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Papoutsi M, Flower M, Hensman Moss DJ, Holmans P, Estevez-Fraga C, Johnson EB, Scahill RI, Rees G, Langbehn D, Tabrizi SJ. Intellectual enrichment and genetic modifiers of cognition and brain volume in Huntington's disease. Brain Commun 2022; 4:fcac279. [PMID: 36519153 PMCID: PMC9732861 DOI: 10.1093/braincomms/fcac279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/22/2022] [Accepted: 10/27/2022] [Indexed: 12/14/2022] Open
Abstract
An important step towards the development of treatments for cognitive impairment in ageing and neurodegenerative diseases is to identify genetic and environmental modifiers of cognitive function and understand the mechanism by which they exert an effect. In Huntington's disease, the most common autosomal dominant dementia, a small number of studies have identified intellectual enrichment, i.e. a cognitively stimulating lifestyle and genetic polymorphisms as potential modifiers of cognitive function. The aim of our study was to further investigate the relationship and interaction between genetic factors and intellectual enrichment on cognitive function and brain atrophy in Huntington's disease. For this purpose, we analysed data from Track-HD, a multi-centre longitudinal study in Huntington's disease gene carriers and focused on the role of intellectual enrichment (estimated at baseline) and the genes FAN1, MSH3, BDNF, COMT and MAPT in predicting cognitive decline and brain atrophy. We found that carrying the 3a allele in the MSH3 gene had a positive effect on global cognitive function and brain atrophy in multiple cortical regions, such that 3a allele carriers had a slower rate of cognitive decline and atrophy compared with non-carriers, in agreement with its role in somatic instability. No other genetic predictor had a significant effect on cognitive function and the effect of MSH3 was independent of intellectual enrichment. Intellectual enrichment also had a positive effect on cognitive function; participants with higher intellectual enrichment, i.e. those who were better educated, had higher verbal intelligence and performed an occupation that was intellectually engaging, had better cognitive function overall, in agreement with previous studies in Huntington's disease and other dementias. We also found that intellectual enrichment interacted with the BDNF gene, such that the positive effect of intellectual enrichment was greater in Met66 allele carriers than non-carriers. A similar relationship was also identified for changes in whole brain and caudate volume; the positive effect of intellectual enrichment was greater for Met66 allele carriers, rather than for non-carriers. In summary, our study provides additional evidence for the beneficial role of intellectual enrichment and carrying the 3a allele in MSH3 in cognitive function in Huntington's disease and their effect on brain structure.
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Affiliation(s)
- Marina Papoutsi
- UCL Huntington’s Disease Centre, Queen Square Institute of Neurology, University College London, London, UK
- Ixico plc, London, UK
| | - Michael Flower
- UCL Huntington’s Disease Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Davina J Hensman Moss
- UCL Huntington’s Disease Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Peter Holmans
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Carlos Estevez-Fraga
- UCL Huntington’s Disease Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Eileanoir B Johnson
- UCL Huntington’s Disease Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Rachael I Scahill
- UCL Huntington’s Disease Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Geraint Rees
- Wellcome Centre for Human Neuroimaging, Queen Square Institute of Neurology, University College London, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Douglas Langbehn
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Sarah J Tabrizi
- UCL Huntington’s Disease Centre, Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute at University College London, London, UK
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Van Rheenen TE, Cropley V, Fagerlund B, Wannan C, Bruggemann J, Lenroot RK, Sundram S, Weickert CS, Weickert TW, Zalesky A, Bousman CA, Pantelis C. Cognitive reserve attenuates age-related cognitive decline in the context of putatively accelerated brain ageing in schizophrenia-spectrum disorders. Psychol Med 2020; 50:1475-1489. [PMID: 31274065 DOI: 10.1017/s0033291719001417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Indexed: 01/01/2023]
Abstract
BACKGROUND In schizophrenia, relative stability in the magnitude of cognitive deficits across age and illness duration is inconsistent with the evidence of accelerated deterioration in brain regions known to support these functions. These discrepant brain-cognition outcomes may be explained by variability in cognitive reserve (CR), which in neurological disorders has been shown to buffer against brain pathology and minimize its impact on cognitive or clinical indicators of illness. METHODS Age-related change in fluid reasoning, working memory and frontal brain volume, area and thickness were mapped using regression analysis in 214 individuals with schizophrenia or schizoaffective disorder and 168 healthy controls. In patients, these changes were modelled as a function of CR. RESULTS Patients showed exaggerated age-related decline in brain structure, but not fluid reasoning compared to controls. In the patient group, no moderation of age-related brain structural change by CR was evident. However, age-related cognitive change was moderated by CR, such that only patients with low CR showed evidence of exaggerated fluid reasoning decline that paralleled the exaggerated age-related deterioration of underpinning brain structures seen in all patients. CONCLUSIONS In schizophrenia-spectrum illness, CR may negate ageing effects on fluid reasoning by buffering against pathologically exaggerated structural brain deterioration through some form of compensation. CR may represent an important modifier that could explain inconsistencies in brain structure - cognition outcomes in the extant literature.
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Affiliation(s)
- Tamsyn E Van Rheenen
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Vanessa Cropley
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Birgitte Fagerlund
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center, Glostrup, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Cassandra Wannan
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
- Mental Health Program, Monash Health, Clayton, Victoria, Australia
| | - Cynthia Shannon Weickert
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
- Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, New York13210, USA
| | - Thomas W Weickert
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
| | - Andrew Zalesky
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- Department of Electrical and Electronic Engineering, University of Melbourne, VIC, Australia
| | - Chad A Bousman
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Departments of Medical Genetics, Psychiatry, and Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Department of Electrical and Electronic Engineering, University of Melbourne, VIC, Australia
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