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Al-Qudah AM, Ta'ani OA, Thirumala PD, Sultan I, Visweswaran S, Nadkarni N, Kiselevskaya V, Crammond DJ, Balzer J, Anetakis KM, Shandal V, Subramaniam K, Subramanium B, Sadhasivam S. Role of Intraoperative Neuromonitoring to Predict Postoperative Delirium in Cardiovascular Surgery. J Cardiothorac Vasc Anesth 2024; 38:526-533. [PMID: 37838509 DOI: 10.1053/j.jvca.2023.09.010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/20/2023] [Accepted: 09/09/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE Postoperative delirium (POD) can occur in up to 50% of older patients undergoing cardiovascular surgery, resulting in hospitalization and significant morbidity and mortality. This study aimed to determine whether intraoperative neurophysiologic monitoring (IONM) modalities can be used to predict delirium in patients undergoing cardiovascular surgery. DESIGN Adult patients undergoing cardiovascular surgery with IONM between 2019 and 2021 were reviewed retrospectively. Delirium was assessed multiple times using the Intensive Care Delirium Screening Checklist (ICDSC). Patients with an ICDSC score ≥4 were considered to have POD. Significant IONM changes were evaluated based on a visual review of electroencephalography (EEG) and somatosensory evoked potentials data and documentation of significant changes during surgery. SETTING University of Pittsburgh Medical Center hospitals. PARTICIPANTS Patients 18 years old and older undergoing cardiovascular surgery with IONM monitoring. MEASUREMENTS AND MAIN RESULTS Of the 578 patients undergoing cardiovascular surgery with IONM, 126 had POD (21.8%). Significant IONM changes were noted in 134 patients, of whom 49 patients had delirium (36.6%). In contrast, 444 patients had no IONM changes during surgery, of whom 77 (17.3%) patients had POD. Upon multivariate analysis, IONM changes were associated with POD (odds ratio 2.12; 95% CI 1.31-3.44; p < 0.001). Additionally, baseline EEG abnormalities were associated with POD (p = 0.002). CONCLUSION Significant IONM changes are associated with an increased risk of POD in patients undergoing cardiovascular surgery. These findings offer a basis for future research and analysis of EEG and somatosensory evoked potential monitoring to predict, detect, and prevent POD.
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Affiliation(s)
- Abdullah M Al-Qudah
- Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Omar Al Ta'ani
- Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Parthasarathy D Thirumala
- Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
| | - Ibrahim Sultan
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Shyam Visweswaran
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Neelesh Nadkarni
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Victoria Kiselevskaya
- Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Donald J Crammond
- Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Jeffrey Balzer
- Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Katherine M Anetakis
- Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Varun Shandal
- Center of Clinical Neurophysiology, Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Kathirvel Subramaniam
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Balachundhar Subramanium
- Department of Anesthesiology, Critical Care & Pain Management, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Senthilkumar Sadhasivam
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
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Queder N, Phelan MJ, Taylor L, Tustison N, Doran E, Hom C, Nguyen D, Lai F, Pulsifer M, Price J, Kreisl WC, Rosas HD, Krinsky‐McHale S, Brickman AM, Yassa MA, Schupf N, Silverman W, Lott IT, Head E, Mapstone M, Keator DB, Ances BM, Andrews HF, Bell K, Birn RM, Brickman AM, Bulova P, Cheema A, Chen K, Christian BT, Clare I, Clark L, Cohen AD, Constantino JN, Doran EW, Fagan A, Feingold E, Foroud TM, Handen BL, Hartley SL, Head E, Henson R, Hom C, Honig L, Ikonomovic MD, Johnson SC, Jordan C, Kamboh MI, Keator D, Klunk WE, Kofler JK, Kreisl WC, Krinsky‐McHale SJ, Lai F, Lao P, Laymon C, Lee JH, Lott IT, Lupson V, Mapstone M, Mathis CA, Minhas DS, Nadkarni N, O'Bryant S, Pang D, Petersen M, Price JC, Pulsifer M, Reiman E, Rizvi B, Rosas HD, Schupf N, Silverman WP, Tudorascu DL, Tumuluru R, Tycko B, Varadarajan B, White DA, Yassa MA, Zaman S, Zhang F. Joint-label fusion brain atlases for dementia research in Down syndrome. Alzheimers Dement (Amst) 2022; 14:e12324. [PMID: 35634535 PMCID: PMC9131930 DOI: 10.1002/dad2.12324] [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] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/28/2022] [Accepted: 04/25/2022] [Indexed: 01/07/2023]
Abstract
Research suggests a link between Alzheimer's Disease in Down Syndrome (DS) and the overproduction of amyloid plaques. Using Positron Emission Tomography (PET) we can assess the in-vivo regional amyloid load using several available ligands. To measure amyloid distributions in specific brain regions, a brain atlas is used. A popular method of creating a brain atlas is to segment a participant's structural Magnetic Resonance Imaging (MRI) scan. Acquiring an MRI is often challenging in intellectually-imparied populations because of contraindications or data exclusion due to significant motion artifacts or incomplete sequences related to general discomfort. When an MRI cannot be acquired, it is typically replaced with a standardized brain atlas derived from neurotypical populations (i.e. healthy individuals without DS) which may be inappropriate for use in DS. In this project, we create a series of disease and diagnosis-specific (cognitively stable (CS-DS), mild cognitive impairment (MCI-DS), and dementia (DEM-DS)) probabilistic group atlases of participants with DS and evaluate their accuracy of quantifying regional amyloid load compared to the individually-based MRI segmentations. Further, we compare the diagnostic-specific atlases with a probabilistic atlas constructed from similar-aged cognitively-stable neurotypical participants. We hypothesized that regional PET signals will best match the individually-based MRI segmentations by using DS group atlases that aligns with a participant's disorder and disease status (e.g. DS and MCI-DS). Our results vary by brain region but generally show that using a disorder-specific atlas in DS better matches the individually-based MRI segmentations than using an atlas constructed from cognitively-stable neurotypical participants. We found no additional benefit of using diagnose-specific atlases matching disease status. All atlases are made publicly available for the research community. Highlight Down syndrome (DS) joint-label-fusion atlases provide accurate positron emission tomography (PET) amyloid measurements.A disorder-specific DS atlas is better than a neurotypical atlas for PET quantification.It is not necessary to use a disease-state-specific atlas for quantification in aged DS.Dorsal striatum results vary, possibly due to this region and dementia progression.
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Affiliation(s)
- Nazek Queder
- Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA,Department of Neurobiology and Behavior and Center for the Neurobiology of Learning and MemoryUniversity of California IrvineIrvineCaliforniaUSA
| | - Michael J. Phelan
- Institute for Memory Impairments and Neurological DisordersUniversity of California IrvineIrvineCaliforniaUSA
| | - Lisa Taylor
- Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA
| | - Nicholas Tustison
- Department of RadiologyUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Eric Doran
- Department of PediatricsUniversity of CaliforniaIrvine Medical CenterOrangeCaliforniaUSA
| | - Christy Hom
- Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA
| | - Dana Nguyen
- Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA
| | - Florence Lai
- Massachusetts General HospitalHarvard UniversityBostonMassachusettsUSA
| | - Margaret Pulsifer
- Massachusetts General HospitalHarvard UniversityBostonMassachusettsUSA
| | - Julie Price
- Massachusetts General HospitalHarvard UniversityBostonMassachusettsUSA
| | | | - Herminia D. Rosas
- Massachusetts General HospitalHarvard UniversityBostonMassachusettsUSA
| | - Sharon Krinsky‐McHale
- New York State Institute for Basic Research in Developmental DisabilitiesNew YorkNew YorkUSA
| | - Adam M. Brickman
- Department of NeurologyColumbia UniversityNew YorkNew YorkUSA,Taub Institute for Research on Alzheimer's Disease and the Aging BrainDepartment of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Michael A. Yassa
- Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA,Department of Neurobiology and Behavior and Center for the Neurobiology of Learning and MemoryUniversity of California IrvineIrvineCaliforniaUSA,Department of NeurologyUniversity of California IrvineIrvineCaliforniaUSA
| | - Nicole Schupf
- Department of NeurologyColumbia UniversityNew YorkNew YorkUSA,Taub Institute for Research on Alzheimer's Disease and the Aging BrainDepartment of NeurologyVagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Wayne Silverman
- Department of PediatricsUniversity of CaliforniaIrvine Medical CenterOrangeCaliforniaUSA
| | - Ira T. Lott
- Department of PediatricsUniversity of CaliforniaIrvine Medical CenterOrangeCaliforniaUSA
| | - Elizabeth Head
- Department of Pathology & Laboratory MedicineUniversity of California IrvineIrvineCaliforniaUSA
| | - Mark Mapstone
- Department of NeurologyUniversity of California IrvineIrvineCaliforniaUSA
| | - David B. Keator
- Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA
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3
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Morenas-Rodríguez E, Li Y, Nuscher B, Franzmeier N, Xiong C, Suárez-Calvet M, Fagan AM, Schultz S, Gordon BA, Benzinger TLS, Hassenstab J, McDade E, Feederle R, Karch CM, Schlepckow K, Morris JC, Kleinberger G, Nellgard B, Vöglein J, Blennow K, Zetterberg H, Ewers M, Jucker M, Levin J, Bateman RJ, Haass C, Allegri R, Araki A, Barthelemy N, Bechara J, Berman S, Bodge C, Brandon S, Brooks W(B, Brosch J, Buck J, Buckles V, Carter K, Cash L, Chen C, Chhatwal J, Chrem P, Chua J, Chui H, Cruchaga C, Day GS, De La Cruz C, Denner D, Diffenbacher A, Dincer A, Donahue T, Douglas J, Duong D, Egido N, Esposito B, Farlow M, Feldman B, Fitzpatrick C, Flores S, Fox N, Franklin E, Friedrichsen N, Fujii H, Gardener S, Ghetti B, Goate A, Goldberg S, Goldman J, Gonzalez A, Gräber-Sultan S, Graff-Radford N, Graham M, Gray J, Gremminger E, Grilo M, Groves A, Häsler L, Hellm C, Herries E, Hoechst-Swisher L, Hofmann A, Holtzman D, Hornbeck R, Igor Y, Ihara R, Ikeuchi T, Ikonomovic S, Ishii K, Jack C, Jerome G, Johnson E, Käser S, Kasuga K, Keefe S, Klunk W(B, Koeppe R, Koudelis D, Kuder-Buletta E, Laske C, Levey A, Lopez O, Marsh J, Martinez R, Martins R, Mason NS, Masters C, Mawuenyega K, McCullough A, Mejia A, MountzMD J, Mummery C, Nadkarni N, Nagamatsu A, Neimeyer K, Niimi Y, Noble J, Norton J, Nuscher B, O'Connor A, Obermüller U, Patira R, Perrin R, Ping L, Preische O, Renton A, Ringman J, Salloway S, Schofield P, Senda M, Seyfried N, Shady K, Shimada H, Sigurdson W, Smith J, Smith L, Snitz B, Sohrabi H, Stephens S, Taddei K, Thompson S, Wang P, Wang Q, Weamer E, Xu J, Xu X. Soluble TREM2 in CSF and its association with other biomarkers and cognition in autosomal-dominant Alzheimer's disease: a longitudinal observational study. Lancet Neurol 2022; 21:329-341. [PMID: 35305339 PMCID: PMC8926925 DOI: 10.1016/s1474-4422(22)00027-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Therapeutic modulation of TREM2-dependent microglial function might provide an additional strategy to slow the progression of Alzheimer's disease. Although studies in animal models suggest that TREM2 is protective against Alzheimer's pathology, its effect on tau pathology and its potential beneficial role in people with Alzheimer's disease is still unclear. Our aim was to study associations between the dynamics of soluble TREM2, as a biomarker of TREM2 signalling, and amyloid β (Aβ) deposition, tau-related pathology, neuroimaging markers, and cognitive decline, during the progression of autosomal dominant Alzheimer's disease. METHODS We did a longitudinal analysis of data from the Dominantly Inherited Alzheimer Network (DIAN) observational study, which includes families with a history of autosomal dominant Alzheimer's disease. Participants aged over 18 years who were enrolled in DIAN between Jan 1, 2009, and July 31, 2019, were categorised as either carriers of pathogenic variants in PSEN1, PSEN2, and APP genes (n=155) or non-carriers (n=93). We measured amounts of cleaved soluble TREM2 using a novel immunoassay in CSF samples obtained every 2 years from participants who were asymptomatic (Clinical Dementia Rating [CDR]=0) and annually for those who were symptomatic (CDR>0). CSF concentrations of Aβ40, Aβ42, total tau (t-tau), and tau phosphorylated on threonine 181 (p-tau) were measured by validated immunoassays. Predefined neuroimaging measurements were total cortical uptake of Pittsburgh compound B PET (PiB-PET), cortical thickness in the precuneus ascertained by MRI, and hippocampal volume determined by MRI. Cognition was measured using a validated cognitive composite (including DIAN word list test, logical memory delayed recall, digit symbol coding test [total score], and minimental status examination). We based our statistical analysis on univariate and bivariate linear mixed effects models. FINDINGS In carriers of pathogenic variants, a high amyloid burden at baseline, represented by low CSF Aβ42 (β=-4·28 × 10-2 [SE 0·013], p=0·0012), but not high cortical uptake in PiB-PET (β=-5·51 × 10-3 [0·011], p=0·63), was the only predictor of an augmented annual rate of subsequent increase in soluble TREM2. Augmented annual rates of increase in soluble TREM2 were associated with a diminished rate of decrease in amyloid deposition, as measured by Aβ42 in CSF (r=0·56 [0·22], p=0·011), in presymptomatic carriers of pathogenic variants, and with diminished annual rate of increase in PiB-PET (r=-0·67 [0·25], p=0·0060) in symptomatic carriers of pathogenic variants. Presymptomatic carriers of pathogenic variants with annual rates of increase in soluble TREM2 lower than the median showed a correlation between enhanced annual rates of increase in p-tau in CSF and augmented annual rates of increase in PiB-PET signal (r=0·45 [0·21], p=0·035), that was not observed in those with rates of increase in soluble TREM2 higher than the median. Furthermore, presymptomatic carriers of pathogenic variants with rates of increase in soluble TREM2 above or below the median had opposite associations between Aβ42 in CSF and PiB-PET uptake when assessed longitudinally. Augmented annual rates of increase in soluble TREM2 in presymptomatic carriers of pathogenic variants correlated with decreased cortical shrinkage in the precuneus (r=0·46 [0·22]), p=0·040) and diminished cognitive decline (r=0·67 [0·22], p=0·0020). INTERPRETATION Our findings in autosomal dominant Alzheimer's disease position the TREM2 response within the amyloid cascade immediately after the first pathological changes in Aβ aggregation and further support the role of TREM2 on Aβ plaque deposition and compaction. Furthermore, these findings underpin a beneficial effect of TREM2 on Aβ deposition, Aβ-dependent tau pathology, cortical shrinkage, and cognitive decline. Soluble TREM2 could, therefore, be a key marker for clinical trial design and interpretation. Efforts to develop TREM2-boosting therapies are ongoing. FUNDING German Research Foundation, US National Institutes of Health.
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Affiliation(s)
- Estrella Morenas-Rodríguez
- German Center for Neurodegenerative Diseases, Munich, Germany; Metabolic Biochemistry, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany.
| | - Yan Li
- Division of Biostatistics, Washington University School of Medicine, St Louis, MO, USA
| | - Brigitte Nuscher
- German Center for Neurodegenerative Diseases, Munich, Germany,Metabolic Biochemistry, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians University, Munich, Germany
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, St Louis, MO, USA
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain,Servei de Neurologia, Hospital del Mar Medical Research Institute, Barcelona, Spain,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Madrid, Spain
| | - Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Stephanie Schultz
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Brian A Gordon
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Tammie L S Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Eric McDade
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Regina Feederle
- German Center for Neurodegenerative Diseases, Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany,Institute for Diabetes and Obesity, Monoclonal Antibody Core Facility, Helmholtz Center, Munich, Germany,German Research Center for Environmental Health, Neuherberg, Germany
| | - Celeste M Karch
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Kai Schlepckow
- German Center for Neurodegenerative Diseases, Munich, Germany,Metabolic Biochemistry, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Gernot Kleinberger
- German Center for Neurodegenerative Diseases, Munich, Germany,Metabolic Biochemistry, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Bengt Nellgard
- Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Mölndal, Sweden,Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jonathan Vöglein
- German Center for Neurodegenerative Diseases, Munich, Germany,Department of Neurology, University Hospital of Munich, Ludwig-Maximilians University, Munich, Germany
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden,Department of Neurodegenerative Disease, UCL Queens Square Institute of Neurology, University College London, London, UK,UK Dementia Research Institute, University College London, London, UK,Hong Kong Center for Neurodegenerative Diseases, Hong Kong Special Administrative Region, China
| | - Michael Ewers
- German Center for Neurodegenerative Diseases, Munich, Germany,Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians University, Munich, Germany
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases, Tübingen, Germany,Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, Tübingen, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases, Munich, Germany,Department of Neurology, University Hospital of Munich, Ludwig-Maximilians University, Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Christian Haass
- German Center for Neurodegenerative Diseases, Munich, Germany,Metabolic Biochemistry, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Gotsch SG, Williams CB, Bicaba R, Cruz-de Hoyos R, Darby A, Davidson K, Dix M, Duarte V, Glunk A, Green L, Ferguson B, Muñoz-Elizondo K, Murray JG, Picado-Fallas I, Nӕsborg R, Dawson TE, Nadkarni N. Trade-offs between succulent and non-succulent epiphytes underlie variation in drought tolerance and avoidance. Oecologia 2022; 198:645-661. [DOI: 10.1007/s00442-022-05140-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/19/2022] [Indexed: 11/28/2022]
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Gotsch SG, Williams CB, Bicaba R, Cruz-de Hoyos R, Darby A, Davidson K, Dix M, Duarte V, Glunk A, Green L, Ferguson B, Muñoz-Elizondo K, Murray JG, Picado-Fallas I, Nӕsborg R, Dawson TE, Nadkarni N. Trade-offs between succulent and non-succulent epiphytes underlie variation in drought tolerance and avoidance. Oecologia 2022; 198:645-661. [PMID: 35279723 DOI: 10.21203/rs.3.rs-899788/v1] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/19/2022] [Indexed: 05/25/2023]
Abstract
Epiphyte communities comprise important components of many forest ecosystems in terms of biomass and diversity, but little is known regarding trade-offs that underlie diversity and structure in these communities or the impact that microclimate has on epiphyte trait allocation. We measured 22 functional traits in vascular epiphyte communities across six sites that span a microclimatic gradient in a tropical montane cloud forest region in Costa Rica. We quantified traits that relate to carbon and nitrogen allocation, gas exchange, water storage, and drought tolerance. Functional diversity was high in all but the lowest elevation site where drought likely limits the success of certain species with particular trait combinations. For most traits, variation was explained by relationships with other traits, rather than differences in microclimate across sites. Although there were significant differences in microclimate, epiphyte abundance, and diversity, we found substantial overlap in multivariate trait space across five of the sites. We found significant correlations between functional traits, many of which related to water storage (leaf water content, leaf thickness, hydrenchymal thickness), drought tolerance (turgor loss point), and carbon allocation (specific leaf area, leaf dry matter content). This suite of trait correlations suggests that the epiphyte community has evolved functional strategies along with a drought avoidance versus drought tolerance continuum where leaf succulence emerged as a pivotal overall trait.
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Affiliation(s)
- S G Gotsch
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA.
| | - C B Williams
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
- Conservation and Research, Santa Barbara Botanic Garden, Santa Barbara, CA, USA
- Channel Islands National Park, Ventura, CA, USA
| | - R Bicaba
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
| | - R Cruz-de Hoyos
- Department of Integrative Biology, University of California-Berkeley, Berkeley, CA, USA
| | - A Darby
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
| | - K Davidson
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
- Department of Ecology and Evolution, Stony Brook University, Stony Brook, NY, USA
| | - M Dix
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
- Warnell School of Forestry and Natural Resources, University of Georgia, Athens, GA, USA
| | - V Duarte
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
| | - A Glunk
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
| | - L Green
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
| | - B Ferguson
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
| | - K Muñoz-Elizondo
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
| | - J G Murray
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
- Department of Biology, Utah State University, Logan, UT, USA
| | - I Picado-Fallas
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
| | - R Nӕsborg
- Department of Biology, Franklin and Marshall College, Lancaster, PA, USA
- Conservation and Research, Santa Barbara Botanic Garden, Santa Barbara, CA, USA
| | - T E Dawson
- Department of Integrative Biology, University of California-Berkeley, Berkeley, CA, USA
| | - N Nadkarni
- School of Biological Sciences, University of Utah, Salt Lake City, UT, USA
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Lopez OL, Kofler J, Chang Y, Berman SB, Becker JT, Sweet RA, Nadkarni N, Patira R, Kamboh MI, Cohen AD, Snitz BE, Kuller LH, Klunk WE. Hippocampal sclerosis, TDP-43, and the duration of the symptoms of dementia of AD patients. Ann Clin Transl Neurol 2020; 7:1546-1556. [PMID: 32735084 PMCID: PMC7480925 DOI: 10.1002/acn3.51135] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To examine the relationship between duration of the cognitive symptoms, from the earliest reported symptom to death, and hippocampal sclerosis (HS) and TAR-DNA binding protein of 43kDA (TDP-43) in Alzheimer's disease (AD) patients. METHODS The study was conducted in 359 cognitively impaired patients who met the pathological criteria for AD (NIA-Reagan intermediate or high). The mean age at onset was 69.5 ± 8.8 years (range 37-95) and the mean duration of the symptoms was 10.5 ± 4.2 years. The association between symptoms duration and HS and TDP-43 was examined with logistic regression analyses controlling for age at death, atherosclerosis in the Circle of Willis (CW), cerebral infarcts, gender, baseline Mini Mental State Examination scores, APOE-4 allele, and presence of Lewy bodies (LB). RESULTS HS was present in 18% (n = 64) and TDP-43 in 51.5% (n = 185) of the patients. HS and TDP-43 were more frequent in patients whose symptoms lasted more than 10 years. LBs were present in 72% of the patients with HS and in 64% of the patients with TDP-43. Age at onset was not associated with TDP-43 or HS. HS was associated with duration of symptoms and LB, TDP-43, and atherosclerosis in the CW. TDP-43 was associated with duration of symptoms, LB, and HS. INTERPRETATION HS and TDP-43 are present in early and late onset AD. However, their presence is mainly driven by the duration of symptoms and the presence of LB. This suggests that HS and TDP-43 are part of the later neuropathological changes in AD.
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Affiliation(s)
- Oscar L. Lopez
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Julia Kofler
- Department of PathologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - YueFang Chang
- Department of NeurosurgeryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Sarah B. Berman
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - James T. Becker
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
- Department of PsychologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Robert A. Sweet
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Neelesh Nadkarni
- Department of MedicineUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Riddhi Patira
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - M. Ilyas Kamboh
- Department of Human GeneticsUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Ann D. Cohen
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Beth E. Snitz
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Lewis H. Kuller
- Department of EpidemiologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - William E. Klunk
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
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Wanigatunga AA, Manini TM, Cook DR, Katula J, Fielding RA, Kramer AF, Verghese J, Rapp SR, Sink KM, King AC, Buford TW, Anton S, Nadkarni N, Jennings JM, Reid K, Espeland MA, Gill TM, Pahor M, Nocera JR. Community-Based Activity and Sedentary Patterns Are Associated With Cognitive Performance in Mobility-Limited Older Adults. Front Aging Neurosci 2018; 10:341. [PMID: 30498440 PMCID: PMC6249499 DOI: 10.3389/fnagi.2018.00341] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 10/10/2018] [Indexed: 01/07/2023] Open
Abstract
Over the last few decades, considerable evidence shows that greater levels of aerobic exercise and cardiovascular fitness benefit cognitive performance. However, the degree to which free-living activity in community settings is related to cognitive performance remains unclear, particularly in older adults vulnerable to disability. Also, it is unknown whether the manner in which daily physical activity (PA) and sedentary time are accumulated throughout the day is associated with cognition. Cross-sectional associations between accelerometer-characterized PA and sedentary patterns and cognitive performance were examined in 1,274 mobility-limited older adults. Percent time spent in various bout lengths of PA (≥1, ≥2, and ≥5 min) and sedentary (≥1, ≥30, and ≥60 min) was defined as the number of minutes registered divided by total wear time × 100. Percent time was then tertiled for each bout length. Multiple linear regression models were used to estimate the associations between accelerometer bout variables and separate cognitive domains that included processing speed (Digit Symbol Coding; DSC), immediate and delayed recall (Hopkins Verbal Learning Test; HVLT), information processing and selective attention (Flanker), working memory (n-back), reaction time (switch and non-switch reaction time), and a composite score that averaged results from all cognitive tests. After adjusting for demographics, behavioral factors, and morbid conditions, more time spent in PA was associated with higher DSC for all bout lengths (p < 0.03 for all). Higher PA was associated with higher HVLT and global cognition scores but only for longer bout lengths (p < 0.05 for all). The association was largely driven by participants who spent the lowest amount of time performing activity while awake (p < 0.04). An inverse linear relationship was observed between total sedentary time and DSC (p = 0.02), but not for other measures of cognition. These results suggest that, while higher PA was associated with higher cognitive performance, PA’s association with memory was sensitive to bout duration. The time, but not the manner, spent in sedentary behaviors showed a minor association with executive function. Further research is warranted to characterize longitudinal changes in daily activity and sedentary patterns as potential biophysical markers of cognitive status in older adults.
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Affiliation(s)
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
| | - Delilah R Cook
- Division of Public Health Sciences, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Jeffrey Katula
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Roger A Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Arthur F Kramer
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Joe Verghese
- Department of Neurology and Medicine, Albert Einstein of Yeshiva University, Bronx, NY, United States
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Kaycee M Sink
- Department of Internal Medicine (Gerontology/Geriatrics), Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Abby C King
- Stanford University School of Medicine, Stanford, CA, United States
| | - Thomas W Buford
- School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Steve Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
| | - Neelesh Nadkarni
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Janine M Jennings
- Department of Psychology, Wake Forest University, Winston-Salem, NC, United States
| | - Kieran Reid
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Thomas M Gill
- Yale School of Medicine, New Haven, CT, United States
| | - Marco Pahor
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
| | - Joe R Nocera
- Center for Visual and Neurocognitive Rehabilitation, Atlanta, GA, United States.,Division of Physical Therapy, Emory University, Atlanta, GA, United States.,Department of Neurology, Emory University, Atlanta, GA, United States
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8
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Nadkarni N, Snitz B, Perera S, Cohen A, Lopresti B, Barinas-Mitchell E, Klunk W, Lopez O. MOBILITY, BRAIN BLOOD FLOW, SYSTEMIC INFLAMMATION AND, CARDIAC AND ARTERIAL STIFFNESS IN COGNITIVELY NORMAL ELDERS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1350] [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: 11/13/2022] Open
Affiliation(s)
| | - B Snitz
- University of Pittsburgh, Pittsburgh, PA, USA
| | - S Perera
- University of Pittsburgh, Pittsburgh, PA, USA
| | - A Cohen
- University of Pittsburgh, Pittsburgh, PA
| | - B Lopresti
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - W Klunk
- University of Pittsburgh, Pittsburgh, PA, USA
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Wong T, Skanthakumar T, Nadkarni N, Nguyen H, Iyer N. Survival of Patients With Head and Neck Squamous Cell Carcinoma by Housing Subsidy in a Tiered Public Housing System. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.15200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Socioeconomic status affects survival in patients diagnosed with head and neck squamous cell carcinoma (HNSCC), even in health systems with universal health care. Singapore has a tiered subsidized housing system, in which income determines eligibility for subsidies by size of apartment. Aim: The objective of this study was to assess whether a patient's residential type (heavily subsidized public housing, moderately subsidized public housing, minimally subsidized or private residential housing type) was associated with mortality. A secondary analysis examined whether patients in more heavily subsidized apartments were more likely to present with advanced disease. Methods: An historical cohort study of patients in a tertiary referral center with HNSCC was identified in the multidisciplinary cancer database from 1992 to 2014. Clinicopathologic data were extracted for analysis. Patient residential postal codes were matched to type of housing. Logistic regression was performed to evaluate the relationship between all-cause mortality and the predictors of interest as well as the association between housing type and disease stage at presentation. Results: Of the 758 patients identified, most were men (73.4%), the median age was 64 years, 30.5% were smokers and 15.2% were ex-smokers. Over one-half (56.8%) of patients presented with advanced disease. Male gender (OR 2.01, 95% CI 1.16-3.48, P = 0.01), age (OR 1.03, 95% CI 1.01-1.05, P < 0.001), stage at presentation (stage 4, reference stage 1, OR 2.03, 95% CI 1.11-3.72, P = 0.02), smoker status (smoker, reference nonsmoker, OR 2.53, 95% CI 1.33-4.87, P < 0.01) and housing subsidy type (living in minimally subsidized or private residences, relative to heavily subsidized public housing, OR 0.36, 95% CI 0.15-0.78, P = 0.01) were significantly associated with increased mortality. Kaplan-Meier curves showed that patients living in the smaller, higher subsidy apartments had the worst adjusted survival, followed by patients in moderately subsidized housing, with those in minimally subsidized or private residences having the best adjusted survival. Patients in higher-subsidy apartments were not more likely to present with advanced disease, suggesting that the survival difference was not because of delayed presentation. Conclusion: Patients with HNSCC living in higher-subsidy residences have worse survival despite no apparent delays in presentation. First published: Cancer. 2017 Jun 1;123(11):1998-2005. doi: 10.1002/cncr.30557 . Epub 2017 Jan 30. Survival of patients with head and neck squamous cell carcinoma by housing subsidy in a tiered public housing system. Wong TH, Skanthakumar T, Nadkarni N, Nguyen HV, Iyer NG.
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Affiliation(s)
- T.H. Wong
- Singapore General Hospital, Department of General Surgery, Singapore, Singapore
| | - T. Skanthakumar
- Singapore General Hospital, Department of General Surgery, Singapore, Singapore
| | - N. Nadkarni
- Singapore General Hospital, Department of General Surgery, Singapore, Singapore
| | - H.V. Nguyen
- Singapore General Hospital, Department of General Surgery, Singapore, Singapore
| | - N.G. Iyer
- Singapore General Hospital, Department of General Surgery, Singapore, Singapore
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10
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Datta R, Trentalange M, Van Ness PH, McGloin JM, Guralnik JM, Miller ME, Walkup MP, Nadkarni N, Pahor M, Gill TM, Quagliarello V, Juthani-Mehta M. Serious adverse events of older adults in nursing home and community intervention trials. Contemp Clin Trials Commun 2017; 9:77-80. [PMID: 29696228 PMCID: PMC5898490 DOI: 10.1016/j.conctc.2017.12.004] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 11/29/2022] Open
Abstract
Background/Aims Clinical trials of older adults are increasingly common, but risks of serious adverse events (SAE) may vary. We describe the incidence of SAE in two randomized trials, one community-based and one nursing home-based. Methods We performed a secondary data analysis from two randomized clinical trials at one academic health center and 21 nursing homes involving 200 sedentary community dwellers aged 70–89 years and 185 female nursing home residents aged 65 years or older. Interventions included structured physical activity to reduce mobility disability in the Lifestyle Interventions and Independence for Elders (LIFE) study and oral cranberry capsules to reduce bacteriuria plus pyuria in nursing home residents (CRANNY) trial. We measured SAE incidence per 100 person-years and incidence of protocol-related unanticipated SAE per 100 person-years in LIFE and CRANNY trials. Results Mean age and proportion of patients with dementia in LIFE and CRANNY trials were 79.3 years and 86.4 years and 0% and 78%, respectively. There were 179 total SAE in LIFE including 8 (4%) deaths, and 116 total SAE in CRANNY including 33 (28%) deaths. SAE incidence was 33.7 (95% CI 27.2, 41.8) events per 100 person-years in LIFE and 69.4 (95% CI 49.1, 98.1) events per 100 person-years in CRANNY. No protocol-related unanticipated SAE occurred in either trial. Conclusions The frequency and severity of SAE vary in older adults. While SAE are common in nursing home residents, protocol-related, unanticipated SAE are rare in nursing home residents and community dwellers. This finding can inform trial monitoring protocols. Trial registration ClinicalTrials.gov identifiers: NCT01072500 and NCT01691430.
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Affiliation(s)
- Rupak Datta
- Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - Mark Trentalange
- Yale School of Medicine, Department of Internal Medicine, Section of Geriatrics, New Haven, CT, USA
| | - Peter H Van Ness
- Yale School of Medicine, Department of Internal Medicine, Section of Geriatrics, New Haven, CT, USA
| | - Joanne M McGloin
- Yale School of Medicine, Department of Internal Medicine, Section of Geriatrics, New Haven, CT, USA
| | - Jack M Guralnik
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, MD, USA
| | - Michael E Miller
- Wake Forest School of Medicine, Department of Biostatistical Sciences, Winston-Salem, NC, USA
| | - Michael P Walkup
- Wake Forest School of Medicine, Department of Biostatistical Sciences, Winston-Salem, NC, USA
| | - Neelesh Nadkarni
- University of Pittsburgh, Department of Medicine, Division of Geriatric Medicine, Pittsburgh, PA, USA
| | - Marco Pahor
- University of Florida, Department of Aging and Geriatric Research, Institute on Aging, Gainesville, FL, USA
| | - Thomas M Gill
- Yale School of Medicine, Department of Internal Medicine, Section of Geriatrics, New Haven, CT, USA
| | - Vincent Quagliarello
- Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - Manisha Juthani-Mehta
- Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, New Haven, CT, USA
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11
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Brach J, Perera S, Van Swearingen J, Gilmore S, Nadkarni N, Ricci E, Brodine D. EFFECTIVENESS OF MOTOR SKILL OF WALKING GROUP EXERCISE IN OLDER ADULTS: A CLUSTER RANDOMIZED TRIAL. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J. Brach
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - S. Perera
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | | | - S. Gilmore
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - N. Nadkarni
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - E. Ricci
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - D. Brodine
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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12
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Buford TW, Miller ME, Church TS, Gill TM, Henderson R, Hsu FC, McDermott MM, Nadkarni N, Pahor M, Stafford RS, Carter CS. Antihypertensive Use and the Effect of a Physical Activity Intervention in the Prevention of Major Mobility Disability Among Older Adults: The LIFE Study. J Gerontol A Biol Sci Med Sci 2016; 71:974-81. [PMID: 26865496 DOI: 10.1093/gerona/glv222] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 11/17/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This subgroup analysis of the Lifestyle Intervention and Independence for Elders trial evaluates the impact of a long-term physical activity (PA) intervention on rates of major mobility disability (MMD) among older adults according to their antihypertensive medication use. METHODS Lifestyle Intervention and Independence for Elders study participants were randomized to center-based PA or health education for a median of 2.7 years. Participants were sedentary men and women aged 70-89 years with objectively measured physical limitations. This analysis evaluated rates of MMD and persistent MMD among 1,633 participants, according to antihypertensive medication use. Participants were designated as either (i) an angiotensin-converting enzyme (ACE) inhibitor user (ACEi+), (ii) a user of other antihypertensives not including ACEi (ACEi-), or (iii) nonusers of antihypertensive medications (AHT-). Interactions were explored between antihypertensive use and randomized arm. RESULTS Interaction terms for MMD (p = .214) and persistent MMD (p = .180) did not reach statistical significance. For MMD, PA displayed marginal effects among ACEi+ (hazard ratio [HR] = 0.76; 95% confidence interval [CI] = 0.57, 1.02) and ACEi- (HR = 0.76; 95% CI = 0.60, 0.97) but not AHT- (HR = 1.19; 95% CI = 0.75, 1.87). For persistent MMD, the effect of PA was greatest among ACEi+ (HR = 0.57; 95% CI = 0.39, 0.84) when compared to ACEi- (HR = 0.76; 95% CI = 0.55, 1.06) or AHT- (HR = 1.18; 95% CI = 0.59, 2.36). CONCLUSIONS The effects of long-term PA on the incidence of MMD and persistent MMD were similar among three subgroups of older adults stratified by their antihypertensive medication use. However, though statistical interactions did not reach significance, several findings may warrant future study in other cohorts given the post hoc nature of this study.
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Affiliation(s)
- Thomas W Buford
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville.
| | - Michael E Miller
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Timothy S Church
- Preventive Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Thomas M Gill
- Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut
| | - Rebecca Henderson
- Section on Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Fang-Chi Hsu
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Mary M McDermott
- Department of Medicine and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Neelesh Nadkarni
- Department of Medicine, School of Medicine, University of Pittsburgh, Pennsylvania
| | - Marco Pahor
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville
| | - Randall S Stafford
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, California
| | - Christy S Carter
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville
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Davidenko O, Bonny JM, Benmoussa A, Claise B, Jean B, Nadkarni N, Fromentin G, Tomé D, Darcel N. P034: Étude par imagerie fonctionnelle des réponses cérébrales aux stimulations alimentaires d’intensité variable. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70677-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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14
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Davidenko O, Delarue J, Blumenthal D, Marsset-Baglieri A, Fromentin G, Darcel N, Tomé D, Nadkarni N. Two effects of sensory anticipation, assimilation and contrast, are on the same scale of anticipated-experienced pleasure divergence. Appetite 2014. [DOI: 10.1016/j.appet.2014.06.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Even P, Klila P, Nadkarni N, Chaumontet C, Azzout-Marniche D, Fromentin G, Tomé D. P109 Tolérance au glucose et sensibilité à l’insuline chez le rat sensible à l’obésité sous régime d’entretien standard. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70441-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pimentel G, Even P, Nadkarni N, Azzout-Marniche D, Fromentin G, Tomé D, Chaumontet C. P124 Influence de l’introduction d’un choix alimentaire sur l’évolution du poids, la composition corporelle et la réponse neuronale du noyau accumbens chez les rats sensibles ou résistants à l’obésité induite par un régime gras. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70456-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Affiliation(s)
- S Patil
- Department of Dermatology, Dr. D Y Patil Medical College and Research Centre, Nerul, Navi Mumbai, India
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Kazi SF, Godse K, Patil S, Nadkarni N. P2.029 All That is Genital is Not Venereal. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nadkarni N, Rogers L, Samuelson M, Neff T, Bender D, Ahmed A, De Geest K, Button A, Dupuy A, Goodheart M. An alternative ZMIZ1 promoter exhibits higher gene expression in epithelial ovarian cancer that is p53-independent. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Decker M, Nadkarni N, Neff T, Rogers L, Park S, Bender D, Ahmed A, DeGeest K, Dupuy A, Goodheart M. BRCA2 mutations substitute for wild type p53 in ovarian cancers with ZMIZ1 overexpression. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Strigenz M, Nadkarni N, Chin Y, Neff T, Park S, Bender D, Ahmed A, De Geest K, Goodheart M. Evaluation of EP300, a histone acetyletransferase, in patients with epithelial ovarian carcinoma. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gurfein B, Stamm A, Bacchetti P, Dallman M, Nadkarni N, Milush J, Touma C, Palme R, Pozzo Di Borgo C, Fromentin G, Lown-Hecht R, Konsman J, Acree M, Premenko-Lanier M, Darcel N, Hecht F, Nixon D. P01.43. The calm mouse: an animal model of stress reduction. Altern Ther Health Med 2012. [PMCID: PMC3373842 DOI: 10.1186/1472-6882-12-s1-p43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Calvez J, Fromentin G, Nadkarni N, Darcel N, Even P, Tomé D, Ballet N, Chaumontet C. Inhibition of food intake induced by acute stress in rats is due to satiation effects. Physiol Behav 2011; 104:675-83. [PMID: 21787797 DOI: 10.1016/j.physbeh.2011.07.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 07/07/2011] [Accepted: 07/08/2011] [Indexed: 11/17/2022]
Abstract
Acute mild stress induces an inhibition of food intake in rats. In most studies, the cumulative daily food intake is measured but this only provides a quantitative assessment of ingestive behavior. The present study was designed to analyze the reduction in food intake induced by acute stress and to understand which behavioral and central mechanisms are responsible for it. Two different stressors, restraint stress (RS) and forced swimming stress (FSS), were applied acutely to male Wistar rats. We first measured corticosterone and ACTH in plasma samples collected immediately after acute RS and FSS in order to validate our stress models. We measured food intake after RS and FSS and determined meal patterns and behavioral satiety sequences. The expressions of CRF, NPY and POMC in the hypothalamus were also determined immediately after acute RS and FSS. The rise in corticosterone and ACTH levels after both acute RS and FSS validated our models. Furthermore, we showed that acute stress induced a reduction in cumulative food intake which lasted the whole day for RS but only for the first hour after FSS. For both stressors, this stress-induced food intake inhibition was explained by a decrease in meal size and duration, but there was no difference in ingestion speed. The behavioral satiety sequence was preserved after RS and FSS but grooming was markedly increased, which thus competed with, and could reduce, other behaviors, including eating. Lastly, we showed that RS induced an increase in hypothalamic POMC expression. These results suggest that acute stress may affect ingestive behavior by increasing satiation and to some extent by enhancing grooming, and this may be due to stimulation of the hypothalamic POMC neurons.
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Affiliation(s)
- J Calvez
- INRA, UMR914 Nutrition Physiology and Ingestive Behavior, F-75005 Paris, France
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Tome D, Nadkarni N, Fromentin G, Chaumontet C, Azzout-Marniche D, Even P. Meal-induced increase in respiratory quotient but not basal energy expenditure or thermic effect of feeding can predict body fat gain sensitivity of rats to a low fat high carbohydrate diet. Appetite 2011. [DOI: 10.1016/j.appet.2011.05.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rasoamanana R, Fromentin G, Tome D, Nadkarni N, Chaumontet C, Darcel N. How can lipid decrease food and energy intakes? Appetite 2011. [DOI: 10.1016/j.appet.2011.05.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Calvez J, Fromentin G, Nadkarni N, Darcel N, Tomé D, Ballet N, Chaumontet C. Effect of chronic variable stress on central regulation of food intake and neurogenesis. Appetite 2010. [DOI: 10.1016/j.appet.2010.04.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zeeni N, Nadkarni N, Bell JD, Even PC, Fromentin G, Tome D, Darcel N. Peripherally injected cholecystokinin-induced neuronal activation is modified by dietary composition in mice. Neuroimage 2010; 50:1560-5. [PMID: 20100582 DOI: 10.1016/j.neuroimage.2010.01.065] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Revised: 12/18/2009] [Accepted: 01/18/2010] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to investigate the effect of long-term nutrient intake on the central response to the anorexigenic gut hormone CCK. C57BL/6 mice were fed one of three diets for 6 weeks: standard high carbohydrate (HC), high fat (HF), or high protein (HP). Assessment of brain response to cholecystokinin (CCK) by manganese-enhanced MRI (MEMRI) showed a reduction in neuronal activity both in an appetite-related area (ventromedial nucleus of the hypothalamus) and areas associated with reward (nucleus accumbens and striatum) regardless of diet. When comparing diet effects, while the HF diet did not induce any change in activity, reductions in MEMRI-associated signal were found in the paraventricular nucleus (PVN) and lateral hypothalamic area (LHA) when comparing the HP to the HC diet. In addition, a significant interaction was found between CCK administration and the HF diet, shown by an increased activation in the PVN, which suggests a decrease the inhibiting action of CCK. Our results put forward that the long-term intake of an HP diet leads to a reduction in basal hypothalamic activation while a high-fat diet leads to desensitization to CCK-induced effects in the hypothalamus.
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Affiliation(s)
- N Zeeni
- AgroParisTech, CNRH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, F-75005 Paris, France
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Abstract
A personality and behavioral disorder is an important and defining feature of frontal lobe dementia (FLD) or frontotemporal degeneration (FTD). The diagnosis usually depends on the progressive development of various behavioral symptoms rather than a set of neuropsychological measures. Quantification of the personality-behavior disorder is important for standardizing the diagnosis. An inventory was constructed to capture the major positive and negative behaviors and personality change, and it was administered prospectively to caregivers of 108 patients in a cognitive neurology clinic, at the time of first diagnostic assessment. The prevalence and extent of behavioral abnormality was quantitated in the clinic population of FLD, vascular dementia (VaD), Alzheimer's disease (AD), primary progressive aphasia (PPA), and depressive disorder (DD) patients. The mean scores of FLD patients were significantly above all other groups. Scores in VaD were also higher than in AD, PPA, and DD. Interrater reliability (Cohen's kappa of .90) and item consistency (a Cronbach alpha of .89) were both high. Perseveration, indifference, inattention, inappropriateness, and loss of insight rated highest in FLD, significantly different from all other groups. Apathy, aspontaneity, inflexibility, disorganization, impulsivity, personal neglect, and poor judgment were also significantly higher in FLD. Discriminant function correctly classified 92.7% versus all other patients (NON-FLD) in the study. A total of 18.8% of VaD patients were misclassified as FLD. Indifference, alien hand, and inappropriateness were the highest discriminant functions. Perseveration and verbal apraxia were important discriminatory items for FLD and PPA, respectively. The FBI is a standardized behavioral inventory useful to diagnose FLD, to differentiate it from other dementias, and to quantify the behavior disorder.
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Affiliation(s)
- A Kertesz
- Department of Cognitive Neurology, St. Joseph's Health Centre, London, Ontario, Canada
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Mandrekar SR, Pinto RG, Patil R, Vernekar J, Palyekar S, Nadkarni N. Solid and papillary epithelial neoplasm of the pancreas. Report of a case with diagnosis by fine needle aspiration cytology. Acta Cytol 1997; 41:1823-7. [PMID: 9390151 DOI: 10.1159/000333195] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Solid and papillary epithelial neoplasm of the pancreas is a distinct clinicopathologic entity. It has a benign clinical course, and surgical resection can be curative. CASE A 17-year-old female presented with a mass measuring about 12 cm in the epigastrium and left hypochondrium. Fine needle aspiration cytology (FNAC) showed papillae with a central fibrovascular core and lined with many layers of bland-appearing cells exhibiting nuclear grooving. These features, along with ultrasound and computed tomographic findings, led to an accurate preoperative diagnosis. CONCLUSION In the setting of typical clinical and radiologic findings, it is possible to make a correct preoperative diagnosis by FNAC. Doing so has important implications for management.
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Abstract
A 62-year-old woman developed profound weakness secondary to a progressive myopathy associated with primary systemic amyloidosis. The characteristic apple-green birefringent amyloid deposits were demonstrated surrounding individual muscle fibers in Congo red stained sections. Electron microscopy demonstrated amyloid filaments in close apposition to muscle fibers exhibiting excessive corrugations of the sarcolemmal membrane. The pathological features of progressive amyloid myopathy associated with primary systemic amyloidosis are distinct from the intracellular amyloid deposits characteristic of sporadic inclusion body myositis and inherited inclusion body myopathy.
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Affiliation(s)
- N Nadkarni
- Department of Neurology, College of Medicine, Ohio State University, Columbus 43210, USA
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Pinto RG, Mandreker S, Nadkarni N, Amonkar SS, Lobo D, Noronha FP. Plexiform (multinodular) schwannoma in a child - a rare variant of schwannoma. J Indian Med Assoc 1995; 93:318-17. [PMID: 8713250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- R G Pinto
- Department of Pathology, Goa Medical College, Goa
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Abstract
Clinical medicine is currently undergoing an enormous upheaval as a result of molecular genetics. Identifying the gene causing a specific disease almost immediately provides knowledge of the gene product and insight into pathogenesis. Mutations of the gene and measurable abnormalities of the gene product provide specific methods for diagnosis, prenatal counseling, and carrier detection. Perhaps, most importantly, new treatment strategies can be devised. In the review that follows, an update is provided on molecular findings in muscle diseases and how they can be applied in clinical practice.
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Affiliation(s)
- N Nadkarni
- Ohio State University College of Medicine, Columbus
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Burghes AH, Ingraham SE, Kóte-Jarai Z, Rosenfeld S, Herta N, Nadkarni N, DiDonato CJ, Carpten J, Hurko O, Florence J. Linkage mapping of the spinal muscular atrophy gene. Hum Genet 1994; 93:305-12. [PMID: 8125483 DOI: 10.1007/bf00212028] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Spinal muscular atrophy (SMA) is a common autosomal recessive disorder resulting in loss of motor neurons. We have performed linkage analysis on a panel of families using nine markers that are closely linked to the SMA gene. The highest lod score was obtained with the marker D5S351 (Zmax = 10.04 at theta = O excluding two unlinked families, and Zmax = 8.77 at theta = 0.007 with all families). One type III family did not show linkage to the 5q13 markers, and in one type I consanguineous family the affected individual did not show homozygosity except for the marker D5S435. Three recombinants were identified with the closet centromeric marker, D5S435, which position the gene telomeric of this marker. These recombinants will facilitate finer mapping of the location of the SMA gene. Lastly, two families provide strong evidence for a remarkable variability in presentation of the SMA phenotype, with the age at onset in one family varying from 17 months to 13 years.
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Affiliation(s)
- A H Burghes
- Department of Medical Biochemistry, College of Medicine, Ohio State University, Columbus 43210
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Pinto RG, Vernekar JA, Gawde G, Dias A, Menzes S, Nadkarni N. Congenital adenomatoid malformation of lung: a case report. INDIAN J PATHOL MICR 1993; 36:474-6. [PMID: 8157319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- R G Pinto
- Pathology Department, Goa Medical College, Bambolim
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Abstract
A patient with acute Guillain-Barré syndrome (GBS), recovering following plasmapheresis, developed bilateral optic neuritis with extensive CNS white matter lesions on MRI. This illness was associated with Mycoplasma pneumoniae infection. The rare association of GBS with CNS disease raises a possibility of a shared pathogenic CNS and PNS epitope in these cases.
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Affiliation(s)
- N Nadkarni
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI
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Mishra YC, Nadkarni N, Mainker AV. Mucoepidermoid carcinoma of minor salivary glands. J Pierre Fauchard Acad 1990; 4:165-7. [PMID: 2073367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Y C Mishra
- Dept. of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim
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Abstract
A case of pseudoglioma diagnosed on histopathology to be retinal tuberculosis is presented with a general review of the literature on ocular tuberculosis. The case is peculiar in that retinal tuberculosis occurred without concomitant involvement of the choroid.
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