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Mohs RC, Beauregard D, Dwyer J, Gaudioso J, Bork J, MaGee‐Rodgers T, Key MN, Kerwin DR, Hughes L, Cordell CB. The Bio-Hermes Study: Biomarker database developed to investigate blood-based and digital biomarkers in community-based, diverse populations clinically screened for Alzheimer's disease. Alzheimers Dement 2024; 20:2752-2765. [PMID: 38415908 PMCID: PMC11032569 DOI: 10.1002/alz.13722] [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: 10/09/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 02/29/2024]
Abstract
INTRODUCTION Alzheimer's disease (AD) trial participants are often screened for eligibility by brain amyloid positron emission tomography/cerebrospinal fluid (PET/CSF), which is inefficient as many are not amyloid positive. Use of blood-based biomarkers may reduce screen failures. METHODS We recruited 755 non-Hispanic White, 115 Hispanic, 112 non-Hispanic Black, and 19 other minority participants across groups of cognitively normal (n = 417), mild cognitive impairment (n = 312), or mild AD (n = 272) participants. Plasma amyloid beta (Aβ)40, Aβ42, Aβ42/Aβ40, total tau, phosphorylated tau (p-tau)181, and p-tau217 were measured; amyloid PET/CSF (n = 956) determined amyloid positivity. Clinical, blood biomarker, and ethnicity/race differences associated with amyloid status were evaluated. RESULTS Greater impairment, older age, and carrying an apolipoprotein E (apoE) ε4 allele were associated with greater amyloid burden. Areas under the receiver operating characteristic curve for amyloid status of plasma Aβ42/Aβ40, p-tau181, and p-tau217 with amyloid positivity were ≥ 0.7117 for all ethnoracial groups (p-tau217, ≥0.8128). Age and apoE ε4 adjustments and imputation of biomarker values outside limit of quantitation provided small improvement in predictive power. DISCUSSION Blood-based biomarkers are highly associated with amyloid PET/CSF results in diverse populations enrolled at clinical trial sites. HIGHLIGHTS Amyloid beta (Aβ)42/Aβ40, phosphorylated tau (p-tau)181, and p-tau 217 blood-based biomarkers predicted brain amyloid positivity. P-tau 217 was the strongest predictor of brain amyloid positivity. Biomarkers from diverse ethnic, racial, and clinical cohorts predicted brain amyloid positivity. Community-based populations have similar Alzheimer's disease (AD) biomarker levels as other populations. A prescreen process with blood-based assays may reduce the number of AD trial screen failures.
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Grants
- Abbvie, Alzheimer's Drug Discovery Foundation (ADDF), Aural Analytics, Biogen, Cognivue, C2N, Gates Ventures, Linus Health, Merck & Co, Quanterix, Retispec, and Roche
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Affiliation(s)
- Richard C. Mohs
- Global Alzheimer's Platform FoundationWashingtonDistrict of ColumbiaUSA
| | | | - John Dwyer
- Global Alzheimer's Platform FoundationWashingtonDistrict of ColumbiaUSA
| | - Jennifer Gaudioso
- Global Alzheimer's Platform FoundationWashingtonDistrict of ColumbiaUSA
| | - Jason Bork
- Global Alzheimer's Platform FoundationWashingtonDistrict of ColumbiaUSA
| | | | - Mickeal N. Key
- Global Alzheimer's Platform FoundationWashingtonDistrict of ColumbiaUSA
| | | | - Lynn Hughes
- Advisor to the Global Alzheimer's Platform Foundation and IXICO plcLondonUK
| | - Cyndy B. Cordell
- Advisor to the Global Alzheimer's Platform FoundationWashingtonDistrict of ColumbiaUSA
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Szabo‐Reed AN, Hall T, Vidoni ED, Van Sciver A, Sewell M, Burns JM, Cullum CM, Gahan WP, Hynan LS, Kerwin DR, Rossetti H, Stowe AM, Vongpatanasin W, Zhu DC, Zhang R, Keller JN, Binder EF. Recruitment methods and yield rates for a multisite clinical trial exploring risk reduction for Alzheimer's disease (rrAD). Alzheimers Dement (N Y) 2023; 9:e12422. [PMID: 37841653 PMCID: PMC10576444 DOI: 10.1002/trc2.12422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/18/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION The risk reduction for Alzheimer's disease (rrAD) trial was a multisite clinical trial to assess exercise and intensive vascular pharmacological treatment on cognitive function in community-dwelling older adults at increased risk for Alzheimer's disease. METHODS Eligibility, consent, and randomization rates across different referral sources were compared. Informal interviews conducted with each site's project team were conducted upon study completion. RESULTS Initially, 3290 individuals were screened, of whom 28% were eligible to consent, 805 consented to participate (87.2% of those eligible), and 513 (36.3% of those consented) were randomized. Emails sent from study site listservs/databases yielded the highest amount (20.9%) of screened individuals. Professional referrals from physicians yielded the greatest percentage of consented individuals (57.1%). Referrals from non-professional contacts (ie, friends, family; 75%) and mail/phone contact from a site (73.8%) had the highest yield of randomization. DISCUSSION Professional referrals or email from listservs/registries were most effective for enrolling participants. The greatest yield of eligible/randomized participants came from non-professional and mail/phone contacts. Future trials should consider special efforts targeting these recruitment approaches. Highlights Clinical trial recruitment is commonly cited as a significant barrier to advancing our understanding of cognitive health interventions.The most cited referral source was email, followed by interviews/editorials on the radio, television, local newspapers, newsletters, or magazine articles.The referral method that brought in the largest number of contacts was email but did not result in the greatest yield of consents or eligible participants.The sources that yielded the greatest likelihood of consent were professional referrals (ie, physician), social media, and mail/phone contact from study site.The greatest yield of eligible/randomized participants came from non-professional contacts and mail/phone contact from a site.Findings suggest that sites may need to focus on more selective referral sources, such as using contact mailing and phone lists, rather than more widely viewed recruitment sources, such as social media or TV/radio advertisements.
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Affiliation(s)
- Amanda N. Szabo‐Reed
- KU Alzheimer's Disease Research Center, University of Kansas Medical CenterFairwayKansasUSA
- Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Tristyn Hall
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasDallasUSA
| | - Eric D. Vidoni
- KU Alzheimer's Disease Research Center, University of Kansas Medical CenterFairwayKansasUSA
- Department of NeurologyUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Angela Van Sciver
- KU Alzheimer's Disease Research Center, University of Kansas Medical CenterFairwayKansasUSA
| | - Monica Sewell
- Department of Internal MedicineDivision of Geriatrics & Nutritional ScienceWashington University School of Medicine in St. LouisSt. LouisMissouriUSA
| | - Jeffrey M. Burns
- KU Alzheimer's Disease Research Center, University of Kansas Medical CenterFairwayKansasUSA
- Department of NeurologyUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - C. Munro Cullum
- Department of PsychiatryUT Southwestern Medical CenterDallasTexasUSA
- Department of NeurologyUT Southwestern Medical CenterDallasTexasUSA
| | - William P. Gahan
- Institute for Dementia Research and PreventionPennington Biomedical Research CenterBaton RougeLouisianaUSA
| | - Linda S. Hynan
- Department of PsychiatryUT Southwestern Medical CenterDallasTexasUSA
- Peter O'Donnell Jr. School of Public HealthUT Southwestern Medical CenterDallasTexasUSA
| | - Diana R. Kerwin
- Kerwin Research Center and Memory CareDallasTexasUSA
- Department of NeurologyUniversity of KentuckyLexingtonKentuckyUSA
| | - Heidi Rossetti
- Department of PsychiatryUT Southwestern Medical CenterDallasTexasUSA
| | - Ann M. Stowe
- Department of NeurologyUniversity of KentuckyLexingtonKentuckyUSA
| | - Wanpen Vongpatanasin
- Institute for Dementia Research and PreventionPennington Biomedical Research CenterBaton RougeLouisianaUSA
| | - David C. Zhu
- Department for RadiologyMichigan State UniversityEast LansingMichiganUSA
| | - Rong Zhang
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasDallasUSA
- Department of NeurologyUT Southwestern Medical CenterDallasTexasUSA
| | - Jeffrey N. Keller
- Institute for Dementia Research and PreventionPennington Biomedical Research CenterBaton RougeLouisianaUSA
| | - Ellen F. Binder
- Department of Internal MedicineDivision of Geriatrics & Nutritional ScienceWashington University School of Medicine in St. LouisSt. LouisMissouriUSA
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Beauregard DW, Mohs R, Dwyer J, Hollingshead S, Smith K, Bork J, Kerwin DR. Bio‐Hermes: A Validation Study to Assess a Meaningful Relationship Between Blood and Digital Biomarkers with Aβ PET Scans for Alzheimer’s Disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.063676] [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)
- Douglas W. Beauregard
- Global Alzheimer's Platform Washington DC USA
- Global Alzheimer's Platform Foundation Washington DC USA
| | - Richard Mohs
- Global Alzheimer's Platform Foundation Washington DC USA
| | - John Dwyer
- Global Alzheimer's Platform Foundation Washington DC USA
| | | | - Katy Smith
- Global Alzheimer's Platform (GAP) Foundation Washington DC USA
| | - Jason Bork
- Global Alzheimer's Platform Foundation Washington DC USA
| | - Diana R. Kerwin
- Global Alzheimer's Platform Foundation Washington DC USA
- Kerwin Research Center Dallas TX USA
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4
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Scheel N, Keller JN, Binder EF, Vidoni ED, Burns JM, Stowe AM, Kerwin DR, Vongpatanasin W, Cullum M, Zhang R, Zhu DC. Introducing rrAD420, an anatomical template and multi‐modal atlas for older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.068920] [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)
| | | | | | - Eric D Vidoni
- University of Kansas Alzheimer's Disease Research Center Fairway KS USA
| | - Jeffrey M. Burns
- University of Kansas Alzheimer's Disease Research Center Fairway KS USA
| | - Ann M Stowe
- University of Kentucky Research Foundation Lexington KY USA
| | | | | | | | - Rong Zhang
- University of Texas Southwestern Medical Center Dallas TX USA
- Texas Health Presbyterian Hospital Dallas Dallas TX USA
| | - David C Zhu
- Michigan State University East Lansing MI USA
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5
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Scheel N, Keller JN, Binder EF, Vidoni ED, Burns JM, Thomas BP, Stowe AM, Hynan LS, Kerwin DR, Vongpatanasin W, Rossetti H, Cullum CM, Zhang R, Zhu DC. Evaluation of noise regression techniques in resting-state fMRI studies using data of 434 older adults. Front Neurosci 2022; 16:1006056. [PMID: 36340768 PMCID: PMC9626831 DOI: 10.3389/fnins.2022.1006056] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/27/2022] [Indexed: 01/24/2023] Open
Abstract
Subject motion is a well-known confound in resting-state functional MRI (rs-fMRI) and the analysis of functional connectivity. Consequently, several clean-up strategies have been established to minimize the impact of subject motion. Physiological signals in response to cardiac activity and respiration are also known to alter the apparent rs-fMRI connectivity. Comprehensive comparisons of common noise regression techniques showed that the "Independent Component Analysis based strategy for Automatic Removal of Motion Artifacts" (ICA-AROMA) was a preferred pre-processing technique for teenagers and adults. However, motion and physiological noise characteristics may differ substantially for older adults. Here, we present a comprehensive comparison of noise-regression techniques for older adults from a large multi-site clinical trial of exercise and intensive pharmacological vascular risk factor reduction. The Risk Reduction for Alzheimer's Disease (rrAD) trial included hypertensive older adults (60-84 years old) at elevated risk of developing Alzheimer's Disease (AD). We compared the performance of censoring, censoring combined with global signal regression, non-aggressive and aggressive ICA-AROMA, as well as the Spatially Organized Component Klassifikator (SOCK) on the rs-fMRI baseline scans from 434 rrAD subjects. All techniques were rated based on network reproducibility, network identifiability, edge activity, spatial smoothness, and loss of temporal degrees of freedom (tDOF). We found that non-aggressive ICA-AROMA did not perform as well as the other four techniques, which performed table with marginal differences, demonstrating the validity of these techniques. Considering reproducibility as the most important factor for longitudinal studies, given low false-positive rates and a better preserved, more cohesive temporal structure, currently aggressive ICA-AROMA is likely the most suitable noise regression technique for rs-fMRI studies of older adults.
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Affiliation(s)
- Norman Scheel
- Department of Radiology, Michigan State University, East Lansing, MI, United States
| | - Jeffrey N. Keller
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Ellen F. Binder
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO, United States
| | - Eric D. Vidoni
- Alzheimer’s Disease Center, University of Kansas, Fairway, KS, United States
| | - Jeffrey M. Burns
- Alzheimer’s Disease Center, University of Kansas, Fairway, KS, United States
| | - Binu P. Thomas
- UT Southwestern Medical Center, Dallas, TX, United States
| | - Ann M. Stowe
- Department of Neurology, University of Kentucky, Lexington, KY, United States
| | - Linda S. Hynan
- UT Southwestern Medical Center, Dallas, TX, United States
| | - Diana R. Kerwin
- Texas Health Presbyterian Hospital, Dallas, TX, United States
| | | | - Heidi Rossetti
- UT Southwestern Medical Center, Dallas, TX, United States
| | | | - Rong Zhang
- UT Southwestern Medical Center, Dallas, TX, United States,Texas Health Presbyterian Hospital, Dallas, TX, United States
| | - David C. Zhu
- Department of Radiology, Michigan State University, East Lansing, MI, United States,*Correspondence: David C. Zhu,
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Assunção SS, Sperling RA, Ritchie C, Kerwin DR, Aisen PS, Lansdall C, Atri A, Cummings J. Meaningful benefits: a framework to assess disease-modifying therapies in preclinical and early Alzheimer's disease. Alzheimers Res Ther 2022; 14:54. [PMID: 35440022 PMCID: PMC9017027 DOI: 10.1186/s13195-022-00984-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 11/05/2021] [Accepted: 03/05/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND The need for preventive therapies that interrupt the progression of Alzheimer's disease (AD) before the onset of symptoms or when symptoms are emerging is urgent and has spurred the ongoing development of disease-modifying therapies (DMTs) in preclinical and early AD (mild cognitive impairment [MCI] to mild dementia). Assessing the meaningfulness of what are likely small initial treatment effects in these earlier stages of the AD patho-clinical disease continuum is a major challenge and warrants further consideration. BODY: To accommodate a shift towards earlier intervention in AD, we propose meaningful benefits as a new umbrella concept that encapsulates the spectrum of potentially desirable outcomes that may be demonstrated in clinical trials and other studies across the AD continuum, with an emphasis on preclinical AD and early AD (i.e., MCI due to AD and mild AD dementia). The meaningful benefits framework applies to data collection, assessment, and communication across three dimensions: (1) multidimensional clinical outcome assessments (COAs) including not only core disease outcomes related to cognition and function but also patient- and caregiver-reported outcomes, health and economic outcomes, and neuropsychiatric symptoms; (2) complementary analyses that help contextualize and expand the understanding of COA-based assessments, such as number-needed-to-treat or time-to-event analyses; and (3) assessment of both cumulative benefit and predictive benefit, where early changes on cognitive, functional, or biomarker assessments predict longer-term clinical benefit. CONCLUSION The concept of meaningful benefits emphasizes the importance of multidimensional reporting of clinical trial data while, conceptually, it advances our understanding of treatment effects in preclinical AD and mild cognitive impairment due to AD. We propose that such an approach will help bridge the gap between the emergence of DMTs and their clinical use, particularly now that a DMT is available for patients diagnosed with MCI due to AD and mild AD dementia.
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Affiliation(s)
- Sheila Seleri Assunção
- US Medical Affairs - Neuroscience, Genentech, A Member of the Roche Group, South San Francisco, CA, USA.
| | - Reisa A Sperling
- Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Craig Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Scotland, UK
| | - Diana R Kerwin
- Kerwin Medical Center, Dallas, TX, USA
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Paul S Aisen
- University of Southern California Alzheimer's Therapeutic Research Institute, San Diego, CA, USA
| | | | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, AZ, USA
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA
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7
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Sexton C, Snyder H, Beher D, Boxer AL, Brannelly P, Brion JP, Buée L, Cacace AM, Chételat G, Citron M, DeVos SL, Diaz K, Feldman HH, Frost B, Goate AM, Gold M, Hyman B, Johnson K, Karch CM, Kerwin DR, Koroshetz WJ, Litvan I, Morris HR, Mummery CJ, Mutamba J, Patterson MC, Quiroz YT, Rabinovici GD, Rommel A, Shulman MB, Toledo-Sherman LM, Weninger S, Wildsmith KR, Worley SL, Carrillo MC. Current directions in tau research: Highlights from Tau 2020. Alzheimers Dement 2021; 18:988-1007. [PMID: 34581500 DOI: 10.1002/alz.12452] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [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: 03/13/2021] [Revised: 07/07/2021] [Accepted: 07/22/2021] [Indexed: 11/07/2022]
Abstract
Studies supporting a strong association between tau deposition and neuronal loss, neurodegeneration, and cognitive decline have heightened the allure of tau and tau-related mechanisms as therapeutic targets. In February 2020, leading tau experts from around the world convened for the first-ever Tau2020 Global Conference in Washington, DC, co-organized and cosponsored by the Rainwater Charitable Foundation, the Alzheimer's Association, and CurePSP. Representing academia, industry, government, and the philanthropic sector, presenters and attendees discussed recent advances and current directions in tau research. The meeting provided a unique opportunity to move tau research forward by fostering global partnerships among academia, industry, and other stakeholders and by providing support for new drug discovery programs, groundbreaking research, and emerging tau researchers. The meeting also provided an opportunity for experts to present critical research-advancing tools and insights that are now rapidly accelerating the pace of tau research.
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Affiliation(s)
| | | | | | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Pat Brannelly
- Alzheimer's Disease Data Initiative, Kirkland, WI, USA
| | - Jean-Pierre Brion
- Laboratory of Histology, Neuroanatomy and Neuropathology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Luc Buée
- Univ Lille, Inserm, CHU-Lille, Lille Neuroscience and Cognition, Place de Verdun, Lille, France
| | | | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Martin Citron
- Neuroscience TA, Braine l'Alleud, UCB Biopharma, Brussels, Belgium
| | - Sarah L DeVos
- Translational Sciences, Denali Therapeutics, San Francisco, California, USA
| | | | - Howard H Feldman
- Alzheimer's Disease Cooperative Study, Department of Neurosciences, University of California, San Diego, La Jolla, California, USA
| | - Bess Frost
- Sam & Ann Barshop Institute for Longevity and Aging Studies, Glenn Biggs Institute for Alzheimer's & Neurodegenerative Disorders, Department of Cell Systems & Anatomy, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Alison M Goate
- Ronald M. Loeb Center for Alzheimer's Disease, Department of Neuroscience, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael Gold
- AbbVie, Neurosciences Development, North Chicago, Illinois, USA
| | - Bradley Hyman
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Keith Johnson
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Celeste M Karch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Diana R Kerwin
- Kerwin Medical Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Walter J Koroshetz
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
| | - Irene Litvan
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Huw R Morris
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, London, UK
| | - Catherine J Mummery
- Dementia Research Centre, National Hospital for Neurology and Neurosurgery, University College London, London, UK
| | | | - Marc C Patterson
- Departments of Neurology, Pediatrics and Medical Genetics, Mayo Clinic, Rochester, Minnesota, USA
| | - Yakeel T Quiroz
- Departments of Neurology and Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Gil D Rabinovici
- Memory & Aging Center, Departments of Neurology, Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Amy Rommel
- Tau Consortium, Rainwater Charitable Foundation, Fort Worth, Texas, USA
| | - Melanie B Shulman
- Neurodegeneration Development Unit, Biogen, Boston, Massachusetts, USA
| | | | | | - Kristin R Wildsmith
- Department of Biomarker Development, Genentech, South San Francisco, California, USA
| | - Susan L Worley
- Independent science writer, Bryn Mawr, Pennsylvania, USA
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Bluett B, Pantelyat AY, Litvan I, Ali F, Apetauerova D, Bega D, Bloom L, Bower J, Boxer AL, Dale ML, Dhall R, Duquette A, Fernandez HH, Fleisher JE, Grossman M, Howell M, Kerwin DR, Leegwater-Kim J, Lepage C, Ljubenkov PA, Mancini M, McFarland NR, Moretti P, Myrick E, Patel P, Plummer LS, Rodriguez-Porcel F, Rojas J, Sidiropoulos C, Sklerov M, Sokol LL, Tuite PJ, VandeVrede L, Wilhelm J, Wills AMA, Xie T, Golbe LI. Best Practices in the Clinical Management of Progressive Supranuclear Palsy and Corticobasal Syndrome: A Consensus Statement of the CurePSP Centers of Care. Front Neurol 2021; 12:694872. [PMID: 34276544 PMCID: PMC8284317 DOI: 10.3389/fneur.2021.694872] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/10/2021] [Indexed: 11/16/2022] Open
Abstract
Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS; the most common phenotype of corticobasal degeneration) are tauopathies with a relentless course, usually starting in the mid-60s and leading to death after an average of 7 years. There is as yet no specific or disease-modifying treatment. Clinical deficits in PSP are numerous, involve the entire neuraxis, and present as several discrete phenotypes. They center on rigidity, bradykinesia, postural instability, gait freezing, supranuclear ocular motor impairment, dysarthria, dysphagia, incontinence, sleep disorders, frontal cognitive dysfunction, and a variety of behavioral changes. CBS presents with prominent and usually asymmetric dystonia, apraxia, myoclonus, pyramidal signs, and cortical sensory loss. The symptoms and deficits of PSP and CBS are amenable to a variety of treatment strategies but most physicians, including many neurologists, are reluctant to care for patients with these conditions because of unfamiliarity with their multiplicity of interacting symptoms and deficits. CurePSP, the organization devoted to support, research, and education for PSP and CBS, created its CurePSP Centers of Care network in North America in 2017 to improve patient access to clinical expertise and develop collaborations. The directors of the 25 centers have created this consensus document outlining best practices in the management of PSP and CBS. They formed a writing committee for each of 12 sub-topics. A 4-member Steering Committee collated and edited the contributions. The result was returned to the entire cohort of authors for further comments, which were considered for incorporation by the Steering Committee. The authors hope that this publication will serve as a convenient guide for all clinicians caring for patients with PSP and CBS and that it will improve care for patients with these devastating but manageable disorders.
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Affiliation(s)
- Brent Bluett
- Neurology, Pacific Central Coast Health Center, Dignity Health, San Luis Obispo, CA, United States
- Neurology, Stanford University, Stanford, CA, United States
| | - Alexander Y. Pantelyat
- Neurology, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Irene Litvan
- Neurology, University of California, San Diego, San Diego, CA, United States
| | - Farwa Ali
- Neurology, Mayo Clinic, Rochester, MN, United States
| | - Diana Apetauerova
- Neurology, Lahey Hospital and Medical Center, Burlington, MA, United States
| | - Danny Bega
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lisa Bloom
- Neurology, Surgery, University of Chicago, Chicago, IL, United States
| | - James Bower
- Neurology, Mayo Clinic, Rochester, MN, United States
| | - Adam L. Boxer
- Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Marian L. Dale
- Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Rohit Dhall
- Neurology, University of Arkansas for Medical Sciences, Little Rock, AK, United States
| | - Antoine Duquette
- Service de Neurologie, Département de Médecine, Unité de Troubles du Mouvement André-Barbeau, Centre Hospitalier de l'Université de Service de Neurologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Hubert H. Fernandez
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Jori E. Fleisher
- Neurological Sciences, Rush Medical College, Rush University, Chicago, IL, United States
| | - Murray Grossman
- Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Michael Howell
- Neurology, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Diana R. Kerwin
- Geriatrics, Presbyterian Hospital of Dallas, Dallas, TX, United States
| | | | - Christiane Lepage
- Service de Neurologie, Département de Médecine, Unité de Troubles du Mouvement André-Barbeau, Centre Hospitalier de l'Université de Service de Neurologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | | | - Martina Mancini
- Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Nikolaus R. McFarland
- Neurology, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Paolo Moretti
- Neurology, The University of Utah, Salt Lake City, UT, United States
| | - Erica Myrick
- Neurological Sciences, Rush Medical College, Rush University, Chicago, IL, United States
| | - Pritika Patel
- Neurology, Lahey Hospital and Medical Center, Burlington, MA, United States
| | - Laura S. Plummer
- Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | | | - Julio Rojas
- Neurology, University of California, San Francisco, San Francisco, CA, United States
| | | | - Miriam Sklerov
- Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Leonard L. Sokol
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Paul J. Tuite
- Neurology, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Lawren VandeVrede
- Neurology, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Jennifer Wilhelm
- Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Anne-Marie A. Wills
- Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Tao Xie
- Neurology, Surgery, University of Chicago, Chicago, IL, United States
| | - Lawrence I. Golbe
- Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
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9
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Heuer HW, Rojas JC, Toller G, Rankin K, Brushaber D, Appleby B, Bordelon YM, Dickerson BC, Kimiko D, Faber K, Foroud TM, Forsberg LK, Ghoshal N, Grant I, Graff‐Radford NR, Grossman M, Hsiung GR, Huey ED, Karydas AM, Kaufer D, Kerwin DR, Lagone E, Litvan I, Ljubenkov PA, Mackenzie IR, Mendez MF, Miller BL, Onyike CU, Ramos EM, Rascovsky K, Roberson ED, Tartaglia C, Weintraub S, Boeve BF, Rosen HJ, Boxer AL. Plasma neurofilament light chain levels reflect caregiver burden and social cognition measures in familial frontotemporal lobar degeneration (FTLD). Alzheimers Dement 2020. [DOI: 10.1002/alz.046247] [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)
| | | | - Gianina Toller
- Memory and Aging Center University of California San Francisco San Francisco CA USA
| | - Katherine Rankin
- Memory and Aging Center, UCSF Weill Institute for Neurosciences University of California San Francisco CA USA
| | | | | | | | | | | | - Kelley Faber
- Indiana University School of Indianapolis IN USA
| | | | | | - Nupur Ghoshal
- Washington University School of Medicine St. Louis MO USA
| | - Ian Grant
- Northwestern University Chicago IL USA
| | | | - Murray Grossman
- Penn FTD Center University of Pennsylvania Philadelphia PA USA
| | | | - Edward D. Huey
- Gertrude H. Sergievsky Center at Columbia University New York NY USA
| | | | | | | | | | - Irene Litvan
- University of California San Diego San Diego CA USA
| | | | | | | | | | | | | | - Katya Rascovsky
- Penn FTD Center, Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | | | | | | | | | | | - Adam L. Boxer
- University of California San Francisco San Francisco CA USA
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10
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Tarumi T, Rossetti H, Thomas BP, Harris T, Tseng BY, Turner M, Wang C, German Z, Martin-Cook K, Stowe AM, Womack KB, Mathews D, Kerwin DR, Hynan L, Diaz-Arrastia R, Lu H, Cullum CM, Zhang R. Exercise Training in Amnestic Mild Cognitive Impairment: A One-Year Randomized Controlled Trial. J Alzheimers Dis 2020; 71:421-433. [PMID: 31403944 DOI: 10.3233/jad-181175] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The current evidence is inconclusive to support the benefits of aerobic exercise training (AET) for preventing neurocognitive decline in patients with amnestic mild cognitive impairment (aMCI). OBJECTIVE To examine the effect of a progressive, moderate-to-high intensity AET program on memory and executive function, brain volume, and cortical amyloid-β (Aβ) plaque deposition in aMCI patients. METHODS This is a proof-of-concept trial that randomized 70 aMCI patients to 12 months of AET or stretching and toning (SAT, active control) interventions. Primary neuropsychological outcomes were assessed by using the California Verbal Learning Test-second edition (CVLT-II) and the Delis-Kaplan Executive Function System (D-KEFS). Secondary outcomes were the global and hippocampal brain volumes and the mean cortical and precuneus Aβ deposition. RESULTS Baseline cognitive scores were similar between the groups. Memory and executive function performance improved over time but did not differ between the AET and SAT groups. Brain volume decreased and precuneus Aβ plaque deposition increased over time but did not differ between the groups. Cardiorespiratory fitness was significantly improved in the AET compared with SAT group. In amyloid positive patients, AET was associated with reduced hippocampal atrophy when compared with the SAT group. CONCLUSION The AET and SAT groups both showed evidence of slightly improved neuropsychological scores in previously sedentary aMCI patients. However, these interventions did not prevent brain atrophy or increases in cortical Aβ deposition over 12 months. In amyloid positive patients, AET reduced hippocampal atrophy when compared with the SAT group.
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Affiliation(s)
- Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Heidi Rossetti
- Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Binu P Thomas
- Departments of Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas Harris
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Benjamin Y Tseng
- Department of Health and Kinesiology, The University of Texas at Tyler, Tyler, TX, USA
| | - Marcel Turner
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Ciwen Wang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Zohre German
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kristin Martin-Cook
- Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ann M Stowe
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kyle B Womack
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Dana Mathews
- Departments of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Diana R Kerwin
- Institute for Texas Alzheimer's and Memory Disorders, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Linda Hynan
- Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Departments of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ramon Diaz-Arrastia
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hanzhang Lu
- Departments of Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Departments of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
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11
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Vidoni ED, Kamat A, Gahan WP, Ourso V, Woodard K, Kerwin DR, Binder EF, Burns JM, Cullum M, Hynan LS, Vongpatanasin W, Zhu DC, Zhang R, Keller JN. Baseline Prevalence of Polypharmacy in Older Hypertensive Study Subjects with Elevated Dementia Risk: Findings from the Risk Reduction for Alzheimer's Disease Study (rrAD). J Alzheimers Dis 2020; 77:175-182. [PMID: 32716358 PMCID: PMC8108402 DOI: 10.3233/jad-200122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Little is known about the prevalence of polypharmacy, the taking of five or more medications a day, in older adults with specific dementia risk factors. OBJECTIVE To examine the prevalence of polypharmacy in participants at baseline in a vascular risk reduction focused Alzheimer's disease (rrAD) trial targeting older patients with hypertension and elevated dementia risk. METHODS We conducted a detailed review of medications in a cross-sectional study of community-dwelling older adults with hypertension and elevated dementia risk. Medications were identified in a structured interview process with an onsite pharmacist or qualified designee. Polypharmacy was defined as use of five or more medications on a regular basis. Descriptive analyses were conducted on the sample as well as direct comparisons of subgroups of individuals with hypertension, diabetes, and hyperlipidemia. RESULTS The 514 rrAD participants, mean age 68.8 (standard deviation [sd] 6), reported taking different combinations of 472 unique medications at their baseline visit. The median number of medications taken by participants was eight [Range 0-21], with 79.2% exhibiting polypharmacy (n = 407). Sites differed in their prevalence of polypharmacy, χ2(3) = 56.0, p < 0.001. A nearly identical percentage of the 2,077 prescribed (51.8%) and over the counter (48.2%) medications were present in the overall medication profile. The presence of diabetes (87.5%), hyperlipidemia (88.2%), or both (97.7%) was associated with a higher prevalence of polypharmacy than participants who exhibited hypertension in the absence of either of these conditions (63.2%), χ2(3) = 35.8, p < 0.001. CONCLUSION Participants in a dementia risk study had high levels of polypharmacy, with the co-existence of diabetes or hyperlipidemia associated with a greater prevalence of polypharmacy as compared to having hypertension alone.
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Affiliation(s)
- Eric D Vidoni
- KU Alzheimer's Disease Center, Fairway KS, USA.,Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | | | | | - Victoria Ourso
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Kaylee Woodard
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Diana R Kerwin
- Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ellen F Binder
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Jeffrey M Burns
- KU Alzheimer's Disease Center, Fairway KS, USA.,Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Munro Cullum
- Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA.,Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Linda S Hynan
- Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA.,Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | - Wanpen Vongpatanasin
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - David C Zhu
- Department of Radiology and Cognitive Imaging Research Center, Michigan State University, East Lansing, MI, USA
| | - Rong Zhang
- Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA.,Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA
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12
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Staffaroni AM, Cobigo Y, Goh SYM, Kornak J, Bajorek L, Chiang K, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber D, Caso C, Coppola G, Dever R, Dheel C, Dickerson BC, Dickinson S, Dominguez S, Domoto-Reilly K, Faber K, Ferrall J, Fields JA, Fishman A, Fong J, Foroud T, Forsberg LK, Gavrilova R, Gearhart D, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grant I, Grossman M, Haley D, Heuer HW, Hsiung GY, Huey ED, Irwin DJ, Jones DT, Jones L, Kantarci K, Karydas A, Kaufer DI, Kerwin DR, Knopman DS, Kraft R, Kramer JH, Kremers WK, Kukull WA, Litvan I, Ljubenkov PA, Lucente D, Lungu C, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis SM, McKinley E, Mendez MF, Miller BL, Multani N, Onyike C, Padmanabhan J, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Rascovsky K, Roberson ED, Rogalski E, Sengdy P, Shaw LM, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski JQ, Weintraub S, Wang P, Wong B, Wszolek Z, Boxer AL, Boeve BF, Rosen HJ. Individualized atrophy scores predict dementia onset in familial frontotemporal lobar degeneration. Alzheimers Dement 2020; 16:37-48. [PMID: 31272932 PMCID: PMC6938544 DOI: 10.1016/j.jalz.2019.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Some models of therapy for neurodegenerative diseases envision starting treatment before symptoms develop. Demonstrating that such treatments are effective requires accurate knowledge of when symptoms would have started without treatment. Familial frontotemporal lobar degeneration offers a unique opportunity to develop predictors of symptom onset. METHODS We created dementia risk scores in 268 familial frontotemporal lobar degeneration family members by entering covariate-adjusted standardized estimates of brain atrophy into a logistic regression to classify asymptomatic versus demented participants. The score's predictive value was tested in a separate group who were followed up longitudinally (stable vs. converted to dementia) using Cox proportional regressions with dementia risk score as the predictor. RESULTS Cross-validated logistic regression achieved good separation of asymptomatic versus demented (accuracy = 90%, SE = 0.06). Atrophy scores predicted conversion from asymptomatic or mildly/questionably symptomatic to dementia (HR = 1.51, 95% CI: [1.16,1.98]). DISCUSSION Individualized quantification of baseline brain atrophy is a promising predictor of progression in asymptomatic familial frontotemporal lobar degeneration mutation carriers.
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Affiliation(s)
- Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Sheng-Yang M. Goh
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco CA, USA
| | - Lynn Bajorek
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Kevin Chiang
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Jessica Bove
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yvette Bordelon
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Patrick Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort Worth, TX, USA
| | | | - Christina Caso
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Giovanni Coppola
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Reilly Dever
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | | | - Bradford C. Dickerson
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan Dickinson
- Association for Frontotemporal Degeneration, Radnor, PA, USA
| | - Sophia Dominguez
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kelly Faber
- National Cell Repository for Alzheimer’s Disease (NCRAD), Indiana University, Indianapolis, IN, USA
| | - Jessica Ferrall
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Ann Fishman
- Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jamie Fong
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Tatiana Foroud
- National Cell Repository for Alzheimer’s Disease (NCRAD), Indiana University, Indianapolis, IN, USA
| | | | | | - Debra Gearhart
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Behnaz Ghazanfari
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Department of Neurology, Columbia University, New York, NY, USA
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| | | | | | - Ian Grant
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dana Haley
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Hilary W. Heuer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Ging-Yuek Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D. Huey
- Department of Neurology, Columbia University, New York, NY, USA
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Lynne Jones
- Department of Radiology, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Anna Karydas
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Daniel I. Kaufer
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Diana R. Kerwin
- Department of Neurology and Neurotherapeutics, Center for Alzheimer’s and Neurodegenerative Diseases, The University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
- Department of Internal Medicine, The University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
| | | | - Ruth Kraft
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Walter A. Kukull
- National Alzheimer Coordinating Center (NACC), University of Washington, Seattle, WA, USA
| | - Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement Disorders Center, University of California, San Diego, San Diego, CA, USA
| | - Peter A. Ljubenkov
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Diane Lucente
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Codrin Lungu
- National Institute of Neurological Disorders and Stroke (NINDS), Bethesda, MD, USA
| | - Ian R. Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Miranda Maldonado
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Scott M. McGinnis
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily McKinley
- Department of Neurology, Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mario F. Mendez
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Namita Multani
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Chiadi Onyike
- Department of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - Jaya Padmanabhan
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alex Pantelyat
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Len Petrucelli
- Department of Neurosciences, Mayo Clinic, Jacksonville, FL, USA
| | - Madeline Potter
- National Cell Repository for Alzheimer’s Disease (NCRAD), Indiana University, Indianapolis, IN, USA
| | - Rosa Rademakers
- Department of Neurosciences, Mayo Clinic, Jacksonville, FL, USA
| | - Eliana Marisa Ramos
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Katya Rascovsky
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erik D. Roberson
- Department of Neurology, Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily Rogalski
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pheth Sengdy
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeremy Syrjanen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - M. Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nadine Tatton
- Association for Frontotemporal Degeneration, Radnor, PA, USA
| | - Joanne Taylor
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Arthur Toga
- Departments of Ophthalmology, Neurology, Psychiatry and the Behavioral Sciences, Radiology and Engineering, Laboratory of Neuroimaging (LONI), USC, Los Angeles, CA, USA
| | - John Q. Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sandra Weintraub
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ping Wang
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Bonnie Wong
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Adam L. Boxer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Brad F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
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13
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Staffaroni AM, Bajorek L, Casaletto KB, Cobigo Y, Goh SYM, Wolf A, Heuer HW, Elahi FM, Ljubenkov PA, Dever R, Kornak J, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber D, Caso C, Coppola G, Dheel C, Dickerson BC, Dickinson S, Dominguez S, Domoto-Reilly K, Faber K, Ferrall J, Fields JA, Fishman A, Fong J, Foroud T, Forsberg LK, Gavrilova R, Gearhart D, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grant I, Grossman M, Haley D, Hsiung GY, Huey ED, Irwin DJ, Jones DT, Jones L, Kantarci K, Karydas A, Kaufer DI, Kerwin DR, Knopman DS, Kraft R, Kremers WK, Kukull WA, Litvan I, Lucente D, Lungu C, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis SM, McKinley E, Mendez MF, Miller BL, Multani N, Onyike C, Padmanabhan J, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Rascovsky K, Roberson ED, Rogalski E, Sengdy P, Shaw LM, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski JQ, Weintraub S, Wang P, Wong B, Wszolek Z, Boxer AL, Boeve BF, Kramer JH, Rosen HJ. Assessment of executive function declines in presymptomatic and mildly symptomatic familial frontotemporal dementia: NIH-EXAMINER as a potential clinical trial endpoint. Alzheimers Dement 2020; 16:11-21. [PMID: 31914230 PMCID: PMC6842665 DOI: 10.1016/j.jalz.2019.01.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Identifying clinical measures that track disease in the earliest stages of frontotemporal lobar degeneration (FTLD) is important for clinical trials. Familial FTLD provides a unique paradigm to study early FTLD. Executive dysfunction is a clinically relevant hallmark of FTLD and may be a marker of disease progression. METHODS Ninety-three mutation carriers with no symptoms or minimal/questionable symptoms (MAPT, n = 31; GRN, n = 28; C9orf72, n = 34; Clinical Dementia Rating scale plus NACC FTLD Module < 1) and 78 noncarriers enrolled through Advancing Research and Treatment in Frontotemporal Lobar Degeneration/Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects studies completed the Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (NIH-EXAMINER) and the UDS neuropsychological battery. Linear mixed-effects models were used to identify group differences in cognition at baseline and longitudinally. We examined associations between cognition, clinical functioning, and magnetic resonance imaging volumes. RESULTS NIH-EXAMINER scores detected baseline and differences in slopes between carriers and noncarriers, even in carriers with a baseline Clinical Dementia Rating scale plus NACC FTLD Module = 0. NIH-EXAMINER declines were associated with worsening clinical symptoms and brain volume loss. DISCUSSION The NIH-EXAMINER is sensitive to cognitive changes in presymptomatic familial FTLD and is a promising surrogate endpoint.
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Affiliation(s)
- Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Lynn Bajorek
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Kaitlin B. Casaletto
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Sheng-Yang M. Goh
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Hilary W. Heuer
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Fanny M. Elahi
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Peter A. Ljubenkov
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Reilly Dever
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of
California, San Francisco, San Francisco, CA, USA
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University,
Cleveland, OH, USA
| | - Jessica Bove
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - Yvette Bordelon
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
| | - Patrick Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort
Worth, TX, USA
| | | | - Christina Caso
- Department of Neurology, University of Washington, Seattle,
WA, USA
| | - Giovanni Coppola
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Bradford C. Dickerson
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan Dickinson
- Association for Frontotemporal Degeneration, Radnor, PA,
USA
| | - Sophia Dominguez
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kelly Faber
- National Cell Repository for Alzheimer’s Disease
(NCRAD), Indiana University, Indianapolis, IN, USA
| | - Jessica Ferrall
- Department of Neurology, University of North Carolina,
Chapel Hill, NC, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic,
Rochester, MN, USA
| | - Ann Fishman
- School of Medicine, Department of Psychiatry, Johns
Hopkins University, Baltimore, MD, USA
| | - Jamie Fong
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Tatiana Foroud
- National Cell Repository for Alzheimer’s Disease
(NCRAD), Indiana University, Indianapolis, IN, USA
| | | | | | - Debra Gearhart
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Behnaz Ghazanfari
- Tanz Centre for Research in Neurodegenerative Diseases,
University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University
of Toronto, Toronto, Ontario, Canada
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Washington
University School of Medicine, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Department of Neurology, Columbia University, New York,
NY, USA
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Columbia University, New York, NY, USA
| | | | | | - Ian Grant
- Feinberg School of Medicine, Department of Neurology,
Northwestern University, Chicago, IL, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - Dana Haley
- Department of Neurology, Mayo Clinic, Jacksonville, FL,
USA
| | - Ging-Yuek Hsiung
- Division of Neurology, Deptartment of Medicine, University
of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D. Huey
- Department of Neurology, Columbia University, New York,
NY, USA
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Columbia University, New York, NY, USA
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Lynne Jones
- Department of Radiology, Washington University School of
Medicine, Washington University, St. Louis, MO, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN,
USA
| | - Anna Karydas
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Daniel I. Kaufer
- Department of Neurology, University of North Carolina,
Chapel Hill, NC, USA
| | - Diana R. Kerwin
- Department of Neurology and Neurotherapeutics, Center for
Alzheimer’s and Neurodegenerative Diseases, The University of Texas,
Southwestern Medical Center at Dallas, Dallas, TX, USA
- Department of Internal Medicine, The University of Texas,
Southwestern Medical Center at Dallas, Dallas, TX, USA
| | | | - Ruth Kraft
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, USA
| | - Walter A. Kukull
- National Alzheimer Coordinating Center (NACC), University
of Washington, Seattle, WA, USA
| | - Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement
Disorders Center, University of California, San Diego, San Diego, CA, USA
| | - Diane Lucente
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Codrin Lungu
- National Institute of Neurological Disorders and Stroke
(NINDS), Bethesda, MD, USA
| | - Ian R. Mackenzie
- Department of Pathology and Laboratory Medicine,
University of British Columbia, Vancouver, British Columbia, Canada
| | - Miranda Maldonado
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
| | | | - Scott M. McGinnis
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily McKinley
- Department of Neurology, Alzheimer’s Disease
Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mario F. Mendez
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, CA, USA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Namita Multani
- Tanz Centre for Research in Neurodegenerative Diseases,
University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University
of Toronto, Toronto, Ontario, Canada
| | - Chiadi Onyike
- Department of Geriatric Psychiatry and Neuropsychiatry,
Johns Hopkins University, Baltimore, MD, USA
| | - Jaya Padmanabhan
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alex Pantelyat
- School of Medicine, Department of Neurology, Johns
Hopkins University, Baltimore, MD, USA
| | | | - Len Petrucelli
- Department of Neurosciences, Mayo Clinic, Jacksonville,
FL, USA
| | - Madeline Potter
- National Cell Repository for Alzheimer’s Disease
(NCRAD), Indiana University, Indianapolis, IN, USA
| | - Rosa Rademakers
- Department of Neurosciences, Mayo Clinic, Jacksonville,
FL, USA
| | - Eliana Marisa Ramos
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Katya Rascovsky
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - Erik D. Roberson
- Department of Neurology, Alzheimer’s Disease
Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily Rogalski
- Feinberg School of Medicine, Department of Psychiatry and
Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Pheth Sengdy
- Division of Neurology, Deptartment of Medicine, University
of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie M. Shaw
- Perelman School of Medicine, Department of Pathology and
Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeremy Syrjanen
- Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, USA
| | - M. Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases,
University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University
of Toronto, Toronto, Ontario, Canada
| | - Nadine Tatton
- Association for Frontotemporal Degeneration, Radnor, PA,
USA
| | - Joanne Taylor
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Arthur Toga
- Departments of Ophthalmology, Neurology, Psychiatry and
the Behavioral Sciences, Radiology and Engineering, Laboratory of Neuroimaging
(LONI), USC, Los Angeles, CA, USA
| | - John Q. Trojanowski
- Perelman School of Medicine, Department of Pathology and
Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sandra Weintraub
- Feinberg School of Medicine, Department of Neurology,
Northwestern University, Chicago, IL, USA
| | - Ping Wang
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Bonnie Wong
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Adam L. Boxer
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Brad F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
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14
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Zhu DC, Scheel N, Thomas B, Lee P, Wang DJJ, Keller JN, Binder EF, Vidoni ED, Burns JM, Kerwin DR, Vongpatanasin W, Cullum M, Zhang R. IC-P-041: STRATEGIES OF BRAIN MRI DATA ACQUISITION, QUALITY CONTROL AND ANALYSIS FOR THE MULTICENTER RISK REDUCTION FOR ALZHEIMER'S DISEASE (RRAD) CLINICAL TRIAL. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4203] [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: 11/28/2022]
Affiliation(s)
| | | | - Binu Thomas
- UT Southwestern Medical Center; Dallas TX USA
| | - Phil Lee
- University of Kansas Alzheimer's Disease Center; Fairway KS USA
| | | | | | | | - Eric D. Vidoni
- University of Kansas Alzheimer's Disease Center; Fairway KS USA
| | | | | | | | | | - Rong Zhang
- UT Southwestern Medical Center; Dallas TX USA
- Texas Health Presbyterian Hospital Dallas; Dallas TX USA
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15
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Florian H, Arnold SE, Bateman R, Braunstein JB, Budur K, Kerwin DR, Soares H, Wang D, Holtzman DM. P1‐050: ABBV‐8E12, A HUMANIZED ANTI‐TAU MONOCLONAL ANTIBODY, FOR TREATING EARLY ALZHEIMER'S DISEASE: UPDATED DESIGN AND BASELINE CHARACTERISTICS OF A PHASE 2 STUDY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.075] [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: 11/28/2022]
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16
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Tarumi T, Thomas BP, Wang C, Zhang L, Liu J, Turner M, Riley J, Tangella N, Womack KB, Kerwin DR, Cullum CM, Lu H, Vongpatanasin W, Zhu DC, Zhang R. Ambulatory pulse pressure, brain neuronal fiber integrity, and cerebral blood flow in older adults. J Cereb Blood Flow Metab 2019; 39:926-936. [PMID: 29219028 PMCID: PMC6501504 DOI: 10.1177/0271678x17745027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/17/2022]
Abstract
Ambulatory blood pressure (ABP) reflects the end-organ vascular stress in daily life; however, its influence on brain neuronal fiber integrity and cerebral blood flow (CBF) remains unclear. The objective of this study was to determine the associations among ABP, white matter (WM) neuronal fiber integrity, and CBF in older adults. We tested 144 participants via ABP monitoring and diffusion tensor imaging. The total level and pulsatile indices of CBF were measured by phase-contrast MRI and transcranial Doppler, respectively. Neuropsychological assessment was conducted in 72 participants. Among ambulatory and office BP measures, elevated 24-h pulse pressure (PP) was associated with the greatest number of WM skeleton voxels with decreased fractional anisotropy (FA) and increased mean diffusivity (MD). Furthermore, these associations remained significant after adjusting for age, antihypertensive use, aortic stiffness, WM lesion volume, and office PP. Radial diffusivity (RD) was elevated in the regions with decreased FA, while axial diffusivity was unaltered. The reduction in diastolic index explained a significant proportion of the individual variability in FA, MD, and RD. Executive function performance was correlated with WM fiber integrity. These findings suggest that elevated ambulatory PP may deteriorate brain neuronal fiber integrity via reduction in diastolic index.
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Affiliation(s)
- Takashi Tarumi
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,2 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Binu P Thomas
- 3 Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ciwen Wang
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - Li Zhang
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,4 Department of Ultrasound Diagnostics, Fourth Military Medical University, Xi'an, China
| | - Jie Liu
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,4 Department of Ultrasound Diagnostics, Fourth Military Medical University, Xi'an, China
| | - Marcel Turner
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - Jonathan Riley
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - Nikita Tangella
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - Kyle B Womack
- 2 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,5 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Diana R Kerwin
- 6 Texas Alzheimer's and Memory Disorders, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - C Munro Cullum
- 2 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,5 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hanzhang Lu
- 3 Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Wanpen Vongpatanasin
- 7 Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - David C Zhu
- 8 Department of Radiology, Cognitive Imaging Research Center, Michigan State University, Lansing, MI, USA.,9 Department of Psychology, Cognitive Imaging Research Center, Michigan State University, Lansing, MI, USA
| | - Rong Zhang
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,2 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,7 Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
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17
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Szabo-Reed AN, Vidoni E, Binder EF, Burns J, Cullum CM, Gahan WP, Gupta A, Hynan LS, Kerwin DR, Rossetti H, Stowe AM, Vongpatanasin W, Zhu DC, Zhang R, Keller JN. Rationale and methods for a multicenter clinical trial assessing exercise and intensive vascular risk reduction in preventing dementia (rrAD Study). Contemp Clin Trials 2019; 79:44-54. [PMID: 30826452 PMCID: PMC6436980 DOI: 10.1016/j.cct.2019.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 09/19/2018] [Revised: 01/28/2019] [Accepted: 02/13/2019] [Indexed: 12/29/2022]
Abstract
Alzheimer's Disease (AD) is an age-related disease with modifiable risk factors such as hypertension, hypercholesterolemia, obesity, and physical inactivity influencing the onset and progression. There is however, no direct evidence that reducing these risk factors prevents or slows AD. The Risk Reduction for Alzheimer's Disease (rrAD) trial is designed to study the independent and combined effects of intensive pharmacological control of blood pressure and cholesterol and exercise training on neurocognitive function. Six hundred and forty cognitively normal older adults age 60 to 85 years with hypertension and increased risk for dementia will be enrolled. Participants are randomized into one of four intervention group for two years: usual care, Intensive Reduction of Vascular Risk factors (IRVR) with blood pressure and cholesterol reduction, exercise training (EX), and IRVR+EX. Neurocognitive function is measured at baseline, 6, 12, 18, and 24 months; brain MRIs are obtained at baseline and 24 months. We hypothesize that both IRVR and EX will improve global cognitive function, while IRVR+EX will provide a greater benefit than either IRVR or EX alone. We also hypothesize that IRVR and EX will slow brain atrophy, improve brain structural and functional connectivity, and improve brain perfusion. Finally, we will explore the mechanisms by which study interventions impact neurocognition and brain. If rrAD interventions are shown to be safe, practical, and successful, our study will have a significant impact on reducing the risks of AD in older adults. NCT Registration: NCT02913664.
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Affiliation(s)
- Amanda N Szabo-Reed
- KU Alzheimer's Disease Center, Fairway, KS, USA; Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Eric Vidoni
- KU Alzheimer's Disease Center, Fairway, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Ellen F Binder
- Department of Internal Medicine, Division of Geriatrics & Nutritional Science, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
| | - Jeffrey Burns
- KU Alzheimer's Disease Center, Fairway, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.
| | - C Munro Cullum
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA.
| | - William P Gahan
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | - Aditi Gupta
- KU Alzheimer's Disease Center, Fairway, KS, USA; Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Linda S Hynan
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Diana R Kerwin
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, USA; Kerwin Research Center and Memory Care, Dallas, TX, USA.
| | - Heidi Rossetti
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Ann M Stowe
- Department of Neurology, University of Kentucky, Lexington, KY, USA.
| | - Wanpen Vongpatanasin
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | - David C Zhu
- Department for Radiology, Michigan State University, East Lansing, MI, USA.
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, USA; Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Jeffrey N Keller
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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18
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Ding K, Tarumi T, Zhu DC, Tseng BY, Thomas BP, Turner M, Repshas J, Kerwin DR, Womack KB, Lu H, Cullum CM, Zhang R. Cardiorespiratory Fitness and White Matter Neuronal Fiber Integrity in Mild Cognitive Impairment. J Alzheimers Dis 2019; 61:729-739. [PMID: 29226864 DOI: 10.3233/jad-170415] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 12/16/2022]
Abstract
BACKGROUND Mounting evidence showed the self-reported levels of physical activity are positively associated with white matter (WM) integrity and cognitive performance in normal adults and patients with mild cognitive impairment (MCI). However, the objective measure of cardiorespiratory fitness (CRF) was not used in these studies. OBJECTIVE To determine the associations of CRF measured by maximal oxygen uptake (VO2max) with WM fiber integrity and neurocognitive performance in older adults with MCI. METHODS Eighty-one participants (age = 65±7 years, 43 women), including 26 cognitively normal older adults and 55 amnestic MCI patients, underwent VO2max test to measure CRF, diffusion tensor imaging (DTI) to assess WM fiber integrity, and neurocognitive assessment focused on memory and executive function. DTI data were analyzed by the tract-based spatial statistics and region-of-interest approach. RESULTS Cognitively normal older adults and MCI patients were not different in global WM fiber integrity and VO2max. VO2max was associated positively with DTI metrics of fractional anisotropy in ∼54% WM fiber tracts, and negatively with mean and radial diffusivities in ∼46% and ∼56% of the WM fiber tracts. The associations of VO2max with DTI metrics remained statistically significant after adjustment of age, sex, body mass index, WM lesion burden, and MCI status. The DTI metrics obtained from the area that correlated to VO2max were associated with executive function performance in MCI patients. CONCLUSIONS Higher levels of CRF are associated with better WM fiber integrity, which in turn is correlated with better executive function performance in MCI patients.
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Affiliation(s)
- Kan Ding
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Takashi Tarumi
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - David C Zhu
- Departments of Radiology and Psychology, and Cognitive Imaging Research Center, Michigan State University, EastLansing, MI, USA
| | - Benjamin Y Tseng
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Binu P Thomas
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Marcel Turner
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Justin Repshas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Diana R Kerwin
- Texas Alzheimer's and Memory Disorders, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Kyle B Womack
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hanzhang Lu
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rong Zhang
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
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19
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Boxer AL, Heuer HW, Wang P, Rascovsky K, Rosen HJ, Boeve BF, Grossman M, Coppola G, Dickerson BC, Bordelon YM, Kimiko DR, Faber K, Feldman HH, Fields JA, Fong J, Foroud TM, Ghoshal N, Graff-Radford NR, Robin Hsiung GY, Huey ED, Irwin D, Kantarci K, Kaufer D, Karydas AM, Kerwin DR, Knopman DS, Kornak J, Kramer JH, Kukull WA, Litvan I, Lungu C, Mackenzie IR, Mendez MF, Miller BL, Onyike CU, Pantelyat A, Rademakers R, Roberson ED, Sutherland M, Tartaglia MC, Toga AW, Weintraub S, Rogalski EJ, Wszolek Z. O2‐14‐06: DIFFERENCES BETWEEN SPORADIC AND FAMILIAL BEHAVIORAL VARIANT FTD IN ADVANCING RESEARCH AND TREATMENT FOR FTLD (ARTFL) CLINICAL RESEARCH CONSORTIUM. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2723] [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: 10/28/2022]
Affiliation(s)
- Adam L. Boxer
- University of California San FranciscoSan FranciscoCAUSA
| | | | - Ping Wang
- University of California San FranciscoSan FranciscoCAUSA
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration CenterUniversity of PennsylvaniaPhiladelphiaPAUSA
| | | | | | - Murray Grossman
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Giovanni Coppola
- University of CaliforniaLos Angeles School of MedicineLos AngelesCAUSA
| | - Brad C. Dickerson
- Massachusetts General Hospital/Harvard Medical SchoolCharlestownMAUSA
| | | | | | - Kelley Faber
- National Cell Repository for Alzheimer's DiseaseIndianapolisINUSA
| | | | | | - Jamie Fong
- University of California San FranciscoSan FranciscoCAUSA
| | | | | | | | | | - Edward D. Huey
- Gertrude H. Sergievsky Center at Columbia UniversityNew YorkNYUSA
| | | | | | | | - Anna M. Karydas
- Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCAUSA
| | | | | | - John Kornak
- University of California San FranciscoSan FranciscoCAUSA
| | - Joel H. Kramer
- University of California San FranciscoSan FranciscoCAUSA
| | - Walter A. Kukull
- National Alzheimer's Coordinating CenterUniversity of WashingtonSeattleWAUSA
| | - Irene Litvan
- University of California San DiegoSan DiegoCAUSA
| | | | | | | | | | | | - Alex Pantelyat
- Johns Hopkins University School of MedicineBaltimoreMDUSA
| | | | | | | | | | - Arthur W. Toga
- Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
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20
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Heuer HW, Boxer AL, Rosen HJ, Boeve BF, Grossman M, Dickerson BC, Appleby B, Bordelon YM, Brushaber D, Kimiko DR, Faber K, Feldman HH, Fields JA, Fong J, Foroud TM, Ghoshal N, Graff-Radford NR, Robin Hsiung GY, Huey ED, Irwin DJ, Kantarci K, Kaufer D, Karydas AM, Kerwin DR, Knopman DS, Kornak J, Kramer JH, Kukull WA, Litvan I, Lungu C, Mackenzie IR, Mendez MF, Miller BL, Onyike CU, Pantelyat A, Potter M, Rademakers R, Ramos EM, Rankin K, Rascovsky K, Roberson ED, Sutherland M, Tartaglia C, Toga AW, Weintraub S, Wszolek Z. O2‐14‐02: THE CLINICAL SPECTRUM OF FRONTOTEMPORAL LOBAR DEGENERATION IN NORTH AMERICA: BASELINE CHARACTERISTICS OF THE FIRST 912 PARTICIPANTS FROM THE ADVANCING RESEARCH AND TREATMENT IN FTLD (ARTFL) CLINICAL RESEARCH CONSORTIUM. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2719] [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: 10/28/2022]
Affiliation(s)
| | - Adam L. Boxer
- University of California San FranciscoSan FranciscoCAUSA
| | | | | | - Murray Grossman
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Brad C. Dickerson
- Massachusetts General Hospital/Harvard Medical SchoolCharlestownMAUSA
| | | | | | | | | | - Kelley Faber
- National Cell Repository for Alzheimer's DiseaseIndianapolisINUSA
| | | | | | - Jamie Fong
- University of California San FranciscoSan FranciscoCAUSA
| | | | - Nupur Ghoshal
- Washington University School of MedicineSt. LouisMOUSA
| | | | | | - Edward D. Huey
- Gertrude H. Sergievsky Center at Columbia UniversityNew YorkNYUSA
| | - David J. Irwin
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | | | | | - Anna M. Karydas
- Memory and Aging Center, Weill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCAUSA
| | | | | | - John Kornak
- University of California San FranciscoSan FranciscoCAUSA
| | - Joel H. Kramer
- University of California San FranciscoSan FranciscoCAUSA
| | - Walter A. Kukull
- National Alzheimer's Coordinating CenterUniversity of WashingtonSeattleWAUSA
| | - Irene Litvan
- University of California San DiegoSan DiegoCAUSA
| | | | | | | | | | | | - Alex Pantelyat
- Johns Hopkins University School of MedicineBaltimoreMDUSA
| | - Madeline Potter
- National Cell Repository for Alzheimer's DiseaseIndianapolisINUSA
| | | | | | | | - Katya Rascovsky
- Penn Frontotemporal Degeneration CenterUniversity of PennsylvaniaPhiladelphiaPAUSA
| | | | | | - Carmela Tartaglia
- Division of Neurology, Krembil Neuroscience Centre, Toronto Western HospitalUniversity Health Network Memory ClinicTorontoONCanada
| | - Arthur W. Toga
- Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
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21
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Reid KF, Walkup MP, Katula JA, Sink KM, Anton S, Axtell R, Kerwin DR, King AC, Kramer F, Miller ME, Myers V, Rosano C, Studenski SA, Lopez OL, Verghese J, Fielding RA, Williamson J. Cognitive Performance Does not Limit Physical Activity Participation in the Lifestyle Interventions and Independence for Elders Pilot Study (LIFE-P). J Prev Alzheimers Dis 2017; 4:44-50. [PMID: 29188859 DOI: 10.14283/jpad.2016.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We examined whether multiple domains of baseline cognitive performance were associated with prospective physical activity (PA) adherence in the Lifestyle Interventions and Independence for Elders Pilot study (LIFE-P). DESIGN, SETTING, PARTICIPANTS The LIFE-P study was a single-blind, multicenter, randomized controlled trial of a PA intervention compared to a successful aging educational intervention in sedentary, mobility-limited older adults. INTERVENTION A 12-month structured, moderate-intensity, multi-modal PA program that included walking, resistance training, and flexibility exercises. For the first 2 months (adoption), 3 center-based exercise sessions (40-60 min) / week were conducted. During the next 4 months (transition), center-based sessions were conducted 2 times / week. The subsequent maintenance phase consisted of optional once-to-twice-per-week center-based sessions and home-based PA. MEASUREMENTS Tests of executive and global cognitive functioning, working memory and psychomotor speed were administered at baseline. Median test scores were used to dichotomize participants into low or high cognitive performance groups. RESULTS 52 mobility-limited older adults (age: 76.9 ±5 yrs) were randomized to the PA arm of LIFE-P. Compared to participants with high cognitive performance, participants with low performance had similar PA adherence rates (all P ≥ 0.34). Furthermore, weak and non-significant univariate relationships were elicited between all measures of cognition and overall PA adherence levels (r values ranged: -0.20 to 0.12, P ≥ 0.12). CONCLUSION These data suggest that cognitive performance does not limit long-term PA adherence in mobility-limited older adults. Additional studies in larger cohorts are warranted to verify these findings.
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Affiliation(s)
- K F Reid
- Kieran F. Reid, PhD, MPH, Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA 02111, USA.
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22
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Budur K, West T, Braunstein JB, Fogelman I, Bordelon YM, Litvan I, Roberson ED, Hu H, Verghese PB, Bateman RJ, Florian H, Wang D, Ryman D, Gault L, Goss S, Mendonca N, Rendenbach‐Mueller B, Kerwin DR, Boxer AL, Holtzman DM. [O2–17–01]: RESULTS OF A PHASE 1, SINGLE ASCENDING DOSE, PLACEBO‐CONTROLLED STUDY OF ABBV‐8E12 IN PATIENTS WITH PROGRESSIVE SUPRANUCLEAR PALSY AND PHASE 2 STUDY DESIGN IN EARLY ALZHEIMER's DISEASE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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)
- Kumar Budur
- AbbVie Inc.North ChicagoILUSA
- C2N Diagnostics LLCSaint LouisMOUSA
- University of California Los AngelesLos AngelesCAUSA
- University of California San DiegoSan DiegoCAUSA
- University of Alabama at BirminghamBirminghamALUSA
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23
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Yanamandra K, Patel TK, Jiang H, Schindler S, Ulrich JD, Boxer AL, Miller BL, Kerwin DR, Gallardo G, Stewart F, Finn MB, Cairns NJ, Verghese PB, Fogelman I, West T, Braunstein J, Robinson G, Keyser J, Roh J, Knapik SS, Hu Y, Holtzman DM. Anti-tau antibody administration increases plasma tau in transgenic mice and patients with tauopathy. Sci Transl Med 2017; 9:9/386/eaal2029. [PMID: 28424326 DOI: 10.1126/scitranslmed.aal2029] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 10/14/2016] [Accepted: 01/13/2017] [Indexed: 11/02/2022]
Abstract
Tauopathies are a group of disorders in which the cytosolic protein tau aggregates and accumulates in cells within the brain, resulting in neurodegeneration. A promising treatment being explored for tauopathies is passive immunization with anti-tau antibodies. We previously found that administration of an anti-tau antibody to human tau transgenic mice increased the concentration of plasma tau. We further explored the effects of administering an anti-tau antibody on plasma tau. After peripheral administration of an anti-tau antibody to human patients with tauopathy and to mice expressing human tau in the central nervous system, there was a dose-dependent increase in plasma tau. In mouse plasma, we found that tau had a short half-life of 8 min that increased to more than 3 hours after administration of anti-tau antibody. As tau transgenic mice accumulated insoluble tau in the brain, brain soluble and interstitial fluid tau decreased. Administration of anti-tau antibody to tau transgenic mice that had decreased brain soluble tau and interstitial fluid tau resulted in an increase in plasma tau, but this increase was less than that observed in tau transgenic mice without these brain changes. Tau transgenic mice subjected to acute neuronal injury using 3-nitropropionic acid showed increased interstitial fluid tau and plasma tau. These data suggest that peripheral administration of an anti-tau antibody results in increased plasma tau, which correlates with the concentration of extracellular and soluble tau in the brain.
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Affiliation(s)
- Kiran Yanamandra
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA.,AbbVie Inc. Foundational Neuroscience Center, Cambridge, MA 02139, USA
| | - Tirth K Patel
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Hong Jiang
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Suzanne Schindler
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Jason D Ulrich
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Adam L Boxer
- Clinical Trials Program, Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Bruce L Miller
- Clinical Trials Program, Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Diana R Kerwin
- Texas Alzheimer's and Memory Disorders, Texas Health Presbyterian Hospital Dallas, Dallas, TX 75231, USA
| | - Gilbert Gallardo
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Floy Stewart
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Mary Beth Finn
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Nigel J Cairns
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Philip B Verghese
- C2N Diagnostics, Center for Emerging Technologies, 4041 Forest Park Avenue, St. Louis, MO 63108, USA
| | - Ilana Fogelman
- C2N Diagnostics, Center for Emerging Technologies, 4041 Forest Park Avenue, St. Louis, MO 63108, USA
| | - Tim West
- C2N Diagnostics, Center for Emerging Technologies, 4041 Forest Park Avenue, St. Louis, MO 63108, USA
| | - Joel Braunstein
- C2N Diagnostics, Center for Emerging Technologies, 4041 Forest Park Avenue, St. Louis, MO 63108, USA
| | - Grace Robinson
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Jennifer Keyser
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Joseph Roh
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA
| | - Stephanie S Knapik
- C2N Diagnostics, Center for Emerging Technologies, 4041 Forest Park Avenue, St. Louis, MO 63108, USA
| | - Yan Hu
- C2N Diagnostics, Center for Emerging Technologies, 4041 Forest Park Avenue, St. Louis, MO 63108, USA
| | - David M Holtzman
- Hope Center for Neurological Disorders and Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO 63110,USA.
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24
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Tarumi T, Harris TS, Hill C, German Z, Riley J, Turner M, Womack KB, Kerwin DR, Monson NL, Stowe AM, Mathews D, Cullum CM, Zhang R. Amyloid burden and sleep blood pressure in amnestic mild cognitive impairment. Neurology 2015; 85:1922-9. [PMID: 26537049 DOI: 10.1212/wnl.0000000000002167] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/25/2015] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To determine whether cortical β-amyloid (Aβ) deposition is associated with circadian blood pressure (BP) profiles and dynamic cerebral blood flow (CBF) regulation in patients with amnestic mild cognitive impairment (aMCI). METHODS Forty participants with aMCI were included in this study. Cortical Aβ depositions were measured by (18)F-florbetapir PET and expressed as the standardized uptake value ratio (SUVR) relative to the cerebellum. Circadian BP profiles were measured by 24-hour ambulatory monitoring during awake and sleep periods. The dipping status of sleep BP (i.e., the percent changes from the awake BP) was calculated and dichotomized into the dipper (≥10%) and nondipper (<10%) groups. Dynamic CBF regulation was assessed by a transfer function analysis between beat-to-beat changes in BP and CBF velocity measured from the middle cerebral artery during a repeated sit-stand maneuver. RESULTS Age was positively correlated with a greater Aβ deposition in the posterior cingulate, precuneus, and mean cortex. Accounting for the age effect, attenuated reductions in sleep systolic BP were associated with higher levels of posterior cingulate SUVR. Consistently, the nondippers exhibited a higher SUVR in the posterior cingulate than the dippers. Transfer function gain between changes in BP and CBF velocity was diminished in the nondippers, and moreover those individuals with a lower gain exhibited a higher SUVR in the posterior cingulate. CONCLUSIONS Attenuated reductions in sleep BP are associated with a greater Aβ burden in the posterior cingulate and altered dynamic CBF regulation in patients with aMCI.
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Affiliation(s)
- Takashi Tarumi
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Thomas S Harris
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Candace Hill
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Zohre German
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Jonathan Riley
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Marcel Turner
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Kyle B Womack
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Diana R Kerwin
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Nancy L Monson
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Ann M Stowe
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Dana Mathews
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - C Munro Cullum
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas
| | - Rong Zhang
- From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas.
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25
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Tarumi T, de Jong DLK, Zhu DC, Tseng BY, Liu J, Hill C, Riley J, Womack KB, Kerwin DR, Lu H, Munro Cullum C, Zhang R. Central artery stiffness, baroreflex sensitivity, and brain white matter neuronal fiber integrity in older adults. Neuroimage 2015; 110:162-70. [PMID: 25623500 DOI: 10.1016/j.neuroimage.2015.01.041] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 11/05/2014] [Revised: 12/22/2014] [Accepted: 01/18/2015] [Indexed: 12/21/2022] Open
Abstract
Cerebral hypoperfusion elevates the risk of brain white matter (WM) lesions and cognitive impairment. Central artery stiffness impairs baroreflex, which controls systemic arterial perfusion, and may deteriorate neuronal fiber integrity of brain WM. The purpose of this study was to examine the associations among brain WM neuronal fiber integrity, baroreflex sensitivity (BRS), and central artery stiffness in older adults. Fifty-four adults (65 ± 6 years) with normal cognitive function or mild cognitive impairment (MCI) were tested. The neuronal fiber integrity of brain WM was assessed from diffusion metrics acquired by diffusion tensor imaging. BRS was measured in response to acute changes in blood pressure induced by bolus injections of vasoactive drugs. Central artery stiffness was measured by carotid-femoral pulse wave velocity (cfPWV). The WM diffusion metrics including fractional anisotropy (FA) and radial (RD) and axial (AD) diffusivities, BRS, and cfPWV were not different between the control and MCI groups. Thus, the data from both groups were combined for subsequent analyses. Across WM, fiber tracts with decreased FA and increased RD were associated with lower BRS and higher cfPWV, with many of the areas presenting spatial overlap. In particular, the BRS assessed during hypotension was strongly correlated with FA and RD when compared with hypertension. Executive function performance was associated with FA and RD in the areas that correlated with cfPWV and BRS. These findings suggest that baroreflex-mediated control of systemic arterial perfusion, especially during hypotension, may play a crucial role in maintaining neuronal fiber integrity of brain WM in older adults.
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Affiliation(s)
- Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX 75235, USA
| | - Daan L K de Jong
- Department of Geriatric Medicine, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, Netherlands
| | - David C Zhu
- Department of Radiology and Psychology, Michigan State University, 220 Trowbridge Rd, East Lansing, MI 48824, USA; Cognitive Imaging Research Center, Michigan State University, 220 Trowbridge Rd, East Lansing, MI 48824, USA
| | - Benjamin Y Tseng
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX 75235, USA
| | - Jie Liu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX 75235, USA
| | - Candace Hill
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA
| | - Jonathan Riley
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA
| | - Kyle B Womack
- Department of Psychiatry, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX 75235, USA; Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX 75235, USA
| | - Diana R Kerwin
- Texas Alzheimer's and Memory Disorders, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA
| | - Hanzhang Lu
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX 75235, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX 75235, USA; Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX 75235, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA; Department of Internal Medicine, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX 75235, USA; Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX 75235, USA.
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Sink KM, Espeland MA, Rushing J, Castro CM, Church TS, Cohen R, Gill TM, Henkin L, Jennings JM, Kerwin DR, Manini TM, Myers V, Pahor M, Reid KF, Woolard N, Rapp SR, Williamson JD. The LIFE Cognition Study: design and baseline characteristics. Clin Interv Aging 2014; 9:1425-36. [PMID: 25210447 PMCID: PMC4154884 DOI: 10.2147/cia.s65381] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Observational studies have shown beneficial relationships between exercise and cognitive function. Some clinical trials have also demonstrated improvements in cognitive function in response to moderate-high intensity aerobic exercise; however, these have been limited by relatively small sample sizes and short durations. The Lifestyle Interventions and Independence for Elders (LIFE) Study is the largest and longest randomized controlled clinical trial of physical activity with cognitive outcomes, in older sedentary adults at increased risk for incident mobility disability. One LIFE Study objective is to evaluate the effects of a structured physical activity program on changes in cognitive function and incident all-cause mild cognitive impairment or dementia. Here, we present the design and baseline cognitive data. At baseline, participants completed the modified Mini Mental Status Examination, Hopkins Verbal Learning Test, Digit Symbol Coding, Modified Rey-Osterrieth Complex Figure, and a computerized battery, selected to be sensitive to changes in speed of processing and executive functioning. During follow up, participants completed the same battery, along with the Category Fluency for Animals, Boston Naming, and Trail Making tests. The description of the mild cognitive impairment/dementia adjudication process is presented here. Participants with worse baseline Short Physical Performance Battery scores (prespecified at ≤ 7) had significantly lower median cognitive test scores compared with those having scores of 8 or 9 with modified Mini Mental Status Examination score of 91 versus (vs) 93, Hopkins Verbal Learning Test delayed recall score of 7.4 vs 7.9, and Digit Symbol Coding score of 45 vs 48, respectively (all P<0.001). The LIFE Study will contribute important information on the effects of a structured physical activity program on cognitive outcomes in sedentary older adults at particular risk for mobility impairment. In addition to its importance in the area of prevention of cognitive decline, the LIFE Study will also likely serve as a model for exercise and other behavioral intervention trials in older adults.
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Affiliation(s)
- Kaycee M Sink
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Julia Rushing
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Cynthia M Castro
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Timothy S Church
- Pennington Biomedical, Louisiana State University, Baton Rouge, LA, USA
| | - Ronald Cohen
- Institute on Aging and Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Thomas M Gill
- Yale School of Medicine, Department of Internal Medicine, New Haven, CT, USA
| | - Leora Henkin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Janine M Jennings
- Department of Psychology, Wake Forest University, Winston-Salem, NC, USA
| | - Diana R Kerwin
- Texas Alzheimer's and Memory Disorders, Texas Health Presbyterian Hospital Dallas, TX, USA
| | - Todd M Manini
- Institute on Aging and Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | | | - Marco Pahor
- Institute on Aging and Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Kieran F Reid
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Nancy Woolard
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jeff D Williamson
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Espeland MA, Katula JA, Rushing J, Kramer AF, Jennings JM, Sink KM, Nadkarni NK, Reid KF, Castro CM, Church T, Kerwin DR, Williamson JD, Marottoli RA, Rushing S, Marsiske M, Rapp SR. Performance of a computer-based assessment of cognitive function measures in two cohorts of seniors. Int J Geriatr Psychiatry 2013; 28:1239-50. [PMID: 23589390 PMCID: PMC3775886 DOI: 10.1002/gps.3949] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 11/27/2012] [Accepted: 01/29/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND Computer-administered assessment of cognitive function is being increasingly incorporated in clinical trials; however, its performance in these settings has not been systematically evaluated. DESIGN The Seniors Health and Activity Research Program pilot trial (N = 73) developed a computer-based tool for assessing memory performance and executive functioning. The Lifestyle Interventions and Independence for Elders investigators incorporated this battery in a full-scale multicenter clinical trial (N = 1635). We describe relationships that test scores have with those from interviewer-administered cognitive function tests and risk factors for cognitive deficits and describe performance measures (completeness, intraclass correlations [ICC]). RESULTS Computer-based assessments of cognitive function had consistent relationships across the pilot and full-scale trial cohorts with interviewer-administered assessments of cognitive function, age, and a measure of physical function. In the Lifestyle Interventions and Independence for Elders cohort, their external validity was further demonstrated by associations with other risk factors for cognitive dysfunction: education, hypertension, diabetes, and physical function. Acceptable levels of data completeness (>83%) were achieved on all computer-based measures; however, rates of missing data were higher among older participants (odds ratio = 1.06 for each additional year; p < 0.001) and those who reported no current computer use (odds ratio = 2.71; p < 0.001). ICCs among clinics were at least as low (ICC < 0.013) as for interviewer measures (ICC < 0.023), reflecting good standardization. All cognitive measures loaded onto the first principal component (global cognitive function), which accounted for 40% of the overall variance. CONCLUSION Our results support the use of computer-based tools for assessing cognitive function in multicenter clinical trials of older individuals.
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Affiliation(s)
- Mark A. Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem NC 27157 ;
| | - Jeffrey A. Katula
- Department of Health and Exercise Sciences, Wake Forest University, Winston-Salem, NC 27109
| | - Julia Rushing
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem NC 27157 ;
| | - Arthur F. Kramer
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL 61801 ()
| | - Janine M. Jennings
- Department of Psychology and, Wake Forest University, Winston-Salem, NC27109
| | - Kaycee M. Sink
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem NC 27157 ;
| | - Neelesh K. Nadkarni
- Division of Geriatric Medicine and Gerontology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213 ()
| | - Kieran F. Reid
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111 ()
| | - Cynthia M. Castro
- Stanford Prevention Research Center, Stanford University, Palo Alto, CA 94304()
| | - Timothy Church
- Pennington Biomedical Research Center, Baton Rouge, LA 70808 ()
| | - Diana R. Kerwin
- Departments of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611 ()
| | - Jeff D. Williamson
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem NC 27157 ;
| | - Richard A. Marottoli
- Department of Medicine, Yale School of Medicine, New Haven, CT 06504 and VA Connecticut Healthcare System, West Haven, CT 06156 ()
| | - Scott Rushing
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem NC 27157 ;
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL 32610 (,edu)
| | - Stephen R. Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem NC 27157
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Geldmacher DS, Kerwin DR. Practical diagnosis and management of dementia due to Alzheimer's disease in the primary care setting: an evidence-based approach. Prim Care Companion CNS Disord 2013; 15:PCC.12r01474. [PMID: 24392252 PMCID: PMC3869604 DOI: 10.4088/pcc.12r01474] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 04/23/2013] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To review evidence-based guidance on the primary care of Alzheimer's disease and clinical research on models of primary care for Alzheimer's disease to present a practical summary for the primary care physician regarding the assessment and management of the disease. DATA SOURCES References were obtained via search using keywords Alzheimer's disease AND primary care OR collaborative care OR case finding OR caregivers OR guidelines. Articles were limited to English language from January 1, 1990, to January 1, 2013. STUDY SELECTION Articles were reviewed and selected on the basis of study quality and pertinence to this topic, covering a broad range of data and opinion across geographical regions and systems of care. The most recent published guidelines from major organizations were included. RESULTS Practice guidelines contained numerous points of consensus, with most advocating a central role for the primary care physician in the detection, diagnosis, and treatment of Alzheimer's disease. Review of the literature indicated that optimal medical and psychosocial care for people with Alzheimer's disease and their caregivers may be best facilitated through collaborative models of care involving the primary care physician working within a wider interdisciplinary team. CONCLUSIONS Evidence-based guidelines assign the primary care physician a critical role in the care of people with Alzheimer's disease. Research on models of care suggests the need for an appropriate medical/nonmedical support network to fulfill this role. Given the diversity and breadth of services required and the necessity for close coordination, nationwide implementation of team-based, collaborative care programs may represent the best option for improving care standards for patients with Alzheimer's disease.
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Affiliation(s)
- David S Geldmacher
- Division of Memory Disorders and Behavioral Neurology, University of Alabama, Birmingham (Dr Geldmacher) and Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Kerwin)
| | - Diana R Kerwin
- Division of Memory Disorders and Behavioral Neurology, University of Alabama, Birmingham (Dr Geldmacher) and Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Kerwin)
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Kerwin DR, Claus TH. Reply. J Am Med Dir Assoc 2011; 12:e1. [PMID: 30029302 DOI: 10.1016/j.jamda.2011.05.004] [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] [Received: 05/11/2011] [Accepted: 05/11/2011] [Indexed: 11/24/2022]
Affiliation(s)
- Diana R Kerwin
- Department of Medicine, Division of Geriatrics, Northwestern University Feinberg School of Medicine, 645 N Michigan Avenue, Suite 630, Chicago, IL 60611.
| | - Thomas H Claus
- Department of Medicine, Division of Geriatrics, Northwestern University Feinberg School of Medicine, 645 N Michigan Avenue, Suite 630, Chicago, IL 60611
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Grossberg GT, Christensen DD, Griffith PA, Kerwin DR, Hunt G, Hall EJ. The art of sharing the diagnosis and management of Alzheimer's disease with patients and caregivers: recommendations of an expert consensus panel. Prim Care Companion J Clin Psychiatry 2011; 12:PCC.09cs00833. [PMID: 20582302 DOI: 10.4088/pcc.09cs00833oli] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Accepted: 07/23/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To develop a set of recommendations for primary care physicians (PCPs) suggesting how best to communicate with patients, caregivers, and other family members regarding the diagnosis and management of Alzheimer's disease (AD). PARTICIPANTS A national roundtable of 6 leading professionals involved in treating or advocating for patients with AD was convened on March 14, 2008. This roundtable included 4 leading academic physicians with diverse backgrounds (a geriatric psychiatrist, a neuropsychiatrist, a neurologist, and a geriatrician) from geographically diverse regions of the United States, who were invited on the basis of their national reputation in the field and experience working with minority populations with dementia; the executive director of a national AD advocacy organization; the executive director of a national advocacy organization for caregivers; and a medical correspondent with expertise in interviewing and small group leadership. EVIDENCE Expert opinion supported by academic literature (search limited to PubMed, English language, 1996-2008, search terms: Alzheimer's disease, primary care, diagnosis, management, caregiver, family, patient-physician relationship). CONSENSUS PROCESS Moderated dialogue aimed at generating consensus opinion; only statements endorsed by all authors were included in the final article. CONCLUSIONS Diagnosis and management of AD by PCPs, utilizing specialist consultation as needed, may contribute to earlier diagnosis and treatment, improved doctor-patient and doctor-caregiver communication, increased attention to caregiver needs, and better clinical and quality-of-life outcomes for patients and caregivers. A set of expert panel recommendations describing practical strategies for achieving these goals was successfully developed.
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Affiliation(s)
- George T Grossberg
- Department of Psychiatry, St Louis University School of Medicine, Missouri ; Departments of Psychiatry, Neurology, and Pharmacology, Neuropsychiatric Institute, University of Utah School of Medicine, Salt Lake City ; Department of Internal Medicine, Meharry Medical College, Nashville, Tennessee ; Division of Geriatrics and Gerontology, Medical College of Wisconsin, Milwaukee ; National Alliance for Caregiving, Bethesda, Maryland ; and Alzheimer's Foundation of America, New York, NY
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Kerwin DR, Gaussoin SA, Chlebowski RT, Kuller LH, Vitolins M, Coker LH, Kotchen JM, Nicklas BJ, Wassertheil-Smoller S, Hoffmann RG, Espeland MA. Interaction Between Body Mass Index and Central Adiposity and Risk of Incident Cognitive Impairment and Dementia: Results from the Women's Health Initiative Memory Study. J Am Geriatr Soc 2011; 59:107-12. [DOI: 10.1111/j.1532-5415.2010.03219.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Kerwin DR, Zhang Y, Kotchen JM, Espeland MA, Van Horn L, McTigue KM, Robinson JG, Powell L, Kooperberg C, Coker LH, Hoffmann R. The cross-sectional relationship between body mass index, waist-hip ratio, and cognitive performance in postmenopausal women enrolled in the Women's Health Initiative. J Am Geriatr Soc 2010; 58:1427-32. [PMID: 20646100 DOI: 10.1111/j.1532-5415.2010.02969.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine whether body mass index (BMI) is independently associated with cognitive function in postmenopausal women and the relationship between body fat distribution as estimated by waist-hip ratio (WHR). DESIGN Cross-sectional data analysis. SETTING Baseline data from the Women's Health Initiative (WHI) hormone trials. PARTICIPANTS Eight thousand seven hundred forty-five postmenopausal women aged 65 to 79 free of clinical evidence of dementia who completed the baseline evaluation in the WHI hormone trials. MEASUREMENTS Participants completed a Modified Mini-Mental State Examination (3MSE), health and lifestyle questionnaires, and standardized measurements of height, weight, body circumference, and blood pressure. Statistical analysis was performed of associations between 3MSE score, BMI, and WHR after controlling for known confounders. RESULTS With the exception of smoking and exercise, vascular disease risk factors, including hypertension, waist measurement, heart disease, and diabetes mellitus, were significantly associated with 3MSE score and were included as covariables in subsequent analyses. BMI was inversely related to 3MSE score; for every 1-unit increase in BMI, 3MSE score decreased 0.988 points (P<.001) after adjusting for age, education, and vascular disease risk factors. BMI had the most pronounced association with poorer cognitive functioning scores in women with smaller waist measurements. In women with the highest WHR, cognitive scores increased with BMI. CONCLUSION Higher BMI was associated with poorer cognitive function in women with smaller WHR. Higher WHR, estimating central fat mass, was associated with higher cognitive function in this cross-sectional study. Further research is needed to clarify the mechanism for this association.
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Affiliation(s)
- Diana R Kerwin
- Division of Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
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Kerwin DR. How to prevent a delayed Alzheimer's diagnosis. J Fam Pract 2009; 58:9-15. [PMID: 19141265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Diana R Kerwin
- Geriatric Memory Disorders Clinic and Division of Geriatrics and Gerontology, Medical College of Wisconsin, Milwaukee, WI, USA.
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McDermott MM, Kerwin DR, Liu K, Martin GJ, O'Brien E, Kaplan H, Greenland P. Prevalence and significance of unrecognized lower extremity peripheral arterial disease in general medicine practice*. J Gen Intern Med 2001; 16:384-90. [PMID: 11422635 PMCID: PMC1495229 DOI: 10.1046/j.1525-1497.2001.016006384.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prevalence of unrecognized lower extremity peripheral arterial disease (PAD) among men and women aged 55 years and older in a general internal medicine (GIM) practice and to identify characteristics and functional performance associated with unrecognized PAD. DESIGN Cross-sectional. SETTING Academic medical center. PARTICIPANTS We identified 143 patients with known PAD from the noninvasive vascular laboratory, and 239 men and women aged 55 and older with no prior PAD history from a GIM practice. Group 1 consisted of patients with PAD consecutively identified from the noninvasive vascular laboratory (n = 143). Group 2 included GIM practice patients found to have an ankle brachial index less than 0.90, consistent with PAD (n = 34). Group 3 consisted of GIM practice patients without PAD (n = 205). MEASUREMENTS AND MAIN RESULTS Leg functioning was assessed with the 6-minute walk, 4-meter walking velocity, and Walking Impairment Questionnaire (WIQ). Of GIM practice patients, 14% had unrecognized PAD. Only 44% of patients in Group 2 had exertional leg symptoms. Distances achieved in the 6-minute walk were 1,130, 1,362, and 1,539 feet for Groups 1, 2, and 3, respectively, adjusting for age, gender, and race (P <.001). The degree of difficulty walking due to leg symptoms as reported on the WIQ was comparable between Groups 2 and 3 and significantly greater in Group 1 than Group 2. In multiple logistic regression analysis including Groups 2 and 3, current cigarette smoking was associated independently with unrecognized PAD (odds ratio [OR], 6.82; 95% confidence interval [95% CI], 1.55 to 29.93). Aspirin therapy was nearly independently associated with absence of PAD (OR, 0.37; 95% CI, 0.12 to 1.12). CONCLUSION Unrecognized PAD is common among men and women aged 55 years and older in GIM practice and is associated with impaired lower extremity functioning. Ankle brachial index screening may be necessary to diagnose unrecognized PAD in a GIM practice.
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Affiliation(s)
- M M McDermott
- Department of Medicine, Northwestern University Medical School, Chicago, IL, USA.
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Krecic-Shepard ME, Park K, Barnas C, Slimko J, Kerwin DR, Schwartz JB. Race and sex influence clearance of nifedipine: results of a population study. Clin Pharmacol Ther 2000; 68:130-42. [PMID: 10976544 DOI: 10.1067/mcp.2000.108678] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To estimate oral clearance of nifedipine and to determine demographic and clinical covariates that affect nifedipine clearance in a clinical population. METHODS Apparent oral clearance of nifedipine and protein binding were measured in 226 patients receiving sustained-release nifedipine formulations for hypertension and coronary artery disease (black men, n = 111; black women, n = 27; white men, n = 64; white women, n = 24). Mean age +/- SD was 71 +/- 11 years, and mean weight was 86 +/- 17 kg. Nifedipine concentrations were analyzed by HPLC, protein binding was measured by equilibrium dialysis, clearance and covariate effects were estimated by a nonlinear mixed effects population model, and statistical analyses were performed by a nonlinear mixed-effects model (clearance) and ANOVA (protein binding). RESULTS Clearance was significantly slower in black subjects (8.9 +/- 0.7 mL/min/kg; mean +/- SE) compared with white subjects (11.6 +/- 0.8 mL/min/kg; P = .00004) and in men compared with women (9.3 +/- 0.6 versus 12.1 +/- 1.5 mL/min/kg; P = .0021). Reported alcohol use (alcohol, 8.6 +/- 1.1 versus no alcohol, 10.8 +/- 0.6 mL/min/kg; P = .0002) and smoking status (smoker, 8.8 +/- 2.0 versus nonsmoker, 10.2 +/- 0.6 mL/min/kg; P = .0362) also affected nifedipine clearance. Race and sex had no effect on protein binding of nifedipine (P = .29 and P = .44, respectively). No effects of age, stable coronary artery disease, or reported intake of beta-blockers on nifedipine clearance were detected in this primarily elderly population with hypertension. CONCLUSIONS The data suggest that race, sex, and environmental factors are identifiable sources of interindividual variation in the oral clearance of nifedipine, a CYP3A substrate. Our experience also suggests that data from clinical populations may be biased with regard to age, sex, and formulation selection, and covariates may not be independently distributed, which can limit analyses.
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Affiliation(s)
- M E Krecic-Shepard
- Department of Medicine, Northwestern University Medical School, Chicago, Ill, USA
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Kerwin DR, Dolney A, Stahle D. Member characteristics, participation, and interests: Public Health Nutrition Practice Group. J Am Diet Assoc 1988; 88:483-6. [PMID: 3351169] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A survey was developed to assess the level of participation and the membership interests of the Public Health Nutrition Practice Group (PHNPG). Forty-six percent (500 members) returned a completed survey. More than 80% of members believe PHNPG to be their main professional practice area "home" within the Council on Practice structure. Members overwhelmingly viewed practice group contributions as a responsibility, with personal career benefits being of secondary importance. Reading the practice group's newsletter and voting in elections were major areas of involvement. However, willingness to contribute time was a positive finding. Areas of interest and issues of greatest concern were identified. Results of the survey can be used to prepare long-range plans for PHNPG. Membership involvement in practice group activities is the key to an increase in re-enrollments and in new memberships.
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