Mediterranean Diet, Alzheimer Disease Biomarkers and Brain Atrophy in Old Age

OBJECTIVE

To determine whether following a Mediterranean-like diet (MeDi) relates to cognitive functions and in vivo biomarkers for Alzheimer disease (AD), we analyzed cross-sectional data from the German DZNE-Longitudinal Cognitive Impairment and Dementia Study. METHOD: The sample (n=512, mean age: 69.5±5.9 years) included 169 cognitively normal participants and subjects at higher AD risk (53 with relatives with AD, 209 with subjective cognitive decline, and 81 with mild cognitive impairment). We defined MeDi adherence based on the Food Frequency Questionnaire. Brain volume outcomes were generated via voxel-based morphometry on T1-MRI and cognitive performance with an extensive neuropsychological battery. AD-related biomarkers (Aβ42/40 ratio, pTau181) in cerebrospinal fluid were assessed in n=226 individuals. We analyzed the associations between MeDi and the outcomes with linear regression models controlling for several covariates. Additionally, we applied hypothesis-driven mediation and moderation analysis.

RESULTS

Higher MeDi adherence related to larger mediotemporal gray matter volume (p<0.05 FWE corrected), better memory (β±SE = 0.03 ± 0.02; p=0.038), and less amyloid (Aβ42/40 ratio, β±SE = 0.003 ± 0.001; p=0.008) and pTau181 pathology (β±SE = -1.96±0.68; p=0.004). Mediotemporal volume mediated the association between MeDi and memory (40% indirect mediation). Finally, MeDi favorably moderated the associations between Aβ42/40 ratio, pTau181 and mediotemporal atrophy. Results were consistent correcting for ApoE-ε4 status.

CONCLUSION

Our findings corroborate the view of MeDi as a protective factor against memory decline and mediotemporal atrophy. Importantly, they suggest that these associations might be explained by a decrease of amyloidosis and tau-pathology. Longitudinal and dietary intervention studies should further examine this conjecture and its treatment implications.

Development of a quality-of-life index for pediatric inflammatory bowel disease: dealing with differences related to age and IBD type

BACKGROUND

A child- and adolescent-generated IBD quality-of-life index was designed to be descriptive (to be used to assess the overall impact of IBD on individual patients), and evaluative (to be used as an outcome measure in clinical trials).

METHODS

Item-generation and item-reduction interviews with 82 patients with IBD aged 8 to 17 years (61 with Crohn's disease, 21 with ulcerative colitis; 36 girls, 45 boys) generated a list of ways in which their lives were affected by IBD. These issues were incorporated into an item-reduction questionnaire, which was administered to 117 patients (87 Crohn's disease, 30 ulcerative colitis). Patients indicated on a visual analog scale how important an item was to them and how often it bothered them. Mean and median importance-plus-frequency scores for each issue were calculated for the entire group and among patients in subgroups according to age and IBD type.

RESULTS

Ulcerative colitis and Crohn's disease affect the lives of children and adolescents differently. Bowel symptoms are more troubling and disabling to patients with ulcerative colitis, whereas systemic symptoms and body image concerns are greater for patients with Crohn's disease. The impact of Crohn's disease on ability to function in school and leisure activities is greater. Worries about future health problems and about the effects of IBD on the family are shared. Crohn's disease and ulcerative colitis trigger emotional responses of unfairness and frustration, but anger and embarrassment are more prevalent in ulcerative colitis. Disparities between age groups are fewer and less marked than those between types of IBD.

CONCLUSION

In selection of items to be retained in a pediatric IBD quality-of-life measure, the variation in concerns with disease type must be considered. A single index to assess IBD-related quality of life must include items of major importance to one subgroup of patients, even if not important to all. Alternately, a core of common concerns could be supplemented by disease-specific modules, thereby increasing the content validity of the tool for all patients.

Subjective cognitive decline and stage 2 of Alzheimer disease in patients from memory centers

INTRODUCTION

It is uncertain whether subjective cognitive decline (SCD) in individuals who seek medical help serves the identification of the initial symptomatic stage 2 of the Alzheimer's disease (AD) continuum.

METHODS

Cross-sectional and longitudinal data from the multicenter, memory clinic-based DELCODE study.

RESULTS

The SCD group showed slightly worse cognition as well as more subtle functional and behavioral symptoms than the control group (CO). SCD-A+ cases (39.3% of all SCD) showed greater hippocampal atrophy, lower cognitive and functional performance, and more behavioral symptoms than CO-A+. Amyloid concentration in the CSF had a greater effect on longitudinal cognitive decline in SCD than in the CO group.

DISCUSSION

Our data suggests that SCD serves the identification of stage 2 of the AD continuum and that stage 2, operationalized as SCD-A+, is associated with subtle, but extended impact of AD pathology in terms of neurodegeneration, symptoms and clinical progression.

Ultrasound screening in the 2nd trimester. The pregnant woman's background knowledge, expectations, experiences and acceptances

OBJECTIVE

Ultrasound screening in the second trimester is widely used in maternal health care. To secure the pregnant woman's autonomy, it is essential to obtain information relating to her understanding and wishes as a starting point for the provision of information. The aim of the study was to explore the pregnant woman's background knowledge, expectations, experiences, and acceptances of second trimester ultrasound screening.

DESIGN

Five-hundred consecutive, unselected pregnant woman, of gestational age between 16 and 20 weeks were asked to fill in a questionnaire containing defined and open ended questions.

RESULTS

Approximately 70% of the women recruited had undergone a pregnancy-related ultrasound examination previously. Ninety percent answered that they had received information, either from the family doctor or as written material from the hospital (or both), concerning the purpose of the examination. Literature/newspaper/TV, family and friends played an important role as sources for general information. The pregnant women wished to undertake the ultrasound examination to ensure that the fetus was alive, healthy and without any malformation. Few answers were clinically irrelevant. The womens' expectations were fulfilled in 96% of cases, 86% felt 'more secure' after the examination while 2% did not have their expectations fulfilled. Only 0.8% felt more insecure after the examination. The vast majority of both pregnant women and their partners reported a positive experience from the event.

CONCLUSION

Pregnant women have a good knowledge of ultrasound examination although the quality of information could be improved. Expectations are fulfilled and are clinically relevant. The acceptability and experiences of the examination are very high.

Human herpesvirus-6 immunoglobulin G antibodies in patients with multiple sclerosis

OBJECTIVE

To further investigate a possible correlation between human herpesvirus-6 (HHV-6) infection and multiple sclerosis by analyzing the level of HHV-6 antibodies in MS patients and healthy controls.

MATERIALS AND METHODS

A total of 189 serum samples from patients with multiple sclerosis (MS) in different disease stages and 190 serum samples from healthy controls matched for age and sex were analyzed for HHV-6 antibodies using a competitive ELISA.

RESULTS

There was no difference between HHV-6 IgG titers in MS patients and controls. Two of the controls were seronegative for HHV-6 versus to none of the MS-patients. There was no apparent difference in HHV-6 titers from patients in different disease stages.

CONCLUSION

This study cannot support the theory that HHV-6 is a contributing factor to the development of MS, although a seroprevalence study like this would not disclose whether a late primary infection (in puberty) with HHV-6 might affect the development of MS.

Expression of beta 1 integrins in non-neoplastic mammary epithelium, fibroadenoma and carcinoma of the breast

beta 1 Integrins were examined immunohistochemically in normal and mastopathic mammary glands, 12 benign tumours and 90 carcinomas of the breast using monoclonal antibodies against beta 1 and alpha 1 to alpha 6 subunits. When compared with epithelial cells of non-neoplastic mammary glands and of benign tumours, carcinoma cells showed considerable quantitative changes in the pattern of alpha 2, alpha 3 and alpha 6 subunit expression. In contrast, the distribution pattern of beta 1, alpha 1, alpha 4 and alpha 5 antigens corresponded to the situation observed in non-neoplastic mammary gland epithelium in most instances. An abnormal expression of alpha 2 was found in 71.0% of the carcinomas ranging from a remarkably low number of alpha 2-positive tumour cells in 27.5% of the cases to a complete absence of the alpha 2 molecule in 43.5% of the carcinomas. Of the carcinomas 39.9% exhibited quantitative changes in alpha 3 expression with an abnormally low content of alpha 3-positive neoplastic cells in 15.4% and a complete absence of this molecule in 24.5% of the cases. Expression of alpha 6 was abnormal in 73.2% of the carcinomas, consisting in a greater number of alpha 6-negative tumour cells in 31.9% and in a complete absence of alpha 6 in 41.3% of the tumours. The abnormally low expression/absence of alpha 2 and alpha 3 subunits correlated with oestrogen receptor negativity (P < 0.033 and P < 0.04, respectively). In addition, abnormally low expression/absence of alpha 2 correlated with poor differentiation of the tumours (P < 0.014). The quantitative changes in the expression pattern of beta 1-associated alpha subunits in breast carcinomas may cause a disturbed cell-cell and/or cell-matrix interaction that increases the invasive and migratory property of the tumour cells.

Serum and plasma fragments of C-telopeptides of type I collagen (CTX) are stable during storage at low temperatures for 3 years

BACKGROUND

Control of pre-analytical variables is essential for successful application of biological markers, including bone resorption markers, in clinical trials and routine use. The effect of storage temperature on stability of bone resorption markers have not been subject of systematically investigation, and therefore the present study was set out to determine the stability of C-telopeptides of type I collagen (CTX) in serum and plasma samples stored frozen for 3 years.

METHODS

The serum and plasma levels of CTX were determined in samples aliquoted and stored frozen for up to 3 years.

RESULTS

No significant decrease could be detected in neither serum nor plasma samples after 3 years of storage at -20, -80 or -150 degrees C. However, at elevated temperature, i.e. 4 and 37 degrees C, improved stability of CTX was observed in EDTA plasma samples compared to serum.

CONCLUSIONS

CTX is stable in frozen serum and plasma samples for up to 3 years. EDTA plasma might be the preferred matrix due to improved stability at elevated temperatures.

Association between composite scores of domain-specific cognitive functions and regional patterns of atrophy and functional connectivity in the Alzheimer's disease spectrum

BACKGROUND

Cognitive decline has been found to be associated with gray matter atrophy and disruption of functional neural networks in Alzheimer's disease (AD) in structural and functional imaging (fMRI) studies. Most previous studies have used single test scores of cognitive performance among monocentric cohorts. However, cognitive domain composite scores could be more reliable than single test scores due to the reduction of measurement error. Adopting a multicentric resting state fMRI (rs-fMRI) and cognitive domain approach, we provide a comprehensive description of the structural and functional correlates of the key cognitive domains of AD.

METHOD

We analyzed MRI, rs-fMRI and cognitive domain score data of 490 participants from an interim baseline release of the multicenter DELCODE study cohort, including 54 people with AD, 86 with Mild Cognitive Impairment (MCI), 175 with Subjective Cognitive Decline (SCD), and 175 Healthy Controls (HC) in the AD-spectrum. Resulting cognitive domain composite scores (executive, visuo-spatial, memory, working memory and language) from the DELCODE neuropsychological battery (DELCODE-NP), were previously derived using confirmatory factor analysis. Statistical analyses examined the differences between diagnostic groups, and the association of composite scores with regional atrophy and network-specific functional connectivity among the patient subgroup of SCD, MCI and AD.

RESULT

Cognitive performance, atrophy patterns and functional connectivity significantly differed between diagnostic groups in the AD-spectrum. Regional gray matter atrophy was positively associated with visuospatial and other cognitive impairments among the patient subgroup in the AD-spectrum. Except for the visual network, patterns of network-specific resting-state functional connectivity were positively associated with distinct cognitive impairments among the patient subgroup in the AD-spectrum.

CONCLUSION

Consistent associations between cognitive domain scores and both regional atrophy and network-specific functional connectivity (except for the visual network), support the utility of a multicentric and cognitive domain approach towards explicating the relationship between imaging markers and cognition in the AD-spectrum.

Cerebral Metabolic Changes Related to Oxidative Metabolism in a Model of Bacterial Meningitis Induced by Lipopolysaccharide

BACKGROUND

Cerebral mitochondrial dysfunction is prominent in the pathophysiology of severe bacterial meningitis. In the present study, we hypothesize that the metabolic changes seen after intracisternal lipopolysaccharide (LPS) injection in a piglet model of meningitis is compatible with mitochondrial dysfunction and resembles the metabolic patterns seen in patients with bacterial meningitis.

METHODS

Eight pigs received LPS injection in cisterna magna, and four pigs received NaCl in cisterna magna as a control. Biochemical variables related to energy metabolism were monitored by intracerebral microdialysis technique and included interstitial glucose, lactate, pyruvate, glutamate, and glycerol. The intracranial pressure (ICP) and brain tissue oxygen tension (PbtO₂) were also monitored along with physiological variables including mean arterial pressure, blood glucose, lactate, and partial pressure of O₂ and CO₂. Pigs were monitored for 60 min at baseline and 240 min after LPS/NaCl injection.

RESULTS

After LPS injection, a significant increase in cerebral lactate/pyruvate ratio (LPR) compared to control group was registered (p = 0.01). This increase was due to a significant increased lactate with stable and normal values of pyruvate. No significant change in PbtO₂ or ICP was registered. No changes in physiological variables were observed.

CONCLUSIONS

The metabolic changes after intracisternal LPS injection is compatible with disturbance in the oxidative metabolism and partly due to mitochondrial dysfunction with increasing cerebral LPR due to increased lactate and normal pyruvate, PbtO₂, and ICP. The metabolic pattern resembles the one observed in patients with bacterial meningitis. Metabolic monitoring in these patients is feasible to monitor for cerebral metabolic derangements otherwise missed by conventional intensive care monitoring.

Optimal filtering for spike sorting of multi-site electrode recordings

We derive an optimal linear filter, to reduce the distortions of the peak amplitudes of action potentials in extracellular multitrode recordings, which are due to background activity and overlapping spikes. This filter is being learned very efficiently from the raw recordings in an unsupervised manner and responds to the average waveform with an impulse of minimal width. The average waveform does not have to be known in advance, but is learned together with the optimal filter. The peak amplitude of a filtered waveform is a more reliable estimate for the amplitude of an action potential than the peak of the biphasic waveform and can improve the accuracy of the event detection and clustering procedures. We demonstrate a spike-sorting application, in which events are detected using the Mahalanobis distance in the N-dimensional space of filtered recordings as a distance measure, and the event amplitudes of the filtered recordings are clustered to assign events to individual units. This method is fast and robust, and we show its performance by applying it to real tetrode recordings of spontaneous activity in the visual cortex of an anaesthetized cat and to realistic artificial data derived therefrom.

Inorganic-Organic Hybrid Polymers as Photo-Patternable Dielectrics for Multilayer Microwave Circuits

Inorganic-organic hybrid polymers (ORMOCE®s) combine very good optical and dielectricproperties in the frequency range up to 1 MHz (εr = 3.1 and tanδ = 0.004, both at 1 MHz). Thisis particularly promising for electro-optical (e/o) applications. Multi-layer microwave circuits forhigh frequency applications up to 100 GHz demand extraordinary material properties such as alow permittivity εr < 3 and a dielectric loss tanδ of about 10-3. For low-cost processing, direct UVpatterning would be particularly advantageous. Additionally, the material should be thermallystable at least up to temperatures around 300°C.

We have developed a series of novel ORMOCE® materials for high frequency applications.Using these ORMOCE®s, thick film coatings (up to 150 m) can be produced and directlypatterned by UV lithography with sufficiently high resolution. The synthesis has been carried outusing styrene-substituted organosilanes and silanediols as precursors reacted by simplified solgel-processing in combination with organic cross-linking of polymerizable organic functions.The materials have been characterized at high frequencies up to 40 GHz, exhibiting verypromising dielectric properties of εr = 2.5 and tanδ = 0.0035.

[Conservative therapy of blunt kidney injuries]

Forty-two patients with blunt renal injuries were treated between 1984 and 1994 at our institution. Twenty-nine patients revealed a contusion (grade I injury), 10 showed lacerations (grade II), 1 a severe fracture (grade III), and 2 presented pedicle injuries (grade IV). All 10 patients with incomplete renal injuries (grade II) were treated conservatively, i.e. without primary surgery. One of these 10 patients required surgical intervention 3 months after the trauma due to a urinary obstruction. Two of the ten patients with grade II injuries suffered late complications, namely a contracted kidney in one case and hypertension in the other. This means that of 10 patients with conservatively treated grade II renal trauma, a loss of the function of the affected kidney occurred in only one. In 9 patients complete function of the kidney could be preserved. In conclusion, conservative management of incomplete blunt renal injuries is an effective treatment option with few complications.

Gaussian Process-based prediction of memory performance and biomarker status in ageing and Alzheimer's disease-A systematic model evaluation

Neuroimaging markers based on Magnetic Resonance Imaging (MRI) combined with various other measures (such as genetic covariates, biomarkers, vascular risk factors, neuropsychological tests etc.) might provide useful predictions of clinical outcomes during the progression towards Alzheimer's disease (AD). The use of multiple features in predictive frameworks for clinical outcomes has become increasingly prevalent in AD research. However, many studies do not focus on systematically and accurately evaluating combinations of multiple input features. Hence, the aim of the present work is to explore and assess optimal combinations of various features for MR-based prediction of (1) cognitive status and (2) biomarker positivity with a multi-kernel learning Gaussian process framework. The explored features and parameters included (A) combinations of brain tissues, modulation, smoothing, and image resolution; (B) incorporating demographics & clinical covariates; (C) the impact of the size of the training data set; (D) the influence of dimensionality reduction and the choice of kernel types. The approach was tested in a large German cohort including 959 subjects from the multicentric longitudinal study of cognitive impairment and dementia (DELCODE). Our evaluation suggests the best prediction of memory performance was obtained for a combination of neuroimaging markers, demographics, genetic information (ApoE4) and CSF biomarkers explaining 57% of outcome variance in out-of-sample predictions. The highest performance for Aβ42/40 status classification was achieved for a combination of demographics, ApoE4, and a memory score while usage of structural MRI further improved the classification of individual patient's pTau status.

Partial amplitude synchronization detection in brain signals using Bayesian Gaussian mixture models

The present work investigates instantaneous synchronization in multivariate signals. It introduces a new method to detect subsets of synchronized time series that do not consider any baseline information. The method is based on a Bayesian Gaussian mixture model applied at each location of a time-frequency map. The work assesses the relevance of detected subsets by a stability measure. The application to Local Field Potentials measured during a visuo-motor experiment in monkeys reveals a subset of synchronized time series measured in the visual cortex.

Plasma amyloid beta X-42/X-40 ratio and cognitive decline in suspected early and preclinical Alzheimer's disease

INTRODUCTION

Blood-based biomarkers are a cost-effective and minimally invasive method for diagnosing the early and preclinical stages of amyloid positivity (AP). Our study aims to investigate our novel immunoprecipitation-immunoassay (IP-IA) as a test for predicting cognitive decline.

METHODS

We measured levels of amyloid beta (Aβ)X-40 and AβX-42 in immunoprecipitated eluates from the DELCODE cohort. Receiver-operating characteristic (ROC) curves, regression analyses, and Cox proportional hazard regression models were constructed to predict AP by Aβ42/40 classification in cerebrospinal fluid (CSF) and conversion to mild cognitive impairment (MCI) or dementia.

RESULTS

We detected a significant correlation between AßX-42/X-40 in plasma and CSF (r = 0.473). Mixed-modeling analysis revealed a substantial prediction of AßX-42/X-40 with an area under the curve (AUC) of 0.81 for AP (sensitivity: 0.79, specificity: 0.74, positive predictive value [PPV]: 0.71, negative predictive value [NPV]: 0.81). In addition, lower AβX-42/X-40 ratios were associated with negative PACC5 slopes, suggesting cognitive decline.

DISCUSSION

Our results suggest that assessing the plasma AβX-42/X-40 ratio via our semiautomated IP-IA is a promising biomarker when examining patients with early or preclinical AD.

HIGHLIGHTS

New plasma Aβ42/Aβ40 measurement using immunoprecipitation-immunoassay Plasma Aβ42/Aβ40 associated with longitudinal cognitive decline Promising biomarker to detect subjective cognitive decline at-risk for brain amyloid positivity.

Expression patterns of CD44 and CD44 splice variants in patients with rheumatoid arthritis

OBJECTIVES

It has been suggested that CD44 is involved in the pathogenesis of rheumatoid arthritis (RA). By alternative splicing, numerous CD44 isoforms can be generated which may play different roles the inflammatory process. We therefore studied the expression of various CD44 splicevariants in the circulation and synovial tissue of patients with RA and correlated expression with clinical features.

METHODS

Expression of distinct CD44 splice variants was analysed by FACS in peripheral monocytes of 46 RA patients and 36 healthy controls. Expression of CD44 splice variants in synovial tissue of RA and OA patients was analysed by immunohistochemistry and the effects of blocking CD44v4 on RA-fibroblast like synoviocytes (FLS) were studied.

RESULTS

On monocytes, the expression of CD44 and CD44v3 was significantly lower in patients with erosive disease than in those without radiographic progression (p<0.05 for CD44 and p<0.01 for CD44v3). CD44v6 on monocytes was significantly associated with the clinical disease activity index (r=0.34, p<0.05) and CRP-levels (r=0.37, p<0.02). Immunhistochemical analyses revealed that most variants were expressed to a significantly higher extent in RA than in OA synovial membranes. Particularly the variants CD44v4, CD44v6 and CD44v7-8 were highly expressed in the RA lining and also abundantly in the endothelium. Blocking CD44v4 in RA-FLS reduced the proliferation to 68±8% (p<0.02) when compared to control experiments and led to a reduction in IL-1ß mRNA expression (p<0.05).

CONCLUSIONS

Expression of CD44 splice variants is generally increased in the synovial lining of RA patients when compared to OA. The inverse association of CD44v3 expression on monocytes with the development of erosive disease and the functional impacts of CD44v4 blockade in RA-FLS suggests a pathogenetic role of this splice variants which needs to be further investigated.

Alterations in cerebral resting state functional connectivity associated with social anxiety disorder and early life adversities

Social Anxiety Disorder (SAD) involves fear of negative evaluation and social avoidance, impacting quality of life. Early life adversities (ELA) are recognized as risk factors for SAD. Previous research indicated inconsistent alterations in resting state functional connectivity (RSFC) in SAD, particularly in the prefrontal cortex and precuneus. This study investigated the interaction between SAD and ELA at the RSFC level. Functional magnetic resonance imaging (fMRI) was conducted on 120 participants (aged 19-48). Four groups were formed: low/ high ELA controls (n = 49, n = 22) and low/ high ELA SAD participants (n = 30, n = 19). Seed-based correlation analyses (SCA) and multi-voxel pattern analysis (MVPA) were applied. A network in which ELA moderates the neural correlates of SAD during the resting state was identified, involving key nodes like the subgenual anterior cingulate cortex, left middle frontal gyrus, and an area in the calcarine fissure/precuneus. Five distinct interaction patterns of SAD and ELA were observed, showcasing opposite RSFC patterns in individuals with SAD based on ELA experience. Results remained significant when controlled for general anxiety and depression measures. Emotional aspects of ELA played a significant role in these interactions. These findings stress the necessity of considering primarily emotional ELA as covariate in neuroimaging studies investigating SAD and potentially also other psychiatric disorders, addressing inconsistencies in prior research. The left middle frontal gyrus emerges as a link in the SAD-ELA interaction during resting state and anxiety-relevant stimulation. Longitudinal studies, starting from childhood, are needed to understand ELA's impact on brain function and to identify potential neuromarkers for SAD predisposition post-ELA exposure.

Short communication: Lifetime musical activity and resting-state functional connectivity in cognitive networks

BACKGROUND

Participation in multimodal leisure activities, such as playing a musical instrument, may be protective against brain aging and dementia in older adults (OA). Potential neuroprotective correlates underlying musical activity remain unclear.

OBJECTIVE

This cross-sectional study investigated the association between lifetime musical activity and resting-state functional connectivity (RSFC) in three higher-order brain networks: the Default Mode, Fronto-Parietal, and Salience networks.

METHODS

We assessed 130 cognitively unimpaired participants (≥ 60 years) from the baseline cohort of the DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE) study. Lifetime musical activity was operationalized by the self-reported participation in musical instrument playing across early, middle, and late life stages using the Lifetime of Experiences Questionnaire (LEQ). Participants who reported musical activity during all life stages (n = 65) were compared to controls who were matched on demographic and reserve characteristics (including education, intelligence, socioeconomic status, self-reported physical activity, age, and sex) and never played a musical instrument (n = 65) in local (seed-to-voxel) and global (within-network and between-network) RSFC patterns using pre-specified network seeds.

RESULTS

Older participants with lifetime musical activity showed significantly higher local RSFC between the medial prefrontal cortex (Default Mode Network seed) and temporal as well as frontal regions, namely the right temporal pole and the right precentral gyrus extending into the superior frontal gyrus, compared to matched controls. There were no significant group differences in global RSFC within or between the three networks.

CONCLUSION

We show that playing a musical instrument during life relates to higher RSFC of the medial prefrontal cortex with distant brain regions involved in higher-order cognitive and motor processes. Preserved or enhanced functional connectivity could potentially contribute to better brain health and resilience in OA with a history in musical activity.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS00007966, 04/05/2015).