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Wilckens KA, Tudorascu D, Snitz BE, Price J, Aizenstein H, Lopez O, Erickson K, Lopresti B, Laymon C, Minhas D, Mathis C, Buysse D, Klunk W, Cohen AD. 1008 Sleep Efficiency Moderates The Relationship Between Beta-Amyloid And Memory Retention. Sleep 2018. [DOI: 10.1093/sleep/zsy061.1007] [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: 11/14/2022] Open
Affiliation(s)
| | | | - B E Snitz
- University of Pittsburgh, Pittsburgh, PA
| | - J Price
- University of Pittsburgh, Charlestown, MA
| | | | - O Lopez
- University of Pittsburgh, Pittsburgh, PA
| | - K Erickson
- University of Pittsburgh, Pittsburgh, PA
| | - B Lopresti
- University of Pittsburgh, Pittsburgh, PA
| | - C Laymon
- University of Pittsburgh, Pittsburgh, PA
| | - D Minhas
- University of Pittsburgh, Pittsburgh, PA
| | - C Mathis
- University of Pittsburgh, Pittsburgh, PA
| | - D Buysse
- University of Pittsburgh, Pittsburgh, PA
| | - W Klunk
- University of Pittsburgh, Pittsburgh, PA
| | - A D Cohen
- University of Pittsburgh, Pittsburgh, PA
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Abstract
Objective The progressive rise in demand on NHS emergency care resources is partly attributable to increases in attendances of children and older people. A quality gap exists in the care provision for the old and the young. The Five Year Forward View suggested new models of care but that the "answer is not one-size-fits-all". This article discusses the urgent need for person-centred outcome measures to bridge the gap that exists between demand and provision. Design This review is based on evidence gathered from literature searching across several platforms using a variety of search terms to account for the obvious heterogeneity, drawing on key 'think-tank' evidence. Settings Qualitative and quantitative studies examining approaches to caring for individuals at the extremes of age. Participants Individuals at the extremes of age (infants and older people). Main Outcome Measures Understanding similarities and disparities in the care of individuals at the extremes of age in an emergency and non-emergency context. Results There exists several similarities and disparities in the care of individuals at the extremes of age. The increasing burden of health disease on the economy must acknowledge the challenges that exist in managing patients in emergency settings at the extremes of age and build systems to acknowledge the traits these individuals exhibit. Conclusion Commissioners of services must optimise the models of care delivery by appreciating the similarities and differences between care requirements in these two large groups seeking emergency care.
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Affiliation(s)
- J S Minhas
- 1 Cerebral Haemodynamics in Ageing and Stroke Medicine (CHIASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester LE2 7LX, UK
| | - D Minhas
- 2 Department of Paediatrics, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK
| | - T Coats
- 3 Emergency Medicine Academic Group, Cardiovascular Sciences, University of Leicester, Leicester LE1 5WW, UK
| | - J Banerjee
- 3 Emergency Medicine Academic Group, Cardiovascular Sciences, University of Leicester, Leicester LE1 5WW, UK
| | - D Roland
- 4 Department of Health Sciences, Centre for Medicine, University of Leicester, Leicester LE1 7RH, UK.,5 Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Royal Infirmary, Leicester LE1 5WW, UK
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Goodheart AE, Tamburo E, Minhas D, Aizenstein HJ, McDade E, Snitz BE, Price JC, Mathis CA, Lopez OL, Klunk WE, Cohen AD. Reduced binding of Pittsburgh Compound-B in areas of white matter hyperintensities. Neuroimage Clin 2015; 9:479-83. [PMID: 26594630 PMCID: PMC4600857 DOI: 10.1016/j.nicl.2015.09.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 07/28/2015] [Accepted: 09/10/2015] [Indexed: 11/16/2022]
Abstract
The amyloid imaging agent, Pittsburgh Compound-B, binds with high affinity to β-amyloid (Aβ) in the brain, and it is well established that PiB also shows non-specific retention in white matter (WM). However, little is known about retention of PiB in areas of white matter hyperintensities (WMH), abnormalities commonly seen in older adults. Further, it is hypothesized that WMH are related to both cognitive dysfunction and Aβ deposition. The goal of the present study was to explore PiB retention in both normal-appearing WM (NAWM) and WMH in a group of elderly, cognitively normal individuals. In a group of cognitively normal elderly (n = 64; 86.5 ± 2.6 years) two analyses were applied: (1) ROIs were placed over periventricular areas in which WMH caps are commonly seen on all subjects, regardless of WMH burden or size. (2) Subject-specific maps of NAWM and WMH were co-registered with the PiB-PET images and mean SUVR values were calculated in these NAWM and WMH maps. PiB retention was significantly reduced in the ROIs of subjects with high WMH compared to subjects with low WMH. Additionally, in subjects with high WMH, there was significantly lower PiB retention in subject-specific maps of WMH compared to NAWM, which was not observed in subjects with low WMH, likely because of the small size of WMH maps in this group. These data suggest that WM in areas of WMH binds PiB less effectively than does normal WM. Further exploration of this phenomenon may lead to insights about the molecular basis of the non-specific retention of amyloid tracers in white matter. PiB retention was significantly reduced in the “typical-WMH” ROIs of subjects with high WMH compared to subjects with low WMH. In subjects with high WMH, there was significantly lower PiB retention in subject-specific maps of WMH compared to NAWM. These data suggest that WM in areas of WMH binds PiB less effectively than does normal WM.
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Affiliation(s)
- A E Goodheart
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - E Tamburo
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - D Minhas
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - H J Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - E McDade
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - B E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - J C Price
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - C A Mathis
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - O L Lopez
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - W E Klunk
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA ; Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - A D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
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