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Pappalettera C, Carrarini C, Miraglia F, Vecchio F, Rossini PM. Cognitive resilience/reserve: Myth or reality? A review of definitions and measurement methods. Alzheimers Dement 2024; 20:3567-3586. [PMID: 38477378 PMCID: PMC11095447 DOI: 10.1002/alz.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 03/14/2024]
Abstract
INTRODUCTION This review examines the concept of cognitive reserve (CR) in relation to brain aging, particularly in the context of dementia and its early stages. CR refers to an individual's ability to maintain or regain cognitive function despite brain aging, damage, or disease. Various factors, including education, occupation complexity, leisure activities, and genetics are believed to influence CR. METHODS We revised the literature in the context of CR. A total of 842 articles were identified, then we rigorously assessed the relevance of articles based on titles and abstracts, employing a systematic approach to eliminate studies that did not align with our research objectives. RESULTS We evaluate-also in a critical way-the methods commonly used to define and measure CR, including sociobehavioral proxies, neuroimaging, and electrophysiological and genetic measures. The challenges and limitations of these measures are discussed, emphasizing the need for more targeted research to improve the understanding, definition, and measurement of CR. CONCLUSIONS The review underscores the significance of comprehending CR in the context of both normal and pathological brain aging and emphasizes the importance of further research to identify and enhance this protective factor for cognitive preservation in both healthy and neurologically impaired older individuals. HIGHLIGHTS This review examines the concept of cognitive reserve in brain aging, in the context of dementia and its early stages. We have evaluated the methods commonly used to define and measure cognitive reserve. Sociobehavioral proxies, neuroimaging, and electrophysiological and genetic measures are discussed. The review emphasizes the importance of further research to identify and enhance this protective factor for cognitive preservation.
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Affiliation(s)
- Chiara Pappalettera
- Brain Connectivity LaboratoryDepartment of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
- Department of Theoretical and Applied ScienceseCampus UniversityNovedrateItaly
| | - Claudia Carrarini
- Brain Connectivity LaboratoryDepartment of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
- Department of NeuroscienceCatholic University of Sacred HeartRomeItaly
| | - Francesca Miraglia
- Brain Connectivity LaboratoryDepartment of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
- Department of Theoretical and Applied ScienceseCampus UniversityNovedrateItaly
| | - Fabrizio Vecchio
- Brain Connectivity LaboratoryDepartment of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
- Department of Theoretical and Applied ScienceseCampus UniversityNovedrateItaly
| | - Paolo M. Rossini
- Brain Connectivity LaboratoryDepartment of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
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Zawiślak-Fornagiel K, Ledwoń D, Bugdol M, Grażyńska A, Ślot M, Tabaka-Pradela J, Bieniek I, Siuda J. Quantitative EEG Spectral and Connectivity Analysis for Cognitive Decline in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2024; 97:1235-1247. [PMID: 38217593 DOI: 10.3233/jad-230485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is considered to be the borderline of cognitive changes associated with aging and very early dementia. Cognitive functions in MCI can improve, remain stable or progress to clinically probable AD. Quantitative electroencephalography (qEEG) can become a useful tool for using the analytical techniques to quantify EEG patterns indicating cognitive impairment. OBJECTIVE The aim of our study was to assess spectral and connectivity analysis of the EEG resting state activity in amnestic MCI (aMCI) patients in comparison with healthy control group (CogN). METHODS 30 aMCI patients and 23 CogN group, matched by age and education, underwent equal neuropsychological assessment and EEG recording, according to the same protocol. RESULTS qEEG spectral analysis revealed decrease of global relative beta band power and increase of global relative theta and delta power in aMCI patients. Whereas, decreased coherence in centroparietal right area considered to be an early qEEG biomarker of functional disconnection of the brain network in aMCI patients. In conclusion, the demonstrated changes in qEEG, especially, the coherence patterns are specific biomarkers of cognitive impairment in aMCI. CONCLUSIONS Therefore, qEEG measurements appears to be a useful tool that complements neuropsychological diagnostics, assessing the risk of progression and provides a basis for possible interventions designed to improve cognitive functions or even inhibit the progression of the disease.
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Affiliation(s)
- Katarzyna Zawiślak-Fornagiel
- Department of Neurology, Prof. Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland
| | - Daniel Ledwoń
- Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - Monika Bugdol
- Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - Anna Grażyńska
- Department of Imaging Diagnostics and Interventional Radiology, Prof. Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland
| | - Maciej Ślot
- Department of Solid State Physics, Faculty of Physics and Applied Computer Science, University of Łódź, Łódź, Poland
| | - Justyna Tabaka-Pradela
- Department of Neurology, Prof. Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland
| | - Izabela Bieniek
- Department of Neurology, Prof. Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland
| | - Joanna Siuda
- Department of Neurology, Prof. Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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3
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Cabrera-Álvarez J, Sánchez-Claros J, Carrasco-Gómez M, del Cerro-León A, Gómez-Ariza CJ, Maestú F, Mirasso CR, Susi G. Understanding the effects of cortical gyrification in tACS: insights from experiments and computational models. Front Neurosci 2023; 17:1223950. [PMID: 37655010 PMCID: PMC10467425 DOI: 10.3389/fnins.2023.1223950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/25/2023] [Indexed: 09/02/2023] Open
Abstract
The alpha rhythm is often associated with relaxed wakefulness or idling and is altered by various factors. Abnormalities in the alpha rhythm have been linked to several neurological and psychiatric disorders, including Alzheimer's disease. Transcranial alternating current stimulation (tACS) has been proposed as a potential tool to restore a disrupted alpha rhythm in the brain by stimulating at the individual alpha frequency (IAF), although some research has produced contradictory results. In this study, we applied an IAF-tACS protocol over parieto-occipital areas to a sample of healthy subjects and measured its effects over the power spectra. Additionally, we used computational models to get a deeper understanding of the results observed in the experiment. Both experimental and numerical results showed an increase in alpha power of 8.02% with respect to the sham condition in a widespread set of regions in the cortex, excluding some expected parietal regions. This result could be partially explained by taking into account the orientation of the electric field with respect to the columnar structures of the cortex, showing that the gyrification in parietal regions could generate effects in opposite directions (hyper-/depolarization) at the same time in specific brain regions. Additionally, we used a network model of spiking neuronal populations to explore the effects that these opposite polarities could have on neural activity, and we found that the best predictor of alpha power was the average of the normal components of the electric field. To sum up, our study sheds light on the mechanisms underlying tACS brain activity modulation, using both empirical and computational approaches. Non-invasive brain stimulation techniques hold promise for treating brain disorders, but further research is needed to fully understand and control their effects on brain dynamics and cognition. Our findings contribute to this growing body of research and provide a foundation for future studies aimed at optimizing the use of non-invasive brain stimulation in clinical settings.
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Affiliation(s)
- Jesús Cabrera-Álvarez
- Centre for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
| | - Jaime Sánchez-Claros
- Instituto de Física Interdisciplinar y Sistemas Complejos (IFISC, UIB-CSIC), Campus UIB, Palma de Mallorca, Spain
| | - Martín Carrasco-Gómez
- Centre for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
| | - Alberto del Cerro-León
- Centre for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
| | | | - Fernando Maestú
- Centre for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
| | - Claudio R. Mirasso
- Instituto de Física Interdisciplinar y Sistemas Complejos (IFISC, UIB-CSIC), Campus UIB, Palma de Mallorca, Spain
| | - Gianluca Susi
- Centre for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain
- Department of Structure of Matter, Thermal Physics and Electronics, School of Physics, Complutense University of Madrid, Madrid, Spain
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Berger M, Ryu D, Reese M, McGuigan S, Evered LA, Price CC, Scott DA, Westover MB, Eckenhoff R, Bonanni L, Sweeney A, Babiloni C. A Real-Time Neurophysiologic Stress Test for the Aging Brain: Novel Perioperative and ICU Applications of EEG in Older Surgical Patients. Neurotherapeutics 2023; 20:975-1000. [PMID: 37436580 PMCID: PMC10457272 DOI: 10.1007/s13311-023-01401-4] [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] [Accepted: 05/29/2023] [Indexed: 07/13/2023] Open
Abstract
As of 2022, individuals age 65 and older represent approximately 10% of the global population [1], and older adults make up more than one third of anesthesia and surgical cases in developed countries [2, 3]. With approximately > 234 million major surgical procedures performed annually worldwide [4], this suggests that > 70 million surgeries are performed on older adults across the globe each year. The most common postoperative complications seen in these older surgical patients are perioperative neurocognitive disorders including postoperative delirium, which are associated with an increased risk for mortality [5], greater economic burden [6, 7], and greater risk for developing long-term cognitive decline [8] such as Alzheimer's disease and/or related dementias (ADRD). Thus, anesthesia, surgery, and postoperative hospitalization have been viewed as a biological "stress test" for the aging brain, in which postoperative delirium indicates a failed stress test and consequent risk for later cognitive decline (see Fig. 3). Further, it has been hypothesized that interventions that prevent postoperative delirium might reduce the risk of long-term cognitive decline. Recent advances suggest that rather than waiting for the development of postoperative delirium to indicate whether a patient "passed" or "failed" this stress test, the status of the brain can be monitored in real-time via electroencephalography (EEG) in the perioperative period. Beyond the traditional intraoperative use of EEG monitoring for anesthetic titration, perioperative EEG may be a viable tool for identifying waveforms indicative of reduced brain integrity and potential risk for postoperative delirium and long-term cognitive decline. In principle, research incorporating routine perioperative EEG monitoring may provide insight into neuronal patterns of dysfunction associated with risk of postoperative delirium, long-term cognitive decline, or even specific types of aging-related neurodegenerative disease pathology. This research would accelerate our understanding of which waveforms or neuronal patterns necessitate diagnostic workup and intervention in the perioperative period, which could potentially reduce postoperative delirium and/or dementia risk. Thus, here we present recommendations for the use of perioperative EEG as a "predictor" of delirium and perioperative cognitive decline in older surgical patients.
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Affiliation(s)
- Miles Berger
- Department of Anesthesiology, Duke University Medical Center, Duke South Orange Zone Room 4315B, Box 3094, Durham, NC, 27710, USA.
- Duke Aging Center, Duke University Medical Center, Durham, NC, USA.
- Duke/UNC Alzheimer's Disease Research Center, Duke University Medical Center, Durham, NC, USA.
| | - David Ryu
- School of Medicine, Duke University, Durham, NC, USA
| | - Melody Reese
- Department of Anesthesiology, Duke University Medical Center, Duke South Orange Zone Room 4315B, Box 3094, Durham, NC, 27710, USA
- Duke Aging Center, Duke University Medical Center, Durham, NC, USA
| | - Steven McGuigan
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Melbourne, VIC, Australia
- Department of Critical Care, School of Medicine, University of Melbourne, Melbourne, Australia
| | - Lisbeth A Evered
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Melbourne, VIC, Australia
- Department of Critical Care, School of Medicine, University of Melbourne, Melbourne, Australia
- Weill Cornell Medicine, New York, NY, USA
| | - Catherine C Price
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - David A Scott
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Melbourne, VIC, Australia
- Department of Critical Care, School of Medicine, University of Melbourne, Melbourne, Australia
| | - M Brandon Westover
- Department of Neurology, Beth Israel Deaconess Hospital, Boston, MA, USA
| | - Roderic Eckenhoff
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura Bonanni
- Department of Medicine and Aging Sciences, University G d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Aoife Sweeney
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
- San Raffaele of Cassino, Cassino, FR, Italy
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5
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Ulbl J, Rakusa M. The Importance of Subjective Cognitive Decline Recognition and the Potential of Molecular and Neurophysiological Biomarkers-A Systematic Review. Int J Mol Sci 2023; 24:10158. [PMID: 37373304 DOI: 10.3390/ijms241210158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/01/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are early stages of Alzheimer's disease (AD). Neurophysiological markers such as electroencephalography (EEG) and event-related potential (ERP) are emerging as alternatives to traditional molecular and imaging markers. This paper aimed to review the literature on EEG and ERP markers in individuals with SCD. We analysed 30 studies that met our criteria, with 17 focusing on resting-state or cognitive task EEG, 11 on ERPs, and two on both EEG and ERP parameters. Typical spectral changes were indicative of EEG rhythm slowing and were associated with faster clinical progression, lower education levels, and abnormal cerebrospinal fluid biomarkers profiles. Some studies found no difference in ERP components between SCD subjects, controls, or MCI, while others reported lower amplitudes in the SCD group compared to controls. Further research is needed to explore the prognostic value of EEG and ERP in relation to molecular markers in individuals with SCD.
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Affiliation(s)
- Janina Ulbl
- Division of Neurology, University Medical Centre Maribor, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
| | - Martin Rakusa
- Division of Neurology, University Medical Centre Maribor, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
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Hampel H, Gao P, Cummings J, Toschi N, Thompson PM, Hu Y, Cho M, Vergallo A. The foundation and architecture of precision medicine in neurology and psychiatry. Trends Neurosci 2023; 46:176-198. [PMID: 36642626 PMCID: PMC10720395 DOI: 10.1016/j.tins.2022.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/18/2022] [Accepted: 12/14/2022] [Indexed: 01/15/2023]
Abstract
Neurological and psychiatric diseases have high degrees of genetic and pathophysiological heterogeneity, irrespective of clinical manifestations. Traditional medical paradigms have focused on late-stage syndromic aspects of these diseases, with little consideration of the underlying biology. Advances in disease modeling and methodological design have paved the way for the development of precision medicine (PM), an established concept in oncology with growing attention from other medical specialties. We propose a PM architecture for central nervous system diseases built on four converging pillars: multimodal biomarkers, systems medicine, digital health technologies, and data science. We discuss Alzheimer's disease (AD), an area of significant unmet medical need, as a case-in-point for the proposed framework. AD can be seen as one of the most advanced PM-oriented disease models and as a compelling catalyzer towards PM-oriented neuroscience drug development and advanced healthcare practice.
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Affiliation(s)
- Harald Hampel
- Alzheimer's Disease & Brain Health, Eisai Inc., Nutley, NJ, USA.
| | - Peng Gao
- Alzheimer's Disease & Brain Health, Eisai Inc., Nutley, NJ, USA
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), Las Vegas, NV, USA
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Yan Hu
- Alzheimer's Disease & Brain Health, Eisai Inc., Nutley, NJ, USA
| | - Min Cho
- Alzheimer's Disease & Brain Health, Eisai Inc., Nutley, NJ, USA
| | - Andrea Vergallo
- Alzheimer's Disease & Brain Health, Eisai Inc., Nutley, NJ, USA
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7
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Sibilano E, Brunetti A, Buongiorno D, Lassi M, Grippo A, Bessi V, Micera S, Mazzoni A, Bevilacqua V. An attention-based deep learning approach for the classification of subjective cognitive decline and mild cognitive impairment using resting-state EEG. J Neural Eng 2023; 20. [PMID: 36745929 DOI: 10.1088/1741-2552/acb96e] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/06/2023] [Indexed: 02/08/2023]
Abstract
Objective. This study aims to design and implement the first deep learning (DL) model to classify subjects in the prodromic states of Alzheimer's disease (AD) based on resting-state electroencephalographic (EEG) signals.Approach. EEG recordings of 17 healthy controls (HCs), 56 subjective cognitive decline (SCD) and 45 mild cognitive impairment (MCI) subjects were acquired at resting state. After preprocessing, we selected sections corresponding to eyes-closed condition. Five different datasets were created by extracting delta, theta, alpha, beta and delta-to-theta frequency bands using bandpass filters. To classify SCDvsMCI and HCvsSCDvsMCI, we propose a framework based on the transformer architecture, which uses multi-head attention to focus on the most relevant parts of the input signals. We trained and validated the model on each dataset with a leave-one-subject-out cross-validation approach, splitting the signals into 10 s epochs. Subjects were assigned to the same class as the majority of their epochs. Classification performances of the transformer were assessed for both epochs and subjects and compared with other DL models.Main results. Results showed that the delta dataset allowed our model to achieve the best performances for the discrimination of SCD and MCI, reaching an Area Under the ROC Curve (AUC) of 0.807, while the highest results for the HCvsSCDvsMCI classification were obtained on alpha and theta with a micro-AUC higher than 0.74.Significance. We demonstrated that DL approaches can support the adoption of non-invasive and economic techniques as EEG to stratify patients in the clinical population at risk for AD. This result was achieved since the attention mechanism was able to learn temporal dependencies of the signal, focusing on the most discriminative patterns, achieving state-of-the-art results by using a deep model of reduced complexity. Our results were consistent with clinical evidence that changes in brain activity are progressive when considering early stages of AD.
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Affiliation(s)
- Elena Sibilano
- Department of Electrical and Information Engineering, Polytechnic University of Bari, Via Orabona 4, 70125 Bari, Italy
| | - Antonio Brunetti
- Department of Electrical and Information Engineering, Polytechnic University of Bari, Via Orabona 4, 70125 Bari, Italy
| | - Domenico Buongiorno
- Department of Electrical and Information Engineering, Polytechnic University of Bari, Via Orabona 4, 70125 Bari, Italy
| | - Michael Lassi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, 56025 Pisa, Italy
| | | | - Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera Careggi, Florence, Italy
| | - Silvestro Micera
- The BioRobotics Institute, Scuola Superiore Sant'Anna, 56025 Pisa, Italy.,Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, Institute of Bioengineering, School of Engineering, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Alberto Mazzoni
- The BioRobotics Institute, Scuola Superiore Sant'Anna, 56025 Pisa, Italy
| | - Vitoantonio Bevilacqua
- Department of Electrical and Information Engineering, Polytechnic University of Bari, Via Orabona 4, 70125 Bari, Italy
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Choi J, Ku B, Doan DNT, Park J, Cha W, Kim JU, Lee KH. Prefrontal EEG slowing, synchronization, and ERP peak latency in association with predementia stages of Alzheimer's disease. Front Aging Neurosci 2023; 15:1131857. [PMID: 37032818 PMCID: PMC10076640 DOI: 10.3389/fnagi.2023.1131857] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background Early screening of elderly individuals who are at risk of dementia allows timely medical interventions to prevent disease progression. The portable and low-cost electroencephalography (EEG) technique has the potential to serve it. Objective We examined prefrontal EEG and event-related potential (ERP) variables in association with the predementia stages of Alzheimer's disease (AD). Methods One hundred elderly individuals were recruited from the GARD cohort. The participants were classified into four groups according to their amyloid beta deposition (A+ or A-) and neurodegeneration status (N+ or N-): cognitively normal (CN; A-N-, n = 27), asymptomatic AD (aAD; A + N-, n = 15), mild cognitive impairment (MCI) with AD pathology (pAD; A+N+, n = 16), and MCI with non-AD pathology (MCI(-); A-N+, n = 42). Prefrontal resting-state eyes-closed EEG measurements were recorded for five minutes and auditory ERP measurements were recorded for 8 min. Three variables of median frequency (MDF), spectrum triangular index (STI), and positive-peak latency (PPL) were employed to reflect EEG slowing, temporal synchrony, and ERP latency, respectively. Results Decreasing prefrontal MDF and increasing PPL were observed in the MCI with AD pathology. Interestingly, after controlling for age, sex, and education, we found a significant negative association between MDF and the aAD and pAD stages with an odds ratio (OR) of 0.58. Similarly, PPL exhibited a significant positive association with these AD stages with an OR of 2.36. Additionally, compared with the MCI(-) group, significant negative associations were demonstrated by the aAD group with STI and those in the pAD group with MDF with ORs of 0.30 and 0.42, respectively. Conclusion Slow intrinsic EEG oscillation is associated with MCI due to AD, and a delayed ERP peak latency is likely associated with general cognitive impairment. MCI individuals without AD pathology exhibited better cortical temporal synchronization and faster EEG oscillations than those with aAD or pAD. Significance The EEG/ERP variables obtained from prefrontal EEG techniques are associated with early cognitive impairment due to AD and non-AD pathology. This result suggests that prefrontal EEG/ERP metrics may serve as useful indicators to screen elderly individuals' early stages on the AD continuum as well as overall cognitive impairment.
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Affiliation(s)
- Jungmi Choi
- Human Anti-Aging Standards Research Institute, Uiryeong-gun, Republic of Korea
| | - Boncho Ku
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Dieu Ni Thi Doan
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Junwoo Park
- Gwangju Alzheimer’s Disease and Related Dementias Cohort Research Center, Chosun University, Gwangju, Republic of Korea
| | - Wonseok Cha
- Human Anti-Aging Standards Research Institute, Uiryeong-gun, Republic of Korea
| | - Jaeuk U. Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
- *Correspondence: Jaeuk U. Kim,
| | - Kun Ho Lee
- Gwangju Alzheimer’s Disease and Related Dementias Cohort Research Center, Chosun University, Gwangju, Republic of Korea
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
- Kun Ho Lee,
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9
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Alzheimer's Disease: Treatment Strategies and Their Limitations. Int J Mol Sci 2022; 23:ijms232213954. [PMID: 36430432 PMCID: PMC9697769 DOI: 10.3390/ijms232213954] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Alzheimer's disease (AD) is the most frequent case of neurodegenerative disease and is becoming a major public health problem all over the world. Many therapeutic strategies have been explored for several decades; however, there is still no curative treatment, and the priority remains prevention. In this review, we present an update on the clinical and physiological phase of the AD spectrum, modifiable and non-modifiable risk factors for AD treatment with a focus on prevention strategies, then research models used in AD, followed by a discussion of treatment limitations. The prevention methods can significantly slow AD evolution and are currently the best strategy possible before the advanced stages of the disease. Indeed, current drug treatments have only symptomatic effects, and disease-modifying treatments are not yet available. Drug delivery to the central nervous system remains a complex process and represents a challenge for developing therapeutic and preventive strategies. Studies are underway to test new techniques to facilitate the bioavailability of molecules to the brain. After a deep study of the literature, we find the use of soft nanoparticles, in particular nanoliposomes and exosomes, as an innovative approach for preventive and therapeutic strategies in reducing the risk of AD and solving problems of brain bioavailability. Studies show the promising role of nanoliposomes and exosomes as smart drug delivery systems able to penetrate the blood-brain barrier and target brain tissues. Finally, the different drug administration techniques for neurological disorders are discussed. One of the promising therapeutic methods is the intranasal administration strategy which should be used for preclinical and clinical studies of neurodegenerative diseases.
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10
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Chedid N, Tabbal J, Kabbara A, Allouch S, Hassan M. The development of an automated machine learning pipeline for the detection of Alzheimer's Disease. Sci Rep 2022; 12:18137. [PMID: 36307518 PMCID: PMC9616932 DOI: 10.1038/s41598-022-22979-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/21/2022] [Indexed: 12/30/2022] Open
Abstract
Although Alzheimer's disease is the most prevalent form of dementia, there are no treatments capable of slowing disease progression. A lack of reliable disease endpoints and/or biomarkers contributes in part to the absence of effective therapies. Using machine learning to analyze EEG offers a possible solution to overcome many of the limitations of current diagnostic modalities. Here we develop a logistic regression model with an accuracy of 81% that addresses many of the shortcomings of previous works. To our knowledge, no other study has been able to solve the following problems simultaneously: (1) a lack of automation and unbiased removal of artifacts, (2) a dependence on a high level of expertise in data pre-processing and ML for non-automated processes, (3) the need for very large sample sizes and accurate EEG source localization using high density systems, (4) and a reliance on black box ML approaches such as deep neural nets with unexplainable feature selection. This study presents a proof-of-concept for an automated and scalable technology that could potentially be used to diagnose AD in clinical settings as an adjunct to conventional neuropsychological testing, thus enhancing efficiency, reproducibility, and practicality of AD diagnosis.
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Affiliation(s)
| | - Judie Tabbal
- MINDig, 35000 Rennes, France ,Institute of Clinical Neurosciences of Rennes (INCR), Rennes, France
| | | | - Sahar Allouch
- grid.410368.80000 0001 2191 9284Univ Rennes, Inserm, LTSI-U1099, 35000 Rennes, France ,Azm Center for Research in Biotechnology and Its Applications, EDST, Tripoli, Lebanon
| | - Mahmoud Hassan
- MINDig, 35000 Rennes, France ,grid.9580.40000 0004 0643 5232School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
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11
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Ferrari-Díaz M, Bravo-Chávez RI, Silva-Pereyra J, Fernández T, García-Peña C, Rodríguez-Camacho M. Verbal intelligence and leisure activities are associated with cognitive performance and resting-state electroencephalogram. Front Aging Neurosci 2022; 14:921518. [PMID: 36268192 PMCID: PMC9577299 DOI: 10.3389/fnagi.2022.921518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022] Open
Abstract
Cognitive reserve (CR) is the adaptability of cognitive processes that helps to explain differences in the susceptibility of cognitive or daily functions to resist the onslaught of brain-related injury or the normal aging process. The underlying brain mechanisms of CR studied through electroencephalogram (EEG) are scarcely reported. To our knowledge, few studies have considered a combination of exclusively dynamic proxy measures of CR. We evaluated the association of CR with cognition and resting-state EEG in older adults using three of the most frequently used dynamic proxy measures of CR: verbal intelligence, leisure activities, and physical activities. Multiple linear regression analyses with the CR proxies as independent variables and cognitive performance and the absolute power (AP) on six resting-state EEG components (beta, alpha1, alpha2, gamma, theta, and delta) as outcomes were performed. Eighty-eight healthy older adults aged 60–77 (58 female) were selected from previous study data. Verbal intelligence was a significant positive predictor of perceptual organization, working memory, processing speed, executive functions, and central delta power. Leisure activities were a significant positive predictor of posterior alpha2 power. The dynamic proxy variables of CR are differently associated with cognitive performance and resting-state EEG. Implementing leisure activities and tasks to increase vocabulary may promote better cognitive performance through compensation or neural efficiency mechanisms.
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Affiliation(s)
- Martina Ferrari-Díaz
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
| | - Ricardo Iván Bravo-Chávez
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
| | - Juan Silva-Pereyra
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
- *Correspondence: Juan Silva-Pereyra,
| | - Thalía Fernández
- Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Juriquilla, Mexico
| | - Carmen García-Peña
- Departamento de Investigación, Instituto Nacional de Geriatría, Ciudad de México, Mexico
| | - Mario Rodríguez-Camacho
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Mexico
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12
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Buján A, Sampaio A, Pinal D. Resting-state electroencephalographic correlates of cognitive reserve: Moderating the age-related worsening in cognitive function. Front Aging Neurosci 2022; 14:854928. [PMID: 36185469 PMCID: PMC9521492 DOI: 10.3389/fnagi.2022.854928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
This exploratory study aimed to investigate the resting-state electroencephalographic (rsEEG) correlates of the cognitive reserve from a life span perspective. Current source density (CSD) and lagged-linear connectivity (LLC) measures were assessed to this aim. We firstly explored the relationship between rsEEG measures for the different frequency bands and a socio-behavioral proxy of cognitive reserve, the Cognitive Reserve Index (CRI). Secondly, we applied moderation analyses to assess whether any of the correlated rsEEG measures showed a moderating role in the relationship between age and cognitive function. Moderate negative correlations were found between the CRI and occipital CSD of delta and beta 2. Moreover, inter- and intrahemispheric LLC measures were correlated with the CRI, showing a negative association with delta and positive associations with alpha 1, beta 1, and beta 2. Among those correlated measures, just two rsEEG variables were significant moderators of the relationship between age and cognition: occipital delta CSD and right hemispheric beta 2 LLC between occipital and limbic regions. The effect of age on cognitive performance was stronger for higher values of both measures. Therefore, lower values of occipital delta CSD and lower beta 2 LLC between right occipital and limbic regions might protect or compensate for the effects of age on cognition. Results of this exploratory study might be helpful to allocate more preventive efforts to curb the progression of cognitive decline in adults with less CR, possibly characterized by these rsEEG parameters at a neural level. However, given the exploratory nature of this study, more conclusive work on these rsEEG measures is needed to firmly establish their role in the cognition–age relationship, for example, verifying if these measures moderate the relationship between brain structure and cognition.
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13
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Arakaki X, Hung SM, Rochart R, Fonteh AN, Harrington MG. Alpha desynchronization during Stroop test unmasks cognitively healthy individuals with abnormal CSF Amyloid/Tau. Neurobiol Aging 2022; 112:87-101. [PMID: 35066324 PMCID: PMC8976735 DOI: 10.1016/j.neurobiolaging.2021.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/27/2021] [Accepted: 11/30/2021] [Indexed: 01/15/2023]
Abstract
Synaptic dysfunctions precede cognitive decline in Alzheimer's disease by decades, affect executive functions, and can be detected by quantitative electroencephalography (qEEG). We used quantitative electroencephalography combined with Stroop testing to identify changes of inhibitory controls in cognitively healthy individuals with an abnormal versus normal ratio of cerebrospinal fluid (CSF) amyloid/total-tau. We studied two groups of participants (60-94 years) with either normal (CH-NAT or controls, n = 20) or abnormal (CH-PAT, n = 21) CSF amyloid/tau ratio. We compared: alpha event-related desynchronization (ERD), alpha spectral entropy (SE), and their relationships with estimated cognitive reserve. CH-PATs had more negative occipital alpha ERD, and higher frontal and occipital alpha SE during low load congruent trials, indicating hyperactivity. CH-PATs demonstrated fewer frontal SE changes with higher load, incongruent Stroop testing. Correlations of alpha ERD with estimated cognitive reserve were significant in CH-PATs but not in CH-NATs. These results suggested compensatory hyperactivity in CH-PATs compared to CH-NATs. We did not find differences in alpha ERD comparisons with individual CSF amyloid(A), p-tau(T), total-tau(N) biomarkers.
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14
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Kok FK, van Leerdam SL, de Lange ECM. Potential Mechanisms Underlying Resistance to Dementia in Non-Demented Individuals with Alzheimer's Disease Neuropathology. J Alzheimers Dis 2022; 87:51-81. [PMID: 35275527 PMCID: PMC9198800 DOI: 10.3233/jad-210607] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Alzheimer’s disease (AD) is the most common form of dementia and typically characterized by the accumulation of amyloid-β plaques and tau tangles. Intriguingly, there also exists a group of elderly which do not develop dementia during their life, despite the AD neuropathology, the so-called non-demented individuals with AD neuropathology (NDAN). In this review, we provide extensive background on AD pathology and normal aging and discuss potential mechanisms that enable these NDAN individuals to remain cognitively intact. Studies presented in this review show that NDAN subjects are generally higher educated and have a larger cognitive reserve. Furthermore, enhanced neural hypertrophy could compensate for hippocampal and cingulate neural atrophy in NDAN individuals. On a cellular level, these individuals show increased levels of neural stem cells and ‘von Economo neurons’. Furthermore, in NDAN brains, binding of Aβ oligomers to synapses is prevented, resulting in decreased glial activation and reduced neuroinflammation. Overall, the evidence stated here strengthens the idea that some individuals are more resistant to AD pathology, or at least show an elongation of the asymptomatic state of the disease compared to others. Insights into the mechanisms underlying this resistance could provide new insight in understanding normal aging and AD itself. Further research should focus on factors and mechanisms that govern the NDAN cognitive resilience in order to find clues on novel biomarkers, targets, and better treatments of AD.
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Affiliation(s)
- Frédérique K Kok
- Predictive Pharmacology, Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre of Drug Research, Leiden University, Leiden, The Netherlands
| | - Suzanne L van Leerdam
- Predictive Pharmacology, Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre of Drug Research, Leiden University, Leiden, The Netherlands
| | - Elizabeth C M de Lange
- Predictive Pharmacology, Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre of Drug Research, Leiden University, Leiden, The Netherlands
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15
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Suárez-Méndez I, Bruña R, López-Sanz D, Montejo P, Montenegro-Peña M, Delgado-Losada ML, Marcos Dolado A, López-Higes R, Maestú F. Cognitive Training Modulates Brain Hypersynchrony in a Population at Risk for Alzheimer's Disease. J Alzheimers Dis 2022; 86:1185-1199. [PMID: 35180120 DOI: 10.3233/jad-215406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recent studies demonstrated that brain hypersynchrony is an early sign of dysfunction in Alzheimer's disease (AD) that can represent a proxy for clinical progression. Conversely, non-pharmacological interventions, such as cognitive training (COGTR), are associated with cognitive gains that may be underpinned by a neuroprotective effect on brain synchrony. OBJECTIVE To study the potential of COGTR to modulate brain synchrony and to eventually revert the hypersynchrony phenomenon that characterizes preclinical AD. METHODS The effect of COGTR was examined in a sample of healthy controls (HC, n = 41, 22 trained) and individuals with subjective cognitive decline (SCD, n = 49, 24 trained). Magnetoencephalographic (MEG) activity and neuropsychological scores were acquired before and after a ten-week COGTR intervention aimed at improving cognitive function and daily living performance. Functional connectivity (FC) was analyzed using the phase-locking value. A mixed-effects ANOVA model with factors time (pre-intervention/post-intervention), training (trained/non-trained), and diagnosis (HC/SCD) was used to investigate significant changes in FC. RESULTS We found an average increase in alpha-band FC over time, but the effect was different in each group (trained and non-trained). In the trained group (HC and SCD), we report a reduction in the increase in FC within temporo-parietal and temporo-occipital connections. In the trained SCD group, this reduction was stronger and showed a tentative correlation with improved performance in different cognitive tests. CONCLUSION COGTR interventions could mitigate aberrant increases in FC in preclinical AD, promoting brain synchrony normalization in groups at a higher risk of developing dementia.
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Affiliation(s)
- Isabel Suárez-Méndez
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Departamento de Estructura de la Materia, Física Térmica y Electrónica, Universidad Complutense de Madrid (UCM), Facultad de Ciencias Físicas, Madrid, Spain.,Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain
| | - Ricardo Bruña
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain.,Networking Research Center on Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - David López-Sanz
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Department of Psychobiology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain
| | - Pedro Montejo
- Center for the Prevention of Cognitive Impairment (Madrid Salud), Madrid City Council, Spain
| | - Mercedes Montenegro-Peña
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain.,Center for the Prevention of Cognitive Impairment (Madrid Salud), Madrid City Council, Spain
| | - María Luisa Delgado-Losada
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain
| | | | - Ramón López-Higes
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain
| | - Fernando Maestú
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain.,Networking Research Center on Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Madrid, Spain
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16
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Griffa A, Legdeur N, Badissi M, van den Heuvel MP, Stam CJ, Visser PJ, Hillebrand A. Magnetoencephalography Brain Signatures Relate to Cognition and Cognitive Reserve in the Oldest-Old: The EMIF-AD 90 + Study. Front Aging Neurosci 2021; 13:746373. [PMID: 34899269 PMCID: PMC8656941 DOI: 10.3389/fnagi.2021.746373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022] Open
Abstract
The oldest-old subjects represent the fastest growing segment of society and are at high risk for dementia with a prevalence of up to 40%. Lifestyle factors, such as lifelong participation in cognitive and leisure activities, may contribute to individual cognitive reserve and reduce the risk for cognitive impairments. However, the neural bases underlying cognitive functioning and cognitive reserve in this age range are still poorly understood. Here, we investigate spectral and functional connectivity features obtained from resting-state MEG recordings in a cohort of 35 cognitively normal (92.2 ± 1.8 years old, 19 women) and 11 cognitively impaired (90.9 ± 1.9 years old, 1 woman) oldest-old participants, in relation to cognitive traits and cognitive reserve. The latter was approximated with a self-reported scale on lifelong engagement in cognitively demanding activities. Cognitively impaired oldest-old participants had slower cortical rhythms in frontal, parietal and default mode network regions compared to the cognitively normal subjects. These alterations mainly concerned the theta and beta band and partially explained inter-subject variability of episodic memory scores. Moreover, a distinct spectral pattern characterized by higher relative power in the alpha band was specifically associated with higher cognitive reserve while taking into account the effect of age and education level. Finally, stronger functional connectivity in the alpha and beta band were weakly associated with better cognitive performances in the whole group of subjects, although functional connectivity effects were less prominent than the spectral ones. Our results shed new light on the neural underpinnings of cognitive functioning in the oldest-old population and indicate that cognitive performance and cognitive reserve may have distinct spectral electrophysiological substrates.
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Affiliation(s)
- Alessandra Griffa
- Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Center of Neuroprosthetics, Institute of Bioengineering, École Polytechnique Fédérale De Lausanne (EPFL), Geneva, Switzerland.,Department of Clinical Neurophysiology and MEG Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Nienke Legdeur
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Maryam Badissi
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Martijn P van den Heuvel
- Dutch Connectome Lab, Department of Complex Trait Genetics, Center for Neuroscience and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and MEG Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pieter Jelle Visser
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Arjan Hillebrand
- Department of Clinical Neurophysiology and MEG Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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17
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Balart-Sánchez SA, Bittencourt-Villalpando M, van der Naalt J, Maurits NM. Electroencephalography, Magnetoencephalography, and Cognitive Reserve: A Systematic Review. Arch Clin Neuropsychol 2021; 36:1374-1391. [PMID: 33522563 PMCID: PMC8517624 DOI: 10.1093/arclin/acaa132] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/20/2020] [Accepted: 12/28/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Cognitive reserve (CR) is the capacity to adapt to (future) brain damage without any or only minimal clinical symptoms. The underlying neuroplastic mechanisms remain unclear. Electrocorticography (ECOG), electroencephalography (EEG), and magnetoencephalography (MEG) may help elucidate the brain mechanisms underlying CR, as CR is thought to be related to efficient utilization of remaining brain resources. The purpose of this systematic review is to collect, evaluate, and synthesize the findings on neural correlates of CR estimates using ECOG, EEG, and MEG. METHOD We examined articles that were published from the first standardized definition of CR. Eleven EEG and five MEG cross-sectional studies met the inclusion criteria: They concerned original research, analyzed (M)EEG in humans, used a validated CR estimate, and related (M)EEG to CR. Quality assessment was conducted using an adapted form of the Newcastle-Ottawa scale. No ECOG study met the inclusion criteria. RESULTS A total of 1383 participants from heterogeneous patient, young and older healthy groups were divided into three categories by (M)EEG methodology: Eight (M)EEG studies employed event-related fields or potentials, six studies analyzed brain oscillations at rest (of which one also analyzed a cognitive task), and three studies analyzed brain connectivity. Various CR estimates were employed and all studies compared different (M)EEG measures and CR estimates. Several associations between (M)EEG measures and CR estimates were observed. CONCLUSION Our findings support that (M)EEG measures are related to CR estimates, particularly in healthy individuals. However, the character of this relationship is dependent on the population and task studied, warranting further studies.
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Affiliation(s)
- Sebastián A Balart-Sánchez
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, 9713 AV, Netherlands
| | - Mayra Bittencourt-Villalpando
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, 9713 AV, Netherlands
| | - Joukje van der Naalt
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, 9713 AV, Netherlands
| | - Natasha M Maurits
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, 9713 AV, Netherlands
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18
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Lemercier P, Vergallo A, Lista S, Zetterberg H, Blennow K, Potier MC, Habert MO, Lejeune FX, Dubois B, Teipel S, Hampel H. Association of plasma Aβ40/Aβ42 ratio and brain Aβ accumulation: testing a whole-brain PLS-VIP approach in individuals at risk of Alzheimer's disease. Neurobiol Aging 2021; 107:57-69. [PMID: 34388400 DOI: 10.1016/j.neurobiolaging.2021.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/25/2021] [Accepted: 07/07/2021] [Indexed: 11/29/2022]
Abstract
Molecular and brain regional/network-wise pathophysiological changes at preclinical stages of Alzheimer's disease (AD) have primarily been found through knowledge-based studies conducted in late-stage mild cognitive impairment/dementia populations. However, such an approach may compromise the objective of identifying the earliest spatial-temporal pathophysiological processes. We investigated 261 individuals with subjective memory complaints, a condition at increased risk of AD, to test a whole-brain, non-a-priori method based on partial least squares in unraveling the association between plasma Aβ42/Aβ40 ratio and an extensive set of brain regions characterized through molecular imaging of Aβ accumulation and cortical metabolism. Significant associations were mapped onto large-scale networks, identified through an atlas and by knowledge, to elaborate on the reliability of the results. Plasma Aβ42/40 ratio was associated with Aβ-PET uptake (but not FDG-PET) in regions generally investigated in preclinical AD such as those belonging to the default mode network, but also in regions/networks normally not accounted - including the central executive and salience networks - which likely have a selective vulnerability to incipient Aβ accumulation. The present whole-brain approach is promising to investigate early pathophysiological changes of AD to fully capture the complexity of the disease, which is essential to develop timely screening, detection, diagnostic, and therapeutic interventions.
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Affiliation(s)
- Pablo Lemercier
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris, France.
| | - Andrea Vergallo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris, France
| | - Simone Lista
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris, France
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK; UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Marie-Claude Potier
- ICM Institut du Cerveau et de la Moelle épinière, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Marie-Odile Habert
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France; Centre pour l'Acquisition et le Traitement des Images (www.cati-neuroimaging.com), Paris, France; Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany; AP-HP, Hôpital Pitié-Salpêtrière, Département de Médecine Nucléaire, Paris, France
| | - François-Xavier Lejeune
- Bioinformatics and Biostatistics Core Facility iCONICS, Sorbonne Université UMR S 1127, Institut du Cerveau et de La Moelle Épinière, Paris, France
| | - Bruno Dubois
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris, France
| | - Stefan Teipel
- Clinical Dementia Research Section, German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Harald Hampel
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris, France.
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19
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Yin W, Mamashli F, Buhl DL, Khudyakov P, Volfson D, Martenyi F, Gevorkyan H, Rosen L, Simen AA. Safety, pharmacokinetics and quantitative EEG modulation of TAK-071, a novel muscarinic M1 receptor positive allosteric modulator, in healthy subjects. Br J Clin Pharmacol 2021; 88:600-612. [PMID: 34240455 PMCID: PMC9291057 DOI: 10.1111/bcp.14975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/06/2021] [Accepted: 06/19/2021] [Indexed: 12/26/2022] Open
Abstract
Aims TAK‐071 is a muscarinic M1 receptor positive allosteric modulator designed to have low cooperativity with acetylcholine. This was a first‐in‐human study to evaluate the safety, pharmacokinetics, and pharmacodynamics of TAK‐071. Methods TAK‐071 was administered as single and multiple doses in a randomized, double‐blind, placebo‐controlled, parallel‐group design in healthy volunteers alone and in combination with donepezil. Laboratory, electrocardiogram (ECG) and electroencephalogram (EEG) evaluations were performed. Cerebrospinal fluid and blood samples were taken to evaluate the pharmacokinetics (PK), relative bioavailability and food effect. Results TAK‐071 was safe and well tolerated, and no deaths or serious adverse events occurred. TAK‐071 demonstrated a long mean (% coefficient of variation) half‐life of 46.3 (25.2%) to 60.5 (51.5%) hours and excellent brain penetration following oral dosing. Coadministration with donepezil had no impact on the PK of either drug. There was no food effect on systemic exposure. Quantitative EEG analysis revealed that TAK‐071 40‐80 mg increased power in the 7‐9 Hz range in the posterior electrode group with eyes open and 120‐160 mg doses increased power in the 16‐18 Hz range and reduced power in the 2‐4 Hz range in central‐posterior areas with eyes open and eyes closed. Functional connectivity was significantly reduced after TAK‐071 at high doses and was enhanced with coadministration of donepezil under the eyes‐closed condition. Conclusions PK and safety profiles of TAK‐071 were favorable, including those exceeding expected pharmacologically active doses based on preclinical data. When administered without donepezil TAK‐071 was largely free of cholinergic adverse effects. Further clinical evaluation of TAK‐071 is warranted.
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Affiliation(s)
- Wei Yin
- Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
| | - Fahimeh Mamashli
- Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA.,Signal Insights, LLC, Cambridge, MA, USA
| | - Derek L Buhl
- Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
| | | | | | | | - Hakop Gevorkyan
- California Clinical Trials Medical Group, in affiliation with Parexel International, Glendale, CA, USA
| | - Laura Rosen
- Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
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20
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Zhang H, Geng X, Wang Y, Guo Y, Gao Y, Zhang S, Du W, Liu L, Sun M, Jiao F, Yi F, Li X, Wang L. The Significance of EEG Alpha Oscillation Spectral Power and Beta Oscillation Phase Synchronization for Diagnosing Probable Alzheimer Disease. Front Aging Neurosci 2021; 13:631587. [PMID: 34163348 PMCID: PMC8215164 DOI: 10.3389/fnagi.2021.631587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/11/2021] [Indexed: 11/30/2022] Open
Abstract
Alzheimer disease (AD) is the most common cause of dementia in geriatric population. At present, no effective treatments exist to reverse the progress of AD, however, early diagnosis and intervention might delay its progression. The search for biomarkers with good safety, repeatable detection, reliable sensitivity and community application is necessary for AD screening and early diagnosis and timely intervention. Electroencephalogram (EEG) examination is a non-invasive, quantitative, reproducible, and cost-effective technique which is suitable for screening large population for possible AD. The power spectrum, complexity and synchronization characteristics of EEG waveforms in AD patients have distinct deviation from normal elderly, indicating these EEG features can be a promising candidate biomarker of AD. However, current reported deviation results are inconsistent, possibly due to multiple factors such as diagnostic criteria, sample sizes and the use of different computational measures. In this study, we collected two neurological tests scores (MMSE and MoCA) and the resting-state EEG of 30 normal control elderly subjects (NC group) and 30 probable AD patients confirmed by Pittsburgh compound B positron emission tomography (PiB-PET) inspection (AD group). We calculated the power spectrum, spectral entropy and phase synchronization index features of these two groups’ EEG at left/right frontal, temporal, central and occipital brain regions in 4 frequency bands: δ oscillation (1–4 Hz), θ oscillation (4–8 Hz), α oscillation (8–13 Hz), and β oscillation (13–30 Hz). In most brain areas, we found that the AD group had significant differences compared to NC group: (1) decreased α oscillation power and increased θ oscillation power; (2) decreased spectral entropy in α oscillation and elevated spectral entropy in β oscillation; and (3) decrease phase synchronization index in δ, θ, and β oscillation. We also found that α oscillation spectral power and β oscillation phase synchronization index correlated well with the MMSE/MoCA test scores in AD groups. Our study suggests that these two EEG features might be useful metrics for population screening of probable AD patients.
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Affiliation(s)
- Haifeng Zhang
- Medical School of Chinese People's Liberation Army, Beijing, China.,Department of Neurology, The 2nd Medical Center, National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China.,Health Service Department of the Guard Bureau of the Joint Staff Department, Joint Staff of the Central Military Commission of Chinese PLA, Beijing, China
| | - Xinling Geng
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Yuanyuan Wang
- Department of Neurology, The 2nd Medical Center, National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yanjun Guo
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ya Gao
- Department of Geriatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shouzi Zhang
- The Psycho Department of Beijing Geriatric Hospital, Beijing, China
| | - Wenjin Du
- Department of Neurology, Air Force Medical Center, Chinese People's Liberation Army, Beijing, China
| | - Lixin Liu
- The Psycho Department of Beijing Geriatric Hospital, Beijing, China
| | - Mingyan Sun
- Ninth Health Care Department of the Second Medical Center of PLA General Hospital, Beijing, China
| | - Fubin Jiao
- Medical School of Chinese People's Liberation Army, Beijing, China.,Department of Neurology, The 2nd Medical Center, National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China.,Health Service Department of the Guard Bureau of the Joint Staff Department, Joint Staff of the Central Military Commission of Chinese PLA, Beijing, China
| | - Fang Yi
- Department of Neurology, The 2nd Medical Center, National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China.,Department of Neurology, Lishilu Outpatient, Jingzhong Medical District, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xiaoli Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Luning Wang
- Medical School of Chinese People's Liberation Army, Beijing, China.,Department of Neurology, The 2nd Medical Center, National Clinical Research Center for Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, China
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21
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Babiloni C, Arakaki X, Azami H, Bennys K, Blinowska K, Bonanni L, Bujan A, Carrillo MC, Cichocki A, de Frutos-Lucas J, Del Percio C, Dubois B, Edelmayer R, Egan G, Epelbaum S, Escudero J, Evans A, Farina F, Fargo K, Fernández A, Ferri R, Frisoni G, Hampel H, Harrington MG, Jelic V, Jeong J, Jiang Y, Kaminski M, Kavcic V, Kilborn K, Kumar S, Lam A, Lim L, Lizio R, Lopez D, Lopez S, Lucey B, Maestú F, McGeown WJ, McKeith I, Moretti DV, Nobili F, Noce G, Olichney J, Onofrj M, Osorio R, Parra-Rodriguez M, Rajji T, Ritter P, Soricelli A, Stocchi F, Tarnanas I, Taylor JP, Teipel S, Tucci F, Valdes-Sosa M, Valdes-Sosa P, Weiergräber M, Yener G, Guntekin B. Measures of resting state EEG rhythms for clinical trials in Alzheimer's disease: Recommendations of an expert panel. Alzheimers Dement 2021; 17:1528-1553. [PMID: 33860614 DOI: 10.1002/alz.12311] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 12/28/2020] [Accepted: 01/01/2021] [Indexed: 12/25/2022]
Abstract
The Electrophysiology Professional Interest Area (EPIA) and Global Brain Consortium endorsed recommendations on candidate electroencephalography (EEG) measures for Alzheimer's disease (AD) clinical trials. The Panel reviewed the field literature. As most consistent findings, AD patients with mild cognitive impairment and dementia showed abnormalities in peak frequency, power, and "interrelatedness" at posterior alpha (8-12 Hz) and widespread delta (< 4 Hz) and theta (4-8 Hz) rhythms in relation to disease progression and interventions. The following consensus statements were subscribed: (1) Standardization of instructions to patients, resting state EEG (rsEEG) recording methods, and selection of artifact-free rsEEG periods are needed; (2) power density and "interrelatedness" rsEEG measures (e.g., directed transfer function, phase lag index, linear lagged connectivity, etc.) at delta, theta, and alpha frequency bands may be use for stratification of AD patients and monitoring of disease progression and intervention; and (3) international multisectoral initiatives are mandatory for regulatory purposes.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy.,San Raffaele of Cassino, Cassino (FR), Italy
| | | | - Hamed Azami
- Department of Neurology and Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Karim Bennys
- Centre Mémoire de Ressources et de Recherche (CMRR), Centre Hospitalier, Universitaire de Montpellier, Montpellier, France
| | - Katarzyna Blinowska
- Institute of Biocybernetics, Warsaw, Poland.,Faculty of Physics University of Warsaw and Nalecz, Warsaw, Poland
| | - Laura Bonanni
- Department of Neuroscience Imaging and Clinical Sciences and CESI, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Ana Bujan
- Psychological Neuroscience Lab, School of Psychology, University of Minho, Minho, Portugal
| | - Maria C Carrillo
- Division of Medical & Scientific Relations, Alzheimer's Association, Chicago, Illinois, USA
| | - Andrzej Cichocki
- Skolkowo Institute of Science and Technology (SKOLTECH), Moscow, Russia.,Systems Research Institute PAS, Warsaw, Poland.,Nicolaus Copernicus University (UMK), Torun, Poland
| | - Jaisalmer de Frutos-Lucas
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Complutense and Universidad Politécnica de Madrid, Madrid, Spain
| | - Claudio Del Percio
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Bruno Dubois
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France.,ICM, INSERM U1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Rebecca Edelmayer
- Division of Medical & Scientific Relations, Alzheimer's Association, Chicago, Illinois, USA
| | - Gary Egan
- Foundation Director of the Monash Biomedical Imaging (MBI) Research Facilities, Monash University, Clayton, Australia
| | - Stephane Epelbaum
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Institute of Memory and Alzheimer's Disease (IM2A), Paris, France.,ICM, INSERM U1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Javier Escudero
- School of Engineering, Institute for Digital Communications, The University of Edinburgh, Edinburgh, UK
| | - Alan Evans
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Francesca Farina
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Keith Fargo
- Division of Medical & Scientific Relations, Alzheimer's Association, Chicago, Illinois, USA
| | - Alberto Fernández
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Complutense and Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Giovanni Frisoni
- IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Harald Hampel
- GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Sorbonne University, Paris, France
| | | | - Vesna Jelic
- Division of Clinical Geriatrics, NVS Department, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jaeseung Jeong
- Department of Bio and Brain Engineering/Program of Brain and Cognitive Engineering Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Yang Jiang
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Maciej Kaminski
- Faculty of Physics University of Warsaw and Nalecz, Warsaw, Poland
| | - Voyko Kavcic
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Kerry Kilborn
- School of Psychology, University of Glasgow, Glasgow, UK
| | - Sanjeev Kumar
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Alice Lam
- MGH Epilepsy Service, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Lew Lim
- Vielight Inc., Toronto, Ontario, Canada
| | | | - David Lopez
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Complutense and Universidad Politécnica de Madrid, Madrid, Spain
| | - Susanna Lopez
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Brendan Lucey
- Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Fernando Maestú
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Universidad Complutense and Universidad Politécnica de Madrid, Madrid, Spain
| | - William J McGeown
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Ian McKeith
- Newcastle upon Tyne, Translational and Clinical Research Institute, Newcastle University, UK
| | | | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.,Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - John Olichney
- UC Davis Department of Neurology and Center for Mind and Brain, Davis, California, USA
| | - Marco Onofrj
- Department of Neuroscience Imaging and Clinical Sciences and CESI, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Ricardo Osorio
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, New York, USA
| | | | - Tarek Rajji
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Petra Ritter
- Brain Simulation Section, Department of Neurology, Charité Universitätsmedizin and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - Andrea Soricelli
- IRCCS SDN, Napoli, Italy.,Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | | | - Ioannis Tarnanas
- Global Brain Health Institute, University of California San Francisco, San Francisco, USA.,Global Brain Health Institute, Trinity College Dublin, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - John Paul Taylor
- Newcastle upon Tyne, Translational and Clinical Research Institute, Newcastle University, UK
| | - Stefan Teipel
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany.,German Center for Neurodegenerative Diseases (DZNE) - Rostock/Greifswald, Rostock, Germany
| | - Federico Tucci
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Pedro Valdes-Sosa
- Cuban Neuroscience Center, Havana, Cuba.,Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Marco Weiergräber
- Experimental Neuropsychopharmacology, BfArM), Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, Bonn, Germany
| | - Gorsev Yener
- Departments of Neurosciences and Department of Neurology, Dokuz Eylül University Medical School, Izmir, Turkey
| | - Bahar Guntekin
- Department of Biophysics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab, Istanbul Medipol University, Istanbul, Turkey
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22
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Babiloni C, Ferri R, Noce G, Lizio R, Lopez S, Lorenzo I, Panzavolta A, Soricelli A, Nobili F, Arnaldi D, Famà F, Orzi F, Buttinelli C, Giubilei F, Cipollini V, Marizzoni M, Güntekin B, Aktürk T, Hanoğlu L, Yener G, Özbek Y, Stocchi F, Vacca L, Frisoni GB, Del Percio C. Abnormalities of Cortical Sources of Resting State Alpha Electroencephalographic Rhythms are Related to Education Attainment in Cognitively Unimpaired Seniors and Patients with Alzheimer's Disease and Amnesic Mild Cognitive Impairment. Cereb Cortex 2021; 31:2220-2237. [PMID: 33251540 DOI: 10.1093/cercor/bhaa356] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 12/21/2022] Open
Abstract
In normal old (Nold) and Alzheimer's disease (AD) persons, a high cognitive reserve (CR) makes them more resistant and resilient to brain neuropathology and neurodegeneration. Here, we tested whether these effects may affect neurophysiological oscillatory mechanisms generating dominant resting state electroencephalographic (rsEEG) alpha rhythms in Nold and patients with mild cognitive impairment (MCI) due to AD (ADMCI). Data in 60 Nold and 70 ADMCI participants, stratified in higher (Edu+) and lower (Edu-) educational attainment subgroups, were available in an Italian-Turkish archive. The subgroups were matched for age, gender, and education. RsEEG cortical sources were estimated by eLORETA freeware. As compared to the Nold-Edu- subgroup, the Nold-Edu+ subgroup showed greater alpha source activations topographically widespread. On the contrary, in relation to the ADMCI-Edu- subgroup, the ADMCI-Edu+ subgroup displayed lower alpha source activations topographically widespread. Furthermore, the 2 ADMCI subgroups had matched cerebrospinal AD diagnostic biomarkers, brain gray-white matter measures, and neuropsychological scores. The current findings suggest that a high CR may be related to changes in rsEEG alpha rhythms in Nold and ADMCI persons. These changes may underlie neuroprotective effects in Nold seniors and subtend functional compensatory mechanisms unrelated to brain structure alterations in ADMCI patients.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy.,San Raffaele of Cassino, Cassino, Italy
| | | | | | | | - Susanna Lopez
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, Aldo Moro University of Bari, Bari, Italy
| | | | - Andrea Panzavolta
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Andrea Soricelli
- IRCCS SDN, Napoli, Italy.,Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Flavio Nobili
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Italy
| | - Dario Arnaldi
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Italy
| | - Francesco Famà
- Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Italy
| | - Francesco Orzi
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Carla Buttinelli
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Franco Giubilei
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Virginia Cipollini
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Moira Marizzoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Bahar Güntekin
- Department of Biophysics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab., Istanbul Medipol University, Istanbul, Turkey
| | - Tuba Aktürk
- REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab., Istanbul Medipol University, Istanbul, Turkey
| | - Lutfu Hanoğlu
- Department of Neurology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Görsev Yener
- Izmir Biomedicine and Genome Center, Dokuz Eylul University Health Campus, Izmir, Turkey.,Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Yağmur Özbek
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Fabrizio Stocchi
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Laura Vacca
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Claudio Del Percio
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
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23
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Resting state EEG biomarkers of cognitive decline associated with Alzheimer's disease and mild cognitive impairment. PLoS One 2021; 16:e0244180. [PMID: 33544703 PMCID: PMC7864432 DOI: 10.1371/journal.pone.0244180] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 12/05/2020] [Indexed: 02/03/2023] Open
Abstract
In this paper, we explore the utility of resting-state EEG measures as potential biomarkers for the detection and assessment of cognitive decline in mild cognitive impairment (MCI) and Alzheimer's disease (AD). Neurophysiological biomarkers of AD derived from EEG and FDG-PET, once characterized and validated, would expand the set of existing diagnostic molecular biomarkers of AD pathology with associated biomarkers of disease progression and neural dysfunction. Since symptoms of AD often begin to appear later in life, successful identification of EEG-based biomarkers must account for age-related neurophysiological changes that occur even in healthy individuals. To this end, we collected EEG data from individuals with AD (n = 26), MCI (n = 53), and cognitively normal healthy controls stratified by age into three groups: 18-40 (n = 129), 40-60 (n = 62) and 60-90 (= 55) years old. For each participant, we computed power spectral density at each channel and spectral coherence between pairs of channels. Compared to age matched controls, in the AD group, we found increases in both spectral power and coherence at the slower frequencies (Delta, Theta). A smaller but significant increase in power of slow frequencies was observed for the MCI group, localized to temporal areas. These effects on slow frequency spectral power opposed that of normal aging observed by a decrease in the power of slow frequencies in our control groups. The AD group showed a significant decrease in the spectral power and coherence in the Alpha band consistent with the same effect in normal aging. However, the MCI group did not show any significant change in the Alpha band. Overall, Theta to Alpha ratio (TAR) provided the largest and most significant differences between the AD group and controls. However, differences in the MCI group remained small and localized. We proposed a novel method to quantify these small differences between Theta and Alpha bands' power using empirically derived distributions of spectral power across the time domain as opposed to averaging power across time. We defined Power Distribution Distance Measure (PDDM) as a distance measure between probability distribution functions (pdf) of Theta and Alpha power. Compared to average TAR, using PDDF enhanced the statistical significance, the effect size, and the spatial distribution of significant effects in the MCI group. We designed classifiers for differentiating individual MCI and AD participants from age-matched controls. The classification performance measured by the area under ROC curve after cross-validation were AUC = 0.85 and AUC = 0.6, for AD and MCI classifiers, respectively. Posterior probability of AD, TAR, and the proposed PDDM measure were all significantly correlated with MMSE score and neuropsychological tests in the AD group.
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24
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Rochart R, Liu Q, Fonteh AN, Harrington MG, Arakaki X. Compromised Behavior and Gamma Power During Working Memory in Cognitively Healthy Individuals With Abnormal CSF Amyloid/Tau. Front Aging Neurosci 2020; 12:574214. [PMID: 33192465 PMCID: PMC7591805 DOI: 10.3389/fnagi.2020.574214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/22/2020] [Indexed: 11/24/2022] Open
Abstract
Research shows that gamma activity changes in Alzheimer’s disease (AD), revealing synaptic pathology and potential therapeutic applications. We aim to explore whether cognitive challenge combined with quantitative EEG (qEEG) can unmask abnormal gamma frequency power in healthy individuals at high risk of developing AD. We analyzed low (30–50 Hz) and high gamma (50–80 Hz) power over six brain regions at EEG sensor level (frontal/central/parietal/left temporal/right temporal/occipital) in a dataset collected from an aging cohort during N-back working memory (WM) testing at two different load conditions (N = 0 or 2). Cognitively healthy (CH) study participants (≥60 years old) of both sexes were divided into two subgroups: normal amyloid/tau ratios (CH-NAT, n = 10) or pathological amyloid/tau (CH-PAT, n = 14) in cerebrospinal fluid (CSF). During low load (0-back) challenge, low gamma is higher in CH-PATs than CH-NATs over frontal and central regions (p = 0.014∼0.032, effect size (Cohen’s d) = 0.95∼1.11). However, during high load (2-back) challenge, low gamma is lower in CH-PATs compared to CH-NATs over the left temporal region (p = 0.045, Cohen’s d = −0.96), and high gamma is lower over the parietal region (p = 0.035, Cohen’s d = −1.02). Overall, our studies show a medium to large negative effect size across the scalp (Cohen’s d = −0.51∼−1.02). In addition, low gamma during 2-back is positively correlated with 0-back accuracy over all regions except the occipital region only in CH-NATs (r = 0.69∼0.77, p = 0.0098∼0.027); high gamma during 2-back correlated positively with 0-back accuracy over all regions in CH-NATs (r = 0.68∼0.78, p = 0.007∼0.030); high gamma during 2-back negatively correlated with 0-back response time over parietal, right temporal, and occipital regions in CH-NATs (r = −0.70∼−0.66, p = 0.025∼0.037). We interpret these preliminary results to show: (1) gamma power is compromised in AD-biomarker positive individuals, who are otherwise cognitively healthy (CH-PATs); (2) gamma is associated with WM performance in normal aging (CH-NATs) (most significantly in the frontoparietal region). Our pilot findings encourage further investigations in combining cognitive challenges and qEEG in developing neurophysiology-based markers for identifying individuals in the prodromal stage, to help improving our understanding of AD pathophysiology and the contributions of low- and high-frequency gamma oscillations in cognitive functions.
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Affiliation(s)
- Roger Rochart
- Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, United States
| | - Quanying Liu
- Department of Biomedical Engineering, Southern University of Science and Technology (SUSTech), Shenzhen, China
| | - Alfred N Fonteh
- Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, United States
| | - Michael G Harrington
- Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, United States
| | - Xianghong Arakaki
- Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, United States
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25
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Chae S, Park J, Byun MS, Yi D, Lee JH, Byeon GH, Suk HW, Choi H, Park JE, Lee DY. Decreased Alpha Reactivity from Eyes-Closed to Eyes-Open in Non-Demented Older Adults with Alzheimer’s Disease: A Combined EEG and [18F]florbetaben PET Study. J Alzheimers Dis 2020; 77:1681-1692. [DOI: 10.3233/jad-200442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The degree of alpha attenuation from eyes-closed (EC) to eyes-open (EO) has been suggested as a neural marker of cognitive health, and its disruption has been reported in patients with clinically defined Alzheimer’s disease (AD) dementia. Objective: We tested if EC-to-EO alpha reactivity was related to cerebral amyloid-β (Aβ) deposition during the early stage of AD. Methods: Non-demented participants aged ≥55 years who visited the memory clinic between March 2018 and June 2019 (N = 143; 67.8% female; mean age±standard deviation, 74.0±7.6 years) were included in the analyses. Based on the [18F]florbetaben positron emission tomography assessment, the participants were divided into Aβ+ (N = 70) and Aβ- (N = 73) groups. EEG was recorded during the 7 min EC condition followed by a 3 min EO phase, and a Fourier transform spectral analysis was performed. Results: A significant three-way interaction was detected among Aβ positivity, eye condition, and the laterality factor on alpha-band power after adjusting for age, sex, educational years, global cognition, depression, medication use, and white matter hyperintensities on magnetic resonance imaging (F = 5.987, p = 0.016); EC-to-EO alpha reactivity in the left hemisphere was significantly reduced in Aβ+ subjects without dementia compared with the others (F = 3.984, p = 0.048). Conclusion: Among mild cognitive impairment subjects, alpha reactivity additively contributed to predict cerebral Aβ positivity beyond the clinical predictors, including vascular risks, impaired memory function, and apolipoprotein E ɛ4. These findings support that EC-to-EO alpha reactivity acts as an early biomarker of cerebral Aβ deposition and is a useful measurement for screening early-stage AD.
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Affiliation(s)
- Soohyun Chae
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Jinsick Park
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Min Soo Byun
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dahyun Yi
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, South Korea
| | - Jun Ho Lee
- Department of Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Gi Hwan Byeon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Hye Won Suk
- Department of Psychology, Sogang University, Seoul, South Korea
| | - Hongyoon Choi
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jee Eun Park
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, South Korea
- Interdisiplinary Program in Cognitive science, Seoul National University, Seoul, South Korea
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