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Ong SS, Peavey JJ, Hiatt KD, Whitlow CT, Sappington RM, Thompson AC, Lockhart SN, Chen H, Craft S, Rapp SR, Fitzpatrick AL, Heckbert SR, Luchsinger JA, Klein BEK, Meuer SM, Cotch MF, Wong TY, Hughes TM. Association of fractal dimension and other retinal vascular network parameters with cognitive performance and neuroimaging biomarkers: The Multi-Ethnic Study of Atherosclerosis (MESA). Alzheimers Dement 2024; 20:941-953. [PMID: 37828734 PMCID: PMC10916935 DOI: 10.1002/alz.13498] [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: 03/24/2023] [Revised: 08/16/2023] [Accepted: 09/09/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Retinal vascular network changes may reflect the integrity of the cerebral microcirculation, and may be associated with cognitive impairment. METHODS Associations of retinal vascular measures with cognitive function and MRI biomarkers were examined amongst Multi-Ethnic Study of Atherosclerosis (MESA) participants in North Carolina who had gradable retinal photographs at Exams 2 (2002 to 2004, n = 313) and 5 (2010 to 2012, n = 306), and detailed cognitive testing and MRI at Exam 6 (2016 to 2018). RESULTS After adjustment for covariates and multiple comparisons, greater arteriolar fractal dimension (FD) at Exam 2 was associated with less isotropic free water of gray matter regions (β = -0.0005, SE = 0.0024, p = 0.01) at Exam 6, while greater arteriolar FD at Exam 5 was associated with greater gray matter cortical volume (in mm3 , β = 5458, SE = 20.17, p = 0.04) at Exam 6. CONCLUSION Greater arteriolar FD, reflecting greater complexity of the branching pattern of the retinal arteries, is associated with MRI biomarkers indicative of less neuroinflammation and neurodegeneration.
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Affiliation(s)
- Sally S. Ong
- Department of OphthalmologyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Jeremy J. Peavey
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Kevin D. Hiatt
- Department of RadiologyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Christopher T. Whitlow
- Department of RadiologyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Rebecca M. Sappington
- Department of OphthalmologyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
- Department of BiochemistryWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Atalie C. Thompson
- Department of OphthalmologyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Samuel N. Lockhart
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Haiying Chen
- Department of Psychiatry and Behavioral MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Suzanne Craft
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Stephen R. Rapp
- Biostatistics and Data ScienceWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Annette L. Fitzpatrick
- Department of EpidemiologySchool of Public HealthUniversity of WashingtonSeattleWashingtonUSA
| | - Susan R. Heckbert
- Department of EpidemiologySchool of Public HealthUniversity of WashingtonSeattleWashingtonUSA
| | - José A. Luchsinger
- Departments of Medicine and EpidemiologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Barbara E. K. Klein
- Department of Ophthalmology and Visual SciencesUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Stacy M Meuer
- Department of Ophthalmology and Visual SciencesUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | | | - Tien Y. Wong
- Singapore Eye Research InstituteSingapore National Eye CenterOphthalmology and Visual Sciences Academic Clinical ProgramDuke‐NUS Medical SchoolSingapore
- Tsinghua MedicineTsinghua UniversityBeijingChina
| | - Timothy M. Hughes
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
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Kumar A, Su Y, Sharma M, Singh S, Kim S, Peavey JJ, Suerken CK, Lockhart SN, Whitlow CT, Craft S, Hughes TM, Deep G. MicroRNA expression in extracellular vesicles as a novel blood-based biomarker for Alzheimer's disease. Alzheimers Dement 2023; 19:4952-4966. [PMID: 37071449 DOI: 10.1002/alz.13055] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [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: 12/22/2022] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 04/19/2023]
Abstract
INTRODUCTION Brain cell-derived small extracellular vesicles (sEVs) in blood offer unique cellular and molecular information related to the onset and progression of Alzheimer's disease (AD). We simultaneously enriched six specific sEV subtypes from the plasma and analyzed a selected panel of microRNAs (miRNAs) in older adults with/without cognitive impairment. METHODS Total sEVs were isolated from the plasma of participants with normal cognition (CN; n = 11), mild cognitive impairment (MCI; n = 11), MCI conversion to AD dementia (MCI-AD; n = 6), and AD dementia (n = 11). Various brain cell-derived sEVs (from neurons, astrocytes, microglia, oligodendrocytes, pericytes, and endothelial cells) were enriched and analyzed for specific miRNAs. RESULTS miRNAs in sEV subtypes differentially expressed in MCI, MCI-AD, and AD dementia compared to the CN group clearly distinguished dementia status, with an area under the curve (AUC) > 0.90 and correlated with the temporal cortical region thickness on magnetic resonance imaging (MRI). DISCUSSION miRNA analyses in specific sEVs could serve as a novel blood-based molecular biomarker for AD. HIGHLIGHTS Multiple brain cell-derived small extracellular vesicles (sEVs) could be isolated simultaneously from blood. MicroRNA (miRNA) expression in sEVs could detect Alzheimer's disease (AD) with high specificity and sensitivity. miRNA expression in sEVs correlated with cortical region thickness on magnetic resonance imaging (MRI). Altered expression of miRNAs in sEVCD31 and sEVPDGFRβ suggested vascular dysfunction. miRNA expression in sEVs could predict the activation state of specific brain cell types.
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Affiliation(s)
- Ashish Kumar
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Yixin Su
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mitu Sharma
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sangeeta Singh
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Susy Kim
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jeremy J Peavey
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Cynthia K Suerken
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Samuel N Lockhart
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Christopher T Whitlow
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Wake Forest Baptist Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Suzanne Craft
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Gagan Deep
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Wake Forest Baptist Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Rundle MM, Peavey JJ, Barcus RA, Okonmah‐Obazee SE, Espeland MA, Sai KKS, Whitlow CT, Williams BJ, Craft S, Bateman JR, Lockhart SN, Hughes TM. In vivo biomarkers of arteriolosclerosis are associated with ADRD biomarkers. Alzheimers Dement 2022. [DOI: 10.1002/alz.064528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Culkin MC, Hughes TM, Peavey JJ, Molina‐Henry DP, Seeman TE, Merkin SS, Hayden KM. Implications of Response Patterns in Questions of Early Life Adverse Events as a Risk Factor for Lower Cognitive Function in the Multi‐Ethnic Study of Atherosclerosis. Alzheimers Dement 2022. [DOI: 10.1002/alz.068660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Rundle MM, Peavey JJ, Barcus RA, Okonmah‐Obazee SE, Espeland MA, Sai KKS, Whitlow CT, Williams BJ, Craft S, Bateman JR, Lockhart SN, Hughes TM. In vivo biomarkers of arteriolosclerosis are associated with ADRD biomarkers. Alzheimers Dement 2022. [DOI: 10.1002/alz.065118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bateman JR, Waugh CE, Kershaw KN, Quillen EE, Lockhart SN, Peavey JJ, Hughes TM, Cole SW, Seeman TE, Craft S. Perceived Stress and Loneliness During the COVID‐19 Pandemic in a Cognitive Aging Cohort. Alzheimers Dement 2022. [DOI: 10.1002/alz.066823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | - Kiarri N Kershaw
- Northwestern University Feinberg School of Medicine Chicago IL USA
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Duran T, Bateman JR, Williams BJ, Hughes TM, Barcus RA, Peavey JJ, Okonmah‐Obazee SE, Whitlow CT, Craft S, Lockhart SN. Generalized
q
‐sampling imaging‐based fiber tracking measures of white matter tracts in cognitive impairment. Alzheimers Dement 2022. [DOI: 10.1002/alz.066574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Tugce Duran
- Wake Forest School of Medicine Winston‐Salem NC USA
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Peavey JJ, D'Amico SL, Kim BY, Higgins ST, Friedman DS, Brady CJ. Impact of Socioeconomic Disadvantage and Diabetic Retinopathy Severity on Poor Ophthalmic Follow-Up in a Rural Vermont and New York Population. Clin Ophthalmol 2020; 14:2397-2403. [PMID: 32904606 PMCID: PMC7457718 DOI: 10.2147/opth.s258270] [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: 04/15/2020] [Accepted: 07/17/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the impact of socioeconomic disadvantage and diabetic retinopathy severity on follow-up for vision care among people with diabetes mellitus (DM) residing in rural Vermont and northern New York State. Methods A retrospective chart review of people with DM who visited our academic eye clinic at least once between October 1, 2015, and March 31, 2016, was done. Of 1,466 unique patient visits, 500 were chosen for full chart review by simple random sampling. DM follow-up within 1 year was recommended for 331 adults. Data about prescribed and actual follow-up intervals were extracted. Regression models were used to identify factors associated with poor attendance at follow-up appointments. Results Sixty-eight [20.5%] patients had poor follow-up, defined as no ophthalmology visit within double the prescribed interval. Of these, 57 were not seen in follow-up by the end of study observation. Poor follow-up was greatest among socioeconomically disadvantaged patients, as defined by Medicaid enrollment (odds ratio [OR], 1.95; 95% CI, 1.07–3.56) in comparison to non-disadvantaged patients. Follow-up was better among those with moderate or worse diabetic retinopathy (OR, 0.38 95% CI, 0.20–0.70), and those with macular edema (OR, 0.19; 95% CI, 0.057–0.62). Conclusion Medicaid insurance and better diabetic retinopathy status were associated with worse follow-up among our predominantly rural population of patients. Patients who did not follow-up within double the recommended interval were unlikely to follow-up at all. Interventions are needed to target those at highest risk for poor follow-up.
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Affiliation(s)
- Jeremy J Peavey
- Department of Surgery, Division of Ophthalmology, University of Vermont Medical Center and Larner College of Medicine, Burlington, VT, USA
| | - Samantha L D'Amico
- Department of Surgery, Division of Ophthalmology, University of Vermont Medical Center and Larner College of Medicine, Burlington, VT, USA
| | - Brian Y Kim
- Department of Surgery, Division of Ophthalmology, University of Vermont Medical Center and Larner College of Medicine, Burlington, VT, USA
| | - Stephen T Higgins
- Vermont Center for Behavior and Health, Larner College of Medicine, Burlington, VT, USA.,Departments of Psychiatry and Psychological Science, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - David S Friedman
- Dana Center for Preventive Ophthalmology, Johns Hopkins University, Baltimore, MD, USA
| | - Christopher J Brady
- Department of Surgery, Division of Ophthalmology, University of Vermont Medical Center and Larner College of Medicine, Burlington, VT, USA.,Vermont Center for Behavior and Health, Larner College of Medicine, Burlington, VT, USA
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