1
|
Dodge HH, Yu K, Wu CY, Pruitt PJ, Asgari M, Kaye JA, Hampstead BM, Struble L, Potempa K, Lichtenberg P, Croff R, Albin RL, Silbert LC. Internet-Based Conversational Engagement Randomized Controlled Clinical Trial (I-CONECT) Among Socially Isolated Adults 75+ Years Old With Normal Cognition or Mild Cognitive Impairment: Topline Results. THE GERONTOLOGIST 2024; 64:gnad147. [PMID: 37935416 PMCID: PMC10943511 DOI: 10.1093/geront/gnad147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Social isolation is a risk factor for cognitive decline and dementia. We conducted a randomized controlled clinical trial (RCT) of enhanced social interactions, hypothesizing that conversational interactions can stimulate brain functions among socially isolated older adults without dementia. We report topline results of this multisite RCT (Internet-based conversational engagement clinical trial [I-CONECT]; NCT02871921). RESEARCH DESIGN AND METHODS The experimental group received cognitively stimulating semistructured conversations with trained interviewers via internet/webcam 4 times per week for 6 months (induction) and twice per week for an additional 6 months (maintenance). The experimental and control groups both received weekly 10 minutes telephone check-ins. Protocol modifications were required due to the coronavirus disease 2019 pandemic. RESULTS A total of 186 participants were randomized. After the induction period, the experimental group had higher global cognitive test scores (Montreal Cognitive Assessment [primary outcome]; 1.75 points [p = .03]) compared with the control group. After induction, experimental group participants with normal cognition had higher language-based executive function (semantic fluency test [secondary outcome]; 2.56 points [p = .03]). At the end of the maintenance period, the experimental group of mild cognitive impairment subjects had higher encoding function (Craft Story immediate recall test [secondary outcome]; 2.19 points [p = .04]). Measure of emotional well-being improved in both control and experimental groups. Resting-state functional magnetic resonance imaging showed that the experimental group had increased connectivity within the dorsal attention network relative to the control group (p = .02), but the sample size was limited. DISCUSSION AND IMPLICATIONS Providing frequent stimulating conversational interactions via the internet could be an effective home-based dementia risk-reduction strategy against social isolation and cognitive decline. CLINICAL TRIALS REGISTRATION NUMBER NCT02871921.
Collapse
Affiliation(s)
- Hiroko H Dodge
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
| | - Kexin Yu
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- Layton Aging and Alzheimer's Disease Center, Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Chao-Yi Wu
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
| | - Patrick J Pruitt
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Meysam Asgari
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - Jeffrey A Kaye
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- Layton Aging and Alzheimer's Disease Center, Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Benjamin M Hampstead
- Michigan Alzheimer's Disease Center, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- Research Program on Cognition and Neuromodulation Based Interventions, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Laura Struble
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Kathleen Potempa
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Peter Lichtenberg
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Raina Croff
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- Layton Aging and Alzheimer's Disease Center, Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Roger L Albin
- Michigan Alzheimer's Disease Center, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- GRECC & Neurology Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Lisa C Silbert
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- VA Portland Healthcare System, Portland, Oregon, USA
| |
Collapse
|
3
|
Čarna M, Onyango IG, Katina S, Holub D, Novotny JS, Nezvedova M, Jha D, Nedelska Z, Lacovich V, Vyvere TV, Houbrechts R, Garcia-Mansfield K, Sharma R, David-Dirgo V, Vyhnalek M, Texlova K, Chaves H, Bakkar N, Pertierra L, Vinkler M, Markova H, Laczo J, Sheardova K, Hortova-Kohoutkova M, Frič J, Forte G, Kaňovsky P, Belaškova S, Damborsky J, Hort J, Seyfried NT, Bowser R, Sevlever G, Rissman RA, Smith RA, Hajduch M, Pirrotte P, Spačil Z, Dammer EB, Limbäck-Stokin C, Stokin GB. Pathogenesis of Alzheimer's disease: Involvement of the choroid plexus. Alzheimers Dement 2023; 19:3537-3554. [PMID: 36825691 PMCID: PMC10634590 DOI: 10.1002/alz.12970] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/30/2022] [Accepted: 12/19/2022] [Indexed: 02/25/2023]
Abstract
The choroid plexus (ChP) produces and is bathed in the cerebrospinal fluid (CSF), which in aging and Alzheimer's disease (AD) shows extensive proteomic alterations including evidence of inflammation. Considering inflammation hampers functions of the involved tissues, the CSF abnormalities reported in these conditions are suggestive of ChP injury. Indeed, several studies document ChP damage in aging and AD, which nevertheless remains to be systematically characterized. We here report that the changes elicited in the CSF by AD are consistent with a perturbed aging process and accompanied by aberrant accumulation of inflammatory signals and metabolically active proteins in the ChP. Magnetic resonance imaging (MRI) imaging shows that these molecular aberrancies correspond to significant remodeling of ChP in AD, which correlates with aging and cognitive decline. Collectively, our preliminary post-mortem and in vivo findings reveal a repertoire of ChP pathologies indicative of its dysfunction and involvement in the pathogenesis of AD. HIGHLIGHTS: Cerebrospinal fluid changes associated with aging are perturbed in Alzheimer's disease Paradoxically, in Alzheimer's disease, the choroid plexus exhibits increased cytokine levels without evidence of inflammatory activation or infiltrates In Alzheimer's disease, increased choroid plexus volumes correlate with age and cognitive performance.
Collapse
Affiliation(s)
- Maria Čarna
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
| | - Isaac G. Onyango
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
| | - Stanislav Katina
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- Institute of Mathematics and Statistics, Masaryk University, Brno, Czech Republic
| | - Dušan Holub
- Institute for Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Jan Sebastian Novotny
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
| | - Marketa Nezvedova
- RECETOX Centre, Faculty of Sciences, Masaryk University, Brno, Czech Republic
| | - Durga Jha
- RECETOX Centre, Faculty of Sciences, Masaryk University, Brno, Czech Republic
| | - Zuzana Nedelska
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- Memory Clinic, Department of Neurology, 2 Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Valentina Lacovich
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
| | | | | | - Krystine Garcia-Mansfield
- Collaborative Center for Translational Mass Spectrometry, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Ritin Sharma
- Collaborative Center for Translational Mass Spectrometry, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Victoria David-Dirgo
- Collaborative Center for Translational Mass Spectrometry, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Martin Vyhnalek
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- Memory Clinic, Department of Neurology, 2 Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Kateřina Texlova
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
| | | | - Nadine Bakkar
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA
| | | | - Mojmir Vinkler
- Institute of Mathematics and Statistics, Masaryk University, Brno, Czech Republic
| | - Hana Markova
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- Memory Clinic, Department of Neurology, 2 Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Jan Laczo
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- Memory Clinic, Department of Neurology, 2 Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Kateřina Sheardova
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- 1 Department of Neurology, St. Anne’s University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Jan Frič
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Giancarlo Forte
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
| | - Petr Kaňovsky
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc and Research and Science Department, University Hospital Olomouc, Olomouc, Czech Republic
| | - Silvie Belaškova
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
| | - Jiři Damborsky
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- RECETOX Centre, Faculty of Sciences, Masaryk University, Brno, Czech Republic
| | - Jakub Hort
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- Memory Clinic, Department of Neurology, 2 Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Nicholas T. Seyfried
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Goizueta Alzheimer’s Disease Research Center, Emory University, Atlanta, GA, USA
- Departments of Biochemistry and Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Robert Bowser
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA
| | | | - Robert A. Rissman
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | | | - Marian Hajduch
- Institute for Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Patrick Pirrotte
- Collaborative Center for Translational Mass Spectrometry, Translational Genomics Research Institute, Phoenix, AZ, USA
- Mass Spectrometry & Proteomics Core Facility, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Zdeněk Spačil
- RECETOX Centre, Faculty of Sciences, Masaryk University, Brno, Czech Republic
| | - Eric B. Dammer
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Goizueta Alzheimer’s Disease Research Center, Emory University, Atlanta, GA, USA
| | - Clara Limbäck-Stokin
- Department of Cellular Pathology, Imperial College Healthcare NHS Trust, London, UK
- Imperial College London, Faculty of Medicine, London, UK
| | - Gorazd B. Stokin
- International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- Division of Neurology, University Medical Centre, Ljubljana, Slovenia
- Translational Aging and Neuroscience Program, Mayo Clinic, MN, Rochester, USA
| |
Collapse
|