaluated via annual assessments of global cognition, memory, and executive function. Results indicated diminished inferior parietal and temporal cerebral blood flow for patients with Alzheimer's disease (n = 33) relative to both non-demented groups, but no cerebral blood flow differences between non-demented amyloid-positive (n = 87) and amyloid-negative (n = 112) cases. In contrast, the cerebrovascular resistance index was significantly elevated in amyloid-positive versus amyloid-negative cases, with additional elevation in patients with Alzheimer's disease. Furthermore, cerebrovascular resistance index group differences were of greater statistical effect size and encompassed a greater number of brain regions than those for cerebral blood flow alone. Cognitive decline over 2-year follow-up was accelerated by elevated baseline cerebrovascular resistance index, particularly for amyloid-positive individuals. Increased baseline cerebrovascular resistance index also predicted greater progression to dementia, beyond that attributable to amyloid-positivity. Finally, increased cerebrovascular resistance index predicted greater regional atrophy among non-demented older adults who were amyloid-negative. Findings suggest that increased cerebrovascular resistance may represent a previously unrecognized contributor to Alzheimer's disease that is independent of neuronal hypometabolism, predates changes in brain perfusion, exacerbates and works synergistically with amyloidosis to produce cognitive decline, and drives amyloid-independent brain atrophy during the earliest stage of disease.
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Affiliation(s)
- Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Daniel A Nation
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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Nation DA, Tan A, McIntosh EC, Yew B, Ho J, Dutt S, Blanken AE, Jang J, Rodgers KE, Gaubert A. [P2–236]: CIRCULATING ANGIOGENIC CELL LEVELS SHOW PROTECTIVE ASSOCIATIONS WITH MEMORY FUNCTION: INTRODUCING THE VASCULAR RESERVE HYPOTHESIS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Alick Tan
- University of Southern CaliforniaLos AngelesCAUSA
| | | | - Belinda Yew
- University of Southern CaliforniaLos AngelesCAUSA
| | - Jean Ho
- University of Southern CaliforniaLos AngelesCAUSA
| | - Shubir Dutt
- University of Southern CaliforniaLos AngelesCAUSA
| | | | - Jung Jang
- University of Southern CaliforniaLos AngelesCAUSA
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Yew B, Nation DA. [P3–366]: CEREBROVASCULAR RESISTANCE AND CEREBRAL AMYLOIDOSIS: EFFECTS ON COGNITIVE DECLINE, CORTICAL ATROPHY AND PROGRESSION TO DEMENTIA. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Belinda Yew
- University of Southern CaliforniaLos AngelesCAUSA
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Abstract
BACKGROUND Evidence suggests that angiotensin II AT1-receptor blockers (ARBs) may be protective against dementia, and studies in transgenic animals indicate that this may be due to improved amyloid-β (Aβ) clearance. OBJECTIVE We investigated whether taking ARBs was associated with an attenuation of age-related increases in cerebral Aβ retention, and reduced progression to dementia. METHODS Eight hundred seventy-one stroke-free and dementia-free older adults from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study underwent baseline lumbar puncture, and a subgroup (n = 124) underwent 12 and 24 month follow-up lumbar puncture. Participants were followed at variable intervals for clinical progression to dementia. Linear mixed models and ANCOVA compared ARBs users with those taking other antihypertensives (O-antiHTN) or no antihypertensives (No-antiHTN) on cerebrospinal fluid (CSF) Aβ and phosphorylated tau (P-tau) levels. Cox regression and chi-square analyses compared groups on progression to dementia. RESULTS ARBs users exhibited greater vascular risk and lower educational attainment than the No-antiHTN group. Longitudinal analyses indicated higher CSF Aβ and lower P-tau in ARBs users versus other groups. Cross-sectional analyses revealed age-related decreases in CSF Aβ in other groups but not ARBs users. ARBs users were less likely to progress to dementia and showed reduced rate of progression relative to the No-antiHTN group. DISCUSSION Patients taking ARBs showed an attenuation of age-related decreases in CSF Aβ, a finding that is consistent with studies done in transgenic animals. These findings may partly explain why ARBs users show reduced progression to dementia despite their lower educational attainment and greater vascular risk burden.
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Frings L, Yew B, Flanagan E, Lam BYK, Hüll M, Huppertz HJ, Hodges JR, Hornberger M. Longitudinal grey and white matter changes in frontotemporal dementia and Alzheimer's disease. PLoS One 2014; 9:e90814. [PMID: 24595028 PMCID: PMC3940927 DOI: 10.1371/journal.pone.0090814] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 02/05/2014] [Indexed: 12/13/2022] Open
Abstract
Behavioural variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) dementia are characterised by progressive brain atrophy. Longitudinal MRI volumetry may help to characterise ongoing structural degeneration and support the differential diagnosis of dementia subtypes. Automated, observer-independent atlas-based MRI volumetry was applied to analyse 102 MRI data sets from 15 bvFTD, 14 AD, and 10 healthy elderly control participants with consecutive scans over at least 12 months. Anatomically defined targets were chosen a priori as brain structures of interest. Groups were compared regarding volumes at clinic presentation and annual change rates. Baseline volumes, especially of grey matter compartments, were significantly reduced in bvFTD and AD patients. Grey matter volumes of the caudate and the gyrus rectus were significantly smaller in bvFTD than AD. The bvFTD group could be separated from AD on the basis of caudate volume with high accuracy (79% cases correct). Annual volume decline was markedly larger in bvFTD and AD than controls, predominantly in white matter of temporal structures. Decline in grey matter volume of the lateral orbitofrontal gyrus separated bvFTD from AD and controls. Automated longitudinal MRI volumetry discriminates bvFTD from AD. In particular, greater reduction of orbitofrontal grey matter and temporal white matter structures after 12 months is indicative of bvFTD.
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Affiliation(s)
- Lars Frings
- Center of Geriatrics and Gerontology, University Medical Center, Freiburg, Germany
- Department of Nuclear Medicine, University Medical Center, Freiburg, Germany
| | - Belinda Yew
- Neuroscience Research Australia, Sydney, Australia
| | | | - Bonnie Y. K. Lam
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Michael Hüll
- Center of Geriatrics and Gerontology, University Medical Center, Freiburg, Germany
| | | | - John R. Hodges
- Neuroscience Research Australia, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Michael Hornberger
- Neuroscience Research Australia, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
- * E-mail:
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Ambikairajah A, Devenney E, Flanagan E, Yew B, Mioshi E, Kiernan MC, Hodges JR, Hornberger M. A visual MRI atrophy rating scale for the amyotrophic lateral sclerosis-frontotemporal dementia continuum. Amyotroph Lateral Scler Frontotemporal Degener 2014; 15:226-34. [DOI: 10.3109/21678421.2014.880180] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mioshi E, Lillo P, Yew B, Hsieh S, Savage S, Hodges JR, Kiernan MC, Hornberger M. Cortical atrophy in ALS is critically associated with neuropsychiatric and cognitive changes. Neurology 2013; 80:1117-23. [PMID: 23427327 DOI: 10.1212/wnl.0b013e31828869da] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To characterize the patterns of brain atrophy in patients with amyotrophic lateral sclerosis (ALS) with and without cognitive and neuropsychiatric symptoms, in comparison to controls and patients with ALS-frontotemporal dementia (FTD). METHODS A total of 57 participants (ALS = 22; ALS-FTD = 17; controls = 18) were included, following current ALS and FTD criteria. Patients with ALS were further subclassified into ALS with cognitive and behavioral symptoms (ALS-plus; n = 8) and those without (ALS; n = 14). By definition, ALS-plus did not reach the diagnostic threshold for ALS-FTD. All patients underwent neuropsychological and neuropsychiatric assessments, and underwent a brain MRI. Voxel-based morphometry analysis was conducted to establish patterns of brain atrophy. RESULTS Cortical atrophy in ALS was linked to neuropsychiatric and cognitive changes (ALS-plus vs ALS). Patients with ALS-plus had significant atrophy across motor and somatosensory as well as adjacent frontal and parietal areas, even after strict multiple comparison correction. By contrast, patients with ALS showed no significant cortical atrophy, and only brainstem atrophy. Importantly, atrophy in ALS-plus was not as widespread as in ALS-FTD, with ALS-plus atrophy mostly confined to motor and somatosensory areas, while atrophy in ALS-FTD also included substantial frontal and temporal atrophy. CONCLUSIONS The present findings establish that cortical atrophy in ALS is highly dependent upon neuropsychiatric and cognitive changes. Previous inconsistent findings of cortical atrophy in ALS likely relate to the inclusion of cognitively affected patients and patients with pure motor ALS.
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Yew B, Alladi S, Shailaja M, Hodges JR, Hornberger M. Lost and Forgotten? Orientation Versus Memory in Alzheimer's Disease and Frontotemporal Dementia. ACTA ACUST UNITED AC 2012; 33:473-81. [DOI: 10.3233/jad-2012-120769] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Belinda Yew
- Neuroscience Research Australia, Sydney, Australia
| | - Suvarna Alladi
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Mekala Shailaja
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - John R. Hodges
- Neuroscience Research Australia, Sydney, Australia
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Michael Hornberger
- Neuroscience Research Australia, Sydney, Australia
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
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Hornberger M, Yew B, Gilardoni S, Mioshi E, Gleichgerrcht E, Manes F, Hodges JR. Ventromedial-frontopolar prefrontal cortex atrophy correlates with insight loss in frontotemporal dementia and Alzheimer's disease. Hum Brain Mapp 2012; 35:616-26. [PMID: 23125121 DOI: 10.1002/hbm.22200] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 08/15/2012] [Accepted: 08/23/2012] [Indexed: 11/09/2022] Open
Abstract
Loss in insight is a major feature of frontotemporal dementia (FTD) but has been investigated relatively little. More importantly, the neural basis of insight loss is still poorly understood. The current study investigated insight deficit profiles across a large cohort of neurodegenerative patients (n = 81), including FTD and Alzheimer's disease (AD) patients. We employed a novel insight questionnaire, which tapped into changes across different domains: social interaction, emotion, diagnosis/treatment, language, and motivation. FTD subtypes varied considerably for insight loss, with the behavioral variant worst and the progressive non-fluent variant least affected. All other subtypes and AD showed milder but consistent insight loss. Voxel-based morphometry analysis revealed that overall insight loss correlated with ventromedial and frontopolar prefrontal atrophy, with exception of social interaction and emotion insight loss, which additionally correlated with lateral temporal and amygdala atrophy, respectively. Our results show that patients with neurodegenerative conditions show variable loss of insight, with ventromedial and frontopolar cortex regions appearing to be particularly important for insight.
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Affiliation(s)
- Michael Hornberger
- Neuroscience Research Australia, Barker St, Randwick, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia; ARC Center of Excellence for Cognition and its Disorders, Sydney, Australia
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Go C, Mioshi E, Yew B, Hodges JR, Hornberger M. Neural correlates of behavioural symptoms in behavioural variant frontotemporal dementia and Alzheimer's disease: Employment of a visual MRI rating scale. Dement Neuropsychol 2012; 6:12-17. [PMID: 29213767 PMCID: PMC5619102 DOI: 10.1590/s1980-57642012dn06010003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Frontotemporal dementia (FTD) patients often present with severe behavioural
disturbances and concomitant lack of insight. The underlying neural correlates
of these disturbances are mostly attributed to prefrontal cortex dysfunction,
but are still poorly understood.
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Affiliation(s)
- Christopher Go
- Neuroscience Research Australia, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Eneida Mioshi
- Neuroscience Research Australia, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Belinda Yew
- Neuroscience Research Australia, Sydney, Australia
| | - John R Hodges
- Neuroscience Research Australia, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Michael Hornberger
- Neuroscience Research Australia, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
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