What is normal in normal aging? Effects of aging, amyloid and Alzheimer's disease on the cerebral cortex and the hippocampus

Inspired by pathogenic mechanisms: A novel gradual multi-modal fusion framework for mild cognitive impairment diagnosis

Mild cognitive impairment (MCI) is a precursor to Alzheimer's disease (AD), and its progression involves complex pathogenic mechanisms. Specifically, disturbed by gene variants, the regulation of gene expression ultimately changes brain structure, resulting in the progression of brain diseases. However, the existing works rarely take these mechanisms into account when designing their diagnosis methods. Therefore, we propose a novel gradual multi-modal fusion framework to fuse representative data from each stage of disease progression in hybrid feature space, including single nucleotide polymorphism (SNP), gene expression (GE), and magnetic resonance imaging (MRI). Specifically, to integrate genetic sequence and expression data, we design a SNP-GE fusion module, which performs multi-modal fusion to obtain genetic embedding by considering the relation between SNP and GE. Compared with SNP-GE fusion, representation of genetic embedding and MRI have more obvious heterogeneity, especially correlation with disease. Therefore, we propose to align the manifold of genetic and imaging representations, which can explore the high-order relationship between imaging and genetic data in the presence of modal heterogeneity. Our proposed framework was validated using the Alzheimer's Disease Neuroimaging Initiative dataset, and achieved diagnosis accuracy of 76.88%, 72.84%, 87.72%, and 95.00% for distinguishing MCI from control normal, lately MCI from early MCI, MCI from AD, and AD from control normal, respectively. Additionally, our proposed framework helps to identify some multi-modal biomarkers related to MCI progression. In summary, our proposed framework is effective not only for MCI diagnosis but also for guiding the further development of genetic and imaging-based brain studies. Our code is published at https://github.com/tianxu8822/workflow_MCI/tree/main/.

Morphological diversity of microglia: Implications for learning, environmental adaptation, ageing, sex differences and neuropathology

Microglia are the brain resident macrophages that respond rapidly to any insult. These non-neuroectodermal cells are decorated with plenty of receptors allowing them to recognise and respond precisely to a multitude of stimuli. To do so, microglia undergo structural and functional changes aiming to actively keep the brain's homeostasis. However, some microglial responses, when sustained or exacerbated, can contribute to neuropathology and neurodegeneration. Many microglial molecular and cellular changes were identified that display a strong correlation with neuronal damage and neuroinflammation/disease status, as well as present key sex-related differences that modulate microglial outcomes. Nevertheless, the relationship between microglial structural and functional features is just beginning to be unravelled. Several reports show that microglia undergo soma and branch remodelling in response to environmental stimuli, ageing, neurodegenerative diseases, trauma, and systemic inflammation, suggesting a complex form and function link. Also, it is reasonable overall to suppose that microglia diminishing their process length and ramification also reduce their monitoring activity of synapses, which is critical for detecting any synaptic disturbance and performing synaptic remodelling. Elucidating the complex interactions between microglial morphological plasticity and its functional implications appears essential for the understanding of complex cognitive and behavioural processes in health and neuropathological conditions.

Bilingualism and "brain reserve" in subregions of the hippocampal formation

With aging, the hippocampal formation shows variable structural atrophy, which is associated with a decline in cognitive performance. Bilingualism is related to higher hippocampal gray matter volume (GMV), potentially representing a form of brain reserve in aging. However, the differential influence of bilingualism on hippocampal subregions remains unclear. Thus, we investigated GMV differences and differences in age-GMV relationships between mono- and bilinguals in the hippocampal formation and its subregions, hippocampus proper and subicular complex. We included 661 adults aged 19 to 85 years (257 monolinguals, 404 sequential bilinguals, predominantly native German speakers with variable second language background) from the population-based 1000BRAINS cohort. GMV differences in mono- vs. bilinguals were assessed for six regions of interest (hippocampal formation, hippocampus proper, and subicular complex; each left and right) using analyses of covariance. Effects of bilingualism on age-GMV relationships were investigated via moderation analyses. We found higher GMV in bilinguals in the bilateral subicular complex, while only a trend towards this effect existed for the hippocampal formation. Moderation analyses revealed similar age-GMV relationships between mono- and bilinguals for all regions of interest. Higher GMV in bilinguals' hippocampal formation seems specifically attributable to the subicular complex rather than the hippocampus proper. With similar age-GMV relationships for mono- and bilinguals, bilingual brain reserve in the subicular complex may persist over time. This may be particularly beneficial since subicular atrophy has previously been associated with higher risk for dementia. Altogether, a differential impact of bilingualism on hippocampal subregions has been demonstrated.

The effect of hippocampal subfield volumes on cognitive decline and incident dementia in a memory clinic cohort

BackgroundThe hippocampus plays a central role in cognition and hippocampal atrophy is a key hallmark of Alzheimer's disease. Evidence has suggested associations between hippocampal subfield volumes and specific cognitive domains and dementia risk. However, to our knowledge, no study has examined the role of hippocampal subfield volumes in cognitive decline across different domains over time.ObjectiveWe investigated associations between hippocampal subfield volumes and changes in cognitive domains together with incident dementia in a memory clinic cohort.MethodsAssociations between hippocampal subfield volumes and cognitive decline over three years (n = 443) were analyzed using generalized estimating equations, and associations with incident dementia (n = 283) using multiple logistic regression.ResultsAt baseline, all hippocampal subfield volumes were associated with diagnosis of dementia, while the CA4-dentate gyrus, molecular layer, subicular complex, and fimbria volumes were associated with diagnosis of CIND. Over three years, all subfields except the hippocampal fissure were associated with memory. Decreased molecular layer (OR:2.26, 95%CI:1.50;3.50) size was associated with increased risk of dementia.ConclusionsOur findings suggest that hippocampal atrophy of the cornu ammonis, CA4-dentate gyrus, and molecular layer may first manifest with cognitive impairment in memory before other subfields of the hippocampus, and that molecular layer volume may be an early biomarker of dementia. Further research demonstrating the biological role of hippocampal subfields in specific cognitive domains is required.

Age Differences in Brain Functional Connectivity Underlying Proactive Interference in Working Memory

Aging is typically accompanied by a decline in working memory (WM) capacity, even in the absence of pathology. Proficient WM requires cognitive control processes that can retain goal-relevant information for easy retrieval and resolve interference from irrelevant information. Aging has been associated with a reduced ability to resolve proactive interference (PI) in WM, leading to impaired retrieval of goal-relevant information. It remains unclear how age-related differences in the ability to resolve PI in WM are related to patterns of resting-state functional connectivity (rsFC) in the brain. Here, we investigated the association between PI in WM and rsFC cross-sectionally (n = 237) and 5 years longitudinally (n = 134) across the adult life span by employing both seed-based and data-driven approaches. Results revealed that the ability to resolve PI was associated with differential patterns of inferior frontal gyrus (IFG) rsFC in younger/middle-aged adults (25-60 years) and older adults (65-80 years) in two clusters centered in the vermis and caudate. Specifically, more PI was associated with stronger inferior frontal gyrus-vermis connectivity and weaker inferior frontal gyrus-caudate connectivity in older adults, while younger/middle-aged adults showed associations in the opposite directions with the identified clusters. Longitudinal analyses revealed that a reduced ability to control PI was associated with reduced inferior frontal gyrus-insula and inferior frontal gyrus-anterior cingulate cortex connectivity in older adults, while younger/middle-aged adults showed associations in the opposite direction with these clusters. Whole brain multivariate pattern analyses showed age-differential patterns of rsFC indicative of age-related structural decline and age-related compensation. The current results show that rsFC is associated with the ability to control PI in WM and that these associations are modulated by age.

Allostatic load, a measure of cumulative physiological stress, impairs brain structure but not β-accumulation in older adults: an exploratory study

Introduction

Allostatic load (AL) is a composite score of progressive physiological dysregulations in response to long-term exposure to everyday stress. Despite growing interest, limited research has focused on links with cerebral and cognitive aspects of aging and with markers sensitive to Alzheimer's disease (AD) in a healthy elderly population and with a multimodal approach.

Methods

At baseline, 111 older adults (without cognitive impairment) from the Age-Well trial completed blood and anthropometric markers collection, cognitive assessments and multimodal neuroimaging within 3 months.

Results

AL was negatively associated with gray matter volume and white matter integrity within frontal and temporal regions and poorer attentional performance.

Discussion

AL is linked to structural brain integrity in aging- and stress-sensitive regions but not with AD-related markers (β-amyloid load) and only in two AD-sensitive brain regions in older adults. These results highlight the potential interest of AL as a sensitive index of stress-induced brain aging.

Vulnerability to memory decline in aging - a mega-analysis of structural brain change

Brain atrophy is a key factor behind episodic memory loss in aging, but the nature and ubiquity of this relationship remains poorly understood. This study leveraged 13 longitudinal datasets, including 3,737 cognitively healthy adults (10,343 MRI scans; 13,460 memory assessments), to determine whether brain change-memory change associations are more pronounced with age and genetic risk for Alzheimer's Disease. Both factors are associated with accelerated brain decline, yet it remains unclear whether memory loss is exacerbated beyond what atrophy alone would predict. Additionally, we assessed whether memory decline aligns with a global pattern of atrophy or stems from distinct regional contributions. Our mega-analysis revealed a nonlinear relationship between memory decline and brain atrophy, primarily affecting individuals with above-average brain structural decline. The associations were stronger in the hippocampus but also spread across diverse cortical and subcortical regions. The associations strengthened with age, reaching moderate associations in participants in their eighties. While APOE ε4 carriers exhibited steeper brain and memory loss, genetic risk had no effect on the change-change associations. These findings support the presence of common biological macrostructural substrates underlying memory function in older age which are vulnerable to multiple age-related factors, even in the absence of overt pathological changes.

Stable hippocampal correlates of high episodic memory function across adulthood

Some older adults show high episodic memory performance compared to same-age peers. It is not known whether their high function is caused by special brain features in aging, or whether superior memory has the same brain foundation throughout adult life. To address this, we measured hippocampal volume and atrophy, microstructural integrity by diffusion tensor imaging, and activity during an episodic memory encoding and retrieval task in cognitively healthy adults (n = 277, age 20.1-81.5 years). Atrophy was quantified by repeated MRIs (2-7 examinations, mean max follow-up time 9.3 years). Superior memory was associated with higher retrieval activity in the anterior hippocampus and less hippocampal atrophy. There were no significant age-interactions, suggesting stable correlates of superior memory function. Age-memory performance curves across the full age-range were similar for participants with high memory performance compared to those with normal and low performance. These trajectories were based on cross-sectional data but did not indicate preserved memory among the superior functioning older adults. In conclusion, the results confirm that aspects of hippocampal structure and function are related to superior memory, without evidence to suggest that the best performing older adults are characterized by special hippocampal features compared to their younger counterparts.

Brain Morphometrics Correlations With Age Among 350 Participants Imaged With Both 3T and 7T MRI: 7T Improves Statistical Power and Reduces Required Sample Size

Magnetic resonance imaging (MRI) at 7T has a superior signal-to-noise ratio to 3T but also presents higher signal inhomogeneities and geometric distortions. A key knowledge gap is to robustly investigate the sensitivity and accuracy of 3T and 7T MRI in assessing brain morphometrics. This study aims to (a) aggregate a large number of paired 3T and 7T scans to evaluate their differences in quantitative brain morphological assessment using a widely available brain segmentation tool, FreeSurfer, as well as to (b) examine the impact of normalization methods for subject variability and smaller sample sizes on data analysis. A total of 401 healthy participants aged 29-68 were imaged at both 3T and 7T. Structural T1-weighted magnetization-prepared rapid gradient-echo (MPRAGE) images were processed and segmented using FreeSurfer. To account for head size variability, the brain volumes underwent intracranial volume (ICV) correction using the Residual (regression model) and Proportional (simple division to ICV) methods. The resulting volumes and thicknesses were correlated with age using Pearson's correlation and false discovery rate correction. The correlations were also calculated in increasing sample size from three to the whole sample to estimate the sample size required to detect aging-related brain variation. Three hundred and fifty subjects (208 females) passed the image quality control, with 51 subjects excluded due to excessive motion artifacts on 3T, 7T, or both. 7T MRI showed an overall stronger correlation between morphometrics and age and a larger number of significantly correlated brain volumes and cortical thicknesses. While the ICV is consistent between both field strengths, the Residual normalization method shows markedly higher correlation with age for 3T when compared with the Proportional normalization method. The 7T results are consistent regardless of the normalization method used. In a large cohort of healthy participants with paired 3T and 7T scans, we compared the statistical performance in assessing age-related brain morphological changes. Our study reaffirmed the inverse correlation between brain volumes and cortical thicknesses and age and highlighted varying correlations in different brain regions and normalization methods at 3T and 7T. 7T imaging significantly improves statistical power and thus reduces the required sample size.

Sequential Proteomic Analysis Reveals the Key APOE4-Induced Pathological and Molecular Features at the Presymptomatic Stage in Alzheimer's Disease Mice

AIMS

Alzheimer's disease (AD) involves a prolonged presymptomatic or preclinical stage with subtle pathological changes. Apolipoprotein E4 (APOE4) is a significant genetic risk factor for AD, yet its specific role at the presymptomatic stage is not fully understood. This study aimed to elucidate the cellular and molecular effects of APOE4 compared to APOE3 on AD progression during the presymptomatic stage.

METHODS

We generated 5xFAD AD mice carrying human APOE3 or APOE4 and their non-AD controls. Behavioral tests, immunostaining, quantitative proteomics and phosphoproteomics, Golgi staining, and Western blotting were conducted at 3 or 10 months of age, respectively. Cell culture experiments were performed to assess APOE4's direct impact on neuronal mitochondrial function.

RESULTS

APOE4 significantly increased β-amyloid (Aβ) deposition and microglial activation compared to APOE3 in 5xFAD mice at the presymptomatic stage, without aggravating the blood-brain barrier disruption. Proteomic and biochemical analysis revealed strong molecular features of synaptic degeneration and mitochondrial dysfunction associated with APOE4. Notably, APOE4 promoted mitochondrial fusion and mitophagy while inhibiting fission, leading to impaired neuronal energy supply and increased reactive oxygen species.

CONCLUSION

Our findings indicate that APOE4 accelerates AD pathologies at the presymptomatic stage by exacerbating Aβ deposition, neuroinflammation, and synaptic degeneration. The study highlights mitochondrial dysfunction as a critical mediator of APOE4-induced AD progression, providing potential targets for early intervention.

Decreased practice effects in cognitively unimpaired amyloid betapositive individuals: a multicenter, longitudinal, cohort study

INTRODUCTION

We aimed to determine whether cognitively unimpaired (CU) amyloid- beta-positive (Aβ+) individuals display decreased practice effects on serial neuropsychological testing.

METHODS

We included 209 CU participants from three research centers, 157 Aβ- controls and 52 Aβ+ individuals. Participants underwent neuropsychological assessment at baseline and annually during a 2-year follow-up. We used linear mixed-effects models to analyze cognitive change over time between the two groups, including time from baseline, amyloid status, their interaction, age, sex, and years of education as fixed effects and the intercept and time as random effects.

RESULTS

The Aβ+ group showed reduced practice effects in verbal learning (β = -1.14, SE = 0.40, p = 0.0046) and memory function (β = -0.56, SE = 0.19, p = 0.0035), as well as in language tasks (β = -0.59, SE = 0.19, p = 0.0027).

DISCUSSION

Individuals with normal cognition who are in the Alzheimer's continuum show decreased practice effects over annual neuropsychological testing. Our findings could have implications for the design and interpretation of primary prevention trials.

HIGHLIGHTS

This was a multicenter study on practice effects in asymptomatic Aβ+ individuals. We used LME models to analyze cognitive trajectories across multiple domains. Practice-effects reductions might be an indicator of subtle cognitive decline. Implications on clinical and research settings within the AD field are discussed.

Emerging Technologies to Track and Improve Sleep Health

This review explores cutting-edge advancements, including wearable sleep trackers, brain age assessments, transcranial electrical stimulation (TES), acoustic stimulation, and glymphatic system modulation. Sleep trackers provide continuous monitoring of sleep patterns, while brain age estimation offers insights into brain health and early detection of accelerated aging. TES shows promise in improving mood, memory, and sleep. Acoustic stimulation during slow-wave sleep has been demonstrated to enhance memory consolidation. Additionally, optimizing the glymphatic system may facilitate brain waste clearance, crucial in preventing neurodegenerative diseases like Alzheimer's. However, significant challenges remain, including the need for rigorous longitudinal studies to validate these technologies' efficacy and safety.

Subtypes of brain change in aging and their associations with cognition and Alzheimer's disease biomarkers

Structural brain changes underlie cognitive changes and interindividual variability in cognition in older age. By using structural MRI data-driven clustering, we aimed to identify subgroups of cognitively unimpaired older adults based on brain change patterns and assess how changes in cortical thickness, surface area, and subcortical volume relate to cognitive change. We tested (1) which brain structural changes predict cognitive change (2) whether these are associated with core cerebrospinal fluid (CSF) Alzheimer's disease biomarkers, and (3) the degree of overlap between clusters derived from different structural modalities in 1899 cognitively healthy older adults followed up to 16 years. We identified four groups for each brain feature, based on the degree of a main longitudinal component of decline. The minimal overlap between features suggested that each contributed uniquely and independently to structural brain changes in aging. Cognitive change and baseline cognition were associated with cortical area change, whereas higher baseline levels of phosphorylated tau and amyloid-β related to changes in subcortical volume. These results may contribute to a better understanding of different aging trajectories.

Association of hippocampal atrophy with tau pathology of temporal regions in preclinical Alzheimer's disease

BackgroundHippocampal atrophy is linked to memory and cognitive deficits, preceding clinical diagnosis of mild cognitive impairment (MCI) by decades. Morphometry changes in the hippocampal formation (HF) and their relationship to tau deposition in non-demented individuals remains unclear.ObjectiveTo investigate morphometry changes in the HF and their association with tau deposition in a non-demented cohort.MethodsEighty-three subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI) underwent T1-weighted MRI and Tau-PET scans at baseline and longitudinal follow-up. Participants were divided into amyloid-negative (Aβ-) and amyloid-positive (Aβ+) groups. Hippocampal volume/thickness were measured, and associations with tau deposition in temporal regions were examined using multivariable linear regression.ResultsNo significant association was found between the hippocampal volume/thickness and tau deposition of temporal regions for the Aβ- group. For the Aβ+ group, the hippocampal thickness was significantly associated with tau deposition of entorhinal cortex (ERC) for both hemispheres, and temporal pole, inferior temporal, and middle temporal regions for right hippocampi with the longitudinal follow up scans, while no significant association with the baseline scans. It was interesting that there was strong association between the baseline tau deposition of ERC and temporal pole and the longitudinal follow up thickness of left hippocampi, while the associated regions for the right hemisphere were ERC, temporal pole, and inferior temporal regions.ConclusionsHippocampal atrophy may precede cognitive symptoms, with tau deposition in adjacent temporal regions contributing to hippocampal changes. The right HF appears more vulnerable than the left, indicating hemispheric differences in pathology.

Microglial circDlg1 modulates neuroinflammation by blocking PDE4B ubiquitination-dependent degradation associated with Alzheimer's disease

Background: Abnormal activation of microglia occurs in the early stage of Alzheimer's disease (AD) and leads to subsequent neuroinflammation and major AD pathologies. Circular RNAs (circRNAs) are emerging as great potential therapeutic targets in AD. However, the extent of circRNAs entwined and the underlying mechanism in microglia-driven neuroinflammation in AD remain elusive. Methods: The circular RNA Dlg1 (circDlg1) was identified using circRNA microarray screening in magnetic-isolated microglia of APP/PS1 mice. CircDlg1 expression in microglia of APP/PS1 mice and AD patients was validated by FISH. Flow cytometry and immunostaining were conducted to explore the roles of circDlg1 in microglia. Adeno-associated virus 9 preparations for interfering with microglial circDlg1 were microinjected into mouse lateral ventricle to explore influences on microglial response, neuroinflammation and AD pathologies. Y-maze, novel object recognition and Morris water maze tasks were performed to assess cognitive performance. RNA pulldown assays, mass spectrometry analysis, RNA immunoprecipitation, and co-immunoprecipitation were performed to validate the underlying regulatory mechanisms of circDlg1. Results: A novel circular RNA circDlg1 was observed elevated using circRNA microarray screening in microglia isolated from APP/PS1 mice and validated increased in intracerebral microglia of AD patients. Microglia-specific knockdown of circDlg1 remarkably ameliorated microglial recruitment and envelopment of amyloid-β (Aβ), mitigated neuroinflammation, and prevented cognitive decline in APP/PS1 mice. Mechanistically, circDlg1 interfered with the interaction between phosphodiesterase 4b (PDE4B) and Smurf2, an E3 ubiquitin ligase of PDE4B. The formed ternary complex protected PDE4B from ubiquitination-dependent degradation via unique N-terminal targeting domain, thus consequently decreasing cAMP levels. We further confirmed that microglial circDlg1 downregulation significantly activated PKA/CREB anti-inflammatory pathway by decreasing PDE4B protein levels in APP/PS1 mice. Conclusion: The novel microglia-upregulated circDlg1 tightly involves in neuroinflammation in APP/PS1 mice via determining the protein fate of PDE4B. Microglial loss of circDlg1 promotes microglial protective response to Aβ deposition and relieves neuroinflammation, thus suggesting a potential therapeutic strategy that specifically targets the microglial response in AD.

Reevaluating the Role of Education in Cognitive Decline and Brain Aging: Insights from Large-Scale Longitudinal Cohorts across 33 Countries

Why education is linked to higher cognitive function in aging is fiercely debated. Leading theories propose that education reduces brain decline in aging, enhances tolerance to brain pathology, or that it does not affect cognitive decline but rather reflects higher early-life cognitive function. To test these theories, we analyzed 407.356 episodic memory scores from 170.795 participants > 50 years, alongside 15.157 brain MRIs from 6.472 participants across 33 Western countries. More education was associated with better memory, larger intracranial volume and slightly larger volume of memory-sensitive brain regions. However, education did not protect against age-related decline or weakened effects of brain decline on cognition. The most parsimonious explanation for the results is that the associations reflect factors present early in life, including propensity of individuals with certain traits to pursue more education. While education has numerous benefits, the notion that it provides protection against cognitive or brain decline is not supported.

Health Behaviors and Executive Function in Late Adulthood: A Time-Varying Effect Modeling Analysis

OBJECTIVE

Cognitive decline in older adults is a public health issue, with modifiable factors like obesity and sleep potentially influencing this trajectory. Previous research on their relationship with executive function has shown mixed results, particularly across older adulthood.

METHODS

This study utilized time-varying effect modeling (TVEM) to assess the impact of body mass index (BMI) and sleep on executive function in older adults aged 60 to 79, using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014 cycles (N = 2543). Executive function was evaluated using the Digit Symbol Substitution Test (DSST).

RESULTS

Findings indicated that while BMI did not significantly affect cognition, adequate sleep (7-8 hours) was linked to better executive function, especially in individuals aged 63 to 65.

CONCLUSION

These results highlight sleep's importance for cognitive health and suggest interventions focusing on sleep and weight management to mitigate age-related cognitive decline.

Structure-function relationships in the human aging brain: An account of cross-sectional and longitudinal multimodal neuroimaging studies

The patterns of brain activation and functional connectivity, task-related and task-free, as a function of age have been well documented over the past 30 years. However, the aging brain undergoes structural changes that are likely to affect the functional properties of the brain. The relationship between brain structure and function started to be investigated more recently. Brain structure and brain function can influence behavioral outcomes independently, and several studies highlight independent contribution of structure and function on cognition. Here, a central assumption is that brain structure also affects behavior indirectly through its influence on brain function. In such a model, structure supports function. Although findings generally suggest that structure may indeed influence function, the direction of the associations, the variability in terms of regional effects and age windows when associations are observed vary greatly. Also, a certain number of studies highlight the independent contribution of structure and function on cognition. A critical aspect of studying aging is the necessity of longitudinal designs, allowing to observe true aging effects - as compared with age differences in cross-sectional designs. This review aims to give an updated account on research dealing with multimodal neuroimaging in aging, and more specifically on the links between structure and function and associated cognitive outcomes, putting in parallel findings from cross-sectional and longitudinal studies. Additionally, we discuss potential mechanisms by which age-related changes in structure may affect function, but also factors (sample characteristics, methodology) that may contribute to the heterogeneity of the findings and the lack of consensus on the associations between structure, function, cognition and aging.

Reevaluating the Role of Education in Cognitive Decline and Brain Aging: Insights from Large-Scale Longitudinal Cohorts across 33 Countries

Why education is linked to higher cognitive function in aging is fiercely debated. Leading theories propose that education reduces brain decline in aging, enhances tolerance to brain pathology, or that it does not affect cognitive decline but rather reflects higher early-life cognitive function. To test these theories, we analyzed 407.356 episodic memory scores from 170.795 participants >50 years, alongside 15.157 brain MRIs from 6.472 participants across 33 Western countries. More education was associated with better memory, larger intracranial volume and slightly larger volume of memory-sensitive brain regions. However, education did not protect against age-related decline or weakened effects of brain decline on cognition. The most parsimonious explanation for the results is that the associations reflect factors present early in life, including propensity of individuals with certain traits to pursue more education. While education has numerous benefits, the notion that it provides protection against cognitive or brain decline is not supported.

Assessing rapid spatial working memory in community-living older adults in a virtual adaptation of the rodent water maze paradigm

Aging often leads to a decline in various cognitive domains, potentially contributing to spatial navigation challenges among older individuals. While the Morris water maze is a common tool in rodents research for evaluating allocentric spatial memory function, its translation to studying aging in humans, particularly its association with hippocampal dysfunction, has predominantly focused on spatial reference memory assessments. This study expanded the adaptation of the Morris water maze for older adults to assess flexible, rapid, one-trial working memory. This adaptation involved a spatial search task guided by allocentric cues within a 3-D virtual reality (VR) environment. The sensitivity of this approach to aging was examined in 146 community-living adults from three Chinese cities, categorized into three age groups. Significant performance deficits were observed in participants over 60 years old compared to younger adults aged between 18 and 43. However, interpreting these findings was complicated by factors such as psychomotor slowness and potential variations in task engagement, except during the probe tests. Notably, the transition from the 60 s to the 70 s was not associated with a substantial deterioration of performance. A distinction only emerged when the pattern of spatial search over the entire maze was examined in the probe tests when the target location was never revealed. The VR task's sensitivity to overall cognitive function in older adults was reinforced by the correlation between Montreal Cognitive Assessment (MoCA) scores and probe test performance, demonstrating up to 17 % shared variance beyond that predicted by chronological age alone. In conclusion, while implementing a VR-based adaptation of rodent water maze paradigms in older adults was feasible, our experience highlighted specific interpretative challenges that must be addressed before such a test can effectively supplement traditional cognitive assessment tools in evaluating age-related cognitive decline.

Age-disproportionate atrophy in Alzheimer's disease and Parkinson's disease spectra

INTRODUCTION

Brain age gap (BAG), defined as the difference between MRI-predicted 'brain age' and chronological age, can capture information underlying various neurological disorders. We investigated the pathophysiological significance of the BAG across neurodegenerative disorders.

METHODS

We developed a brain age estimator using structural MRIs of healthy-aged individuals from one cohort study. Subsequently, we applied this estimator to people with Alzheimer's disease spectra (AD) and Parkinson's disease (PD) from another cohort study. We investigated brain sources responsible for BAGs among these groups.

RESULTS

Both AD and PD exhibited a positive BAG. Brain sources showed overlapping, yet partially segregated, neuromorphological differences between these groups. Furthermore, employing with t-distributed stochastic neighbor embedding on the brain sources, we subclassified PD into two groups with and without cognitive impairment.

DISCUSSION

Our findings suggest that brain age estimation becomes a clinically relevant method for finely stratifying neurodegenerative disorders.

Highlights

Brain age estimated from structure MRI data was greater than chronological age in patients with Alzheimer's disease/mild cognitive impairment or Parkinson's disease.Brain regions attributed to brain age estimation were located mainly in the fronto-temporo-parietal cortices but not in the motor cortex or subcortical regions.Brain sources responsible for the brain age gaps revealed roughly overlapping, yet partially segregated, neuromorphological differences between participants with Alzheimer's disease/mild cognitive impairment and Parkinson's disease.Participants with Parkinson's disease were subclassified into two groups (with and without cognitive impairment) based on brain sources responsible for the brain age gaps.

Aerobic Exercise Training for the Aging Brain: Effective Dosing and Vascular Mechanism

This article presents evidence supporting the hypothesis that starting aerobic exercise in early adulthood and continuing it throughout life leads to significant neurocognitive benefits compared with starting exercise later in life. Regular aerobic exercise at moderate-to-vigorous intensity during midlife is associated with significant improvement in cardiorespiratory fitness, which may create a favorable brain microenvironment promoting neuroplasticity through enhanced vascular function.

Neuroprotective Effect of Curcumin-Metavanadate in the Hippocampus of Aged Rats

Brain aging is a multifactorial process that includes a reduction in the biological and metabolic activity of individuals. Oxidative stress and inflammatory processes are characteristic of brain aging. Given the current problems, the need arises to implement new therapeutic approaches. Polyoxidovanadates (POV), as well as curcumin, have stood out for their participation in a variety of biological activities. This work aimed to evaluate the coupling of metavanadate and curcumin (Cuma-MV) on learning, memory, redox balance, neuroinflammation, and cell death in the hippocampal region (CA1 and CA3) and dentate gyrus (DG) of aged rats. Rats 18 months old were administered a daily dose of curcumin (Cuma), sodium metavanadate (MV), or Cuma-MV for two months. The results demonstrated that administration of Cuma-MV for 60 days in aged rats improved short- and long-term recognition memory, decreased reactive oxygen species, and substantially improved lipoperoxidation in the hippocampus. Furthermore, the activity of superoxide dismutase and catalase increased in animals treated with Cuma-MV. It is important to highlight that the treatment with Cuma-MV exhibited a significantly greater effect than the treatments with MV or Cuma in all the parameters evaluated. Finally, we conclude that Cuma-MV represents a potential therapeutic option in the prevention and treatment of cognitive decline associated with aging.

A neural implementation of cognitive reserve: Insights from a longitudinal fMRI study of set-switching in aging

Aging is often accompanied by changes in brain structure and executive functions, particularly in tasks involving cognitive flexibility, such as task-switching. However, substantial individual differences in the degree of cognitive impairment indicate that some individuals can cope with brain changes more effectively than others, suggesting higher cognitive reserve (CR). This study identified a neural basis for CR by examining the longitudinal relationship between task-related brain activation, structural brain changes, and changes in cognitive performance during an executive task-switching paradigm including single and dual conditions. Fifty-two older individuals were assessed at baseline and followed up after five years. Structural brain changes related to task-switching performance were analyzed using elastic net regression. Task-related functional brain activation was measured using ordinal trends canonical variate analysis (OrT CVA), capturing patterns of activation increasing from single to dual conditions. A differential task-related expression score (dOrT) was calculated as the difference in pattern expression scores between single and dual conditions at baseline. A linear regression model tested whether dOrT moderated the impact of brain changes on changes in switch cost over five years. Results showed a significant interaction between changes in brain structure and dOrT activation on switch cost change, indicating a moderation effect of task-related activation. Higher dOrT buffered the impact of brain structural decline on switch costs, enabling older adults to better cope with age-related brain structural changes and preserve cognitive flexibility. These findings suggest that these task-related activation patterns represent a neural basis for CR.

Effects of MicroRNAs and Long Non-coding RNAs on Beneficial Action of Exercise on Cognition in Degenerative Diseases: A Review

Recent research has exposed a growing body of proof underscoring the importance of microRNAs (miRNAs) and long noncoding RNAs (lncRNAs) in maintaining the physical composition of neurons and influencing cognitive functioning in both standard and atypical circumstances. Extensive research has been conducted on the possible application of miRNAs and lncRNAs as biomarkers for various diseases, with a particular focus on brain disorders, as they possess remarkable durability in cell-free surroundings and can endure repeated freezing and thawing processes. It is intriguing to note that miRNAs and lncRNAs have the ability to function through paracrine mechanisms, thereby playing a role in communication between different organs. Recent research has proposed that the improvement of cognitive abilities through physical exercise in mentally healthy individuals is a valuable method for uncovering potential connections between miRNAs, or microRNAs, and lncRNAs, and human cognitive function. The process of cross-correlating data from disease models and patients with existing data will be crucial in identifying essential miRNAs and lncRNAs, which can potentially act as biomarkers or drug targets in the treatment of cognitive disorders. By combining this method with additional research in animal models, we can determine the function of these molecules and their potential impact on therapy. This article discusses the latest research about the primary miRNAs, lncRNAs, and their exosomes that are affected by physical activity in terms of human cognitive function.

Development and early life stress sensitivity of the rat cortical microstructural similarity network

The rat offers a uniquely valuable animal model in neuroscience, but we currently lack an individual-level understanding of the in vivo rat brain network. Here, leveraging longitudinal measures of cortical magnetization transfer ratio (MTR) from in vivo neuroimaging between postnatal days 20 (weanling) and 290 (mid-adulthood), we design and implement a computational pipeline that captures the network of structural similarity (MIND, morphometric inverse divergence) between each of 53 distinct cortical areas. We first characterized the normative development of the network in a cohort of rats undergoing typical development (N=47), and then contrasted these findings with a cohort exposed to early life stress (ELS, N=40). MIND as a metric of cortical similarity and connectivity was validated by cortical cytoarchitectonics and axonal tract-tracing data. The normative rat MIND network had high between-study reliability and complex topological properties including a rich club. Similarity changed during post-natal and adolescent development, including a phase of fronto-hippocampal convergence, or increasing inter-areal similarity. An inverse process of increasing fronto-hippocampal dissimilarity was seen with post-adult aging. Exposure to ELS in the form of maternal separation appeared to accelerate the normative trajectory of brain development - highlighting embedding of stress in the dynamic rat brain network. Our work provides novel tools for systems-level study of the rat brain that can now be used to understand network-based underpinnings of complex lifespan behaviors and experimental manipulations that this model organism allows.

Auditory brainstem responses as a biomarker for cognition

A non-invasive, accessible and effective biomarker is critical to the diagnosis, monitoring and treatment of age-related cognitive decline. Recent work has suggested a strong association between auditory brainstem responses (ABR) and cognitive function in aging macaques. Here we show in 118 human participants (66 females; age range=18-92 years; hearing loss = -5 to 70 dB HL) that cognition is associated with both age and hearing level, but this triad relationship is mainly driven by the age factor. After adjusting for age, cognition is still significantly associated with both the ABR wave V amplitude (B, 0.110, 95% CI, 0.018- 0.202; p = 0.020) and latency (B, -0.101, 95% CI, -0.186- -0.016; p = 0.021). Importantly, this age-adjusted ABR-cognition association is primarily driven by older individuals and language-dependent cognitive functions. We also perform the area under the curve (AUC) of the receiver-operating-characteristic analysis and find that the ABR wave V amplitude is best for detecting good cognitive performers (AUC = 0.96) whereas the wave V latency is best for detecting poor ones (AUC = 0.86). The present result not only confirms the previous animal work in humans but also shows the clinical potential of using auditory brainstem responses to improve diagnosis and treatment of age-related cognitive decline.

Brain maps of general cognitive function and spatial correlations with neurobiological cortical profiles

In this paper, we attempt to answer two questions: 1) which regions of the human brain, in terms of morphometry, are most strongly related to individual differences in domain-general cognitive functioning (g)? and 2) what are the underlying neurobiological properties of those regions? We meta-analyse vertex-wise g-cortical morphometry (volume, surface area, thickness, curvature and sulcal depth) associations using data from 3 cohorts: the UK Biobank (UKB), Generation Scotland (GenScot), and the Lothian Birth Cohort 1936 (LBC1936), with the meta-analytic N = 38,379 (age range = 44 to 84 years old). These g-morphometry associations vary in magnitude and direction across the cortex (|β| range = -0.12 to 0.17 across morphometry measures) and show good cross-cohort agreement (mean spatial correlation r = 0.57, SD = 0.18). Then, to address (2), we bring together existing - and derive new - cortical maps of 33 neurobiological characteristics from multiple modalities (including neurotransmitter receptor densities, gene expression, functional connectivity, metabolism, and cytoarchitectural similarity). We discover that these 33 profiles spatially covary along four major dimensions of cortical organisation (accounting for 65.9% of the variance) and denote aspects of neurobiological scaffolding that underpin the spatial patterning of MRI-cognitive associations we observe (significant |r| range = 0.21 to 0.56). Alongside the cortical maps from these analyses, which we make openly accessible, we provide a compendium of cortex-wide and within-region spatial correlations among general and specific facets of brain cortical organisation and higher order cognitive functioning, which we hope will serve as a framework for analysing other aspects of behaviour-brain MRI associations.

Assessing age-related changes in brain activity during isometric upper and lower limb force control tasks

Despite the widespread use of older adults (OA) as controls in movement disorder studies, the specific effects of aging on the neural control of upper and lower limb movements remain unclear. While functional MRI paradigms focusing on hand movements are widely used to investigate age-related brain changes, research on lower limb movements is limited due to technical challenges in an MRI environment. This study addressed this gap by examining both upper and lower limb movements in healthy young adults (YA) vs. OA. Sixteen YA and 20 OA, matched for sex, dominant side, and cognitive status, performed pinch grip and ankle dorsiflexion tasks, each requiring 15% of their maximum voluntary contraction. While both groups achieved the target force and exhibited similar force variability and accuracy, OA displayed distinct differences in force control dynamics, with a slower rate of force increase in the hand task and a greater rate of force decrease in the foot task. Imaging results revealed that OA exhibited more widespread activation, extending beyond brain regions typically involved in movement execution. In the hand task, OA showed increased activity in premotor and visuo-motor integration regions, as well as in the cerebellar hemispheres. During the foot task, OA engaged the cerebellar hemispheres more than YA. Collectively, results suggest that OA may recruit additional brain regions to manage motor tasks, possibly to achieve similar performance. Future longitudinal studies that track changes over time could help clarify if declines in motor performance lead to corresponding changes in brain activation.

Brain change trajectories in healthy adults correlate with Alzheimer's related genetic variation and memory decline across life

Throughout adulthood and ageing our brains undergo structural loss in an average pattern resembling faster atrophy in Alzheimer's disease (AD). Using a longitudinal adult lifespan sample (aged 30-89; 2-7 timepoints) and four polygenic scores for AD, we show that change in AD-sensitive brain features correlates with genetic AD-risk and memory decline in healthy adults. We first show genetic risk links with more brain loss than expected for age in early Braak regions, and find this extends beyond APOE genotype. Next, we run machine learning on AD-control data from the Alzheimer's Disease Neuroimaging Initiative using brain change trajectories conditioned on age, to identify AD-sensitive features and model their change in healthy adults. Genetic AD-risk linked with multivariate change across many AD-sensitive features, and we show most individuals over age ~50 are on an accelerated trajectory of brain loss in AD-sensitive regions. Finally, high genetic risk adults with elevated brain change showed more memory decline through adulthood, compared to high genetic risk adults with less brain change. Our findings suggest quantitative AD risk factors are detectable in healthy individuals, via a shared pattern of ageing- and AD-related neurodegeneration that occurs along a continuum and tracks memory decline through adulthood.

Exercise intervention on the brain structure and function of patients with mild cognitive impairment: systematic review based on magnetic resonance imaging studies

Objective

This systematic review evaluates the impact of exercise intervention in MCI patients and discusses the potential neural mechanisms.

Methods

A systematic search and screening of relevant literature was conducted in English and Chinese databases. Based on predefined keywords and criteria, 24 articles were assessed and analyzed.

Results

Structurally, a significant increase was observed in the hippocampal and gray matter volumes of MCI patients following exercise intervention, with a trend of improvement in cortical thickness and white matter integrity. Functionally, after the exercise intervention, there were significant changes in the local spontaneous brain activity levels, cerebral blood flow, and functional connectivity during rest and memory encoding and retrieval tasks in MCI patients.

Conclusion

Exercise may contribute to delaying neurodegenerative changes in brain structure and function in patients with MCI. However, the underlying neural mechanisms require further research.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023482419.

Frontotemporal structure preservation underlies the protective effect of lifetime intellectual cognitive reserve on cognition in the elderly

BACKGROUND

Cognitive decline with age has heterogeneous, which might be related to the accumulation of protective factors called cognitive reserve, especially intellectual engagement factors over the life course. However, how lifetime intellectual cognitive reserve (LICR) protects cognitive function in the elderly remains unclear. We aimed to examine the relationship between LICR and cognition and the mild cognitive impairment (MCI) risk, as well as the neural mechanism of LICR on cognition.

METHODS

A total of 5126 participants completed extensive neuropsychological tests, with LICR indicator encompassing early education, midlife occupational complexity, and mental leisure activities after retirement. Confirmatory factor analysis was performed to derive LICR score and cognitive function scores, then the hierarchical regression analysis was used to explore the relationship between LICR and cognitive functions and the risk of MCI. We further explored the macro- and micro-structural preservation underly LICR in 1117 participants. Multiple regressions and tract-based spatial statistics were used to explore the relationship between LICR and gray matter volume and white matter microstructure (FA value). Finally, using the mediation model to explore the relationship of "LICR-brain-cognition".

RESULT

The new LICR index, which was more protective than its single indexes, could protect widespread cognitive functions and was associated with a reduction in MCI risk (Odds Ratio, 0.52; 95% CI, 0.47-0.57). For the structure basis of LICR, the higher LICR score was associated with the greater gray matter volume in right fusiform gyrus (t = 4.62, FDR corrected, p < 0.05) and left orbital superior frontal gyrus (t = 4.56, FDR corrected, p < 0.05), and the higher FA values in the frontotemporal related white matter fiber tracts. Furthermore, the right fusiform gyrus partially mediated the relationship between LICR and executive processing ability (β = 0.01, p = 0.02) and general cognitive ability (β = 0.01, p = 0.03).

CONCLUSIONS

The new comprehensive cognitive reserve index could promote the temporal macro-structural preservation and thus contribute to maintain better cognitive function. These findings highlight the importance of intellectual CR accumulation over the life course in successful cognitive aging and MCI prevention, thereby contributing to improve the quality of life in the elderly.

Large-scale proteomic analyses of incident Alzheimer's disease reveal new pathophysiological insights and potential therapeutic targets

Pathophysiological evolutions in early-stage Alzheimer's disease (AD) are not well understood. We used data of 2923 Olink plasma proteins from 51,296 non-demented middle-aged adults. During a follow-up of 15 years, 689 incident AD cases occurred. Cox-proportional hazard models were applied to identify AD-associated proteins in different time intervals. Through linking to protein categories, changing sequences of protein z-scores can reflect pathophysiological evolutions. Mendelian randomization using blood protein quantitative loci data provided causal evidence for potentially druggable proteins. We identified 48 AD-related proteins, with CEND1, GFAP, NEFL, and SYT1 being top hits in both near-term (HR:1.15-1.77; P:9.11 × 10-65-2.78 × 10-6) and long-term AD risk (HR:1.20-1.54; P:2.43 × 10-21-3.95 × 10-6). These four proteins increased 15 years before AD diagnosis and progressively escalated, indicating early and sustained dysfunction in synapse and neurons. Proteins related to extracellular matrix organization, apoptosis, innate immunity, coagulation, and lipid homeostasis showed early disturbances, followed by malfunctions in metabolism, adaptive immunity, and final synaptic and neuronal loss. Combining CEND1, GFAP, NEFL, and SYT1 with demographics generated desirable predictions for 10-year (AUC = 0.901) and over-10-year AD (AUC = 0.864), comparable to full model. Mendelian randomization supports potential genetic link between CEND1, SYT1, and AD as outcome. Our findings highlight the importance of exploring the pathophysiological evolutions in early stages of AD, which is essential for the development of early biomarkers and precision therapeutics.

Trajectories and sex differences of brain structure, oxygenation and perfusion functions in normal aging

BACKGROUND

Brain structure, oxygenation and perfusion are important factors in aging. Coupling between regional cerebral oxygen consumption and perfusion also reflects functions of neurovascular unit (NVU). Their trajectories and sex differences during normal aging important for clinical interpretation are still not well defined. In this study, we aim to investigate the relationship between brain structure, functions and age, and exam the sex disparities.

METHOD

A total of 137 healthy subjects between 20∼69 years old were enrolled with conventional MRI, structural three-dimensional T1-weighted imaging (3D-T1WI), 3D multi-echo gradient echo sequence (3D-mGRE), and 3D pseudo-continuous arterial spin labeling (3D-pCASL). Oxygen extraction fraction (OEF) and cerebral blood flow (CBF) were respectively reconstructed from 3D-mGRE and 3D-pCASL images. Cerebral metabolic rate of oxygen (CMRO2) were calculated as follows: CMRO2=CBF·OEF·[H]a, [H]a=7.377 μmol/mL. Brains were segmented into global gray matter (GM), global white matter (WM), and 148 cortical subregions. OEF, CBF, CMRO2, and volumes of GM/WM relative to intracranial volumes (rel_GM/rel_WM) were compared between males and females. Generalized additive models were used to evaluate the aging trajectories of brain structure and functions. The coupling between OEF and CBF was analyzed by correlation analysis. P or PFDR < 0.05 was considered statistically significant.

RESULTS

Females had larger rel_GM, higher CMRO2 and CBF of GM/WM than males (P < 0.05). With control of sex, CBF of GM significantly declined between 20 and 32 years, CMRO2 of GM declined subsequently from 33 to 41 years and rel_GM decreased significantly at all ages (R2 = 0.27, P < 0.001; R2 = 0.17, P < 0.001; R2 = 0.52, P < 0.001). In subregion analysis, CBF declined dispersedly while CMRO2 declined widely across most subregions of the cortex during aging. Robust negative coupling between OEF and CBF was found in most of the subregions (r range = -0.12∼-0.48, PFDR < 0.05).

CONCLUSION

The sex disparities, age trajectories of brain structure and functions as well as the coupling of NVU in healthy individuals provide insights into normal aging which are potential targets for study of pathological conditions.

The novel estrogen receptor beta agonist EGX358 and APOE genotype influence memory, vasomotor, and anxiety outcomes in an Alzheimer's mouse model

Introduction

Alzheimer's disease (AD) prevalence and severity are associated with increased age, female sex, and apolipoprotein E4 (APOE4) genotype. Although estrogen therapy (ET) effectively reduces symptoms of menopause including hot flashes and anxiety, and can reduce dementia risk, it is associated with increased risks of breast and uterine cancer due to estrogen receptor alpha (ERα)-mediated increases in cancer cell proliferation. Because ERβ activation reduces this cell proliferation, selective targeting of ERβ may provide a safer method of improving memory and reducing hot flashes in menopausal women, including those with AD. APOE genotype influences the response to ET, although it is unknown whether effects of ERβ activation vary by genotype.

Methods

Here, we tested the ability of long-term oral treatment with a novel highly selective ERβ agonist, EGX358, to enhance object recognition and spatial recognition memory, reduce drug-induced hot flashes, and influence anxiety-like behaviors in female mice expressing 5 familial AD mutations (5xFAD-Tg) and human APOE3 (E3FAD) or APOE3 and APOE4 (E3/4FAD). Mice were ovariectomized at 5 months of age and were then treated orally with vehicle (DMSO) or EGX358 (10 mg/kg/day) via hydrogel for 8 weeks. Spatial and object recognition memory were tested in object placement (OP) and object recognition (OR) tasks, respectively, and anxiety-like behaviors were tested in the open field (OF) and elevated plus maze (EPM). Hot flash-like symptoms (change in tail skin temperature) were measured following injection of the neurokinin receptor agonist senktide (0.5 mg/kg).

Results

EGX358 enhanced object recognition memory in E3FAD and E3/4FAD mice but did not affect spatial recognition memory. EGX358 also reduced senktide-induced tail temperature elevations in E3FAD, but not E3/4FAD, females. EGX358 did not influence anxiety-like behaviors or body weight.

Discussion

These data indicate that highly selective ERβ agonism can facilitate object recognition memory in both APOE3 homozygotes and APOE3/4 heterozygotes, but only reduce the magnitude of a drug-induced hot flash in APOE3 homozygotes, suggesting that APOE4 genotype may blunt the beneficial effects of ET on hot flashes. Collectively, these data suggest a potentially beneficial effect of selective ERβ agonism for memory and hot flashes in females with AD-like pathology, but that APOE genotype plays an important role in responsiveness.

Frontoparietal atrophy trajectories in cognitively unimpaired elderly individuals using longitudinal Bayesian clustering

INTRODUCTION

Frontal and/or parietal atrophy has been reported during aging. To disentangle the heterogeneity previously observed, this study aimed to uncover different clusters of grey matter profiles and trajectories within cognitively unimpaired individuals.

METHODS

Structural magnetic resonance imaging (MRI) data of 307 Aβ-negative cognitively unimpaired individuals were modelled between ages 60-85 from three cohorts worldwide. We applied unsupervised clustering using a novel longitudinal Bayesian approach and characterized the clusters' cerebrovascular and cognitive profiles.

RESULTS

Four clusters were identified with different grey matter profiles and atrophy trajectories. Differences were mainly observed in frontal and parietal brain regions. These distinct frontoparietal grey matter profiles and longitudinal trajectories were differently associated with cerebrovascular burden and cognitive decline.

DISCUSSION

Our findings suggest a conciliation of the frontal and parietal theories of aging, uncovering coexisting frontoparietal GM patterns. This could have important future implications for better stratification and identification of at-risk individuals.

Oral health, treatment burden and demographics of elders with care-resistant behavior: A cross-sectional study

AIMS

To assess oral health, treatment burden, mortality risk, and demographics in elders with care-resistant behaviors (CRB) in nursing homes (NH) and compare them with those without CRB.

METHODS AND RESULTS

503 participants from eight NH who received dental treatment through a mobile dental clinic were included. Their medical and dental records were screened regarding oral/dental health, treatment history, general health, demographics, and CRB. Statistical analysis was performed to show correlations between CRB and the measured parameters. Data were verified for normal distribution; a point-biserial correlation model was used (95% CI: α = 0.05). No correlation was found between CRB and Decayed Missing Filled Teeth (DMF-T) (rpb = -0.061, p = .177), as well as periodontal status (rpb = 0.004, p = .946). A negative correlation was observed between CRB and the required number of treatment procedures (rpb = -0.181, p < .0001), time (rpb = -0.118, p = .010), and costs (rpb = -0.100, p = .028). Sex predilection for men regarding CRB was evident (rpb = -0.155, p = .01). No correlation appeared between CRB and vital status (rpb = -0.41, p = .355).

CONCLUSION

Oral health seems to be similar in institutionalized elders with or without CRB. Treatment burden was not elevated, but even reduced in elders with CRB, evincing that few/no treatment procedures were performed in those elders. CRB demonstrated a sex predilection for men. An association between CRB and increased mortality was not evident.

HOPE: Hybrid-Granularity Ordinal Prototype Learning for Progression Prediction of Mild Cognitive Impairment

Mild cognitive impairment (MCI) is often at high risk of progression to Alzheimer's disease (AD). Existing works to identify the progressive MCI (pMCI) typically require MCI subtype labels, pMCI vs. stable MCI (sMCI), determined by whether or not an MCI patient will progress to AD after a long follow-up. However, prospectively acquiring MCI subtype data is time-consuming and resource-intensive; the resultant small datasets could lead to severe overfitting and difficulty in extracting discriminative information. Inspired by that various longitudinal biomarkers and cognitive measurements present an ordinal pathway on AD progression, we propose a novel Hybrid-granularity Ordinal PrototypE learning (HOPE) method to characterize AD ordinal progression for MCI progression prediction. First, HOPE learns an ordinal metric space that enables progression prediction by prototype comparison. Second, HOPE leverages a novel hybrid-granularity ordinal loss to learn the ordinal nature of AD via effectively integrating instance-to-instance ordinality, instance-to-class compactness, and class-to-class separation. Third, to make the prototype learning more stable, HOPE employs an exponential moving average strategy to learn the global prototypes of NC and AD dynamically. Experimental results on the internal ADNI and the external NACC datasets demonstrate the superiority of the proposed HOPE over existing state-of-the-art methods as well as its interpretability.

Brain morphometrics correlations with age among 352 participants imaged with both 3T and 7T MRI: 7T improves statistical power and reduces required sample size

Introduction

Magnetic resonance imaging (MRI) at 7 Telsa (7T) has superior signal-to-noise ratio to 3 Telsa (3T) but also presents higher signal inhomogeneities and geometric distortions. A key knowledge gap is to robustly investigate the sensitivity and accuracy of 3T and 7T MRI in assessing brain morphometrics. This study aims to (a) aggregate a large number of paired 3T and 7T scans to evaluate their differences in quantitative brain morphological assessment using a widely available brain segmentation tool, FreeSurfer, as well as to (b) examine the impact of normalization methods for subject variability and smaller sample sizes on data analysis.

Methods

A total of 452 healthy participants aged 29 to 68 were imaged at both 3T and 7T. Structural T1-weighted magnetization-prepared rapid gradient-echo (MPRAGE) images were processed and segmented using FreeSurfer. To account for head size variability, the brain volumes underwent intracranial volume (ICV) correction using the Residual (regression model) and Proportional (simple division to ICV) methods. The resulting volumes and thicknesses were correlated with age using Pearson correlation and false discovery rate correction. The correlations were also calculated in increasing sample size from 3 to the whole sample to estimate the sample size required to detect aging-related brain variation.

Results

352 subjects (210 females) passed the image quality control with 100 subjects excluded due to excessive motion artifacts on 3T, 7T, or both. 7T MRI showed an overall stronger correlation between morphometrics and age and a larger number of significantly correlated brain volumes and cortical thicknesses. While the ICV is consistent between both field strengths, the Residual normalization method shows markedly higher correlation with age for 3T when compared with the Proportional normalization method. The 7T results are consistent regardless of the normalization method used.

Conclusion

In a large cohort of healthy participants with paired 3T and 7T scans, we compared the statistical performance in assessing age-related brain morphological changes. Our study reaffirmed the inverse correlation between brain volumes and cortical thicknesses and age and highlighted varying correlations in different brain regions and normalization methods at 3T and 7T. 7T imaging significantly improves statistical power and thus reduces required sample size.

Phytoactive drugs used in the treatment of Alzheimer's disease and dementia

The prevalence of Alzheimer's disease and other forms of dementia is increasing worldwide, and finding effective treatments for these conditions is a major public health challenge. Natural bioactive drugs have been identified as a promising source of potential treatments, due to their ability to target multiple pathways and their low toxicity. This paper reviews the current state of research on natural bioactive drugs used in the treatment of Alzheimer's disease and other dementias. The paper summarizes the findings of studies on various natural compounds, including curcumin, resveratrol, caffeine, genistein, quercetin, GinkoBiloba, Withaniasomnifera, Ginseng Brahmi, Giloy, and huperzine, and their effects on cognitive function, neuroinflammation, and amyloid-beta accumulation. In this review, we discuss the mechanism of action involved in the treatment of Alzheimer's disease. The paper also discusses the challenges associated with developing natural bioactive drugs for dementia treatment, including issues related to bioavailability and standardization. Finally, the paper suggests directions for future research in this area, including the need for more rigorous clinical trials and the development of novel delivery systems to improve the efficacy of natural bioactive drugs. Overall, this review highlights the potential of natural bioactive drugs as a promising avenue for the development of safe and effective treatments for Alzheimer's disease and other dementias.

Dysbiosis and fecal microbiota transplant: Contemplating progress in health, neurodegeneration and longevity

The gut-brain axis plays an important role in mental health. The intestinal epithelial surface is colonized by billions of commensal and transitory bacteria, known as the Gut Microbiota (GM). However, potential pathogens continuously stimulate intestinal immunity when they find the place. The last two decades have witnessed several studies revealing intestinal bacteria as a key factor in the health-disease balance of the gut, as well as disease-emergent in other parts of the body. Various neurological processes, such as cognition, learning, and memory, could be affected by dysbiosis in GM. Additionally, the aging process and longevity are related to systemic inflammation caused by dysbiosis. Commensal GM affects brain development, behavior, and healthy aging suggesting that building changes in GM might be a potential therapeutic method. The innovation in GM dysbiosis is intervention by Fecal Microbiota Transplantation (FMT), which has been confirmed as a therapy for recurrent Clostridium difficile infections and is promising for other clinical disorders, such as Parkinson's disease, Multiple Sclerosis (MS), Alzheimer's disease, and depression. Additionally, FMT may be possible to promote healthy aging, and extend longevity. This review aims to connect dysbiosis, neurological disorders, and aging and the potential of FMT as a therapeutic strategy to treat these disorders, and to enhance the quality of life in the elderly.

Cerebral hyperactivation across the Alzheimer's disease pathological cascade

Neuronal dysfunction in specific brain regions or across distributed brain networks is a known feature of Alzheimer's disease. An often reported finding in the early stage of the disease is the presence of increased functional MRI (fMRI) blood oxygenation level-dependent signal under task conditions relative to cognitively normal controls, a phenomenon known as 'hyperactivation'. However, research in the past decades yielded complex, sometimes conflicting results. The magnitude and topology of fMRI hyperactivation patterns have been found to vary across the preclinical and clinical spectrum of Alzheimer's disease, including concomitant 'hypoactivation' in some cases. These incongruences are likely due to a range of factors, including the disease stage at which the cohort is examined, the brain areas or networks studied and the fMRI paradigm utilized to evoke these functional abnormalities. Additionally, a perennial question pertains to the nature of hyperactivation in the context of Alzheimer's disease. Some propose it reflects compensatory mechanisms to sustain cognitive performance, while others suggest it is linked to the pathological disruption of a highly regulated homeostatic cycle that contributes to, or even drives, disease progression. Providing a coherent narrative for these empirical and conceptual discrepancies is paramount to develop disease models, understand the synergy between hyperactivation and the Alzheimer's disease pathological cascade and tailor effective interventions. We first provide a comprehensive overview of functional brain changes spanning the course from normal ageing to the clinical spectrum of Alzheimer's disease. We then highlight evidence supporting a close relationship between fMRI hyperactivation and in vivo markers of Alzheimer's pathology. We primarily focus on task-based fMRI studies in humans, but also consider studies using different functional imaging techniques and animal models. We then discuss the potential mechanisms underlying hyperactivation in the context of Alzheimer's disease and provide a testable framework bridging hyperactivation, ageing, cognition and the Alzheimer's disease pathological cascade. We conclude with a discussion of future challenges and opportunities to advance our understanding of the fundamental disease mechanisms of Alzheimer's disease, and the promising development of therapeutic interventions incorporating or aimed at hyperactivation and large-scale functional systems.

Discovery of High-Risk Clinical Factors That Accelerate Brain Aging in Adults: A Population-Based Machine Learning Study

Introduction: Brain age prediction using neuroimaging data and machine learning algorithms holds significant promise for gaining insights into the development of neurodegenerative diseases. The estimation of brain age may be influenced not only by the imaging modality but also by multidomain clinical factors. However, the degree to which various clinical factors in individuals are associated with brain structure, as well as the comprehensive relationship between these factors and brain aging, is not yet clear. Methods: In this study, multimodal brain magnetic resonance imaging data and longitudinal clinical information were collected from 964 participants in a population-based cohort with 16 years of follow-up in northern China. We developed a machine learning-based algorithm to predict multimodal brain age and compared the estimated brain age gap (BAG) differences among the 5 groups characterized by varying exposures to these high-risk clinical factors. We then estimated modality-specific brain age in the hypertension group based on hypertension-related regional imaging metrics. Results: The results revealed a significantly larger BAG estimated from multimodal neuroimaging in subjects with 4 or 5 risk factors compared to other groups, suggesting an acceleration of brain aging under cumulative exposure to multiple risk factors. The estimated T1-based BAG exhibited a significantly higher level in the hypertensive subjects compared to the normotensive individuals. Conclusion: Our study provides valuable insights into a range of health factors across lifestyle, metabolism, and social context that are reflective of brain aging and also contributes to the advancement of interventions and public health initiatives targeted at the general population aimed at promoting brain health.

A Map of Transcriptomic Signatures of Different Brain Areas in Alzheimer's Disease

Alzheimer's disease (AD) is a neurodegenerative disorder that progressively involves brain regions with an often-predictable pattern. Damage to the brain appears to spread and worsen with time, but the molecular mechanisms underlying the region-specific distribution of AD pathology at different stages of the disease are still under-investigated. In this study, a whole-transcriptome analysis was carried out on brain samples from the hippocampus (HI), temporal and parietal cortices (TC and PC, respectively), cingulate cortex (CG), and substantia nigra (SN) of six subjects with a definite AD diagnosis and three healthy age-matched controls in duplicate. The transcriptomic results showed a greater number of differentially expressed genes (DEGs) in the TC (1571) and CG (1210) and a smaller number of DEGs in the HI (206), PC (109), and SN (60). Furthermore, the GSEA showed a difference between the group of brain areas affected early (HI and TC) and the group of areas that were subsequently involved (PC, CG, and SN). Notably, in the HI and TC, there was a significant downregulation of shared DEGs primarily involved in synaptic transmission, while in the PC, CG, and SN, there was a significant downregulation of genes primarily involved in protein folding and trafficking. The course of AD could follow a definite time- and severity-related pattern that arises from protein misfolding, as observed in the PC, CG, and SN, and leads to synaptic impairment, as observed in the HI and TC. Therefore, a map of the molecular and biological processes involved in AD pathogenesis may be traced. This could aid in the discovery of novel biological targets in order to develop effective and well-timed therapeutic approaches.

Comparing single- and multi-post labeling delays for the measurements of resting cerebral and hippocampal blood flow for cerebrovascular testing in midlife adults

Objectives

To assess the reliability and validity of measuring resting cerebral blood flow (CBF) and hippocampal CBF using a single-post-labeling delay (PLD) and a multi-PLD pseudo-continuous arterial spin labeling (pCASL) protocol for cerebrovascular reactivity (CVR) testing.

Methods

25 healthy, midlife adults (57 ± 4 years old) were imaged in a Siemens Prisma 3T magnetic resonance imaging (MRI) scanner. Resting CBF and hippocampal CBF were assessed using two pCASL protocols, our modified single-PLD protocol (pCASL-MOD) to accommodate the needs for CVR testing and the multi-PLD Human Connectome Project (HCP) Lifespan protocol to serve as the reference control (pCASL-HCP). During pCASL-MOD, CVR was calculated as the change in CBF from rest to hypercapnia (+9 mmHg increase in end-tidal partial pressure of carbon dioxide [PETCO2]) and then normalized for PETCO2. The reliability and validity in resting gray matter (GM) CBF, white matter (WM) CBF, and hippocampal CBF between pCASL-MOD and pCASL-HCP protocols were examined using correlation analyses, paired t-tests, and Bland Altman plots.

Results

The pCASL-MOD and pCASL-HCP protocols were significantly correlated for resting GM CBF [r = 0.72; F (1, 23) = 25.24, p < 0.0001], WM CBF [r = 0.57; F (1, 23) = 10.83, p = 0.003], and hippocampal CBF [r = 0.77; F (1, 23) = 32.65, p < 0.0001]. However, pCASL-MOD underestimated resting GM CBF (pCASL-MOD: 53.7 ± 11.1 v. pCASL-HCP: 69.1 ± 13.1 mL/100 g/min; p < 0.0001), WM CBF (pCASL-MOD: 32.4 ± 4.8 v. pCASL-HCP: 35.5 ± 6.9 mL/100 g/min; p = 0.01), and hippocampal CBF (pCASL-MOD: 50.5 ± 9.0 v. pCASL-HCP: 68.1 ± 12.5 mL/100 g/min; p < 0.0001). PETCO2 increased by 8.0 ± 0.7 mmHg to induce CVR (GM CBF: 4.8% ± 2.6%; WM CBF 2.9% ± 2.5%; and hippocampal CBF: 3.4% ± 3.8%).

Conclusion

Our single-PLD pCASL-MOD protocol reliably measured CBF and hippocampal CBF at rest given the significant correlation with the multi-PLD pCASL-HCP protocol. Despite the lower magnitude relative to pCASL-HCP, we recommend using our pCASL-MOD protocol for CVR testing in which an exact estimate of CBF is not required such as the assessment of relative change in CBF to hypercapnia.

Interpretable deep clustering survival machines for Alzheimer's disease subtype discovery

Alzheimer's disease (AD) is a complex neurodegenerative disorder that has impacted millions of people worldwide. The neuroanatomical heterogeneity of AD has made it challenging to fully understand the disease mechanism. Identifying AD subtypes during the prodromal stage and determining their genetic basis would be immensely valuable for drug discovery and subsequent clinical treatment. Previous studies that clustered subgroups typically used unsupervised learning techniques, neglecting the survival information and potentially limiting the insights gained. To address this problem, we propose an interpretable survival analysis method called Deep Clustering Survival Machines (DCSM), which combines both discriminative and generative mechanisms. Similar to mixture models, we assume that the timing information of survival data can be generatively described by a mixture of parametric distributions, referred to as expert distributions. We learn the weights of these expert distributions for individual instances in a discriminative manner by leveraging their features. This allows us to characterize the survival information of each instance through a weighted combination of the learned expert distributions. We demonstrate the superiority of the DCSM method by applying this approach to cluster patients with mild cognitive impairment (MCI) into subgroups with different risks of converting to AD. Conventional clustering measurements for survival analysis along with genetic association studies successfully validate the effectiveness of the proposed method and characterize our clustering findings.

An insight into the concept of neuroinflammation and neurodegeneration in Alzheimer's disease: targeting molecular approach Nrf2, NF-κB, and CREB

Alzheimer's disease (AD) is a most prevalent neurologic disorder characterized by cognitive dysfunction, amyloid-β (Aβ) protein accumulation, and excessive neuroinflammation. It affects various life tasks and reduces thinking, memory, capability, reasoning and orientation ability, decision, and language. The major parts responsible for these abnormalities are the cerebral cortex, amygdala, and hippocampus. Excessive inflammatory markers release, and microglial activation affect post-synaptic neurotransmission. Various mechanisms of AD pathogenesis have been explored, but still, there is a need to debate the role of NF-κB, Nrf2, inflammatory markers, CREB signaling, etc. In this review, we have briefly discussed the signaling mechanisms and function of the NF-ĸB signaling pathway, inflammatory mediators, microglia activation, and alteration of autophagy. NF-κB inhibition is a current strategy to counter neuroinflammation and neurodegeneration in the brain of individuals with AD. In clinical trials, numbers of NF-κB modulators are being examined. Recent reports revealed that molecular and cellular pathways initiate complex pathological competencies that cause AD. Moreover, this review will provide extensive knowledge of the cAMP response element binding protein (CREB) and how these nuclear proteins affect neuronal plasticity.

Entorhinal cortex-hippocampal circuit connectivity in health and disease

The entorhinal cortex (EC) and hippocampal (HC) connectivity is the main source of episodic memory formation and consolidation. The entorhinal-hippocampal (EC-HC) connection is classified as canonically glutamatergic and, more recently, has been characterized as a non-canonical GABAergic connection. Recent evidence shows that both EC and HC receive inputs from dopaminergic, cholinergic, and noradrenergic projections that modulate the mnemonic processes linked to the encoding and consolidation of memories. In the present review, we address the latest findings on the EC-HC connectivity and the role of neuromodulations during the mnemonic mechanisms of encoding and consolidation of memories and highlight the value of the cross-species approach to unravel the underlying cellular mechanisms known. Furthermore, we discuss how EC-HC connectivity early neurodegeneration may contribute to the dysfunction of episodic memories observed in aging and Alzheimer's disease (AD). Finally, we described how exercise may be a fundamental tool to prevent or decrease neurodegeneration.

A biophysical minimal model to investigate age-related changes in CA1 pyramidal cell electrical activity

Aging is a physiological process that is still poorly understood, especially with respect to effects on the brain. There are open questions about aging that are difficult to answer with an experimental approach. Underlying challenges include the difficulty of recording in vivo single cell and network activity simultaneously with submillisecond resolution, and brain compensatory mechanisms triggered by genetic, pharmacologic, or behavioral manipulations. Mathematical modeling can help address some of these questions by allowing us to fix parameters that cannot be controlled experimentally and investigate neural activity under different conditions. We present a biophysical minimal model of CA1 pyramidal cells (PCs) based on general expressions for transmembrane ion transport derived from thermodynamical principles. The model allows directly varying the contribution of ion channels by changing their number. By analyzing the dynamics of the model, we find parameter ranges that reproduce the variability in electrical activity seen in PCs. In addition, increasing the L-type Ca2+ channel expression in the model reproduces age-related changes in electrical activity that are qualitatively and quantitatively similar to those observed in PCs from aged animals. We also make predictions about age-related changes in PC bursting activity that, to our knowledge, have not been reported previously. We conclude that the model's biophysical nature, flexibility, and computational simplicity make it a potentially powerful complement to experimental studies of aging.

Subcortical volume in middle-aged adults with fetal alcohol spectrum disorders

Studies of youth and young adults with prenatal alcohol exposure (PAE) have most consistently reported reduced volumes of the corpus callosum, cerebellum and subcortical structures. However, it is unknown whether this continues into middle adulthood or if individuals with PAE may experience premature volumetric decline with aging. Forty-eight individuals with fetal alcohol spectrum disorders (FASD) and 28 healthy comparison participants aged 30 to 65 participated in a 3T MRI session that resulted in usable T1-weighted and T2-weighted structural images. Primary analyses included volumetric measurements of the caudate, putamen, pallidum, cerebellum and corpus callosum using FreeSurfer software. Analyses were conducted examining both raw volumetric measurements and subcortical volumes adjusted for overall intracranial volume (ICV). Models tested for main effects of age, sex and group, as well as interactions of group with age and group with sex. We found the main effects for group; all regions were significantly smaller in participants with FASD for models using raw volumes (P's < 0.001) as well as for models using volumes adjusted for ICV (P's < 0.046). Although there were no significant interactions of group with age, females with FASD had smaller corpus callosum volumes relative to both healthy comparison females and males with FASD (P's < 0.001). As seen in children and adolescents, adults aged 30 to 65 with FASD showed reduced volumes of subcortical structures relative to healthy comparison adults, suggesting persistent impact of PAE. Moreover, the observed volumetric reduction of the corpus callosum in females with FASD could suggest more rapid degeneration, which may have implications for cognition as these individuals continue to age.