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Kim T, Kang DW, Salazar Fajardo JC, Jang H, Um YH, Kim S, Wang SM, Kim D, Lim HK. Safety and feasibility of optimized transcranial direct current stimulation in patients with mild cognitive impairment due to Alzheimer's disease: a multicenter study protocol for a randomized controlled trial. Front Neurol 2024; 15:1356073. [PMID: 38660096 PMCID: PMC11040101 DOI: 10.3389/fneur.2024.1356073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Transcranial direct current stimulation (tDCS) may effectively preserve and improve cognitive function in patients with mild cognitive impairment (MCI). Research has shown that Individual brain characteristics can influence the effects of tDCS. Computer three-dimensional brain modeling based on magnetic resonance imaging (MRI) has been suggested as an alternative for determining the most accurate tDCS electrode position based on the patients' individual brain characteristics to enhance tDCS effects. Therefore, this study aims to determine the feasibility and safety of applying tDCS treatment using optimized and personalized tDCS electrode positions in patients with Alzheimer's disease (AD)-induced MCI using computer modeling and compare the results with those of a sham group to improve cognitive function. Method A prospective active-sham group feasibility study was set to recruit 40 participants, who will be randomized into Optimized-tDCS and Sham-tDCS groups. The parameters for tDCS will be 2 mA (disk electrodes R = 1.5 cm) for 30 min during two sets of 15 sessions (2 weeks of resting period in between), using two electrodes in pairs. Using computer modeling, the tDCS electrode positions of each participant will be personalized. Outcome measurements are going to be obtained at three points: baseline, first post-test, and second post-test. The AD assessment scale-cognitive subscale (ADAS-Cog) and the Korean version of Mini-Mental State Examination (K-MMSE), together with other secondary outcomes and safety tests will be used. Discussion For the present study, we hypothesize that compared to a sham group, the optimized personalized tDCS application would be effective in improving the cognitive function of patients with AD-induced MCI and the participants would tolerate the tDCS intervention without any significant adverse effects.Clinical trial registration: https://cris.nih.go.kr, identifier [KCT0008918].
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Affiliation(s)
- TaeYeong Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | - Hanna Jang
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Donghyeon Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Wang SM, Kang DW, Um YH, Kim S, Lee CU, Scheltens P, Lim HK. Plasma oligomer beta-amyloid is associated with disease severity and cerebral amyloid deposition in Alzheimer's disease spectrum. Alzheimers Res Ther 2024; 16:55. [PMID: 38468313 PMCID: PMC10926587 DOI: 10.1186/s13195-024-01400-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 01/26/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Multimer detection system-oligomeric amyloid-β (MDS-OAβ) is a measure of plasma OAβ, which is associated with Alzheimer's disease (AD) pathology. However, the relationship between MDS-OAβ and disease severity of AD is not clear. We aimed to investigate MDS-OAβ levels in different stages of AD and analyze the association between MDS-OAβ and cerebral Aβ deposition, cognitive function, and cortical thickness in subjects within the AD continuum. METHODS In this cross-sectional study, we analyzed a total 126 participants who underwent plasma MDS-OAβ, structural magnetic resonance image of brain, and neurocognitive measures using Korean version of the Consortium to Establish a Registry for Alzheimer's Disease, and cerebral Aβ deposition or amyloid positron emission tomography (A-PET) assessed by [18F] flutemetamol PET. Subjects were divided into 4 groups: N = 39 for normal control (NC), N = 31 for A-PET-negative mild cognitive impairment (MCI) patients, N = 30 for A-PET-positive MCI patients, and N = 22 for AD dementia patients. The severity of cerebral Aβ deposition was expressed as standard uptake value ratio (SUVR). RESULTS Compared to the NC (0.803 ± 0.27), MDS-OAβ level was higher in the A-PET-negative MCI group (0.946 ± 0.137) and highest in the A-PET-positive MCI group (1.07 ± 0.17). MDS-OAβ level in the AD dementia group was higher than in the NC, but it fell to that of the A-PET-negative MCI group level (0.958 ± 0.103). There were negative associations between MDS-OAβ and cognitive function and both global and regional cerebral Aβ deposition (SUVR). Cortical thickness of the left fusiform gyrus showed a negative association with MDS-OAβ when we excluded the AD dementia group. CONCLUSIONS These findings suggest that MDS-OAβ is not only associated with neurocognitive staging, but also with cerebral Aβ burden in patients along the AD continuum.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, South Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, South Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent Hospital, Suwon, Korea, College of Medicine, The Catholic University of Korea, Suwon, 16247, South Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, South Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, South Korea
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Boelelaan 1118, Amsterdam, 1081, HZ, Netherlands
- EQT Life Sciences Partners, Amsterdam, 1071, DV, The Netherlands
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, South Korea.
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Kim J, Kim S, Um YH, Wang SM, Kim REY, Choe YS, Lee J, Kim D, Lim HK, Lee CU, Kang DW. Associations between Education Years and Resting-state Functional Connectivity Modulated by APOE ε4 Carrier Status in Cognitively Normal Older Adults. Clin Psychopharmacol Neurosci 2024; 22:169-181. [PMID: 38247423 PMCID: PMC10811405 DOI: 10.9758/cpn.23.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 01/23/2024]
Abstract
Objective : Cognitive reserve has emerged as a concept to explain the variable expression of clinical symptoms in the pathology of Alzheimer's disease (AD). The association between years of education, a proxy of cognitive reserve, and resting-state functional connectivity (rFC), a representative intermediate phenotype, has not been explored in the preclinical phase, considering risk factors for AD. We aimed to evaluate whether the relationship between years of education and rFC in cognitively preserved older adults differs depending on amyloid-beta deposition and APOE ε4 carrier status as effect modifiers. Methods : A total of 121 participants underwent functional magnetic resonance imaging, [18F] flutemetamol positron emission tomography-computed tomography, APOE genotyping, and a neuropsychological battery. Potential interactions between years of education and AD risk factors for rFC of AD-vulnerable neural networks were assessed with whole-brain voxel-wise analysis. Results : We found a significant education years-by-APOE ε4 carrier status interaction for the rFC from the seed region of the central executive (CEN) and dorsal attention networks. Moreover, there was a significant interaction of rFC between right superior occipital gyrus and the CEN seed region by APOE ε4 carrier status for memory performances and overall cognitive function. Conclusion : In preclinical APOE ε4 carriers, higher years of education were associated with higher rFC of the AD vulnerable network, but this contributed to lower cognitive function. These results contribute to a deeper understanding of the impact of cognitive reserve on sensitive functional intermediate phenotypic markers in the preclinical phase of AD.
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Affiliation(s)
- Jiwon Kim
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | | | - Jiyeon Lee
- Research Institute, NEUROPHET Inc., Seoul, Korea
| | | | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Research Institute, NEUROPHET Inc., Seoul, Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Park J, Wang SM, Kang DW, Lee B, Choi H. Effect of Anti-Aging Standard Forest Healing Program With Multiple Visits to a Forest Facility on Cognition in Older Age Patients. Dement Neurocogn Disord 2024; 23:44-53. [PMID: 38362051 PMCID: PMC10864698 DOI: 10.12779/dnd.2024.23.1.44] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/17/2024] Open
Abstract
Background and purpose The anti-aging standard forest healing program (ASFHP), which uses forest therapy, was reported to be effective in improving psychological, physical, and cognitive functions. However, there are several challenges to directly visiting the forest. This study aimed to investigate the impact of multi-session ASFHP with forest visit on the mental and physical health of the older people with visits to forest facilities and compared them with those of the same program conducted indoors. Methods Individuals aged over 70 years with concerns about cognitive decline were recruited at dementia relief centers and divided into control and experimental groups. A total of 33 people were administered ASFHP under the supervision of a forest therapy instructor. The control group stayed indoors, while the experimental group visited a forest healing center and repeated the program 20 weeks. Results The multiple-session ASFHP positively affected cognitive impairment screening test (CIST) total scores (p=0.002), memory (p=0.014), Korean version of the Repeatable Battery for the Assessment of Neuropsychological Status total scores (p<0.001), immediate recall (p=0.001), visuospatial/construction (p<0.001), language (p<0.001), forest healing standard questionnaire total scores (p=0.002), and cognitive function (p=0.019), regardless of location. The forest visits during the ASFHP showed positive effects on orientation (p=0.035), delayed recall (p=0.042), emotional stability (p=0.032), physical activity (p=0.005), and health (p=0.022). The CIST scores of the memory domain were the strongest indicator of the multiple-session ASFHP effects. Conclusions The 20-week multi-session ASFHP with forest visit showed effects on cognitive improvement and physical and emotional stability compared to indoor education.
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Affiliation(s)
- Jinseok Park
- Department of Neurology, Hanyang University Hospital, Seoul, Korea
- Society for Cognitive Intervention, Seoul, Korea
| | - Sheng-Min Wang
- Society for Cognitive Intervention, Seoul, Korea
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Woo Kang
- Society for Cognitive Intervention, Seoul, Korea
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Beom Lee
- Forest Welfare Research Center, Korea Forest Welfare Institute, Yeongju, Korea
| | - Hojin Choi
- Society for Cognitive Intervention, Seoul, Korea
- Department of Neurology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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Kim REY, Lee M, Kang DW, Wang SM, Kim D, Lim HK. Increased Likelihood of Dementia with Coexisting Atrophy of Multiple Regions of Interest. J Alzheimers Dis 2024; 97:259-271. [PMID: 38143346 DOI: 10.3233/jad-230602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
BACKGROUND Brain volume is associated with cognitive decline in later life, and cortical brain atrophy exceeding the normal range is related to inferior cognitive and behavioral outcomes in later life. OBJECTIVE To investigate the likelihood of cognitive decline, mild cognitive impairment (MCI), or dementia, when regional atrophy is present in participants' magnetic resonance imaging (MRI). METHODS Multi-center MRI data of 2,545 adults were utilized to measure regional volumes using NEUROPHET AQUA. Four lobes (frontal, parietal, temporal, and occipital), four Alzheimer's disease-related regions (entorhinal, fusiform, inferior temporal, and middle temporal area), and the hippocampus in the left and right hemispheres were measured and analyzed. The presence of regional atrophy from brain MRI was defined as ≤1.5 standard deviation (SD) compared to the age- and sex-matched cognitively normal population. The risk ratio for cognitive decline was investigated for participants with regional atrophy in contrast to those without regional atrophy. RESULTS The risk ratio for cognitive decline was significantly higher when hippocampal atrophy was present (MCI, 1.84, p < 0.001; dementia, 4.17, p < 0.001). Additionally, participants with joint atrophy in multiple regions showed a higher risk ratio for dementia, e.g., 9.6 risk ratio (95% confidence interval, 8.0-11.5), with atrophy identified in the frontal, temporal, and hippocampal gray matter, than those without atrophy. CONCLUSIONS Our study showed that individuals with multiple regional atrophy (either lobar or AD-specific regions) have a higher likelihood of developing dementia compared to the age- and sex-matched population without atrophy. Thus, further consideration is needed when assessing MRI findings.
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Affiliation(s)
- Regina E Y Kim
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
- Department of Psychiatry, Iowa City, IA, University of Iowa, United States of America
| | - Minho Lee
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Kim S, Wang SM, Kang DW, Um YH, Yang H, Lee H, Kim REY, Kim D, Lee CU, Lim HK. Development of Efficient Brain Age Estimation Method Based on Regional Brain Volume From Structural Magnetic Resonance Imaging. Psychiatry Investig 2024; 21:37-43. [PMID: 38281737 PMCID: PMC10822742 DOI: 10.30773/pi.2023.0183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/17/2023] [Accepted: 09/20/2023] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVE We aimed to create an efficient and valid predicting model which can estimate individuals' brain age by quantifying their regional brain volumes. METHODS A total of 2,560 structural brain magnetic resonance imaging (MRI) scans, along with demographic and clinical data, were obtained. Pretrained deep-learning models were employed to automatically segment the MRI data, which enabled fast calculation of regional brain volumes. Brain age gaps for each subject were estimated using volumetric values from predefined 12 regions of interest (ROIs): bilateral frontal, parietal, occipital, and temporal lobes, as well as bilateral hippocampus and lateral ventricles. A larger weight was given to the ROIs having a larger mean volumetric difference between the cognitively unimpaired (CU) and cognitively impaired group including mild cognitive impairment (MCI), and dementia groups. The brain age was predicted by adding or subtracting the brain age gap to the chronological age according to the presence or absence of the atrophy region. RESULTS The study showed significant differences in brain age gaps among CU, MCI, and dementia groups. Furthermore, the brain age gaps exhibited significant correlations with education level and measures of cognitive function, including the clinical dementia rating sum-of-boxes and the Korean version of the Mini-Mental State Examination. CONCLUSION The brain age that we developed enabled fast and efficient brain age calculations, and it also reflected individual's cognitive function and cognitive reserve. Thus, our study suggested that the brain age might be an important marker of brain health that can be used effectively in real clinical settings.
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Affiliation(s)
- Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeonsik Yang
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Hyunji Lee
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Regina EY Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Donghyeon Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Um YH, Wang SM, Kang DW, Kim S, Lee CU, Kim D, Choe YS, Kim REY, Lee S, Lee MK, Lim HK. Impact of Apolipoprotein E4 on the Locus Coeruleus Functional Connectivity in Preclinical Alzheimer's Disease. J Alzheimers Dis 2024; 99:705-714. [PMID: 38669549 DOI: 10.3233/jad-240065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Background Recent interest has surged in the locus coeruleus (LC) for its early involvement in Alzheimer's disease (AD), notably concerning the apolipoprotein ɛ4 allele (APOE4). Objective This study aimed to discern LC functional connectivity (FC) variations in preclinical AD subjects, dissecting the roles of APOE4 carrier status and amyloid-β (Aβ) deposition. Methods A cohort of 112 cognitively intact individuals, all Aβ-positive, split into 70 APOE4 noncarriers and 42 carriers, underwent functional MRI scans, neuropsychological assessments, and APOE genotyping. The research utilized seed to voxel analysis for illustrating LC rsFC discrepancies between APOE4 statuses and employed a general linear model to examine the interactive influence of APOE4 carrier status and Aβ deposition on LC FC values. Results The investigation revealed no significant differences in sex, age, or SUVR between APOE4 carriers and noncarriers. It found diminished LC FC with the occipital cortex in APOE4 carriers and identified a significant interaction between APOE4 carrier status and temporal lobe SUVR in LC FC with the occipital cortex. This interaction suggested a proportional increase in LC FC for APOE4 carriers. Additional notable interactions were observed affecting LC FC with various brain regions, indicating a proportional decrease in LC FC for APOE4 carriers. Conclusions These findings confirm that APOE4 carrier status significantly influences LC FC in preclinical AD, showcasing an intricate relationship with regional Aβ deposition. This underscores the critical role of genetic and pathological factors in early AD pathophysiology, offering insights into potential biomarkers for early detection and intervention strategies.
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | | | | | - Soyoung Lee
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Min-Kyung Lee
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- CMC Institute for Basic Medical Science, The Catholic Medical Center of The Catholic University of Korea, Seoul, Korea
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Na S, Kang DW, Kim GH, Kim KW, Kim Y, Kim HJ, Park KH, Park YH, Byeon G, Suh J, Shin JH, Shim Y, Yang Y, Um YH, Oh SI, Wang SM, Yoon B, Yoon HJ, Lee SM, Lee J, Lee JS, Rhee HY, Lim JS, Jung YH, Chin J, Hong YJ, Jang H, Choi H, Choi M, Jang JW. The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis. Dement Neurocogn Disord 2024; 23:54-66. [PMID: 38362056 PMCID: PMC10864694 DOI: 10.12779/dnd.2024.23.1.54] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/17/2024] Open
Abstract
Background and Purpose Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the gold-standard clinical diagnosis for dementia subtypes. Results From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98) and specificity was 0.84 (95% CI, 0.70-0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70-0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91) and the specificity was 0.88 (95% CI, 0.80-0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions 18F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.
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Affiliation(s)
- Seunghee Na
- Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Geon Ha Kim
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ko Woon Kim
- Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University College of Medicine, Jeonju, Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Hee-Jin Kim
- Department of Neurology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Young Ho Park
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Gihwan Byeon
- Department of Psychiatry, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Jeewon Suh
- Department of Neurology, National Medical Center, Seoul, Korea
| | | | - YongSoo Shim
- Department of Neurology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - YoungSoon Yang
- Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Seong-il Oh
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bora Yoon
- Department of Neurology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Hai-Jeon Yoon
- Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Sun Min Lee
- Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Juyoun Lee
- Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hak Young Rhee
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hee Jung
- Department of Neurology, Myungji Hospital, Goyang, Korea
| | - Juhee Chin
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun Jeong Hong
- Department of Neurology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Hyemin Jang
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Hongyoon Choi
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Miyoung Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
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Choi IH, Wang SM, Um YH, Lim HK, Lee CU, Kang DW. Higher Fat-Related Body Composition Measurement and Lower Resting-State Inter-Network Functional Connectivity of APOE ε4 Carrier in Mild Cognitive Impairment Patients With Aβ Deposition. Psychiatry Investig 2023; 20:1177-1184. [PMID: 38163657 PMCID: PMC10758323 DOI: 10.30773/pi.2023.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/05/2023] [Accepted: 09/12/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE We aimed to evaluate the impact of interaction between APOE ε4 carrier status and body composition measurements on intra- and inter-regional functional connectivity (FC) in mild cognitive impairment (MCI) patients with Aβ deposition. METHODS MCI patients with and without APOE ε4 allele (carrier, n=86; non-carrier, n=95) underwent neuropsychological battery, resting-state functional magnetic resonance imaging scans, positron emission tomography scans with [18F]flutemetamol, and bioelectrical impedance analysis for measuring body composition. We employed a priori defined regions of interest to investigate the intra- and inter-network FC profiles of default mode network (DMN), central executive network (CEN), and salience network. RESULTS There was a significant interaction of APOE ε4 carrier status with body fat mass index, visceral fat area, and waist-hip circumference ratio for inter-network FC between DMN and CEN, contributing higher fat-related body composition measurements in the APOE ε4 carrier with lower DMN-CEN FC. CONCLUSION The present results highlight the detrimental effect of APOE ε4 carrier status on the associations between the fat-related body composition measurements and FC in the MCI patients with Aβ accumulation.
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Affiliation(s)
- In Hyeok Choi
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Wang SM, Kang DW, Um YH, Kim S, Lee CU, Lim HK. Functional Connectivity Change Associated With Apolipoprotein E Allotypes Precedes Structural Connectivity and Neurodegeneration in Cognitive Normal Older Adults Without Cerebral Aβ Deposition. Psychiatry Investig 2023; 20:1054-1060. [PMID: 37997333 PMCID: PMC10678152 DOI: 10.30773/pi.2023.0164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/27/2023] [Accepted: 08/20/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE Apolipoprotein E (APOE) gene is known to influence cerebral functional connectivity (FC) in Alzheimer's disease continuum. We investigated association between APOE allotypes and FC, structural connectivity, and cortical thickness in amyloid-PET negative cognitive normal older adults (CN). METHODS A total of 188 CN (37 had ε2/ε2 or ε2/ε3 [ε2 group], 113 had ε3/ε3 [ε3 group], and 38 had ε3/ε4 or ε4/ε4 [ε4 group]) were recruited. Voxel-based morphometry and cortical thickness analysis were used to investigate differences in cortical thickness between three APOE allotypes. To investigate integrity of structural connectivity, we analyzed diffusion weighted imaging using fractional anisotropy and mean diffusivity. In terms of FC, differences of FC in default mode network (DMN) among APOE allotypes were measured using functional magnetic resonance imaging. RESULTS There were no significant differences in age, sex, education, cerebral beta-amyloid (Aβ) deposition severity, or neuropsychological profiles. No significant differences were found in cortical thickness and structural connectivity among the APOE allotypes. However, FC within the DMN was significantly lower in ε4 and ε2 carriers compared to ε3 homozygotes. CONCLUSION This study suggests that both ε4 and ε2 exhibit APOE-associated DMN FC changes before Aβ deposition, structural changes, and neurodegeneration.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Um YH, Wang SM, Kang DW, Kim S, Lee CU, Kim D, Choe YS, Kim REY, Lee S, Lim HK. Sex-Related Disparities in the Resting State Functional Connectivity of the Locus Coeruelus and Salience Network in Preclinical Alzheimer's Disease. Int J Mol Sci 2023; 24:15092. [PMID: 37894772 PMCID: PMC10606651 DOI: 10.3390/ijms242015092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Recent studies have demonstrated the pivotal role of locus coeruleus (LC) and salience network (SN) resting state functional connectivity (rsFC) changes in the early stage of Alzheimer's disease (AD). Moreover, sex has been a crucial point of discussion in understanding AD pathology. We aimed to demonstrate the sex-related disparities in the functional connectivity (FC) of the SN and LC in preclinical AD. A total of 89 cognitively normal patients with evidence of amyloid beta (Aβ) accumulation ([18F] flutemetamol +) were recruited in the study. A seed-to-voxel analysis was conducted to measure the LC and SN rsFC differences between sexes. In addition, sex by Aβ interactive effects on FC values were analyzed with a general linear model. There were statistically significant sex by regional standardized uptake value ratio (SUVR) interactions in the LC FC with the parietal, frontal, and occipital cortices. Moreover, there was a significant sex by global SUVR interaction in the SN FC with the temporal cortex. The findings suggest that there are differential patterns of LC FC and SN FC in males and females with preclinical AD, which interact with regional Aβ deposition.
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Donghyeon Kim
- Research Institute, Neurophet Inc., Seoul 08380, Republic of Korea
| | - Yeong Sim Choe
- Research Institute, Neurophet Inc., Seoul 08380, Republic of Korea
| | - Regina E. Y. Kim
- Research Institute, Neurophet Inc., Seoul 08380, Republic of Korea
| | - Soyoung Lee
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Wang SM, Kang DW, Kim HJ, Park SS, Lim HK. Neuroplastic and Pro-cognitive Effects of Granulocyte Colony Stimulating Factor in Healthy Adults: A Pilot Study. Psychiatry Investig 2023; 20:984-990. [PMID: 37899222 PMCID: PMC10620331 DOI: 10.30773/pi.2023.0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/29/2023] [Accepted: 08/13/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE Granulocyte colony-stimulating factor (G-CSF) is a growth factor used to regulate the mobilization of bone marrow progenitor cells and has been shown to promote brain repair and reduce inflammation. This study aimed to investigate the pro-cognitive and neuroplastic effects of G-CSF in healthy adults. METHODS Sixteen healthy adults or donors of hematopoietic stem cell transplantation received G-CSF injections for 5 consecutive days, and their blood samples were collected before, immediately after, and 3 weeks after the G-CSF injections. Twelve subjects underwent neuropsychological testing before and 12 weeks after the G-CSF injections. RESULTS The study found that G-CSF administration resulted in significant improvements in cognitive function, as measured by the Rey- Osterrieth Complex Figure test for immediate recall, delayed recall, and recognition score at 12 weeks after the injections. The blood levels of brain-derived neurotrophic factor, interleukin-4, and interleukin-8 were significantly increased immediately after the injections and returned to baseline levels after 3 weeks. There was no significant change in the plasma level of Multimer Detection System-oligomerized amyloid beta. CONCLUSION Our results might suggest that G-CSF has neuroplastic and pro-cognitive effects in healthy adults. However, further study containing a larger sample size is needed to confirm our findings.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hee-Je Kim
- Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Soo Park
- Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Kim HB, Kim SH, Um YH, Wang SM, Kim REY, Choe YS, Lee J, Kim D, Lim HK, Lee CU, Kang DW. Modulation of associations between education years and cortical volume in Alzheimer's disease vulnerable brain regions by Aβ deposition and APOE ε4 carrier status in cognitively normal older adults. Front Aging Neurosci 2023; 15:1248531. [PMID: 37829142 PMCID: PMC10565031 DOI: 10.3389/fnagi.2023.1248531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/05/2023] [Indexed: 10/14/2023] Open
Abstract
Background Education years, as a measure of cognitive reserve, have been shown to affect the progression of Alzheimer's disease (AD), both pathologically and clinically. However, inconsistent results have been reported regarding the association between years of education and intermediate structural changes in AD-vulnerable brain regions, particularly when AD risk factors were not considered during the preclinical phase. Objective This study aimed to examine how Aβ deposition and APOE ε4 carrier status moderate the relationship between years of education and cortical volume in AD-vulnerable regions among cognitively normal older adults. Methods A total of 121 participants underwent structural MRI, [18F] flutemetamol PET-CT imaging, and neuropsychological battery assessment. Multiple regression analysis was conducted to examine the interaction between years of education and the effects of potential modifiers on cortical volume. The associations between cortical volume and neuropsychological performance were further explored in subgroups categorized based on AD risk factors. Results The cortical volume of the left lateral occipital cortex and bilateral fusiform gyrus demonstrated a significant differential association with years of education, depending on the presence of Aβ deposition and APOE ε4 carrier status. Furthermore, a significant relationship between the cortical volume of the bilateral fusiform gyrus and AD-nonspecific cognitive function was predominantly observed in individuals without AD risk factors. Conclusion AD risk factors exerted varying influences on the association between years of education and cortical volume during the preclinical phase. Further investigations into the long-term implications of these findings would enhance our understanding of cognitive reserves in the preclinical stages of AD.
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Affiliation(s)
- Hak-Bin Kim
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Hwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | - Yeong Sim Choe
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Jiyeon Lee
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Kang DW, Wang SM, Um YH, Kim S, Kim T, Kim D, Lee CU, Lim HK. Impact of transcranial direct current stimulation on white matter microstructure integrity in mild cognitive impairment patients according to effect modifiers as risk factors for Alzheimer's disease. Front Aging Neurosci 2023; 15:1234086. [PMID: 37744398 PMCID: PMC10517264 DOI: 10.3389/fnagi.2023.1234086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Background Little research exists on how individual risk factors for Alzheimer's disease (AD) affect the intermediate phenotype after transcranial direct current stimulation (tDCS), despite the importance of precision medicine-based therapeutic approaches. Objective To determine how an application of sequential tDCS (2 mA/day, left dorsolateral prefrontal cortex, 10 sessions) affects changes in white matter (WM) microstructure integrity in 63 mild cognitive impairment (MCI) patients with effect modifiers such as Aβ deposition, APOE ε4 carrier status, BDNF Val66Met polymorphism status, and sex. Methods We examined individual effect modifier-by-tDCS interactions and multiple effect modifiers-by-tDCS interactions for diffusion metrics. We also evaluated the association between baseline Aβ deposition and changes in WM microstructure integrity following tDCS. Results We found that APOE ε4 carrier status and sex had a significant interaction with tDCS, resulting in increased fractional anisotropy (FA) in the right uncinate fasciculus (UF) after stimulation. Additionally, we observed multiple effect modifiers-by-tDCS interactions on WM integrity of the right UF, leading to a more pronounced increase in FA values in APOE ε4 carriers and females with Val66 homozygotes. Finally, baseline Aβ deposition was positively associated with a difference in FA of the left cingulum in the hippocampal area, which showed a positive association with the changes in the score for delayed memory. Conclusion Our study shows the differential impact of individual AD risk factors on changes in the early intermediate phenotype after sequential tDCS in MCI patients. This research emphasizes the importance of precision medicine approaches in tDCS for the prodromal stages of AD.
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Affiliation(s)
- Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - TaeYeong Kim
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
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Wang SM, Kang DW, Um YH, Kim S, Lee CU, Lim HK. Olfactory Dysfunction Is Associated with Cerebral Amyloid Deposition and Cognitive Function in the Trajectory of Alzheimer's Disease. Biomolecules 2023; 13:1336. [PMID: 37759734 PMCID: PMC10526796 DOI: 10.3390/biom13091336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Olfactory dysfunction is consistently observed in individuals with Alzheimer's disease (AD), but its association with beta-amyloid (Aβ) deposition remains unclear. This study aimed to investigate the relationship among olfactory function, cerebral Aβ deposition, and neuropsychological profiles in individuals with no cognitive impairment (NCI), mild cognitive impairment (MCI), and AD dementia. A total of 164 participants were included, and olfactory function was assessed using the brief smell identification test (B-SIT). Cerebral Aβ deposition was measured using [18F]-flutemetamol PET imaging (A-PET). The results show a significant group difference in olfactory function, with the highest impairment observed in the Aβ-positive MCI and AD dementia groups, and the impairment was the lowest in Aβ-negative NCI. Olfactory dysfunction was positively associated with cognitive impairments across multiple domains. Furthermore, individuals with Aβ deposition had lower olfactory function compared to those without Aβ, even within the same neuropsychological stage. The association between olfactory dysfunction and Aβ deposition was observed globally and in specific cortical regions. These findings suggest that olfactory dysfunction is associated with both cognitive function and cerebral Aβ pathology in the trajectory of AD. Olfactory deficits may serve as an additional marker for disease progression and contribute to understanding the underlying mechanisms of AD.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent Hospital, Suwon, Korea, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Wang SM, Kang DW, Um YH, Kim S, Lee CU, Lim HK. Depression Is Associated with the Aberration of Resting State Default Mode Network Functional Connectivity in Patients with Amyloid-Positive Mild Cognitive Impairment. Brain Sci 2023; 13:1111. [PMID: 37509041 PMCID: PMC10377088 DOI: 10.3390/brainsci13071111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Mild cognitive impairment (MCI) is an intermediate stage between normal aging and dementia, and a significant number of individuals with MCI progress to develop dementia. Depression is prevalent in MCI patients and has been found to influence the disease progression of MCI. The default mode network (DMN), a brain network associated with Alzheimer's disease (AD), and its functional connectivity might be a neurological mechanism linking depression and AD. However, the relationship between depression, DMN functional connectivity, and cerebral beta-amyloid (Aβ) pathology remains unclear. This study aimed to investigate DMN functional connectivity differences in Aβ-positive MCI patients with depression compared to those without depression. A total of 126 Aβ-positive MCI patients were included, with 66 having depression and 60 without depression. The results revealed increased functional connectivity in the anterior DMN in the depression group compared to the non-depression group. The functional connectivity of the anterior DMN positively correlated with depression severity but not with Aβ deposition. Our findings suggest that depression influences DMN functional connectivity in Aβ-positive MCI patients, and the depression-associated DMN functional connectivity aberrance might be an important neural mechanism linking depression, Aβ pathology, and disease progression in the trajectory of AD.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Department of Psychiatry, St. Vincent Hospital, Suwon, Korea, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
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Wang SM, Kang DW, Um YH, Kim S, Kim REY, Kim D, Lee CU, Lim HK. Cognitive Normal Older Adults with APOE-2 Allele Show a Distinctive Functional Connectivity Pattern in Response to Cerebral Aβ Deposition. Int J Mol Sci 2023; 24:11250. [PMID: 37511008 PMCID: PMC10380008 DOI: 10.3390/ijms241411250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/29/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
The ε2 allele of apolipoprotein E (ε2) has neuroprotective effects against beta-amyloid (Aβ) pathology in Alzheimer's disease (AD). However, its impact on the functional connectivity and hub efficiency in cognitively normal older adults (CN) with ε2 is unclear. We investigated the functional connectivity differences in the default mode network (DMN), salience network, and central executive network (CEN) between A-PET-negative (N = 29) and A-PET-positive (N = 15) CNs with ε2/ε2 or ε2/ε3 genotypes. The A-PET-positive CNs exhibited a lower anterior DMN functional connectivity, higher posterior DMN functional connectivity, and increased CEN functional connectivity compared to the A-PET-negative CNs. Cerebral Aβ retention was negatively correlated with anterior DMN functional connectivity and positively correlated with posterior DMN and anterior CEN functional connectivity. A graph theory analysis showed that the A-PET-positive CNs displayed a higher betweenness centrality in the middle frontal gyrus (left) and medial fronto-parietal regions (left). The betweenness centrality in the middle frontal gyrus (left) was positively correlated with Aβ retention. Our findings reveal a reversed anterior-posterior dissociation in the DMN functional connectivity and heightened CEN functional connectivity in A-PET-positive CNs with ε2. Hub efficiencies, measured by betweenness centrality, were increased in the DMN and CEN of the A-PET-positive CNs with ε2. These results suggest unique functional connectivity responses to Aβ pathology in CN individuals with ε2.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Regina E Y Kim
- Research Institute, Neurophet Inc., Seoul 08380, Republic of Korea
| | - Donghyeon Kim
- Research Institute, Neurophet Inc., Seoul 08380, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Kim RE, Lee M, Kang DW, Wang SM, Kim D, Lim HK. Effects of education mediated by brain size on regional brain volume in adults. Psychiatry Res Neuroimaging 2023; 330:111600. [PMID: 36780773 DOI: 10.1016/j.pscychresns.2023.111600] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/04/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND PURPOSE Brain structure and function change with age. Both educational attainments, a proxy for cognitive reserve, and intracranial volume (ICV), a proxy for brain reserve, could contribute to resilience against degenerative change in the brain with aging. Whether the effect of educational attainment on regional brain volume in adults is mediated by ICV is yet unclear. We aimed to investigate the direct and indirect effects (mediated through ICV) of education in early life on regional brain volume in later life. MATERIALS AND METHOD We investigated the association between ICV and education level and regional brain volume in adults using magnetic resonance imaging scans of 1,731 individuals from multicenter studies. The mediation effect of ICV was analyzed to determine the association between educational attainment at an earlier age and regional brain volume in adults. RESULTS Our results showed that the effect of education on regional brain volume was significantly mediated by ICV in both men and women. The indirect (mediated via ICV) effect of education on brain volume amounted to 75% of the total effect in the hippocampus (p < 0.001) and 100% in the frontal and insular gray matter (p < 0.001). CONCLUSION Our study demonstrated that the association between educational attainment in early life and regional brain volume in later life was largely mediated by ICV. Attention should be given to the effect of educational attainment and ICV on regional brain size in adults as a measurable resilience effect in brain aging.
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Affiliation(s)
- Regina Ey Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea; College of Medicine, Institute of Human Genomic Study, Korea University, Seoul, Republic of Korea; Department of Psychiatry, University of Iowa, Iowa, IA, United States of America
| | - Minho Lee
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Donghyeon Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
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Wang SM, Kang DW, Um YH, Kim S, Lee CU, Scheltens P, Lim HK. Plasma Oligomer β-Amyloid and White Matter Microstructural Integrity in Cognitively Normal Older Adults According to Cerebral Amyloid Deposition. J Prev Alzheimers Dis 2023; 10:837-846. [PMID: 37874106 DOI: 10.14283/jpad.2023.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND Multimer detection system-oligomeric amyloid-β (MDS-OAβ) measure plasma OAβ level, which is associated with earlier Alzheimer's disease (AD) pathology. However, no study has investigated MDS-OAβ differences in cognitive normal older adults (CN) with or without cerebral Aβ burden and its correlation with Aβ deposition and white matter (WM) integrity. OBJECTIVE To investigate associations among cerebral Aβ burden, MDS-OAβ, and WM integrity in CN. DESIGN This is a single center, cross-sectional study which used data from Catholic Aging Brain Imaging (CABI) database. SETTING CABI database contains brain scans of patients who visited the outpatient clinic at Catholic Brain Health Center, Yeouido St. Mary's Hospital, The Catholic University of Korea, between 2017 and 2022. PARTICIPANTS A total 34 amyloid-PET negative CN and 23 amyloid-PET positive CN were included. MEASUREMENTS Plasma Aβ level using MDS-OAβ, cerebral Aβ deposition level using global standardized uptake value ratio (SUVR) values, WM integrity using fractional anisotropy (FA) and mean diffusivity (MD), and cortical thickness from structural MRI were utilized. RESTULS The amyloid-PET positive group showed higher MDS-OAβ level than the amyloid-PET negative group (0.997 ± 0.19 vs. 0.79 ± 0.28, P <0.005), but they did not differ in WM integrity or cortical thickness. The MDS-OAβ positive group showed higher global cerebral Aβ deposition or mean global SUVR values (0.609 ± 0.135 vs. 0.533 ± 0.121 vs. P <0.05), lower regional FA of left forceps minor and the right superior longitudinal fasciculus (family-wise error rate, p <0.05), and lower cortical thickness of left fusiform (p <0.05, Monte Carlo simulation) than the MDS-OAβ negative group. MDS-OAβ was positively associated with global cerebral Aβ deposition (r=0.278, P <0.05) and negatively associated (r = - 0.324, P < 0.05) with regional WM integrity. CONCLUSIONS In this study, MDS-OAβ value demonstrated earlier and different AD pathology than cerebral Aβ retention according to amyloid-PET. Longitudinal studies are needed to elucidate the causal relationships of plasma OAβ and cerebral Aβ with WM integrity disturbance and cortical atrophy during the AD trajectory.
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Affiliation(s)
- Sheng-Min Wang
- Hyun Kook Lim, MD, PhD, Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, Korea, Tel; +82-2-3779-1048, Fax: +82-2-780-6577,
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Kang DW, Park SS, Choi HJ, Park JH, Lee JH, Lee SM, Choi JH, Moon J, Kim BG. One-Dimensional Porous Li-Confinable Hosts for High-Rate and Stable Li-Metal Batteries. ACS Nano 2022; 16:11892-11901. [PMID: 35737978 DOI: 10.1021/acsnano.2c01309] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Li-confinable core-shell hosts have been extensively studied because they mitigate Li dendrite growth and volume change by reducing the effective current density and storing Li inside the core space during consecutive cycling. However, despite these fascinating features, these hosts suffer from unwanted Li growth on their surface (i.e., top plating) due to the carbon shell hindering Li-ion movement especially at higher current densities and capacities, resulting in poor electrochemical performance. In this study, we propose a one-dimensional porous Li-confinable host with lithiophilic Au (Au@PHCF), which is synthesized by a scalable dual-nozzle electrospinning. Because of the well-interconnected conductive networks forming three-dimensional structure, porous shell design enabling facile Li-ion transport, and hollow core space with lithiophilic Au storing metallic Li, the Au@PHCF can suppress the Li top plating and improve the Li stripping/plating efficiency compared to their counterparts even at 5 mA cm-2, eventually achieving stable cycling performances of the LiFePO4 full cell and Au@PHCF-Li symmetric cell for over 1000 and 2000 cycles, respectively. Finite element analysis reveals that the structural merit and lithiophilicity of Au enable fast reversible Li operation at the designated core space of the Au@PHCF, implying that the structural design of the Li-confinable host is crucial for the stable operation of promising Li-metal batteries at a practical test level.
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Affiliation(s)
- Dong Woo Kang
- Next Generation Battery Research Center, Korea Electrotechnology Research Institute (KERI), 12 Jeongiui-gil, Seongsan-gu, Changwon-si, Gyeongsangnam-do 51543, Republic of Korea
| | - Seong Soo Park
- School of Energy Systems Engineering, Chung-Ang University, 84 Heukseok-ro, Dongjakgu, Seoul 06974, Republic of Korea
| | - Hong Jun Choi
- Next Generation Battery Research Center, Korea Electrotechnology Research Institute (KERI), 12 Jeongiui-gil, Seongsan-gu, Changwon-si, Gyeongsangnam-do 51543, Republic of Korea
| | - Jun-Ho Park
- Next Generation Battery Research Center, Korea Electrotechnology Research Institute (KERI), 12 Jeongiui-gil, Seongsan-gu, Changwon-si, Gyeongsangnam-do 51543, Republic of Korea
| | - Ji Hoon Lee
- School of Materials Science and Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu 41566, Republic of Korea
| | - Sang-Min Lee
- Graduate Institute of Ferrous and Energy Materials Technology, Pohang University of Science and Technology (POSTECH), 77 Cheongam-Ro, Nam-gu, Pohang, Gyeongbuk 37673, Republic of Korea
| | - Jeong-Hee Choi
- Next Generation Battery Research Center, Korea Electrotechnology Research Institute (KERI), 12 Jeongiui-gil, Seongsan-gu, Changwon-si, Gyeongsangnam-do 51543, Republic of Korea
- Electro-functional Materials Engineering, University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
| | - Janghyuk Moon
- School of Energy Systems Engineering, Chung-Ang University, 84 Heukseok-ro, Dongjakgu, Seoul 06974, Republic of Korea
| | - Byung Gon Kim
- Next Generation Battery Research Center, Korea Electrotechnology Research Institute (KERI), 12 Jeongiui-gil, Seongsan-gu, Changwon-si, Gyeongsangnam-do 51543, Republic of Korea
- Electro-functional Materials Engineering, University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
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Kang DW, Wang SM, Um YH, Kim NY, Lee CU, Lim HK. Associations Between Sub-Threshold Amyloid-β Deposition, Cortical Volume, and Cognitive Function Modulated by APOE ɛ4 Carrier Status in Cognitively Normal Older Adults. J Alzheimers Dis 2022; 89:1003-1016. [PMID: 35964194 PMCID: PMC9535581 DOI: 10.3233/jad-220427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: There has been renewed interest in the deteriorating effects of sub-threshold amyloid-β (Aβ) accumulation in Alzheimer’s disease (AD). Despite evidence suggesting a synergistic interaction between the APOE ɛ4 allele and Aβ deposition in neurodegeneration, few studies have investigated the modulatory role of this allele in sub-threshold Aβ deposition during the preclinical phase. Objective: We aimed to explore the differential effect of the APOE ɛ4 carrier status on the association between sub-threshold Aβ deposition, cortical volume, and cognitive performance in cognitively normal older adults (CN). Methods: A total of 112 CN with sub-threshold Aβ deposition was included in the study. Participants underwent structural magnetic resonance imaging, [18F] flutemetamol PET-CT, and a neuropsychological battery. Potential interactions between APOE ɛ4 carrier status, Aβ accumulation, and cognitive function for cortical volume were assessed with whole-brain voxel-wise analysis. Results: We found that greater cortical volume was observed with higher regional Aβ deposition in the APOE ɛ4 carriers, which could be attributed to an interaction between the APOE ɛ4 carrier status and regional Aβ deposition in the posterior cingulate cortex/precuneus. Finally, the APOE ɛ4 carrier status-neuropsychological test score interaction demonstrated a significant effect on the gray matter volume of the left middle occipital gyrus. Conclusion: There might be a compensatory response to initiating Aβ in APOE ɛ4 carriers during the earliest AD stage. Despite its exploratory nature, this study offers some insight into recent interests concerning probabilistic AD modeling, focusing on the modulating role of the APOE ɛ4 carrier status during the preclinical period.
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Affiliation(s)
- Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Nak Young Kim
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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23
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Kang DW, Wang SM, Um YH, Kim NY, Lee CU, Lim HK. Impact of APOE ε4 Carrier Status on Associations Between Subthreshold, Positive Amyloid-β Deposition, Brain Function, and Cognitive Performance in Cognitively Normal Older Adults: A Prospective Study. Front Aging Neurosci 2022; 14:871323. [PMID: 35677201 PMCID: PMC9168227 DOI: 10.3389/fnagi.2022.871323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/12/2022] [Indexed: 12/19/2022] Open
Abstract
BackgroundA growing body of evidence suggests a deteriorating effect of subthreshold amyloid-beta (Aβ) accumulation on cognition before the onset of clinical symptoms of Alzheimer's disease (AD). Despite the association between the Aβ-dependent pathway and the APOE ε4 allele, the impact of this allele on the progression from the subthreshold Aβ deposits to cognitive function impairment is unclear. Furthermore, the comparative analysis of positive Aβ accumulation in the preclinical phase is lacking.ObjectiveThis study aimed to explore the differential effect of the APOE ε4 carrier status on the association between Aβ deposition, resting-state brain function, and cognitive performance in cognitively normal (CN) older adults, depending on the Aβ burden status.MethodsOne hundred and eighty-two older CN adults underwent resting-state functional magnetic resonance imaging, [18F] flutemetamol (FMM) positron emission tomography, a neuropsychological battery, and APOE genotyping. We evaluated the resting-state brain function by measuring the local and remote functional connectivity (FC) and measured the remote FC in the default-mode network (DMN), central-executive network (CEN), and salience network (SN). In addition, the subjects were dichotomized into those with subthreshold and positive Aβ deposits using a neocortical standardized uptake value ratio with the cut-off value of 0.62, which was calculated with respect to the pons.ResultsThe present result showed that APOE ε4 carrier status moderated the relationship between Aβ deposition, local and remote resting-state brain function, and cognitive performance in each CN subthreshold and positive Aβ group. We observed the following: (i) the APOE ε4 carrier status-Aβ deposition and APOE ε4 carrier status-local FC interaction for the executive and memory function; (ii) the APOE ε4 carrier status-regional Aβ accumulation interaction for the local FC; and (iv) the APOE ε4 carrier status-local FC interaction for the remote inter-network FC between the DMN and CEN, contributing higher cognitive performance in the APOE ε4 carrier with higher inter-network FC. Finally, these results were modulated according to Aβ positivity.ConclusionThis study is the first attempt to thoroughly examine the influence of the APOE ε4 carrier status from the subthreshold to positive Aβ accumulation during the preclinical phase.
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Affiliation(s)
- Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Uiwang, South Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- *Correspondence: Hyun Kook Lim
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Kim K, Kang DW, Yun CY, Choi Y, Lee JW. Fundamental reaction kinetics of high-pressure reductive amination of polyalkylene glycol. J IND ENG CHEM 2022. [DOI: 10.1016/j.jiec.2021.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Um YH, Wang SM, Kang DW, Kim NY, Lim HK. Subcortical and Cerebellar Neural Correlates of Prodromal Alzheimer’s Disease with Prolonged Sleep Latency. J Alzheimers Dis 2022; 86:565-578. [PMID: 35068468 PMCID: PMC9028620 DOI: 10.3233/jad-215460] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Despite the important associations among sleep, Alzheimer’s disease (AD), subcortical structures, and the cerebellum, structural and functional magnetic resonance imaging (MRI) with regard to these regions and sleep on patients in AD trajectory are scarce. Objective: This study aimed to evaluate the influence of prolonged sleep latency on the structural and functional alterations in the subcortical and cerebellar neural correlates in amyloid-β positive amnestic mild cognitive impairment patients (Aβ+aMCI). Methods: A total of 60 patients with aMCI who were identified as amyloid positive ([18F] flutemetamol+) were recruited in the study, 24 patients with normal sleep latency (aMCI-n) and 36 patients prolonged sleep latency (aMCI-p). Cortical thickness and volumes between the two groups were compared. Volumetric analyses were implemented on the brainstem, thalamus, and hippocampus. Subcortical and cerebellar resting state functional connectivity (FC) differences were measured between the both groups through seed-to-voxel analysis. Additionally, group x Aβ interactive effects on FC values were tested with a general linear model. Result: There was a significantly decreased brainstem volume in aMCI-p subjects. We observed a significant reduction of the locus coeruleus (LC) FC with frontal, temporal, insular cortices, hippocampus, and left thalamic FC with occipital cortex. Moreover, the LC FC with occipital cortex and left hippocampal FC with frontal cortex were increased in aMCI-p subjects. In addition, there was a statistically significant group by regional standardized uptake value ratio interactions discovered in cerebro-cerebellar networks. Conclusion: The aforementioned findings suggest that prolonged sleep latency may be a detrimental factor in compromising structural and functional correlates of subcortical structures and the cerebellum, which may accelerate AD pathophysiology.
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Um YH, Wang SM, Kang DW, Kim NY, Lim HK. Alterations of Resting-State Locus Coeruleus Functional Connectivity After Transdermal Trigeminal Electrical Neuromodulation in Insomnia. Front Psychiatry 2022; 13:875227. [PMID: 35619611 PMCID: PMC9127056 DOI: 10.3389/fpsyt.2022.875227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Transdermal trigeminal electrical neuromodulation (TTEN) is a novel treatment modality that is known for noradrenergic modulation through the trigeminal nerve and locus coeruleus (LC). This study aimed to demonstrate the alterations of LC functional connectivity (FC) in patients with insomnia after a 4-week TTEN. METHODS The Cefaly device targeting the ophthalmic division of the trigeminal nerve was applied to a total of 12 patients with insomnia to monitor for the effects of TTEN. All the patients went through a 4-week daily 20 min TTEN sessions before bedtime. Baseline and post-TTEN demographic data, polysomnography (PSG) parameters, and insomnia severity index (ISI) were attained. Data from pre- and post-intervention resting-state functional magnetic resonance imaging (MRI) were collected. LC FC differences were measured between the pre-and post-TTEN groups through seed-to-voxel analysis. Correlation analyses were conducted between LC FC changes after TTEN, ISI score changes, and PSG parameter changes. RESULTS There was a significantly decreased LC FC with occipital and temporal cortices after a 4-week TTEN. However, there was no significant correlation between LC FC, ISI score changes, and PSG parameter changes. CONCLUSION By targeting hyperarousal symptoms of insomnia, TTEN can be a promising intervention that can modulate LC FC in patients with insomnia patients. The data presented in the study are from a study exploring the effect of TTEN on insomnia (www.clinicaltrials.gov, NCT04838067).
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Choi HJ, Kang DW, Park J, Park J, Lee Y, Ha Y, Lee S, Yoon SY, Kim BG. In Situ Formed Ag-Li Intermetallic Layer for Stable Cycling of All-Solid-State Lithium Batteries. Adv Sci (Weinh) 2022; 9:e2103826. [PMID: 34802193 PMCID: PMC8728838 DOI: 10.1002/advs.202103826] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/14/2021] [Indexed: 05/15/2023]
Abstract
With the timely advent of the electric vehicle era, where battery stability has emerged as a major issue, all-solid-state batteries (ASSBs) have attracted significant attention as the game changer owing to their high stability. However, despite the introduction of a densely packed solid electrolyte (SE) layer, when Li is used to increase the energy density of the cell, the short-circuit problem caused by Li protrusion is unavoidable. Furthermore, most strategies to control nonuniform Li growth are so complicated that they hinder the practical application of ASSBs. To overcome these limitations, this study proposes an Ag-Li alloy anode via mass-producible roll pressing method. Unlike previous studies reporting solid-solution-based metal alloys containing a small amount of lithiophilic Ag, the in situ formed and Ag-enriched Ag-Li intermetallic layer mitigates uneven Li deposition and maintains a stable SE/Ag-Li interface, facilitating reversible Li operation. Contrary to Li cells showing frequent initial short-circuit, the cell incorporating the Ag-Li anode exhibits a better capacity retention of 94.3% for 140 cycles, as well as stable cycling even under 12 C. Through a facile approach enabling the fabrication of a large-area anode with controllable Li growth, this study provides practical insight for developing ASSBs with stable cyclabilities.
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Affiliation(s)
- Hong Jun Choi
- Next Generation Battery Research CenterKorea Electrotechnology Research Institute (KERI)12, Jeongiui‐gil, Seongsan‐guChangwon‐siGyeongsangnam‐do51543Republic of Korea
- School of Materials Science and EngineeringPusan National University2, Busandaehak‐ro 63beon‐gil, Geumjeong‐guBusan46241Republic of Korea
| | - Dong Woo Kang
- Next Generation Battery Research CenterKorea Electrotechnology Research Institute (KERI)12, Jeongiui‐gil, Seongsan‐guChangwon‐siGyeongsangnam‐do51543Republic of Korea
| | - Jun‐Woo Park
- Next Generation Battery Research CenterKorea Electrotechnology Research Institute (KERI)12, Jeongiui‐gil, Seongsan‐guChangwon‐siGyeongsangnam‐do51543Republic of Korea
| | - Jun‐Ho Park
- Next Generation Battery Research CenterKorea Electrotechnology Research Institute (KERI)12, Jeongiui‐gil, Seongsan‐guChangwon‐siGyeongsangnam‐do51543Republic of Korea
| | - Yoo‐Jin Lee
- Next Generation Battery Research CenterKorea Electrotechnology Research Institute (KERI)12, Jeongiui‐gil, Seongsan‐guChangwon‐siGyeongsangnam‐do51543Republic of Korea
| | - Yoon‐Cheol Ha
- Next Generation Battery Research CenterKorea Electrotechnology Research Institute (KERI)12, Jeongiui‐gil, Seongsan‐guChangwon‐siGyeongsangnam‐do51543Republic of Korea
| | - Sang‐Min Lee
- Graduate Institute of Ferrous and Energy Materials TechnologyPohang University of Science and Technology (POSTECH)77 Cheongam‐Ro, Nam‐guPohangGyeongbuk37673Republic of Korea
| | - Seog Young Yoon
- School of Materials Science and EngineeringPusan National University2, Busandaehak‐ro 63beon‐gil, Geumjeong‐guBusan46241Republic of Korea
| | - Byung Gon Kim
- Next Generation Battery Research CenterKorea Electrotechnology Research Institute (KERI)12, Jeongiui‐gil, Seongsan‐guChangwon‐siGyeongsangnam‐do51543Republic of Korea
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Kang DW, Lim HK, Wang S, Um YH. Differential impact of sub‐threshold amyloid‐beta deposition on regional homogeneity for cognitively normal older adults according to
APOE
genotype: Whole brain voxel‐wise analysis. Alzheimers Dement 2021. [DOI: 10.1002/alz.057718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Hyun Kook Lim
- College of Medicine The Catholic University of Korea Seoul South Korea
| | | | - Yoo Hyun Um
- St. Vincent' Hospital College of Medicine The Catholic University of Korea Suwon South Korea
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Kang DW, Lim HK, Wang S, Um YH. Differential impact of sub‐threshold amyloid‐beta deposition on gray matter volume for cognitively normal older adults according to
APOE
genotype: Whole brain voxel‐wise analysis. Alzheimers Dement 2021. [DOI: 10.1002/alz.057680] [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: 11/10/2022]
Affiliation(s)
| | - Hyun Kook Lim
- College of Medicine The Catholic University of Korea Seoul South Korea
| | | | - Yoo Hyun Um
- St. Vincent' Hospital College of Medicine The Catholic University of Korea Suwon South Korea
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Wang SM, Kim NY, Um YH, Kang DW, Na HR, Lee CU, Lim HK. Default mode network dissociation linking cerebral beta amyloid retention and depression in cognitively normal older adults. Neuropsychopharmacology 2021; 46:2180-2187. [PMID: 34158614 PMCID: PMC8505502 DOI: 10.1038/s41386-021-01072-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/12/2021] [Indexed: 11/09/2022]
Abstract
Cerebral beta amyloid (Aβ) deposition and late-life depression (LLD) are known to be associated with the trajectory of Alzheimer's disease (AD). However, their neurobiological link is not clear. Previous studies showed aberrant functional connectivity (FC) changes in the default mode network (DMN) in early Aβ deposition and LLD, but its mediating role has not been elucidated. This study was performed to investigate the distinctive association pattern of DMN FC linking LLD and Aβ retention in cognitively normal older adults. A total of 235 cognitively normal older adults with (n = 118) and without depression (n = 117) underwent resting-state functional magnetic resonance imaging and 18F-flutemetamol positron emission tomography to investigate the associations between Aβ burden, depression, and DMN FC. Independent component analysis showed increased anterior DMN FC and decreased posterior DMN FC in the depression group compared with the no depression group. Global cerebral Aβ retention was positively correlated with anterior and negatively correlated with posterior DMN FC. Anterior DMN FC was positively correlated with severity of depression, whereas posterior DMN FC was negatively correlated with cognitive function. In addition, the effects of global cerebral Aβ retention on severity of depression were mediated by subgenual anterior cingulate FC. Our results of anterior and posterior DMN FC dissociation pattern may be pivotal in linking cerebral Aβ pathology and LLD in the course of AD progression. Further longitudinal studies are needed to confirm the causal relationships between cerebral Aβ retention and LLD.
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Affiliation(s)
- Sheng-Min Wang
- grid.411947.e0000 0004 0470 4224Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Nak-Young Kim
- Department of Psychiatry, Geyo Hospital, Uiwang, South Korea
| | - Yoo Hyun Um
- grid.411947.e0000 0004 0470 4224Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Dong Woo Kang
- grid.411947.e0000 0004 0470 4224Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hae-Ran Na
- grid.411947.e0000 0004 0470 4224Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang Uk Lee
- grid.411947.e0000 0004 0470 4224Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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Um YH, Wang SM, Kang DW, Kim NY, Lim HK. Impact of transdermal trigeminal electrical neuromodulation on subjective and objective sleep parameters in patients with insomnia: a pilot study. Sleep Breath 2021; 26:865-870. [PMID: 34383274 DOI: 10.1007/s11325-021-02459-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/02/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Transcutaneous trigeminal electrical neuromodulation (TTEN) is a new treatment modality that has a potential to improve sleep through the suppression of noradrenergic activity. This study aimed to explore the changes of subjective and objective sleep parameters after 4-weeks of daily session of transcutaneous trigeminal electrical neuromodulation in a group of patients with insomnia. METHODS In a group of patients with insomnia, TTEN targeting the ophthalmic division of the trigeminal nerve was utilized to test the effects of transcutaneous trigeminal electrical neuromodulation. Patients went through daily 20-min sessions of TTEN for 4 weeks. Polysomnography parameters, Pittsburgh sleep quality index, insomnia severity index, and Epworth sleepiness scale were obtained pre- and post-intervention. Changes in these parameters were compared and analyzed. RESULTS Among 13 patients with insomnia there was a statistically significant reduction in Pittsburgh sleep quality index, insomnia severity index, and Epworth sleepiness scale scores after 4-week daily sessions of TTEN. There were no differences in polysomnography parameters pre- and post-intervention. CONCLUSION This is the first study to demonstrate the effects of TTEN in a group of insomnia patients. TTEN may improve subjective parameters in patients with insomnia. Further replication studies are needed to support this finding. TRIAL REGISTRATION The data presented in the study are from a study exploring the effect of TTEN on insomnia ( www.clinicaltrials.gov , registration number: NCT04838067, date of registration: April 8, 2021, "retrospectively registered").
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St.Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Kang DW, Wang SM, Um YH, Na HR, Kim NY, Lee CU, Lim HK. Distinctive Association of the Functional Connectivity of the Posterior Cingulate Cortex on Memory Performances in Early and Late Amnestic Mild Cognitive Impairment Patients. Front Aging Neurosci 2021; 13:696735. [PMID: 34276347 PMCID: PMC8281268 DOI: 10.3389/fnagi.2021.696735] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022] Open
Abstract
Background Attempts have been made to explore the biological basis of neurodegeneration in the amnestic mild cognitive impairment (MCI) stage, subdivided by memory performance. However, few studies have evaluated the differential impact of functional connectivity (FC) on memory performances in early- and late-MCI patients. Objective This study aims to explore the difference in FC of the posterior cingulate cortex (PCC) among healthy controls (HC) (n = 37), early-MCI patients (n = 30), and late-MCI patients (n = 35) and to evaluate a group-memory performance interaction against the FC of PCC. Methods The subjects underwent resting-state functional MRI scanning and a battery of neuropsychological tests. Results A significant difference among the three groups was found in FC between the PCC (seed region) and bilateral crus cerebellum, right superior medial frontal gyrus, superior temporal gyrus, and left middle cingulate gyrus (Monte Carlo simulation-corrected p < 0.01; cluster p < 0.05). Additionally, the early-MCI patients displayed higher FC values than the HC and late-MCI patients in the right superior medial frontal gyrus, cerebellum crus 1, and left cerebellum crus 2 (Bonferroni-corrected p < 0.05). Furthermore, there was a significant group-memory performance interaction (HC vs. early MCI vs. late MCI) for the FC between PCC and bilateral crus cerebellum, right superior medial frontal gyrus, superior temporal gyrus, and left middle cingulate gyrus (Bonferroni-corrected p < 0.05). Conclusion These findings contribute to the biological implications of early- and late-MCI stages, categorized by evaluating the impairment of memory performance. Additionally, comprehensively analyzing the structural differences in the subdivided amnestic MCI (aMCI) stages could deepen our understanding of these biological meanings.
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Affiliation(s)
- Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Uiwang, South Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Wang SM, Park SH, Kim NY, Kang DW, Na HR, Um YH, Han S, Park SS, Lim HK. Association between Dementia and Clinical Outcome after COVID-19: A Nationwide Cohort Study with Propensity Score Matched Control in South Korea. Psychiatry Investig 2021; 18:523-529. [PMID: 34218641 PMCID: PMC8256148 DOI: 10.30773/pi.2021.0064] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/31/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Despite a high prevalence of dementia in older adults hospitalized with severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2), or so called COVID-19, research investigating association between preexisting diagnoses of dementia and prognosis of COVID-19 is scarce. We aimed to investigate treatment outcome of patients with dementia after COVID-19. METHODS We explored a nationwide cohort with a total of 2,800 subjects older than 50 years who were diagnosed with COVID-19 between January and April 2020. Among them, 223 patients had underlying dementia (dementia group). We matched 1:1 for each dementia- non-dementia group pair yielding 223 patients without dementia (no dementia group) using propensity score matching. RESULTS Mortality rate after COVID-19 was higher in dementia group than in no dementia group (33.6% vs. 20.2%, p=0.002). Dementia group had higher proportion of patients requiring invasive ventilatory support than no dementia group (34.1% vs. 22.0%, p=0.006). Multivariable analysis showed that dementia group had a higher risk of mortality than no dementia group (odds ratio=3.05, p<0.001). We also found that patients in dementia group had a higher risk of needing invasive ventilatory support than those in no dementia group. CONCLUSION Our results suggest that system including strengthen quarantines are required for patients with dementia during the COVID- 19 pandemic.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - See Hyun Park
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Seunghoon Han
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Soo Park
- Department of Hematology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Wang SM, Park SS, Park SH, Kim NY, Kang DW, Na HR, Bae YY, Lee JW, Han S, Lim HK. Pre-transplant Dementia is Associated with Poor Survival After Hematopoietic Stem Cell Transplantation: A Nationwide Cohort Study with Propensity Score Matched Control. Clin Psychopharmacol Neurosci 2021; 19:294-302. [PMID: 33888658 PMCID: PMC8077055 DOI: 10.9758/cpn.2021.19.2.294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/14/2020] [Accepted: 10/26/2020] [Indexed: 01/07/2023]
Abstract
Objective No previous study examined impact of dementia in the outcome of allogeneic hematopoietic stem cell transplantation (HSCT). We aimed to investigate overall survival (OS) of patients with dementia after receiving HSCT. Methods Among 8,230 patients who underwent HSCT between 2002 and 2018, 5,533 patients younger than 50 years were first excluded. Remaining patients were divided into those who were and were not diagnosed with dementia before HSCT (dementia group n = 31; no dementia n = 2,666). Thereafter, among 2,666 participants without dementia, 93 patients were selected via propensity-matched score as non-dementia group. Patients were followed from the day they received HSCT to the occurrence of death or the last follow-up day (December 31, 2018), whichever came first. Results With median follow-up of 621 days for dementia group and 654 days for non-dementia group, 2 year-OS of dementia group was lower than that of non-dementia group (53.3% [95% confidence interval, 95% CI, 59.0−80.2%] vs. 68.8% [95% CI, 38.0−68.2%], p = 0.076). In multivariate analysis, dementia had significant impacts on OS (hazard risk = 2.539, 95% CI, 1.166−4.771, p = 0.017). Conclusion Our results indicated that patients diagnosed with dementia before HSCT have 2.539 times higher risk of mortality after transplantation than those not having dementia. With number of elderly needing HSCT is increasing, further work to establish treatment guidelines for the management of HSCT in people with dementia is needed.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Soo Park
- Department of Hematology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - See Hyun Park
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Nak-Young Kim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Yi Bae
- Department of Hematology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Wook Lee
- Department of Hematology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seunghoon Han
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Rieu Z, Kim J, Kim REY, Lee M, Lee MK, Oh SW, Wang SM, Kim NY, Kang DW, Lim HK, Kim D. Semi-Supervised Learning in Medical MRI Segmentation: Brain Tissue with White Matter Hyperintensity Segmentation Using FLAIR MRI. Brain Sci 2021; 11:720. [PMID: 34071634 PMCID: PMC8228966 DOI: 10.3390/brainsci11060720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022] Open
Abstract
White-matter hyperintensity (WMH) is a primary biomarker for small-vessel cerebrovascular disease, Alzheimer's disease (AD), and others. The association of WMH with brain structural changes has also recently been reported. Although fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) provide valuable information about WMH, FLAIR does not provide other normal tissue information. The multi-modal analysis of FLAIR and T1-weighted (T1w) MRI is thus desirable for WMH-related brain aging studies. In clinical settings, however, FLAIR is often the only available modality. In this study, we thus propose a semi-supervised learning method for full brain segmentation using FLAIR. The results of our proposed method were compared with the reference labels, which were obtained by FreeSurfer segmentation on T1w MRI. The relative volume difference between the two sets of results shows that our proposed method has high reliability. We further evaluated our proposed WMH segmentation by comparing the Dice similarity coefficients of the reference and the results of our proposed method. We believe our semi-supervised learning method has a great potential for use for other MRI sequences and will encourage others to perform brain tissue segmentation using MRI modalities other than T1w.
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Affiliation(s)
- ZunHyan Rieu
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (Z.R.); (R.E.K.); (M.L.)
| | - JeeYoung Kim
- Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06247, Korea; (J.K.); (S.W.O.)
| | - Regina EY Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (Z.R.); (R.E.K.); (M.L.)
| | - Minho Lee
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (Z.R.); (R.E.K.); (M.L.)
| | - Min Kyoung Lee
- Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06247, Korea;
| | - Se Won Oh
- Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06247, Korea; (J.K.); (S.W.O.)
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06247, Korea; (S.-M.W.); (N.-Y.K.)
| | - Nak-Young Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06247, Korea; (S.-M.W.); (N.-Y.K.)
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06247, Korea; (S.-M.W.); (N.-Y.K.)
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (Z.R.); (R.E.K.); (M.L.)
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Kang DW, Hwang WC, Noh YN, Che X, Lee SH, Jang Y, Choi KY, Choi JY, Min DS. Deletion of phospholipase D1 decreases bone mass and increases fat mass via modulation of Runx2, β-catenin-osteoprotegerin, PPAR-γ and C/EBPα signaling axis. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166084. [PMID: 33497821 DOI: 10.1016/j.bbadis.2021.166084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/12/2021] [Accepted: 01/20/2021] [Indexed: 11/16/2022]
Abstract
In osteoporosis, mesenchymal stem cells (MSCs) prefer to differentiate into adipocytes at the expense of osteoblasts. Although the balance between adipogenesis and osteogenesis has been closely examined, the mechanism of commitment determination switch is unknown. Here we demonstrate that phospholipase D1 (PLD1) plays a key switch in determining the balance between bone and fat mass. Ablation of Pld1 reduced bone mass but increased fat in mice. Mechanistically, Pld1/- MSCs inhibited osteoblast differentiaion with diminished Runx2 expression, while osteoclast differentiation was accelerated in Pld1-/- bone marrow-derived macrophages. Pld1-/- osteoblasts showed decreased expression of osteogenic makers. Increased number and resorption activity of osteoclasts in Pld1-/- mice were corroborated with upregulation of osteoclastogenic markers. Moreover, Pld1-/- osteoblasts reduced β-catenin mediated-osteoprotegerin (OPG) with increased RANKL/OPG ratio which resulted in accelerated osteoclast differentiation. Thus, low bone mass with upregulated osteoclasts could be due to the contribution of both osteoblasts and osteoclasts during bone remodeling. Moreover, ablation of Pld1 further increased bone loss in ovariectomized mice, suggesting that PLD1 is a negative regulator of osteoclastogenesis. Furthermore, loss of PLD1 increased adipogenesis, body fat mass, and hepatic steatosis along with upregulation of PPAR-γ and C/EBPα. Interestingly, adipocyte-specific Pld1 transgenic mice rescued the compromised phenotypes of fat mass and adipogenesis in Pld1 knockout mice. Collectively, PLD1 regulated the bifurcating pathways of mesenchymal cell lineage into increased osteogenesis and decreased adipogenesis, which uncovered a previously unrecognized role of PLD1 in homeostasis between bone and fat mass.
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Affiliation(s)
- Dong Woo Kang
- Department of Molecular Biology, College of Natural Science, Pusan National University, Busan 609-735, Republic of Korea; Institute for Innovative Cancer Research, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Won Chan Hwang
- Department of Molecular Biology, College of Natural Science, Pusan National University, Busan 609-735, Republic of Korea; College of Pharmacy, Yonsei University, Incheon 21983, Republic of Korea
| | - Yu Na Noh
- Department of Molecular Biology, College of Natural Science, Pusan National University, Busan 609-735, Republic of Korea
| | - Xiangguo Che
- Department of Biochemistry and Cell Biology, Korea Mouse Phenotyping Center, Cell and Matrix Research Institute, BK21 Plus KNU Biomedical Convergence Program, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Soung-Hoon Lee
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - Younghoon Jang
- Department of Biology and Chemistry, Changwon National University, Changwon, Republic of Korea
| | - Kang-Yell Choi
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - Je-Yong Choi
- Department of Biochemistry and Cell Biology, Korea Mouse Phenotyping Center, Cell and Matrix Research Institute, BK21 Plus KNU Biomedical Convergence Program, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Do Sik Min
- College of Pharmacy, Yonsei University, Incheon 21983, Republic of Korea.
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Wang SM, Kim NY, Kang DW, Um YH, Na HR, Woo YS, Lee CU, Bahk WM, Lim HK. A Comparative Study on the Predictive Value of Different Resting-State Functional Magnetic Resonance Imaging Parameters in Preclinical Alzheimer's Disease. Front Psychiatry 2021; 12:626332. [PMID: 34177638 PMCID: PMC8226028 DOI: 10.3389/fpsyt.2021.626332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/23/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: Diverse resting-state functional magnetic resonance imaging (rs-fMRI) studies showed that rs-fMRI might be able to reflect the earliest detrimental effect of cerebral beta-amyloid (Aβ) pathology. However, no previous studies specifically compared the predictive value of different rs-fMRI parameters in preclinical AD. Methods: A total of 106 cognitively normal adults (Aβ+ group = 66 and Aβ- group = 40) were included. Three different rs-fMRI parameter maps including functional connectivity (FC), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) were calculated. Receiver operating characteristic (ROC) curve analyses were utilized to compare classification performance of the three rs-fMRI parameters. Results: FC maps showed the best classifying performance in ROC curve analysis (AUC, 0.915, p < 0.001). Good but weaker performance was achieved by using ReHo maps (AUC, 0.836, p < 0.001) and fALFF maps (AUC, 0.804, p < 0.001). The brain regions showing the greatest discriminative power included the left angular gyrus for FC, left anterior cingulate for ReHo, and left middle frontal gyrus for fALFF. However, among the three measurements, ROI-based FC was the only measure showing group difference in voxel-wise analysis. Conclusion: Our results strengthen the idea that rs-fMRI might be sensitive to earlier changes in spontaneous brain activity and FC in response to cerebral Aβ retention. However, further longitudinal studies with larger sample sizes are needed to confirm their utility in predicting the risk of AD.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Nak-Young Kim
- Department of Psychiatry, Keyo Hospital, Uiwang, South Korea
| | - Dong Woo Kang
- Department of Psychiatry, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Yoo Hyun Um
- Department of Psychiatry, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Hae-Ran Na
- Department of Psychiatry, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Chang Uk Lee
- Department of Psychiatry, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, College of Medicine, Catholic University of Korea, Seoul, South Korea
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Kang DW, Wang SM, Na HR, Kim NY, Lim HK, Lee CU. Differential Impact of Education on Gray Matter Volume According to Sex in Cognitively Normal Older Adults: Whole Brain Surface-Based Morphometry. Front Psychiatry 2021; 12:644148. [PMID: 33746800 PMCID: PMC7973038 DOI: 10.3389/fpsyt.2021.644148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background: The effect of educational status on brain structural measurements depends on demographic and clinical factors in cognitively healthy older adults. Objectives: The current study aimed to evaluate the impact of interaction between years of education and sex on gray matter volume and to investigate whether cortical volume has a differential impact on cognitive function according to sex. Methods: One hundred twenty-one subjects between 60 and 85 years old were included in this study. Gray matter volume was evaluated by whole brain surface-based morphometry. Multiple regression analysis was used to analyze the effects of sex-cortical volume interactions on cognitive functions. Results: There was a significant interaction between years of education and sex on the cortical volume of the left inferior temporal gyrus after adjusting for age, APOE ε4 allele prevalence, and total intracranial volume. In addition, we found a significant impact of the interaction between adjusted left inferior temporal volume and sex on CERAD-K total scores. Conclusion: These findings have significant implications for the understanding of how sex could affect the role of cognitive reserve for cortical atrophy in cognitively intact older adults.
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Affiliation(s)
- Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Nak-Young Kim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Kim J, Lee M, Lee MK, Wang SM, Kim NY, Kang DW, Um YH, Na HR, Woo YS, Lee CU, Bahk WM, Kim D, Lim HK. Development of Random Forest Algorithm Based Prediction Model of Alzheimer's Disease Using Neurodegeneration Pattern. Psychiatry Investig 2021; 18:69-79. [PMID: 33561931 PMCID: PMC7897872 DOI: 10.30773/pi.2020.0304] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/25/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Alzheimer's disease (AD) is the most common type of dementia and the prevalence rapidly increased as the elderly population increased worldwide. In the contemporary model of AD, it is regarded as a disease continuum involving preclinical stage to severe dementia. For accurate diagnosis and disease monitoring, objective index reflecting structural change of brain is needed to correctly assess a patient's severity of neurodegeneration independent from the patient's clinical symptoms. The main aim of this paper is to develop a random forest (RF) algorithm-based prediction model of AD using structural magnetic resonance imaging (MRI). METHODS We evaluated diagnostic accuracy and performance of our RF based prediction model using newly developed brain segmentation method compared with the Freesurfer's which is a commonly used segmentation software. RESULTS Our RF model showed high diagnostic accuracy for differentiating healthy controls from AD and mild cognitive impairment (MCI) using structural MRI, patient characteristics, and cognitive function (HC vs. AD 93.5%, AUC 0.99; HC vs. MCI 80.8%, AUC 0.88). Moreover, segmentation processing time of our algorithm (<5 minutes) was much shorter than of Freesurfer's (6-8 hours). CONCLUSION Our RF model might be an effective automatic brain segmentation tool which can be easily applied in real clinical practice.
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Affiliation(s)
- JeeYoung Kim
- Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Minho Lee
- Research Institute, NEUROPHET Inc., Seoul, Korea
| | - Min Kyoung Lee
- Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Nak-Young Kim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital Seoul, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sup Woo
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Kang DW, Wang SM, Um YH, Na HR, Kim NY, Han K, Lee CU, Lim HK. Differential Risk of Incident Fractures Depending on Intensity and Frequency of Physical Activity According to Cognitive Status: A Nationwide Longitudinal Study. Front Med (Lausanne) 2020; 7:572466. [PMID: 33364244 PMCID: PMC7753209 DOI: 10.3389/fmed.2020.572466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Previous studies have demonstrated an increased risk of fractures in subjects with various degrees of cognitive impairments. Recently, there has been growing recognition of the vital effect of physical activity (PA) on delay and prevention of fractures in older adults. Objectives: This study aimed to evaluate the optimal intensity and frequency of PA needed to prevent fractures in cognitively preserved older adults (CP), participants with subjective cognitive decline (SCD), and dementia patients using a large-scale nationwide cohort study. Methods: Data from a nationwide health screening program for individuals at the transitional age of 66 years were used in this study. A total of 968,240 subjects was enrolled, followed from 2007 to 2014, and classified as CP (n = 759,874), SCD (n = 195,365), or dementia group (n = 13,001). Adjusted hazard ratios (aHRs) by demographic and known risk factors for fractures were evaluated to identify the impact of various frequency and intensity PA on the occurrence of hip, vertebral, and limb fractures. Results: In CP participants, the most noticeable reduction of hip and vertebral fracture risk was shown in those performing vigorous-intensity PA at least three times per week. In the SCD group, the risk decrement in hip and vertebral fractures was most prominent in subjects who performed multiple-intensity PAs at least three times a week regardless of intensity. In the dementia group, only high-frequency walking and high-frequency & multiple-intensity PA decreased the risk of hip fractures compared with absence of PA. Conclusion: These findings suggest a role for various PA intensity and frequency levels to prevent hip and vertebral fractures according to cognitive status. Further study is needed to validate the effects of PA intensity and frequency proposed in this study on fractures according to cognitive status.
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Affiliation(s)
- Dong Woo Kang
- Department of Psychiatry, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Sheng-Min Wang
- Department of Psychiatry, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Yoo Hyun Um
- Department of Psychiatry, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, South Korea
| | - Hae-Ran Na
- Department of Psychiatry, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Nak-Young Kim
- Department of Psychiatry, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Chang Uk Lee
- Department of Psychiatry, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
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Kim REY, Lee M, Kang DW, Wang SM, Kim NY, Lee MK, Lim HK, Kim D. Deep Learning-Based Segmentation to Establish East Asian Normative Volumes Using Multisite Structural MRI. Diagnostics (Basel) 2020; 11:diagnostics11010013. [PMID: 33374745 PMCID: PMC7824436 DOI: 10.3390/diagnostics11010013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 11/16/2022] Open
Abstract
Normative brain magnetic resonance imaging (MRI) is essential to interpret the state of an individual's brain health. However, a normative study is often expensive for small research groups. Although several attempts have been made to establish brain MRI norms, the focus has been limited to certain age ranges. This study aimed to establish East Asian normative brain data using multi-site MRI and determine the robustness of these data for clinical research. Normative MRI was gathered covering a wide range of cognitively normal East Asian populations (age: 18-96 years) from two open sources and three research sites. Eight sub-regional volumes were extracted in the left and right hemispheres using an in-house deep learning-based tool. Repeated measure consistency and multicenter reliability were determined using intraclass correlation coefficients and compared to a widely used tool, FreeSurfer. Our results showed highly consistent outcomes with high reliability across sites. Our method outperformed FreeSurfer in repeated measure consistency for most structures and multicenter reliability for all structures. The normative MRI we constructed was able to identify sub-regional differences in mild cognitive impairments and dementia after covariate adjustments. Our investigation suggests it is possible to provide a sound normative reference for neurodegenerative or aging research.
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Affiliation(s)
- Regina E. Y. Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (R.E.Y.K.); (M.L.)
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul 15355, Korea
- Department of Psychiatry, University of Iowa, Iowa City, IA 52240, USA
| | - Minho Lee
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (R.E.Y.K.); (M.L.)
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (N.-Y.K.)
| | - Nak-Young Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (N.-Y.K.)
| | - Min Kyoung Lee
- Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (N.-Y.K.)
- Correspondence: (H.K.L.); (D.K.); Tel.: +82-70-5223-4414 (D.K.)
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (R.E.Y.K.); (M.L.)
- Correspondence: (H.K.L.); (D.K.); Tel.: +82-70-5223-4414 (D.K.)
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Kim K, Kang DW, Choi Y, Kim W, Lee H, Lee JW. Improved H 2 utilization by Pd doping in cobalt catalysts for reductive amination of polypropylene glycol. RSC Adv 2020; 10:45159-45169. [PMID: 35516265 PMCID: PMC9058643 DOI: 10.1039/d0ra10033a] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 12/11/2020] [Indexed: 11/21/2022] Open
Abstract
Cobalt based catalysts having enhanced H2 dissociation and desorption were synthesized by inserting a trace amount of palladium. These catalysts were used for the reductive amination of polypropylene glycol (PPG) to polyetheramine (PEA). The catalytic activity toward PEA was significantly increased by incorporating an extremely low content of palladium (around 0.01 wt%) into cobalt based catalysts. The Pd inserted cobalt catalysts promoted reduction of cobalt oxide to cobalt metal and inhibited formation of cobalt nitride in the reductive amination. The Pd inserted cobalt catalysts not only enhanced hydrogen dissociation but also accelerated hydrogen desorption by increasing the electron density of cobalt through interaction between cobalt and palladium. These play a critical role in reducing cobalt oxide or cobalt nitride to cobalt metal as an active site for the reductive amination. Thus, the Pd inserted cobalt catalysts provide improved catalytic performance toward PEA production by maintaining the cobalt metal state. Addition of Pd into Co helped remarkably to reduce cobalt oxide and nitride to cobalt metal by enhanced hydrogen dissociation and desorption.![]()
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Affiliation(s)
- Kyungjun Kim
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST) Daejeon 34141 Republic of Korea .,LOTTE CHEMICAL R&D Center Daejeon 34110 Republic of Korea
| | - Dong Woo Kang
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST) Daejeon 34141 Republic of Korea
| | - Youngheon Choi
- LOTTE CHEMICAL R&D Center Daejeon 34110 Republic of Korea
| | - Wanggyu Kim
- LOTTE CHEMICAL R&D Center Daejeon 34110 Republic of Korea
| | - Hyunjoo Lee
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST) Daejeon 34141 Republic of Korea
| | - Jae W Lee
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST) Daejeon 34141 Republic of Korea
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Lee M, Kim J, EY Kim R, Kim HG, Oh SW, Lee MK, Wang SM, Kim NY, Kang DW, Rieu Z, Yong JH, Kim D, Lim HK. Split-Attention U-Net: A Fully Convolutional Network for Robust Multi-Label Segmentation from Brain MRI. Brain Sci 2020; 10:E974. [PMID: 33322640 PMCID: PMC7764312 DOI: 10.3390/brainsci10120974] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/30/2020] [Accepted: 12/07/2020] [Indexed: 02/03/2023] Open
Abstract
Multi-label brain segmentation from brain magnetic resonance imaging (MRI) provides valuable structural information for most neurological analyses. Due to the complexity of the brain segmentation algorithm, it could delay the delivery of neuroimaging findings. Therefore, we introduce Split-Attention U-Net (SAU-Net), a convolutional neural network with skip pathways and a split-attention module that segments brain MRI scans. The proposed architecture employs split-attention blocks, skip pathways with pyramid levels, and evolving normalization layers. For efficient training, we performed pre-training and fine-tuning with the original and manually modified FreeSurfer labels, respectively. This learning strategy enables involvement of heterogeneous neuroimaging data in the training without the need for many manual annotations. Using nine evaluation datasets, we demonstrated that SAU-Net achieved better segmentation accuracy with better reliability that surpasses those of state-of-the-art methods. We believe that SAU-Net has excellent potential due to its robustness to neuroanatomical variability that would enable almost instantaneous access to accurate neuroimaging biomarkers and its swift processing runtime compared to other methods investigated.
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Affiliation(s)
- Minho Lee
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (M.L.); (R.E.K.); (Z.R.); (J.H.Y.)
| | - JeeYoung Kim
- Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea; (J.K.); (H.G.K.); (S.W.O.)
| | - Regina EY Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (M.L.); (R.E.K.); (Z.R.); (J.H.Y.)
- Institute of Human Genomic Study, College of Medicine, Korea University, Ansan 15355, Korea
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA
| | - Hyun Gi Kim
- Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea; (J.K.); (H.G.K.); (S.W.O.)
| | - Se Won Oh
- Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea; (J.K.); (H.G.K.); (S.W.O.)
| | - Min Kyoung Lee
- Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea;
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (N.-Y.K.)
| | - Nak-Young Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (N.-Y.K.)
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - ZunHyan Rieu
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (M.L.); (R.E.K.); (Z.R.); (J.H.Y.)
| | - Jung Hyun Yong
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (M.L.); (R.E.K.); (Z.R.); (J.H.Y.)
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (M.L.); (R.E.K.); (Z.R.); (J.H.Y.)
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (N.-Y.K.)
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Kang DW, Lee CU, Lim HK. Why do we need an Asian brain template in clinical trials of Alzheimer's disease? A comparative study of brain structures between Asian vs Caucasian brains. Alzheimers Dement 2020. [DOI: 10.1002/alz.039096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Chang Uk Lee
- Seoul St. Mary's Hospital Catholic Medical College the Catholic University of Korea Seoul South Korea
| | - Hyun Kook Lim
- College of Medicine The Catholic University of Korea Seoul South Korea
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Lee CU, Kang DW. Impact of repetitive transcranial magnetic stimulation with computerized cognitive enhancement training on change in cognitive function of mild cognitive impairment patients: Existing, sham treatment‐controlled, pilot study. Alzheimers Dement 2020. [DOI: 10.1002/alz.039713] [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)
- Chang Uk Lee
- Seoul St. Mary’s Hospital, The College of Medicine The Catholic University of Korea Seoul Korea
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Kang DW, Wang SM, Na HR, Park SY, Kim NY, Lee CU, Kim D, Son SJ, Lim HK. Differences in cortical structure between cognitively normal East Asian and Caucasian older adults: a surface-based morphometry study. Sci Rep 2020; 10:20905. [PMID: 33262399 PMCID: PMC7708477 DOI: 10.1038/s41598-020-77848-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 10/19/2020] [Indexed: 11/30/2022] Open
Abstract
There is a growing literature on the impact of ethnicity on brain structure and function. Despite the regional heterogeneity in age-related changes and non-uniformity across brain morphometry measurements in the aging process, paucity of studies investigated the difference in cortical anatomy between the East Asian and Caucasian older adults. The present study aimed to compare cortical anatomy measurements, including cortical thickness, volume and surface area, between cognitively normal East Asian (n = 171) and Caucasian (n = 178) older adults, using surface-based morphometry and vertex-wise group analysis of high-dimensional structural magnetic resonance imaging (MRI) data. The East Asian group showed greater cortical thickness and larger cortical volume in the right superior temporal gyrus, postcentral gyrus, bilateral inferior temporal gyrus, and inferior parietal cortex. The Caucasian group showed thicker and larger cortex in the left transverse temporal cortex, lingual gyrus, right lateral occipital cortex, and precentral gyrus. Additionally, the difference in surface area was discordant with that in cortical thickness. Differences in brain structure between the East Asian and Caucasian might reflect differences in language and information processing, but further studies using standardized methods for assessing racial characteristics are needed. The research results represent a further step towards developing a comprehensive understanding of differences in brain structure between ethnicities of older adults, and this would enrich clinical research on aging and neurodegenerative diseases.
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Affiliation(s)
- Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sonya Youngju Park
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Nak Young Kim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | | | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Kim K, Kang DW, Im HG, Choi Y, Lee JW. Effects of Propylene Oxide End Capping on Amination of Polyalkylene Glycols. ACS Omega 2020; 5:26545-26550. [PMID: 33110982 PMCID: PMC7581240 DOI: 10.1021/acsomega.0c03295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
Polyalkylene glycols with two different end-capping groups of ethylene oxide (EO) and propylene oxide (PO) were used for amination to produce polyetheramine (PEA) on cobalt-based catalysts. Although it is known that the amination of secondary alcohol is more difficult than that of primary alcohol, PO end-capped block copolymers showed remarkably enhanced activity toward PEA and selectivity toward the primary amine compared to EO end-capped block copolymers.
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Affiliation(s)
- Kyungjun Kim
- Department
of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291, Daehak-ro,
Yuseong-gu, Daejeon 34141, Republic of Korea
- LOTTE
Chemical R&D Center, 115, Gajeongbuk-ro, Yuseong-gu, Daejeon 34110, Republic of Korea
| | - Dong Woo Kang
- Department
of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291, Daehak-ro,
Yuseong-gu, Daejeon 34141, Republic of Korea
| | - Hyun Gyu Im
- LOTTE
Chemical R&D Center, 115, Gajeongbuk-ro, Yuseong-gu, Daejeon 34110, Republic of Korea
| | - Youngheon Choi
- LOTTE
Chemical R&D Center, 115, Gajeongbuk-ro, Yuseong-gu, Daejeon 34110, Republic of Korea
| | - Jae W. Lee
- Department
of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), 291, Daehak-ro,
Yuseong-gu, Daejeon 34141, Republic of Korea
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Hwang WC, Kang DW, Kang Y, Jang Y, Kim JA, Min DS. Inhibition of phospholipase D2 augments histone deacetylase inhibitor-induced cell death in breast cancer cells. Biol Res 2020; 53:34. [PMID: 32998768 PMCID: PMC7528251 DOI: 10.1186/s40659-020-00294-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/10/2020] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND Histone deacetylase (HDAC) inhibitors are promising anticancer drugs but their effect on tumor treatment has been disappointing mainly due to the acquisition of HDAC inhibitor resistance. However, the mechanisms underlying such resistance remain unclear. METHODS In this study, we performed Western blot, q-PCR, and promoter assay to examine the expression of HDAC inhibitor-induced phospholipase D2 (PLD2) in MDA-MB231and MDA-MB435 breast cancer cells. Apoptosis and proliferation were analyzed by flow cytometry. In addition to invasion and migration assay, angiogenesis was further measured using in vitro tube formation and chick embryo chorioallantoic membrane model. RESULTS HDAC inhibitors including suberoylanilide hydroxamic acid (SAHA), trichostatin, and apicidin, induce expression of PLD2 in a transcriptional level. SAHA upregulates expression of PLD2 via protein kinase C-ζ in breast cancer cells and increases the enzymatic activity of PLD. The combination treatment of SAHA with PLD2 inhibitor significantly enhances cell death in breast cancer cells. Phosphatidic acid, a product of PLD activity, prevented apoptosis promoted by cotreatment with SAHA and PLD2 inhibitor, suggesting that SAHA-induced PLD2 expression and subsequent activation of PLD2 might confers resistance of breast cancer cells to HDAC inhibitor. The combinational treatment of the drugs significantly suppressed invasion, migration, and angiogenesis, compared with that of either treatment. CONCLUSION These findings provide further insight into elucidating the advantages of combination therapy with HDAC and PLD2 inhibitors over single-agent strategies for the treatment of cancer.
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Affiliation(s)
- Won Chan Hwang
- Department of Molecular Biology, College of Natural Science, Pusan National University, Busan, 609-735, South Korea.,College of Pharmacy, Yonsei University, 85 Songdogwahak-ro, Yeonsu-gu, Incheon, 21983, South Korea
| | - Dong Woo Kang
- Department of Molecular Biology, College of Natural Science, Pusan National University, Busan, 609-735, South Korea
| | - Youra Kang
- College of Pharmacy, Yeungnam University, Gyeongsan, 712-749, South Korea
| | - Younghoon Jang
- Department of Biology and Chemistry, Changwon National University, Changwon, South Korea
| | - Jung-Ae Kim
- College of Pharmacy, Yeungnam University, Gyeongsan, 712-749, South Korea
| | - Do Sik Min
- College of Pharmacy, Yonsei University, 85 Songdogwahak-ro, Yeonsu-gu, Incheon, 21983, South Korea.
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Wang SM, Han KD, Kim NY, Um YH, Kang DW, Na HR, Lee CU, Lim HK. Association of Alcohol Intake and Fracture Risk in Elderly Varied by Affected Bones: A Nationwide Longitudinal Study. Psychiatry Investig 2020; 17:1013-1020. [PMID: 33059395 PMCID: PMC7596281 DOI: 10.30773/pi.2020.0143] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/20/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Previous studies investigating association of alcohol intake and fracture risk in elderly yielded conflicting results. We first examined the association between alcohol intake and total fracture risk in elderly subjects and further analyzed whether the association varied by fracture locations. METHODS This is a nationwide population-based cohort study which included all people aged 66 (n=1,431,539) receiving the National Screening Program during 2009-2014. Time-to-event were defined as duration from study recruitment, the day they received health screening, to the occurrence of fracture. RESULTS Total fracture was significantly lower in mild drinkers [adjusted hazard ratio (aHR)=0.952; 95% confidence interval (95% CI) =0.931-0.973] and higher in heavy drinkers (aHR=1.246; 95% CI=1.201-1.294) than non-drinkers. Risk pattern of alcohol consumption and fracture differed according to affected bones. Similar J-shaped trends were observed for vertebra fractures, but risk of limb fracture showed a linear relationship with alcohol intake. For hip fracture, risk decrement was more pronounced in mild and moderate drinkers, and significant increment was noted only in very severe drinkers [≥60 g/day; (aHR)=1.446; 1.162-1.801]. CONCLUSION Light to moderate drinking generally lowered risk of fractures, but association between alcohol and fracture risk varied depending on the affected bone lesions.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Nak-Young Kim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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