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Cammisuli DM, Marchesi G, Bellocchio V, Aiello EN, Poletti B, Verde F, Silani V, Ticozzi N, Zago S, Difonzo T, Isella V, Pomati S, Granese V, Vignati B, Prete LA, Castelnuovo G. Behavioral Disorders of Spatial Cognition in Patients with Mild Cognitive Impairment Due to Alzheimer's Disease (The BDSC-MCI Project): Ecological Validity of the Corsi Learning Suvra-Span Test. J Pers Med 2024; 14:539. [PMID: 38793121 PMCID: PMC11122154 DOI: 10.3390/jpm14050539] [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: 04/09/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Spatial navigation deficits are reported as early symptoms of Alzheimer's disease (AD) alongside episodic memory ones. The aim of the present study was to ascertain whether neuropsychological deficits of visuospatial long-term memory can predict behavioral alterations during the navigation of older adults in novel urban environments along the normal aging-dementia continuum of the Alzheimer's type. METHODS A total of 24 community-dwelling patients with Mild Cognitive Impairment (MCI) due to AD, 27 individuals with subjective cognitive decline (SCD), and 21 healthy controls were assessed in terms of their sequential egocentric and allocentric navigation abilities by using a modified version of the Detour Navigation Test, and neuropsychologically tested by the Corsi learning suvra-span (CLSS) test. Generalized linear models were adopted to verify whether the scores obtained by the three groups in the CLSS test predicted wrong turns and moments of hesitation during the navigation task, with the results presented as topographical disorientation scores. RESULTS Higher scores in the CLSS test predicted fewer wrong turns (b = -0.05; z = -2.91; p = 0.004; net of between-groups differences) and moments of hesitation for patients with MCI due to AD (b = -0.14; z = -2.43; p = 0.015), and individuals with SCD (b = -0.17; z = -3.85; p < 0.001). CONCLUSIONS Since the CLSS test has been reported to be a reliable measure of ecological navigational abilities in the progression towards AD dementia, we recommend its use in clinical practice and highlight implications for future research.
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Affiliation(s)
| | - Gloria Marchesi
- Department of Psychology, Catholic University, 20123 Milan, Italy; (G.M.); (G.C.)
| | | | - Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy; (E.N.A.); (B.P.); (F.V.); (V.S.); (N.T.)
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy; (E.N.A.); (B.P.); (F.V.); (V.S.); (N.T.)
- Department of Oncology and Hemato-Oncology, Università Degli Studi di Milano, 20133 Milan, Italy
| | - Federico Verde
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy; (E.N.A.); (B.P.); (F.V.); (V.S.); (N.T.)
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, University of Milan, 20122 Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy; (E.N.A.); (B.P.); (F.V.); (V.S.); (N.T.)
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, University of Milan, 20122 Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy; (E.N.A.); (B.P.); (F.V.); (V.S.); (N.T.)
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, University of Milan, 20122 Milan, Italy
| | - Stefano Zago
- Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy; (S.Z.); (T.D.)
| | - Teresa Difonzo
- Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy; (S.Z.); (T.D.)
| | - Valeria Isella
- Department of Neurology, School of Medicine, University of Milano-Bicocca, 20126 Milan, Italy;
- Milan Centre for Neurosciences, 20133 Milan, Italy
| | - Simone Pomati
- Neurology Unit, Luigi Sacco University Hospital, 20157 Milan, Italy;
| | - Valentina Granese
- Catholic University, 20123 Milan, Italy; (V.B.); (V.G.); (B.V.); (L.A.P.)
| | - Benedetta Vignati
- Catholic University, 20123 Milan, Italy; (V.B.); (V.G.); (B.V.); (L.A.P.)
| | | | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, 20123 Milan, Italy; (G.M.); (G.C.)
- IRCCS Istituto Auxologico Italiano, Clinical Psychology Research Laboratory, 20149 Milan, Italy
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Philippen S, Hanert A, Schönfeld R, Granert O, Yilmaz R, Jensen-Kondering U, Splittgerber M, Moliadze V, Siniatchkin M, Berg D, Bartsch T. Transcranial direct current stimulation of the right temporoparietal junction facilitates hippocampal spatial learning in Alzheimer's disease and mild cognitive impairment. Clin Neurophysiol 2024; 157:48-60. [PMID: 38056370 DOI: 10.1016/j.clinph.2023.11.003] [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: 05/22/2023] [Revised: 10/11/2023] [Accepted: 11/05/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Spatial memory deficits are an early symptom in Alzheimer's disease (AD), reflecting the neurodegenerative processes in the neuronal navigation network such as in hippocampal and parietal cortical areas. As no effective treatment options are available, neuromodulatory interventions are increasingly evaluated. Against this backdrop, we investigated the neuromodulatory effect of anodal transcranial direct current stimulation (tDCS) on hippocampal place learning in patients with AD or mild cognitive impairment (MCI). METHODS In this randomized, double-blind, sham-controlled study with a cross-over design anodal tDCS of the right temporoparietal junction (2 mA for 20 min) was applied to 20 patients diagnosed with AD or MCI and in 22 healthy controls while they performed a virtual navigation paradigm testing hippocampal place learning. RESULTS We show an improved recall performance of hippocampal place learning after anodal tDCS in the patient group compared to sham stimulation but not in the control group. CONCLUSIONS These results suggest that tDCS can facilitate spatial memory consolidation via stimulating the parietal-hippocampal navigation network in AD and MCI patients. SIGNIFICANCE Our findings suggest that tDCS of the temporoparietal junction may restore spatial navigation and memory deficits in patients with AD and MCI.
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Affiliation(s)
- S Philippen
- Dept. of Neurology, Memory Disorder and Plasticity Group, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A Hanert
- Dept. of Neurology, Memory Disorder and Plasticity Group, University Hospital Schleswig-Holstein, Kiel, Germany
| | - R Schönfeld
- Psychology Department, Halle University, Germany
| | - O Granert
- Dept. of Neurology, Memory Disorder and Plasticity Group, University Hospital Schleswig-Holstein, Kiel, Germany
| | - R Yilmaz
- Dept. of Neurology, University of Ankara, Medical School, Ankara, Turkey
| | - U Jensen-Kondering
- Dept. of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Kiel, Germany; Dept. of Neuroradiology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - M Splittgerber
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Germany
| | - V Moliadze
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Germany
| | - M Siniatchkin
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Germany; Clinic for Child and Adolescent Psychiatry and Psychotherapy, Medical Center Bethel, University Clinics OWL, Bielefeld University, Germany
| | - D Berg
- Dept. of Neurology, Memory Disorder and Plasticity Group, University Hospital Schleswig-Holstein, Kiel, Germany
| | - T Bartsch
- Dept. of Neurology, Memory Disorder and Plasticity Group, University Hospital Schleswig-Holstein, Kiel, Germany.
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Feng Q, Wang L, Tang X, Ge X, Hu H, Liao Z, Ding Z. Machine learning classifiers and associations of cognitive performance with hippocampal subfields in amnestic mild cognitive impairment. Front Aging Neurosci 2023; 15:1273658. [PMID: 38099266 PMCID: PMC10719844 DOI: 10.3389/fnagi.2023.1273658] [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: 08/07/2023] [Accepted: 11/10/2023] [Indexed: 12/17/2023] Open
Abstract
Background Neuroimaging studies have demonstrated alterations in hippocampal volume and hippocampal subfields among individuals with amnestic mild cognitive impairment (aMCI). However, research on using hippocampal subfield volume modeling to differentiate aMCI from normal controls (NCs) is limited, and the relationship between hippocampal volume and overall cognitive scores remains unclear. Methods We enrolled 50 subjects with aMCI and 44 NCs for this study. Initially, a univariate general linear model was employed to analyze differences in the volumes of hippocampal subfields. Subsequently, two sets of dimensionality reduction methods and four machine learning techniques were applied to distinguish aMCI from NCs based on hippocampal subfield volumes. Finally, we assessed the correlation between the relative volumes of hippocampal subfields and cognitive test variables (Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA)). Results Significant volume differences were observed in several hippocampal subfields, notably in the left hippocampus. Specifically, the volumes of the hippocampal tail, subiculum, CA1, presubiculum, molecular layer, GC-ML-DG, CA3, CA4, and fimbria differed significantly between the two groups. The highest area under the curve (AUC) values for left and right hippocampal machine learning classifiers were 0.678 and 0.701, respectively. Moreover, the volumes of the left subiculum, left molecular layer, right subiculum, right CA1, right molecular layer, right GC-ML-DG, and right CA4 exhibited the strongest and most consistent correlations with MoCA scores. Conclusion Hippocampal subfield volume may serve as a predictive marker for aMCI. These findings underscore the sensitivity of hippocampal subfield volume to overall cognitive performance.
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Affiliation(s)
- Qi Feng
- Department of Radiology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Xue Tang
- School of Medical Imaging, Hangzhou Medical College, Hangzhou, China
| | - Xiuhong Ge
- Department of Radiology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Hanjun Hu
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhengluan Liao
- Department of Psychiatry, Zhejiang Provincial People’s Hospital/People’s Hospital of Hangzhou Medical College, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People’s Hospital, Hangzhou, China
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Li K, Ma X, Chen T, Xin J, Wang C, Wu B, Ogihara A, Zhou S, Liu J, Huang S, Wang Y, Li S, Chen Z, Xu R. A new early warning method for mild cognitive impairment due to Alzheimer's disease based on dynamic evaluation of the "spatial executive process". Digit Health 2023; 9:20552076231194938. [PMID: 37654709 PMCID: PMC10467230 DOI: 10.1177/20552076231194938] [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: 02/21/2023] [Accepted: 07/28/2023] [Indexed: 09/02/2023] Open
Abstract
Objective Mild cognitive impairment (MCI) due to Alzheimer's disease (AD), as an early stage of AD, is an important point for early warning of AD. Neuropathological studies have shown that AD pathology in pre-dementia patients involves the hippocampus and caudate nucleus, which are responsible for controlling cognitive mechanisms such as the spatial executive process (SEP). The aim of this study is to design a new method for early warning of MCI due to AD by dynamically evaluating SEP. Methods We designed fingertip interaction handwriting digital evaluation paradigms and analyzed the dynamic trajectory of fingertip interaction and image data during "clock drawing" and "repetitive writing" tasks. Extracted fingertip interaction digital biomarkers were used to assess participants' SEP disorders, ultimately enabling intelligent diagnosis of MCI due to AD. A cross-sectional study demonstrated the predictive performance of this new method. Results We enrolled 30 normal cognitive (NC) elderly and 30 MCI due to AD patients, and clinical research results showed that there may be neurobehavioral differences between the two groups in digital biomarkers captured during SEP. The early warning performance for MCI due to AD of this new method (areas under the curve (AUC) = 0.880) is better than that of the Minimum Mental State Examination (MMSE) neuropsychological scale (AUC = 0.856) assessed by physicians. Conclusion Patients with MCI due to AD may have SEP disorders, and this new method based on dynamic evaluation of SEP will provide a novel human-computer interaction and intelligent early warning method for home and community screening of MCI due to AD.
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Affiliation(s)
- Kai Li
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
- Joint Laboratory of Police Health Smart Surveillance, Zhejiang Police College, Hangzhou, China
| | - Xiaowen Ma
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Tong Chen
- Department of Neurology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Junyi Xin
- School of Information Engineering, Hangzhou Medical College, Hangzhou, China
| | - Chen Wang
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Bo Wu
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China
- School of Computer Science, Tokyo University of Technology, Hachioji City, Tokyo, Japan
| | - Atsushi Ogihara
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Health Sciences and Social Welfare, Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Siyu Zhou
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China
- School of Public health, Hangzhou Normal University, Hangzhou, China
| | - Jiakang Liu
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shouqiang Huang
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yujia Wang
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuwu Li
- Zhejiang-Japan Digital Diagnosis and Treatment and Equipment of Integrated Traditional Chinese Medicine and Western Medicine for Major Brain Diseases Joint Laboratory, Zhejiang Chinese Medical University, Hangzhou, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zeyuan Chen
- Joint Laboratory of Police Health Smart Surveillance, Zhejiang Police College, Hangzhou, China
- School of International Studies and Cooperation, Zhejiang Police College, Hangzhou, China
| | - Runlong Xu
- School of Information Engineering, Hangzhou Medical College, Hangzhou, China
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Walker JM, Gonzales MM, Goette W, Farrell K, White CL, Crary JF, Richardson TE. Cognitive and Neuropsychological Profiles in Alzheimer's Disease and Primary Age-Related Tauopathy and the Influence of Comorbid Neuropathologies. J Alzheimers Dis 2023; 92:1037-1049. [PMID: 36847012 PMCID: PMC11138480 DOI: 10.3233/jad-230022] [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] [Indexed: 02/25/2023]
Abstract
BACKGROUND Alzheimer's disease neuropathologic change (ADNC) is defined by the progression of both hyperphosphorylated-tau (p-tau) and amyloid-β (Aβ) and is the most common underlying cause of dementia worldwide. Primary age-related tauopathy (PART), an Aβ-negative tauopathy largely confined to the medial temporal lobe, is increasingly being recognized as an entity separate from ADNC with diverging clinical, genetic, neuroanatomic, and radiologic profiles. OBJECTIVE The specific clinical correlates of PART are largely unknown; we aimed to identify cognitive and neuropsychological differences between PART, ADNC, and subjects with no tauopathy (NT). METHODS We compared 2,884 subjects with autopsy-confirmed intermediate-high stage ADNC to 208 subjects with definite PART (Braak stage I-IV, Thal phase 0, CERAD NP score "absent") and 178 NT subjects from the National Alzheimer's Coordinating Center dataset. RESULTS PART subjects were older than either ADNC or NT patients. The ADNC cohort had more frequent neuropathological comorbidities as well as APOE ɛ4 alleles than the PART or NT cohort, and less frequent APOE ɛ2 alleles than either group. Clinically, ADNC patients performed significantly worse than NT or PART subjects across cognitive measures, but PART subjects had selective deficits in measures of processing speed, executive function, and visuospatial function, although additional cognitive measures were further impaired in the presence of neuropathologic comorbidities. In isolated cases of PART with Braak stage III-IV, there are additional deficits in measures of language. CONCLUSION Overall, these findings demonstrate underlying cognitive features specifically associated with PART, and reinforce the concept that PART is a distinct entity from ADNC.
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Affiliation(s)
- Jamie M. Walker
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mitzi M. Gonzales
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - William Goette
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kurt Farrell
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer’s Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charles L. White
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John F. Crary
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer’s Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Timothy E. Richardson
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Two Immersive Virtual Reality Tasks for the Assessment of Spatial Orientation in Older Adults with and Without Cognitive Impairment: Concurrent Validity, Group Comparison, and Accuracy Results. J Int Neuropsychol Soc 2022; 28:460-472. [PMID: 34080532 DOI: 10.1017/s1355617721000655] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Spatial disorientation is common in Alzheimer's disease (AD), Mild Cognitive Impairment (MCI), and preclinical individuals with AD biomarkers. However, traditional neuropsychological tests lack ecological validity for the assessment of spatial orientation and to date, there is still no gold standard. The current study aimed to determine the validity and accuracy of two virtual reality tasks for the assessment of spatial orientation. METHODS We adapted two spatial orientation tasks to immersive virtual environments: a "survey to route" task in which participants had to transfer information from a map to their body position within a maze [Spatial Orientation in Immersive Virtual Environment Test (SOIVET) Maze], and an allocentric-type, route learning task, with well-established topographic landmarks (SOIVET Route). A total of 19 MCI patients and 29 cognitively healthy older adults aged 61-92 participated in this study. Regular neuropsychological assessments were used for correlation analysis and participant performances were compared between groups. Receiver Operating Characteristic (ROC) curve analysis was performed for accuracy. RESULTS The SOIVET Maze correlated with measures of visuoperception, mental rotation, and planning, and was not related to age, educational level, or technology use profile. The SOIVET Route immediate correlated with measures of mental rotation, memory, and visuoconstruction, and was influenced only by education. Both tasks significantly differentiated MCI and control groups, and demonstrated moderate accuracy for the MCI diagnosis. CONCLUSION Traditional neuropsychological assessment presents limitations and immersive environments allow for the reproduction of complex cognitive processes. The two immersive virtual reality tasks are valid tools for the assessment of spatial orientation and should be considered for cognitive assessments of older adults.
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Plácido J, de Almeida CAB, Ferreira JV, de Oliveira Silva F, Monteiro-Junior RS, Tangen GG, Laks J, Deslandes AC. Spatial navigation in older adults with mild cognitive impairment and dementia: A systematic review and meta-analysis. Exp Gerontol 2022; 165:111852. [DOI: 10.1016/j.exger.2022.111852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/03/2022] [Accepted: 05/23/2022] [Indexed: 11/04/2022]
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Zhang JX, Wang L, Hou HY, Yue CL, Wang L, Li HJ. Age-related impairment of navigation and strategy in virtual star maze. BMC Geriatr 2021; 21:108. [PMID: 33546606 PMCID: PMC7866711 DOI: 10.1186/s12877-021-02034-y] [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: 07/19/2020] [Accepted: 01/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background Although it is well known that aging impairs navigation performance, the underlying mechanisms remain largely unknown. Egocentric strategy requires navigators to remember a series of body-turns without relying on the relationship between environmental cues. Previous study suggested that the egocentric strategy, compared with non-egocentric strategy, was relatively unimpaired during aging. In this study, we aimed to examine strategy use during virtual navigation task and the underlying cognitive supporting mechanisms in older adults. Methods Thirty young adults and thirty-one older adults were recruited from the local community. This study adapted star maze paradigm using non-immersive virtual environment. Participants moved freely in a star maze with adequate landmarks, and were requested to find a fixed destination. After 9 learning trials, participants were probed in the same virtual star maze but with no salient landmarks. Participants were classified as egocentric or non-egocentric strategy group according to their response in the probe trial. Results The results revealed that older adults adopting egocentric strategy completed the navigation task as accurate as young adults, whereas older adults using non-egocentric strategy completed the navigation task with more detours and lower accuracy. The relatively well-maintained egocentric strategy in older adults was related to better visuo-spatial ability. Conclusions Visuo-spatial ability might play an important role in navigation accuracy and navigation strategy of older adults. This study demonstrated the potential value of the virtual star maze in evaluating navigation strategy and visuo-spatial ability in older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02034-y.
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Affiliation(s)
- Jia-Xin Zhang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 16 Lincui Road, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Lin Wang
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.,CAS Key Laboratory of Mental Health, Institute of Psychology, 16 Lincui Road, Beijing, 100101, China
| | - Hai-Yan Hou
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 16 Lincui Road, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chun-Lin Yue
- College of Physical Education and Sport Science, Soochow University, Suzhou, 215021, China
| | - Liang Wang
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China. .,CAS Key Laboratory of Mental Health, Institute of Psychology, 16 Lincui Road, Beijing, 100101, China.
| | - Hui-Jie Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 16 Lincui Road, Beijing, 100101, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
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Vattimo EFQ, Dos Santos AC, Hoexter MQ, Frudit P, Miguel EC, Shavitt RG, Batistuzzo MC. Higher volumes of hippocampal subfields in pediatric obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2021; 307:111200. [PMID: 33059948 DOI: 10.1016/j.pscychresns.2020.111200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 09/12/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
Differences in hippocampus volume have been identified in adult patients with obsessive-compulsive disorder (OCD). However, the role of this limbic structure in pediatric patients is unclear. This study aimed to investigate the hippocampus and its subregions in a sample of 29 children and adolescents with OCD compared to 28 healthy controls, matched for age, sex, education, and IQ. Volumetric segmentation was performed using the Freesurfer software to calculate the volumes of the subregions that reflect the hippocampal cytoarchitecture. The volumes of three anatomic subregions (tail, body, and head) were also calculated. ANCOVA was performed to investigate differences of these volumes between patients and controls, controlling for total gray matter volume. After Bonferroni correction for multiple comparisons (p-value < 0.00556 for the body and < 0.00625 for the head structures), patients presented statistically significant larger volumes of the following structures: left subiculum body; left CA4 body; left GC-DG body; left molecular layer body; right parasubiculum; left CA4 head; left molecular layer head; right subiculum head and right molecular layer head. These enlarged volumes resulted in larger left and right whole hippocampi in patients, as well as bilateral hippocampal heads and left hippocampal body (all p-values < 0.00625). There were no associations between OCD severity and hippocampal volumes. These findings diverge from previous reports on adults and may indicate that larger hippocampal volumes could reflect an early marker of OCD, not present in adults.
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Affiliation(s)
- Edoardo F Q Vattimo
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | | | - Marcelo Q Hoexter
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Paula Frudit
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, SP, Brazil
| | - Euripedes C Miguel
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Roseli G Shavitt
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Marcelo C Batistuzzo
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil; Departamento de Métodos e Técnicas, Curso de Psicologia da Faculdade de Ciências Humanas e da Saúde, Pontifícia Universidade Católica de São Paulo, SP, Brazil.
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10
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Bocanegra Y, Fox-Fuller JT, Baena A, Guzmán-Vélez E, Vila-Castelar C, Martínez J, Torrico-Teave H, Lopera F, Quiroz YT. Association Between Visual Memory and In Vivo Amyloid and Tau Pathology in Preclinical Autosomal Dominant Alzheimer's Disease. J Int Neuropsychol Soc 2021; 27:47-55. [PMID: 32762790 PMCID: PMC8101259 DOI: 10.1017/s1355617720000673] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Visual memory (ViM) declines early in Alzheimer's disease (AD). However, it is unclear whether ViM impairment is evident in the preclinical stage and relates to markers of AD pathology. We examined the relationship between ViM performance and in vivo markers of brain pathology in individuals with autosomal dominant AD (ADAD). METHODS Forty-five cognitively unimpaired individuals from a Colombian kindred with the Presenilin 1 (PSEN1) E280A ADAD mutation (19 carriers and 26 noncarriers) completed the Rey-Osterrieth Complex Figure immediate recall test, a measure of ViM. Cortical amyloid burden and regional tau deposition in the entorhinal cortex (EC) and inferior temporal cortex (IT) were measured using 11C-Pittsburgh compound B positron emission tomography (PET) and 11F-flortaucipir PET, respectively. RESULTS Cognitively unimpaired carriers and noncarriers did not differ on ViM performance. Compared to noncarriers, carriers had higher levels of cortical amyloid and regional tau in both the EC and IT. In cognitively unimpaired carriers, greater cortical amyloid burden, higher levels of regional tau, and greater age were associated with worse ViM performance. Only a moderate correlation between regional tau and ViM performance remained after adjusting for verbal memory scores. None of these correlations were observed in noncarriers. CONCLUSIONS Results suggest that AD pathology and greater age are associated with worse ViM performance in ADAD before the onset of clinical symptoms. Further investigation with larger samples and longitudinal follow-up is needed to examine the utility of ViM measures for identifying individuals at high risk of developing dementia later in life.
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Affiliation(s)
- Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Joshua T. Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Boston University, Boston, MA, USA
| | - Ana Baena
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Edmarie Guzmán-Vélez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Clara Vila-Castelar
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jairo Martínez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Heirangi Torrico-Teave
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Yakeel T. Quiroz
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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11
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Costa RQMD, Pompeu JE, Viveiro LAPD, Brucki SMD. Spatial orientation tasks show moderate to high accuracy for the diagnosis of mild cognitive impairment: a systematic literature review. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:713-723. [DOI: 10.1590/0004-282x20200043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/15/2020] [Indexed: 12/17/2022]
Abstract
Abstract Spatial disorientation has been observed in mild cognitive impairment (MCI) and is associated with a higher risk of progression to Alzheimer's disease (AD). However, there is no gold standard assessment for spatial orientation and paper-and-pencil tests lack ecological validity. Recently, there has been an increasing number of studies demonstrating the role of spatial disorientation as a cognitive marker of pathological decline, shedding new light on its importance for MCI. This systematic review aimed to investigate the accuracy of spatial orientation tasks for the diagnosis of MCI by comparison with cognitively healthy elderly. The search was conducted in the databases Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Web of Science, Scopus, Excerpta Medica Database (Embase), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO). Only original studies reporting spatial orientation assessment in MCI patients compared to a healthy control group were included. Studies were excluded if the MCI classification did not follow well described criteria and/or if accuracy results of spatial orientation assessment were not provided. Seven studies met the eligibility criteria, describing a variety of spatial orientation assessments including questionnaires, paper-and-pencil, office-based route learning, and computer-based and virtual reality tasks. Spatial orientation tasks demonstrated moderate to high accuracy in detecting elderly with MCI compared to cognitively healthy elderly, with areas under the curve (AUC) ranging from 0.77 to 0.99. However, important methodological issues were found in the selected studies which should be considered when interpreting results. Although the inclusion of spatial orientation assessments in MCI evaluations seems to have significant value, further studies are needed to clarify their true capacity to distinguish pathological from non-pathological aging.
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12
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Boccia M, Di Vita A, Diana S, Margiotta R, Imbriano L, Rendace L, Campanelli A, D'Antonio F, Trebbastoni A, de Lena C, Piccardi L, Guariglia C. Is Losing One's Way a Sign of Cognitive Decay? Topographical Memory Deficit as an Early Marker of Pathological Aging. J Alzheimers Dis 2020; 68:679-693. [PMID: 30883347 DOI: 10.3233/jad-180890] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Spatial navigation tasks reveal small differences between normal and pathological aging and may thus disclose potential neuropsychological predictors of neurodegenerative diseases. The aim of our study was to investigate which navigational skills are compromised in the early phase of pathological aging as well as the extent to which they are compromised. We performed an extensive neuropsychological evaluation based on working memory and learning tasks (i.e., Corsi Block-Tapping Test and Walking Corsi Test) involving both reaching and navigational vista spaces. We also assessed spatial navigation skills in the real world by asking participants to perform route-learning and landmark-recognition tasks. We conducted a cross-sectional study on nineteen patients with a diagnosis of mild cognitive impairment (MCI) who displayed either an isolated memory deficit (single-domain amnestic MCI, MCIsd; N = 3) or a memory deficit associated with deficits in other cognitive functions (multi-domain MCI, MCImd; N = 16) as well as on nineteen healthy control participants. The groups' performances were compared by means of mixed factorial ANOVA and two-sample t-tests. We found that patients with MCI performed worse than controls, especially when they were required to learn spatial positions within the navigational vista space. Route-learning within the real environment was also impaired whereas landmark-recognition was spared. The same pattern of results emerged in the MCImd subgroup. Moreover, single case analyses on MCIsd patients revealed a dissociation between learning of spatial positions within navigational vista space and within reaching space. These results suggest that topographical learning is compromised in the early phase of MCIsd and MCImd and that spatial navigation tasks may be used to better characterize topographical disorientation in MCI patients as well as for the early diagnosis of pathological aging.
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Affiliation(s)
- Maddalena Boccia
- Cognitive and Motor Rehabilitation Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Antonella Di Vita
- Cognitive and Motor Rehabilitation Unit, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy.,Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy
| | - Sofia Diana
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy
| | - Roberta Margiotta
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy
| | - Letizia Imbriano
- Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy
| | - Lidia Rendace
- Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy
| | | | - Fabrizia D'Antonio
- Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy
| | | | - Carlo de Lena
- Department of Human Neuroscience, "Sapienza" University of Rome, Rome, Italy
| | - Laura Piccardi
- Cognitive and Motor Rehabilitation Unit, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Life, Health and Environmental Sciences, L'Aquila University, L'Aquila, Italy
| | - Cecilia Guariglia
- Cognitive and Motor Rehabilitation Unit, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
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13
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Feng Q, Song Q, Wang M, Pang P, Liao Z, Jiang H, Shen D, Ding Z. Hippocampus Radiomic Biomarkers for the Diagnosis of Amnestic Mild Cognitive Impairment: A Machine Learning Method. Front Aging Neurosci 2019; 11:323. [PMID: 31824302 PMCID: PMC6881244 DOI: 10.3389/fnagi.2019.00323] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 11/06/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Recent evidence suggests the presence of hippocampal neuroanatomical abnormalities in subjects of amnestic mild cognitive impairment (aMCI). Our study aimed to identify the radiomic biomarkers of the hippocampus for building the classification models in aMCI diagnosis. Methods: For this target, we recruited 42 subjects with aMCI and 44 normal controls (NC). The right and left hippocampi were segmented for each subject using an efficient learning-based method. Then, the radiomic analysis was applied to calculate and select the radiomic features. Finally, two logistic regression models were built based on the selected features obtained from the right and left hippocampi. Results: There were 385 features derived after calculation, and four features remained after feature selection from each group of data. The area under the receiver operating characteristic (ROC) curve, specificity, sensitivity, positive predictive value, negative predictive value, precision, recall, and F-score of the classification evaluation index of the right hippocampus logistic regression model were 0.76, 0.71, 0.69, 0.69, 0.71, 0.69, 0.69, and 0.69, and those of the left hippocampus model were 0.79, 0.71, 0.54, 0.64, 0.63, 0.64, 0.54, and 0.58, respectively. Conclusion: Results demonstrate the potential hippocampal radiomic biomarkers are valid for the aMCI diagnosis. The MRI-based radiomic analysis, with further improvement and validation, can be used to identify patients with aMCI and guide the individual treatment.
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Affiliation(s)
- Qi Feng
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiaowei Song
- Department of Radiology, Zhejiang Provincial People's Hospital/People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Mei Wang
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - PeiPei Pang
- GE Healthcare Life Sciences, Hangzhou, China
| | - Zhengluan Liao
- Department of Psychiatry, Zhejiang Provincial People's Hospital/People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Hongyang Jiang
- Department of Radiology, Zhejiang Provincial People's Hospital/People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Dinggang Shen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Brain and Cognitive Engineering, Korea University, Seoul, South Korea
| | - Zhongxiang Ding
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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14
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Machado M, Lefèvre N, Philoxene B, Le Gall A, Madeleine S, Fleury P, Smith P, Besnard S. New software dedicated to virtual mazes for human cognitive investigations. J Neurosci Methods 2019; 327:108388. [DOI: 10.1016/j.jneumeth.2019.108388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 07/23/2019] [Accepted: 08/01/2019] [Indexed: 12/27/2022]
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15
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Palac D, Bullard T, Cohen JD, Nguyen LT, Mudar RA, Mullen SP. Effects of Traditional vs. iPad-Enhanced Aerobic Exercise on Wayfinding Efficacy and Cognition: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183495. [PMID: 31546856 PMCID: PMC6766024 DOI: 10.3390/ijerph16183495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/09/2019] [Accepted: 09/14/2019] [Indexed: 12/19/2022]
Abstract
The purpose of this pilot study was to test the feasibility and efficacy of an iPad-enhanced aerobic exercise intervention designed to enhance wayfinding efficacy and performance and relevant cognitive functioning among middle-aged adults at risk for cognitive impairment. Twenty-seven low active adults (21 females) aged 45 to 62 years (51.22 ± 5.20) participated in a ten-week randomized controlled trial. Participants were randomized to an iPad-enhanced aerobic exercise group (experimental group) or an aerobic exercise-only group (control group) following baseline assessment. Both groups exercised at 50% to 75% of age-predicted heart rate maximum for 30 to 50 min/d, 2 d/wk for 10 weeks. During aerobic exercise, the experimental group engaged in virtual tours delivered via iPad. Baseline and post-intervention assessments of wayfinding self-efficacy, wayfinding task performance, cognitive functioning, electroencephalogram (EEG), and psychosocial questionnaires were administered. The results suggest that ten weeks of iPad-enhanced, moderately intense aerobic exercise had specific effects on wayfinding self-efficacy; however, no statistical differences were found between groups on the behavioral wayfinding task or spatial memory performance at follow-up. Performance scores on an inhibitory attentional-control cognitive assessment revealed significant differences between groups, favoring the experimental group (p < 0.05). Virtual reality-enhanced aerobic exercise may prove to be an effective method for improving cognitive function and increasing confidence to navigate real-world scenarios among individuals at risk of cognitive impairment.
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Affiliation(s)
- Daniel Palac
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Tiffany Bullard
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Jason D Cohen
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Lydia T Nguyen
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Raksha A Mudar
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign; Champaign, IL 61820, USA.
| | - Sean P Mullen
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign; Urbana, IL 61801, USA.
- Illinois Informatics Institute, University of Illinois at Urbana-Champaign; Urbana, IL 61801, USA.
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16
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Minkova L, Peter J, Abdulkadir A, Schumacher LV, Kaller CP, Nissen C, Klöppel S, Lahr J. Determinants of Inter-Individual Variability in Corticomotor Excitability Induced by Paired Associative Stimulation. Front Neurosci 2019; 13:841. [PMID: 31474818 PMCID: PMC6702284 DOI: 10.3389/fnins.2019.00841] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/26/2019] [Indexed: 12/23/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is a well-established tool in probing cortical plasticity in vivo. Changes in corticomotor excitability can be induced using paired associative stimulation (PAS) protocol, in which TMS over the primary motor cortex is conditioned with an electrical peripheral nerve stimulation of the contralateral hand. PAS with an inter-stimulus interval of 25 ms induces long-term potentiation (LTP)-like effects in cortical excitability. However, the response to a PAS protocol tends to vary substantially across individuals. In this study, we used univariate and multivariate data-driven methods to investigate various previously proposed determinants of inter-individual variability in PAS efficacy, such as demographic, cognitive, clinical, neurophysiological, and neuroimaging measures. Forty-one right-handed participants, comprising 22 patients with amnestic mild cognitive impairment (MCI) and 19 healthy controls (HC), underwent the PAS protocol. Prior to stimulation, demographic, genetic, clinical, as well as structural and resting-state functional MRI data were acquired. The two groups did not differ in any of the variables, except by global cognitive status. Univariate analysis showed that only 61% of all participants were classified as PAS responders, irrespective of group membership. Higher PAS response was associated with lower TMS intensity and with higher resting-state connectivity within the sensorimotor network, but only in responders, as opposed to non-responders. We also found an overall positive correlation between PAS response and structural connectivity within the corticospinal tract, which did not differ between groups. A multivariate random forest (RF) model identified age, gender, education, IQ, global cognitive status, sleep quality, alertness, TMS intensity, genetic factors, and neuroimaging measures (functional and structural connectivity, gray matter (GM) volume, and cortical thickness as poor predictors of PAS response. The model resulted in low accuracy of the RF classifier (58%; 95% CI: 42 - 74%), with a higher relative importance of brain connectivity measures compared to the other variables. We conclude that PAS variability in our sample was not well explained by factors known to influence PAS efficacy, emphasizing the need for future replication studies.
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Affiliation(s)
- Lora Minkova
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany
| | - Jessica Peter
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ahmed Abdulkadir
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lena V Schumacher
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph P Kaller
- Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany.,Department of Neuroradiology, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Nissen
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,University Hospital of Psychiatry and Psychotherapy, University Psychiatric Services, University of Bern, Bern, Switzerland.,Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Center for Geriatrics and Gerontology Freiburg, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jacob Lahr
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany
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17
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Dissociable age and memory relationships with hippocampal subfield volumes in vivo:Data from the Irish Longitudinal Study on Ageing (TILDA). Sci Rep 2019; 9:10981. [PMID: 31358771 PMCID: PMC6662668 DOI: 10.1038/s41598-019-46481-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 07/01/2019] [Indexed: 11/18/2022] Open
Abstract
The heterogeneous specialisation of hippocampal subfields across memory functions has been widely shown in animal models. Yet, few in vivo studies in humans have explored correspondence between hippocampal subfield anatomy and memory performance in ageing. Here, we used a well-validated automated MR segmentation protocol to measure hippocampal subfield volumes in 436 non-demented adults aged 50+. We explored relationships between hippocampal subfield volume and verbal episodic memory, as indexed by word list recall at immediate presentation and following delay. In separate multilevel models for each task, we tested linearity and non-linearity of associations between recall performance and subfield volume. Fully-adjusted models revealed that immediate and delayed recall were both associated with cubic fits with respect to volume of subfields CA1, CA2/3, CA4, molecular layer, and granule cell layer of dentate gyrus; moreover, these effects were partly dissociable from quadratic age trends, observed for subiculum, molecular layer, hippocampal tail, and CA1. Furthermore, analyses of semantic fluency data revealed little evidence of robust associations with hippocampal subfield volumes. Our results show that specific hippocampal subfields manifest associations with memory encoding and retrieval performance in non-demented older adults; these effects are partly dissociable from age-related atrophy, and from retrieval of well-consolidated semantic categories.
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18
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Howett D, Castegnaro A, Krzywicka K, Hagman J, Marchment D, Henson R, Rio M, King JA, Burgess N, Chan D. Differentiation of mild cognitive impairment using an entorhinal cortex-based test of virtual reality navigation. Brain 2019; 142:1751-1766. [PMID: 31121601 PMCID: PMC6536917 DOI: 10.1093/brain/awz116] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/15/2019] [Accepted: 02/27/2019] [Indexed: 12/19/2022] Open
Abstract
The entorhinal cortex is one of the first regions to exhibit neurodegeneration in Alzheimer's disease, and as such identification of entorhinal cortex dysfunction may aid detection of the disease in its earliest stages. Extensive evidence demonstrates that the entorhinal cortex is critically implicated in navigation underpinned by the firing of spatially modulated neurons. This study tested the hypothesis that entorhinal-based navigation is impaired in pre-dementia Alzheimer's disease. Forty-five patients with mild cognitive impairment (26 with CSF Alzheimer's disease biomarker data: 12 biomarker-positive and 14 biomarker-negative) and 41 healthy control participants undertook an immersive virtual reality path integration test, as a measure of entorhinal-based navigation. Behavioural performance was correlated with MRI measures of entorhinal cortex volume, and the classification accuracy of the path integration task was compared with a battery of cognitive tests considered sensitive and specific for early Alzheimer's disease. Biomarker-positive patients exhibited larger errors in the navigation task than biomarker-negative patients, whose performance did not significantly differ from controls participants. Path-integration performance correlated with Alzheimer's disease molecular pathology, with levels of CSF amyloid-β and total tau contributing independently to distance error. Path integration errors were negatively correlated with the volumes of the total entorhinal cortex and of its posteromedial subdivision. The path integration task demonstrated higher diagnostic sensitivity and specificity for differentiating biomarker positive versus negative patients (area under the curve = 0.90) than was achieved by the best of the cognitive tests (area under the curve = 0.57). This study demonstrates that an entorhinal cortex-based virtual reality navigation task can differentiate patients with mild cognitive impairment at low and high risk of developing dementia, with classification accuracy superior to reference cognitive tests considered to be highly sensitive to early Alzheimer's disease. This study provides evidence that navigation tasks may aid early diagnosis of Alzheimer's disease, and the basis of this in animal cellular and behavioural studies provides the opportunity to answer the unmet need for translatable outcome measures for comparing treatment effect across preclinical and clinical trial phases of future anti-Alzheimer's drugs.
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Affiliation(s)
- David Howett
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Andrea Castegnaro
- Institute of Cognitive Neuroscience, University College London, London, UK
- Department of Electrical Engineering, University College London, London, UK
| | - Katarzyna Krzywicka
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Johanna Hagman
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Deepti Marchment
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Richard Henson
- MRC Cognition and Brain Sciences Unit, and Department of Psychiatry, University of Cambridge, UK
| | - Miguel Rio
- Department of Electrical Engineering, University College London, London, UK
| | - John A King
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Neil Burgess
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Dennis Chan
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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