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Caruana GF, Carruthers SP, Berk M, Rossell SL, Van Rheenen TE. To what extent does white matter map to cognition in bipolar disorder? A systematic review of the evidence. Prog Neuropsychopharmacol Biol Psychiatry 2024; 128:110868. [PMID: 37797735 DOI: 10.1016/j.pnpbp.2023.110868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/19/2023] [Accepted: 10/01/2023] [Indexed: 10/07/2023]
Abstract
Cognitive impairment is a prominent feature of bipolar disorder (BD), however the neural substrates underpinning it remain unclear. Several studies have explored white matter as a correlate of cognitive functioning in BD cohorts, but mixed results and varied methodologies from one to another make inferences about this relationship difficult to draw. Here we sought to systematically synthesise the findings of these studies to more clearly explicate the nature and extent of relationships between white matter and cognition in BD and determine best practice methodologies and areas for future research in this area. Using PRISMA guidelines, we identified and systematically reviewed 37 relevant studies, all of which were cross-sectional by design. There was substantial methodological heterogeneity and variability in the clinical presentations of BD cohorts encapsulated within the studies we reviewed, which complicated our synthesis of the findings. Nonetheless, there was some evidence that cognition is related to both white matter macrostructure and microstructure in people with BD. In particular, multiple microstructural studies consistently reported that higher fractional anisotropy, both globally and in the corpus callosum, associated with better complex attention skills and executive functioning. However, several reports did not identify any associations at all, and in general, associations between WM and cognition tended to only be evident in studies utilising larger samples and post-hoc selection of WM regions of interest. Further research with increased statistical power and standardised methods are required moving forward.
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Affiliation(s)
- Georgia F Caruana
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria 3053, Australia
| | - Sean P Carruthers
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong 3220, Australia; Centre for Youth Mental Health and Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Victoria 3052, Australia; Barwon Health, University Hospital Geelong, Victoria 3220, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Victoria 3052, Australia
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia; St Vincent's Mental Health, St Vincent's Hospital, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria 3053, Australia; Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong 3220, Australia.
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Durrani R, Badhwar A, Bhangu J, Ganesh A, Black SE, Barber PA, Frayne R, Field TS, Hachinski V, Sahlas D, Mai LM, Sharma M, Swartz RH, Smith EE. Vascular Brain Lesions, Cognitive Reserve, and Their Association with Cognitive Profile in Persons with Early-Stage Cognitive Decline. J Alzheimers Dis Rep 2022; 6:607-616. [DOI: 10.3233/adr-220054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 08/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Cognitive reserve may protect against the effects of brain pathology, but few studies have looked at whether cognitive reserve modifies the adverse effects of vascular brain pathology. Objective: We determined if cognitive reserve attenuates the associations of vascular brain lesions with worse cognition in persons with subjective concerns or mild impairment. Methods: We analyzed 200 participants aged 50–90 years from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. Cognition was measured using the Montreal Cognitive Assessment and a neuropsychological test battery. High vascular lesion burden was defined as two or more supratentorial infarcts or beginning confluent or confluent white matter hyperintensity. Cognitive reserve proxies included education, occupational attainment, marital status, social activities, physical activity, household income, and multilingualism. Results: Mean age was 72.8 years and 48% were female; 73.5% had mild cognitive impairment and 26.5% had subjective concerns. Professional/managerial occupations, annual household income≥$60,000 per year, not being married/common law, and high physical activity were independently associated with higher cognition. Higher vascular lesion burden was associated with lower executive function, but the association was not modified by cognitive reserve. Conclusion: Markers of cognitive reserve are associated with higher cognition. Vascular lesion burden is associated with lower executive function. However, cognitive reserve does not mitigate the effects of vascular lesion burden on executive function. Public health efforts should focus on preventing vascular brain injury as well as promoting lifestyle factors related to cognitive reserve, as cognitive reserve alone may not mitigate the effects of vascular brain injury.
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Affiliation(s)
- Romella Durrani
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amanpreet Badhwar
- Department of Pharmacology and Physiology, University of Montreal, and Centre de recherche de l’Institut Universitaire de de Gériatrie, University of Montreal, Quebec, Canada
| | - Jaspreet Bhangu
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Aravind Ganesh
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Sandra E. Black
- Department of Medicine (Neurology), Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Philip A. Barber
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Richard Frayne
- Seaman Family MR Research Centre, Foothills Medical Centre and Department of Radiology and Clinical Neuro sciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Thalia S. Field
- Department of Medicine (Neurology), Djavad Mowafaghian Centre for Brain Health, Vancouver Stroke Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vladimir Hachinski
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Demetrios Sahlas
- Department of Medicine (Neurology), Population Health Research Institute, Mc Master University, Hamilton, Ontario, Canada
| | - Lauren M. Mai
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Mukul Sharma
- Department of Medicine (Neurology), Population Health Research Institute, Mc Master University, Hamilton, Ontario, Canada
| | - Richard H. Swartz
- Department of Medicine (Neurology), Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Eric E. Smith
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada
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Hotz I, Deschwanden PF, Mérillat S, Liem F, Kollias S, Jäncke L. Associations of subclinical cerebral small vessel disease and processing speed in non-demented subjects: A 7-year study. Neuroimage Clin 2021; 32:102884. [PMID: 34911190 PMCID: PMC8633374 DOI: 10.1016/j.nicl.2021.102884] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/26/2021] [Accepted: 11/16/2021] [Indexed: 12/22/2022]
Abstract
Markers of cerebral small vessel disease (CSVD) have previously been associated with age-related cognitive decline. Using longitudinal data of cognitively healthy, older adults (N = 216, mean age at baseline = 70.9 years), we investigated baseline status and change in white matter hyperintensities (WMH) (total, periventricular, deep), normal appearing white matter (NAWM), brain parenchyma volume (BPV) and processing speed over seven years as well as the impact of different covariates by applying latent growth curve (LGC) models. Generally, we revealed a complex pattern of associations between the different CSVD markers. More specifically, we observed that changes of deep WMH (dWMH), as compared to periventricular WMH (pWMH), were more strongly related to the changes of other CSVD markers and also to baseline processing speed performance. Further, the number of lacunes rather than their volume reflected the severity of CSVD. With respect to the studied covariates, we revealed that higher education had a protective effect on subsequent total WMH, pWMH, lacunar number, NAWM volume, and processing speed performance. The indication of antihypertensive drugs was associated with lower lacunar number and volume at baseline and the indication of antihypercholesterolemic drugs came along with higher processing speed performance at baseline. In summary, our results confirm previous findings, and extend them by providing information on true within-person changes, relationships between the different CSVD markers and brain-behavior associations. The moderate to strong associations between changes of the different CSVD markers indicate a common pathological relationship and, thus, support multidimensional treatment strategies.
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Affiliation(s)
- Isabel Hotz
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland; University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
| | - Pascal Frédéric Deschwanden
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Susan Mérillat
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Franziskus Liem
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Spyridon Kollias
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland; University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
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4
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Soldan A, Pettigrew C, Zhu Y, Wang M, Gottesman RF, DeCarli C, Albert M. Cognitive reserve and midlife vascular risk: Cognitive and clinical outcomes. Ann Clin Transl Neurol 2020; 7:1307-1317. [PMID: 32856790 PMCID: PMC7448143 DOI: 10.1002/acn3.51120] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/18/2020] [Accepted: 06/05/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Examine whether cognitive reserve moderates the association of 1) vascular risk factors and 2) white matter hyperintensity burden with risk of clinical progression and longitudinal cognitive decline. METHODS BIOCARD Study participants were cognitively normal and primarily middle-aged (M = 57 years) at baseline and have been followed with annual cognitive and clinical assessments (M = 13 years). Baseline cognitive reserve was indexed with a composite score combining education with reading and vocabulary scores. Baseline vascular risk (N = 229) was assessed with a composite risk score reflecting five vascular risk factors. Baseline white matter hyperintensity load (N = 271) was measured with FLAIR magnetic resonance imaging. Cox regression models assessed risk of progression from normal cognition to onset of clinical symptoms of Mild Cognitive Impairment. Longitudinal mixed effects models measured the relationship of these variables to cognitive decline, using a global composite score, and executive function and episodic memory sub-scores. RESULTS Both vascular risk and white matter hyperintensities were associated with cognitive decline, particularly in executive function. Higher vascular risk, but not white matter hyperintensity burden, was associated with an increased risk of progression to Mild Cognitive Impairment. Higher cognitive reserve was associated with a reduced risk of symptom onset and higher levels of baseline cognition but did not modify the associations between the vascular risk score and white matter hyperintensities with clinical progression or cognitive decline. INTERPRETATION Although cognitive reserve has protective effects on clinical and cognitive outcomes, it does not mitigate the negative impact of vascular risk and small vessel cerebrovascular disease on these same outcomes.
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Affiliation(s)
- Anja Soldan
- Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreMD21205
| | - Corinne Pettigrew
- Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreMD21205
| | - Yuxin Zhu
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMD21287
| | - Mei‐Cheng Wang
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMD21287
| | - Rebecca F. Gottesman
- Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreMD21205
| | - Charles DeCarli
- Department of NeurologyUniversity of California, Davis, School of MedicineDavisCA95616
| | - Marilyn Albert
- Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreMD21205
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5
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Lin C, Huang CM, Fan YT, Liu HL, Chen YL, Aizenstein HJ, Lee TMC, Lee SH. Cognitive Reserve Moderates Effects of White Matter Hyperintensity on Depressive Symptoms and Cognitive Function in Late-Life Depression. Front Psychiatry 2020; 11:249. [PMID: 32322221 PMCID: PMC7158948 DOI: 10.3389/fpsyt.2020.00249] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 03/16/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION White matter hyperintensity (WMH) has been regarded as one of the major contributor of the vascular hypothesis of late-life depression (LLD) and cognitive decline in the elderly. On the other hand, cognitive reserve (CR) has long been hypothesized to provide resilience and adaptability against age- and disease-related insults. This study examined the role of CR, using proxy of education, in moderating the association between WMH and clinical LLD expression. METHODS A total of 54 elderly diagnosed with major depressive disorder and 38 matched healthy controls participated in this study. They received MRI scanning and a battery of neuropsychological tests. WMH was quantified by an automated segmentation algorithm. Linear regression analyses were conducted separately in the LLD and control groups to examine the effects of WMH, education and their interaction in depression severity and various cognitive domains. RESULTS WMH was significantly and negatively associated with executive function only in the healthy controls. In patients with LLD, we observed a significant interactive effect in education on the association between WMH and depression severity and language domain (category fluency task). Specifically, those with high education showed less depressive symptoms and cognitive decline as WMH increased. CONCLUSION WMH is associated with lower cognitive function. However, in patients with LLD, high education attenuates the deleterious effect of WMH on mood and cognition. Therefore, CR appears to exert a protective effect on neurocognitive functioning in people with LLD.
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Affiliation(s)
- Chemin Lin
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan County, Taiwan.,Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.,Center for Intelligent Drug Systems and Smart Bio-devices (IDS2B), National Chiao Tung University, Taipei, Taiwan
| | - Yang-Teng Fan
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.,Center for Intelligent Drug Systems and Smart Bio-devices (IDS2B), National Chiao Tung University, Taipei, Taiwan
| | - Ho-Ling Liu
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Yao-Liang Chen
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tatia Mei-Chun Lee
- Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong, Hong Kong.,State Key Laboratory of Brain and Cognitive Science, The University of Hong Kong, Hong Kong, Hong Kong
| | - Shwu-Hua Lee
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan.,Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan County, Taiwan
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6
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Ter Telgte A, van Leijsen EMC, Wiegertjes K, Klijn CJM, Tuladhar AM, de Leeuw FE. Cerebral small vessel disease: from a focal to a global perspective. Nat Rev Neurol 2019; 14:387-398. [PMID: 29802354 DOI: 10.1038/s41582-018-0014-y] [Citation(s) in RCA: 273] [Impact Index Per Article: 54.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Cerebral small vessel disease (SVD) is commonly observed on neuroimaging among elderly individuals and is recognized as a major vascular contributor to dementia, cognitive decline, gait impairment, mood disturbance and stroke. However, clinical symptoms are often highly inconsistent in nature and severity among patients with similar degrees of SVD on brain imaging. Here, we provide a new framework based on new advances in structural and functional neuroimaging that aims to explain the remarkable clinical variation in SVD. First, we discuss the heterogeneous pathology present in SVD lesions despite an identical appearance on imaging and the perilesional and remote effects of these lesions. We review effects of SVD on structural and functional connectivity in the brain, and we discuss how network disruption by SVD can lead to clinical deficits. We address reserve and compensatory mechanisms in SVD and discuss the part played by other age-related pathologies. Finally, we conclude that SVD should be considered a global rather than a focal disease, as the classically recognized focal lesions affect remote brain structures and structural and functional network connections. The large variability in clinical symptoms among patients with SVD can probably be understood by taking into account the heterogeneity of SVD lesions, the effects of SVD beyond the focal lesions, the contribution of neurodegenerative pathologies other than SVD, and the interaction with reserve mechanisms and compensatory mechanisms.
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Affiliation(s)
- Annemieke Ter Telgte
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Esther M C van Leijsen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Kim Wiegertjes
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Catharina J M Klijn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Anil M Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.
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7
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Zahodne LB, Mayeda ER, Hohman TJ, Fletcher E, Racine AM, Gavett B, Manly JJ, Schupf N, Mayeux R, Brickman AM, Mungas D. The role of education in a vascular pathway to episodic memory: brain maintenance or cognitive reserve? Neurobiol Aging 2019; 84:109-118. [PMID: 31539647 DOI: 10.1016/j.neurobiolaging.2019.08.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 08/02/2019] [Accepted: 08/09/2019] [Indexed: 01/05/2023]
Abstract
Educational attainment is associated with cognition among older adults, but this association is complex and not well understood. While associated with better cognition among healthy adults, more education predicts faster decline in older adults with cognitive impairment. Education may influence cognitive functioning through mechanisms involving brain maintenance (BM: reduced age-related pathology) or cognitive reserve (CR: altered pathology-cognition association). We examined evidence for each mechanism by quantifying main and interaction effects of education within a well-studied pathway involving systolic blood pressure, white matter hyperintensities (WMH), and episodic memory in 2 samples without dementia at the baseline (total N = 1136). There were no effects of education on systolic blood pressure or WMH, suggesting a lack of evidence for BM. In the sample less likely to progress to dementia, education attenuated the effect of WMH on memory at the baseline. In the sample more likely to progress to dementia, education exacerbated this effect at the baseline. These moderations provide evidence for a CR mechanism and are consistent with previous findings of faster decline once CR is depleted.
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Affiliation(s)
- Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Timothy J Hohman
- Department of Neurology, Vanderbilt University, Nashville, TN, USA
| | - Evan Fletcher
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | | | - Brandon Gavett
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Jennifer J Manly
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Departments of Epidemiology and Psychiatry, New York, NY, USA
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Departments of Neurology, Epidemiology, and Psychiatry, New York, NY, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Dan Mungas
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
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Basilakos A, Stark BC, Johnson L, Rorden C, Yourganov G, Bonilha L, Fridriksson J. Leukoaraiosis Is Associated With a Decline in Language Abilities in Chronic Aphasia. Neurorehabil Neural Repair 2019; 33:718-729. [PMID: 31315507 DOI: 10.1177/1545968319862561] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background. A fraction of stroke survivors with chronic aphasia experience declines in language abilities over time, but the reason for this remains unclear. Objective. To evaluate the effect of leukoaraiosis on baseline aphasia severity and long-term changes in aphasia severity. This study directly compares the predictive capacity of leukoaraiosis severity to that of lesion damage, a factor known to account for a substantial proportion of variance in the degree of language impairment and recovery. Methods. Using a longitudinal database of behavioral and neuroimaging data from 35 individuals in the chronic stage of recovery after a single-event left-hemisphere stroke (9 females, mean stroke age = 55.8 ± 9.1 years, mean months poststroke at initial evaluation = 36.3 ± 40.8), we examined 2 lines of inquiry: (1) to what extent does leukoaraiosis severity at initial evaluation predict aphasia severity and (2) to what extent does leukoaraiosis severity at initial evaluation predict longitudinal change in aphasia severity. Participants underwent high-resolution magnetic resonance imaging for the purpose of lesion volume analysis and leukoaraiosis severity rating. Biographical information was also considered. Results. Lesion volume and time poststroke at initial assessment best predicted initial aphasia severity (adjusted R2 = 0.37). Leukoaraiosis severity and initial aphasia severity significantly predicted decline in language abilities at follow-up, accounting for approximately one-third of the variance (adjusted R2 = 0.33). More severe leukoaraiosis was associated with a 4.3 odds increase of decline. Conclusions. Leukoaraiosis is a significant risk factor for declining language abilities in aphasia and should be considered for better identification of individuals at risk for long-term decline, which can guide clinical decision making.
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Affiliation(s)
| | - Brielle C Stark
- 1 University of South Carolina, Columbia, SC, USA.,2 Indiana University, Bloomington, IN, USA.,3 Medical University of South Carolina, Charleston, SC, USA
| | - Lisa Johnson
- 1 University of South Carolina, Columbia, SC, USA
| | - Chris Rorden
- 1 University of South Carolina, Columbia, SC, USA
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9
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Abstract
PURPOSE OF REVIEW The aim of this review is to summarize current conceptual models of cognitive reserve (CR) and related concepts and to discuss evidence for these concepts within the context of aging and Alzheimer's disease. RECENT FINDINGS Evidence to date supports the notion that higher levels of CR, as measured by proxy variables reflective of lifetime experiences, are associated with better cognitive performance, and with a reduced risk of incident mild cognitive impairment/dementia. However, the impact of CR on longitudinal cognitive trajectories is unclear and may be influenced by a number of factors. Although there is promising evidence that some proxy measures of CR may influence structural brain measures, more research is needed. The protective effects of CR may provide an important mechanism for preserving cognitive function and cognitive well-being with age, in part because it can be enhanced throughout the lifespan. However, more research on the mechanisms by which CR is protective is needed.
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Affiliation(s)
- Corinne Pettigrew
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD, 21205, USA
| | - Anja Soldan
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD, 21205, USA.
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10
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Benson G, Hildebrandt A, Lange C, Schwarz C, Köbe T, Sommer W, Flöel A, Wirth M. Functional connectivity in cognitive control networks mitigates the impact of white matter lesions in the elderly. Alzheimers Res Ther 2018; 10:109. [PMID: 30368250 PMCID: PMC6204269 DOI: 10.1186/s13195-018-0434-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/19/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cerebrovascular pathology, quantified by white matter lesions (WML), is known to affect cognition in aging, and is associated with an increased risk of dementia. The present study aimed to investigate whether higher functional connectivity in cognitive control networks mitigates the detrimental effect of WML on cognition. METHODS Nondemented older participants (≥ 50 years; n = 230) underwent cognitive evaluation, fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI), and resting state functional magnetic resonance imaging (fMRI). Total WML volumes were quantified algorithmically. Functional connectivity was assessed in preselected higher-order resting state networks, namely the fronto-parietal, the salience, and the default mode network, using global and local measures. Latent moderated structural equations modeling examined direct and interactive relationships between WML volumes, functional connectivity, and cognition. RESULTS Larger WML volumes were associated with worse cognition, having a greater impact on executive functions (β = -0.37, p < 0.01) than on memory (β = -0.22, p < 0.01). Higher global functional connectivity in the fronto-parietal network and higher local connectivity between the salience network and medial frontal cortex significantly mitigated the impact of WML on executive functions, (unstandardized coefficients: b = 2.39, p = 0.01; b = 3.92, p = 0.01) but not on memory (b = -5.01, p = 0.51, b = 2.01, p = 0.07, respectively). No such effects were detected for the default mode network. CONCLUSION Higher functional connectivity in fronto-parietal and salience networks may protect against detrimental effects of WML on executive functions, the cognitive domain that was predominantly affected by cerebrovascular pathology. These results highlight the crucial role of cognitive control networks as a neural substrate of cognitive reserve in older individuals.
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Affiliation(s)
- Gloria Benson
- NeuroCure Clinical Research Center, Department of Neurology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Andrea Hildebrandt
- Department of Psychology, University Medicine Greifswald, Greifswald, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Catharina Lange
- Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Claudia Schwarz
- NeuroCure Clinical Research Center, Department of Neurology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Theresa Köbe
- NeuroCure Clinical Research Center, Department of Neurology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Department of Psychiatry, McGill University, Montreal, Quebec Canada
- Douglas Mental Health University Institute, Studies on Prevention of Alzheimer’s Disease Centre, Montreal, Quebec Canada
| | - Werner Sommer
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Agnes Flöel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Miranka Wirth
- NeuroCure Clinical Research Center, Department of Neurology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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11
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Jung NY, Cho H, Kim YJ, Kim HJ, Lee JM, Park S, Kim ST, Kim EJ, Kim JS, Moon SH, Lee JH, Ewers M, Na DL, Seo SW. The impact of education on cortical thickness in amyloid-negative subcortical vascular dementia: cognitive reserve hypothesis. ALZHEIMERS RESEARCH & THERAPY 2018; 10:103. [PMID: 30261914 PMCID: PMC6161352 DOI: 10.1186/s13195-018-0432-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/17/2018] [Indexed: 01/22/2023]
Abstract
Background The protective effect of education has been well established in Alzheimer’s disease, whereas its role in patients with isolated cerebrovascular diseases remains unclear. We examined the correlation of education with cortical thickness and cerebral small vessel disease markers in patients with pure subcortical vascular mild cognitive impairment (svMCI) and patients with pure subcortical vascular dementia (SVaD). Methods We analyzed 45 patients with svMCI and 47 patients with SVaD with negative results on Pittsburgh compound B positron emission tomographic imaging who underwent structural brain magnetic resonance imaging. The main outcome was cortical thickness measured using surface-based morphometric analysis. We also assessed the volumes of white matter hyperintensities (WMH) and numbers of lacunes as other outcomes. To investigate the correlation of education with cortical thickness, WMH volume, and number of lacunes, multiple linear regression analyses were performed after controlling for covariates, including Mini Mental State Examination, in the svMCI and SVaD groups. Results In the SVaD group, higher education was correlated with more severe cortical thinning in the bilateral dorsolateral frontal, left medial frontal, and parahippocampal areas, whereas there was no correlation of education with cortical thickness in the svMCI group. There was no correlation between education and cerebral small vessel disease, including WMH and lacunes, in both patients with svMCI and patients with SVaD. Conclusions Our findings suggest that the compensatory effects of education on cortical thinning apply to patients with SVaD, which might be explained by the cognitive reserve hypothesis.
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Affiliation(s)
- Na-Yeon Jung
- Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea.,Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Jong Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Seongbeom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Busan, Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung Hwan Moon
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. .,Neuroscience Center, Samsung Medical Center, Seoul, Korea.
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12
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Wilckens KA, Tudorascu DL, Snitz BE, Price JC, Aizenstein HJ, Lopez OL, Erickson KI, Lopresti BJ, Laymon CM, Minhas D, Mathis CA, Buysse DJ, Klunk WE, Cohen AD. Sleep moderates the relationship between amyloid beta and memory recall. Neurobiol Aging 2018; 71:142-148. [PMID: 30138767 DOI: 10.1016/j.neurobiolaging.2018.07.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/18/2018] [Accepted: 07/17/2018] [Indexed: 12/21/2022]
Abstract
Amyloid-β (Aβ) accumulation is a hallmark of Alzheimer's disease, although Aβ alone may be insufficient to cause impairments. Modifiable health factors, including sleep, may mitigate functional symptoms of neurodegeneration. We assessed whether sleep moderated the relationship between Aβ and cognitive performance in 41 older adults, mean age 83 years. Sleep measures included actigraphy-assessed wake after sleep onset and total sleep time. Cognitive performance was assessed with memory recall, cognitive flexibility, and verbal fluency. Memory recall was assessed with the Rey-Osterrieth Complex Figure task, cognitive flexibility with the Trail Making test, and verbal fluency with FAS word generation. Aβ was assessed with a global measure of Pittsburgh Compound B. Wake after sleep onset moderated the relationship between Aβ and memory, with a stronger positive association for Aβ and forgetting in those with poorer sleep. These results suggest a possible protective role of sleep in preclinical Alzheimer's disease.
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Affiliation(s)
- Kristine A Wilckens
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Dana L Tudorascu
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Julie C Price
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brian J Lopresti
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Charles M Laymon
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Davneet Minhas
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Chester A Mathis
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - William E Klunk
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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13
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Hinrichs KH, Hayek A, Kalmbach D, Gabel N, Bieliauskas LA. Cognitive reserve and executive function: Effect on judgment of health and safety. ACTA ACUST UNITED AC 2018; 53:863-872. [PMID: 28273320 DOI: 10.1682/jrrd.2015.04.0073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/31/2016] [Indexed: 11/05/2022]
Abstract
Individuals with the same neurological conditions do not necessarily manifest the same behavioral presentation, which suggests differences in resilience and vulnerability among individuals, a concept known as cognitive reserve. This study sought to explore the relationship among cognitive reserve, executive functioning, and health and safety judgment among a sample of older adult inpatients in an extended medical care unit at a Veterans Health Administration hospital. We hypothesized that cognitive reserve, as determined by an estimate of premorbid intellectual ability, would act as a protective factor against poor judgment in older adults with executive dysfunction. Participants included 200 Veterans who completed a comprehensive neuropsychological assessment, including measures of health and safety judgment, executive functioning, global cognitive functioning, and premorbid intellectual ability. After controlling for global cognitive functioning, executive functioning abilities did not have an effect on judgment abilities among those with high estimated intellectual ability. However, executive functioning had a significant effect on judgment abilities among those with low estimated intellectual ability. Our results suggest that intact executive functioning is critical for making appropriate health and safety decisions for patients with lower measured intellectual abilities and provide further support for the cognitive reserve model. Clinical implications are also discussed.
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Affiliation(s)
| | | | | | - Nicolette Gabel
- Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
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14
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Baker LM, Laidlaw DH, Cabeen R, Akbudak E, Conturo TE, Correia S, Tate DF, Heaps-Woodruff JM, Brier MR, Bolzenius J, Salminen LE, Lane EM, McMichael AR, Paul RH. Cognitive reserve moderates the relationship between neuropsychological performance and white matter fiber bundle length in healthy older adults. Brain Imaging Behav 2017; 11:632-639. [PMID: 26961092 PMCID: PMC7083104 DOI: 10.1007/s11682-016-9540-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Recent work using novel neuroimaging methods has revealed shorter white matter fiber bundle length (FBL) in older compared to younger adults. Shorter FBL also corresponds to poorer performance on cognitive measures sensitive to advanced age. However, it is unclear if individual factors such as cognitive reserve (CR) effectively moderate the relationship between FBL and cognitive performance. This study examined CR as a potential moderator of cognitive performance and brain integrity as defined by FBL. Sixty-three healthy adults underwent neuropsychological evaluation and 3T brain magnetic resonance imaging. Cognitive performance was measured using the Repeatable Battery of Assessment of Neuropsychological Status (RBANS). FBL was quantified from tractography tracings of white matter fiber bundles, derived from the diffusion tensor imaging. CR was determined by estimated premorbid IQ. Analyses revealed that lower scores on the RBANS were associated with shorter whole brain FBL (p = 0.04) and lower CR (p = 0.01) CR moderated the relationship between whole brain FBL and RBANS score (p < 0.01). Tract-specific analyses revealed that CR also moderated the association between FBL in the hippocampal segment of the cingulum and RBANS performance (p = 0.03). These results demonstrate that lower cognitive performance on the RBANS is more common with low CR and short FBL. On the contrary, when individuals have high CR, the relationship between FBL and cognitive performance is attenuated. Overall, CR protects older adults against lower cognitive performance despite age-associated reductions in FBL.
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Affiliation(s)
- Laurie M Baker
- Department of Psychological Sciences, University of Missouri - Saint Louis, One University Boulevard, Stadler Hall 327, Saint Louis, MO, 63121, USA.
| | - David H Laidlaw
- Computer Science Department, Brown University, Providence, RI, 02912, USA
| | - Ryan Cabeen
- Computer Science Department, Brown University, Providence, RI, 02912, USA
| | - Erbil Akbudak
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Thomas E Conturo
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Stephen Correia
- Division of Biology and Medicine, Brown Medical School, Providence, RI, 02912, USA
| | - David F Tate
- Missouri Institute of Mental Health, St. Louis, MO, 63134, USA
| | | | - Matthew R Brier
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Jacob Bolzenius
- Missouri Institute of Mental Health, St. Louis, MO, 63134, USA
| | - Lauren E Salminen
- Department of Psychological Sciences, University of Missouri - Saint Louis, One University Boulevard, Stadler Hall 327, Saint Louis, MO, 63121, USA
| | - Elizabeth M Lane
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Amanda R McMichael
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Robert H Paul
- Department of Psychological Sciences, University of Missouri - Saint Louis, One University Boulevard, Stadler Hall 327, Saint Louis, MO, 63121, USA
- Missouri Institute of Mental Health, St. Louis, MO, 63134, USA
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15
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Fernández-Cabello S, Valls-Pedret C, Schurz M, Vidal-Piñeiro D, Sala-Llonch R, Bargallo N, Ros E, Bartrés-Faz D. White matter hyperintensities and cognitive reserve during a working memory task: a functional magnetic resonance imaging study in cognitively normal older adults. Neurobiol Aging 2016; 48:23-33. [DOI: 10.1016/j.neurobiolaging.2016.08.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 07/08/2016] [Accepted: 08/09/2016] [Indexed: 01/16/2023]
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16
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Vaqué-Alcázar L, Sala-Llonch R, Valls-Pedret C, Vidal-Piñeiro D, Fernández-Cabello S, Bargalló N, Ros E, Bartrés-Faz D. Differential age-related gray and white matter impact mediates educational influence on elders’ cognition. Brain Imaging Behav 2016; 11:318-332. [DOI: 10.1007/s11682-016-9584-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Hannigan C, Coen RF, Lawlor BA, Robertson IH, Brennan S. The NEIL Memory Research Unit: psychosocial, biological, physiological and lifestyle factors associated with healthy ageing: study protocol. BMC Psychol 2015; 3:20. [PMID: 26131366 PMCID: PMC4486120 DOI: 10.1186/s40359-015-0079-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 06/19/2015] [Indexed: 01/02/2023] Open
Abstract
Background Population ageing is a global phenomenon that has characterised demographic trends during the 20th and 21st century. The rapid growth in the proportion of older adults in the population, and resultant increase in the incidence of age-related cognitive decline, dementia and Alzheimer’s disease, brings significant social, economic and healthcare challenges. Decline in cognitive abilities represents the most profound threat to active and healthy ageing. Current evidence suggests that a significant proportion of cases of age-related cognitive decline and dementia may be preventable through the modification of risk factors including education, depressive symptomology, physical activity, social engagement and participation in cognitively stimulating activities. The NEIL Memory Research Unit cohort study was established to investigate factors related to brain health and the maintenance of cognitive function. Methods A cohort of 1000 normally ageing adults aged 50 years and over are being recruited to participate in comprehensive assessments at baseline, and at follow-up once every 2 years. The assessment protocol comprises a comprehensive neuropsychological battery, some basic physical measures, psychosocial scales, questionnaire measures related to a range of health, lifestyle and behavioural factors, and a measure of resting state activity using electroencephalography (EEG). Discussion The NEIL Memory Research Unit cohort study will address key questions about brain health and cognitive ageing in the population aged 50+, with a particular emphasis on the influence of potentially modifiable factors on cognitive outcomes. Analyses will be conducted with a focus on factors involved in the maintenance of cognitive function among older adults, and therefore will have the potential to contribute significant knowledge related to key questions within the field of cognitive ageing, and to inform the development of public health interventions aimed at preventing cognitive decline and promoting active and healthy ageing.
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Affiliation(s)
- Caoimhe Hannigan
- NEIL (NeuroEnhancement for Independent Lives), Trinity College Institute of Neuroscience, Trinity College, Dublin 2, Ireland
| | - Robert F Coen
- Mercers Institute for Research on Ageing, Hospital 4, St James's Hospital, Dublin 8, Ireland
| | - Brian A Lawlor
- NEIL (NeuroEnhancement for Independent Lives), Trinity College Institute of Neuroscience, Trinity College, Dublin 2, Ireland ; Mercers Institute for Research on Ageing, Hospital 4, St James's Hospital, Dublin 8, Ireland
| | - Ian H Robertson
- NEIL (NeuroEnhancement for Independent Lives), Trinity College Institute of Neuroscience, Trinity College, Dublin 2, Ireland
| | - Sabina Brennan
- NEIL (NeuroEnhancement for Independent Lives), Trinity College Institute of Neuroscience, Trinity College, Dublin 2, Ireland
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18
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Cerebral small vessel disease, cognitive reserve and cognitive dysfunction. J Neurol 2015; 262:2411-9. [DOI: 10.1007/s00415-015-7776-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 05/04/2015] [Accepted: 05/06/2015] [Indexed: 11/25/2022]
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19
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Education modulates the impact of white matter lesions on the risk of mild cognitive impairment and dementia. Am J Geriatr Psychiatry 2014; 22:1336-45. [PMID: 24021219 PMCID: PMC4143478 DOI: 10.1016/j.jagp.2013.06.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 04/24/2013] [Accepted: 06/05/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Conflicting results have been reported regarding the association between white matter lesions (WML) and cognitive impairment. We hypothesized that education, a marker of cognitive reserve (CR), could modulate the effects of WML on the risk of mild cognitive impairment (MCI) or dementia. METHODS We followed 500 healthy subjects from a cohort of community-dwelling persons aged 65 years and over (ESPRIT Project). At baseline, WML volume was measured using a semi-automatic method on T2-weighted MRI. Standardized cognitive and neurological evaluations were repeated after 2, 4, and 7 years. The sample was dichotomized according to education level into low (≤8 years) and high (>8 years) education groups. Cox proportional hazard models were constructed to study the association between WML and risk of MCI/dementia. RESULTS The interaction between education level and WML volume reached significance (p = 0.017). After adjustment for potential confounders, the association between severe WML and increased MCI/dementia risk was significant in the low education group (≤8 years) (p = 0.02, hazard ratio [HR]: 3.77 [1.29-10.99]), but not in the high education group (>8 years) (p = 0.82, HR: 1.07 [0.61-1.87]). CONCLUSIONS Severe WML significantly increases the risk of developing MCI/dementia over a 7-year period in low educated participants. Subjects with higher education levels were seen to be more likely to be resilient to the deleterious effects of severe WML. The CR hypothesis suggests several avenues for dementia prevention.
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20
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Genova HM, Rajagopalan V, DeLuca J, Das A, Binder A, Arjunan A, Chiaravalloti N, Wylie G. Examination of cognitive fatigue in multiple sclerosis using functional magnetic resonance imaging and diffusion tensor imaging. PLoS One 2013; 8:e78811. [PMID: 24223850 PMCID: PMC3815348 DOI: 10.1371/journal.pone.0078811] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 09/16/2013] [Indexed: 12/21/2022] Open
Abstract
The present study investigated the neural correlates of cognitive fatigue in Multiple Sclerosis (MS), looking specifically at the relationship between self-reported fatigue and objective measures of cognitive fatigue. In Experiment 1, functional magnetic resonance imaging (fMRI) was used to examine where in the brain BOLD activity covaried with “state” fatigue, assessed during performance of a task designed to induce cognitive fatigue while in the scanner. In Experiment 2, diffusion tensor imaging (DTI) was used to examine where in the brain white matter damage correlated with increased “trait” fatigue in individuals with MS, assessed by the Fatigue Severity Scale (FSS) completed outside the scanning session. During the cognitively fatiguing task, the MS group had increased brain activity associated with fatigue in the caudate as compared with HCs. DTI findings revealed that reduced fractional anisotropy in the anterior internal capsule was associated with increased self-reported fatigue on the FSS. Results are discussed in terms of identifying a “fatigue-network” in MS.
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Affiliation(s)
- Helen M. Genova
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation Research Center, West Orange, New Jersey, United States of America
- Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark, New Jersey, United States of America
- * E-mail: (HG); (GW)
| | - Venkateswaran Rajagopalan
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation Research Center, West Orange, New Jersey, United States of America
- Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark, New Jersey, United States of America
| | - John DeLuca
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation Research Center, West Orange, New Jersey, United States of America
- Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark, New Jersey, United States of America
| | - Abhijit Das
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation Research Center, West Orange, New Jersey, United States of America
- Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark, New Jersey, United States of America
| | - Allison Binder
- Department of Psychology, University of Massachusetts, Amherst, Amherst, Massachusetts, United States of America
| | - Aparna Arjunan
- Department of Clinical Psychology, Suffolk University, Boston, Massachusetts, United States of America
| | - Nancy Chiaravalloti
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation Research Center, West Orange, New Jersey, United States of America
- Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark, New Jersey, United States of America
| | - Glenn Wylie
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation Research Center, West Orange, New Jersey, United States of America
- Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark, New Jersey, United States of America
- * E-mail: (HG); (GW)
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21
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Genova HM, DeLuca J, Chiaravalloti N, Wylie G. The relationship between executive functioning, processing speed, and white matter integrity in multiple sclerosis. J Clin Exp Neuropsychol 2013; 35:631-41. [PMID: 23777468 DOI: 10.1080/13803395.2013.806649] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The primary purpose of the current study was to examine the relationship between performance on executive tasks and white matter integrity, assessed by diffusion tensor imaging (DTI) in multiple sclerosis (MS). A second aim was to examine how processing speed affects the relationship between executive functioning and fractional anisotropy (FA). This relationship was examined in two executive tasks that rely heavily on processing speed: the Color-Word Interference Test and the Trail Making Test (Delis-Kaplan Executive Function System). It was hypothesized that reduced FA is related to poor performance on executive tasks in MS, but that this relationship would be affected by the statistical correction of processing speed from the executive tasks. A total of 15 healthy controls and 25 persons with MS participated. Regression analyses were used to examine the relationship between executive functioning and FA, both before and after processing speed was removed from the executive scores. Before processing speed was removed from the executive scores, reduced FA was associated with poor performance on the Color-Word Interference Test and Trail Making Test in a diffuse network including corpus callosum and superior longitudinal fasciculus. However, once processing speed was removed, the relationship between executive functions and FA was no longer significant on the Trail Making Test, and significantly reduced and more localized on the Color-Word Interference Test.
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Affiliation(s)
- Helen M Genova
- Neuropsychology & Neuroscience Laboratory, Kessler Foundation Research Center, West Orange, NJ 07052, USA.
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22
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Vuoksimaa E, Panizzon MS, Chen CH, Eyler LT, Fennema-Notestine C, Fiecas MJA, Fischl B, Franz CE, Grant MD, Jak AJ, Lyons MJ, Neale MC, Thompson WK, Tsuang MT, Xian H, Dale AM, Kremen WS. Cognitive reserve moderates the association between hippocampal volume and episodic memory in middle age. Neuropsychologia 2013; 51:1124-31. [PMID: 23499725 DOI: 10.1016/j.neuropsychologia.2013.02.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 02/26/2013] [Accepted: 02/28/2013] [Indexed: 10/27/2022]
Abstract
Cognitive reserve is hypothesized to help people withstand greater brain pathology without manifesting clinical symptoms, and may be regarded as a preventive factor of dementia. It is unclear whether the effect of cognitive reserve is evident only among the older adults or after conversion to dementia, or if it can also be seen earlier in life before the prominent effects of cognitive aging become apparent. While finding a main effect of cognitive reserve on cognitive outcome may be consistent with the reserve hypothesis, in our view, it is unnecessary to invoke the idea of reserve if only a main effect is present. Rather, it is the interaction between a measure of reserve and a brain measure on cognitive outcome that is key for confirming that the effects of brain pathology affect people differently according to their cognitive reserve. We studied whether general cognitive ability at an average age of 20 years, as a direct measure of cognitive reserve, moderates the association between hippocampal volume and episodic memory performance in 494 middle-aged men ages 51 to 60. Whereas there was no statistically significant direct relationship between hippocampal volume and episodic memory performance in middle age, we found a statistically significant interaction such that there was a positive association between hippocampal volume and episodic memory only among people with lower general cognitive ability at age 20, i.e., lower levels of cognitive reserve. Our results provide support for the hypothesis that cognitive reserve moderates the relationship between brain structure and cognition in middle age, well before the onset of dementia.
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Affiliation(s)
- Eero Vuoksimaa
- Department of Psychiatry, University of California-San Diego, La Jolla, CA, USA.
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23
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Mortamais M, Artero S, Ritchie K. Cerebral white matter hyperintensities in the prediction of cognitive decline and incident dementia. Int Rev Psychiatry 2013; 25:686-98. [PMID: 24423222 PMCID: PMC5104835 DOI: 10.3109/09540261.2013.838151] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cerebral white matter hyperintensities (WMH), detected in vivo with magnetic resonance imaging (MRI), are commonly used to assess cerebrovascular burden in cognitive impairment. However, the association between WMH and cognition is not consistent across the literature. The present review examines evidence from published longitudinal studies. We reviewed the PubMed data base from January 1990 to March 2013 and included studies investigating the association of WMH with (1) the risk of dementia in the general population, (2) the risk of conversion to dementia in the mild cognitive impairment (MCI) population, and (3) cognitive decline in the general population. WMH were associated with all types of dementia in the general population, but not in MCI patients. Results are discrepant for global decline. WMH appear to be early predictors of the risk of dementia, but this association appears to be modulated by cognitive reserve, age and the spatial distribution of lesions. There are, however, some limits in the use of WMH as a marker of vascular burden. In addition to their ischaemic origin, WMH may be the result of co-occurring morbidity. Further research is needed to elucidate to what extent WMH actually reflect vascular risk to evaluate the likely efficacy of interventions specifically targeting WMH reduction.
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Affiliation(s)
- Marion Mortamais
- Neuropsychiatrie : Recherche Epidémiologique et Clinique
Institut National de la Santé et de la Recherche Médicale - U1061Université Montpellier 1 - Hôpital La Colombière 39 avenue Charles Flahault BP 34493 -pavillon 42 Calixte Cavalier 34093 Cedex 5 Montpellier,* Correspondence should be addressed to Marion Mortamais
| | - Sylvaine Artero
- Neuropsychiatrie : Recherche Epidémiologique et Clinique
Institut National de la Santé et de la Recherche Médicale - U1061Université Montpellier 1 - Hôpital La Colombière 39 avenue Charles Flahault BP 34493 -pavillon 42 Calixte Cavalier 34093 Cedex 5 Montpellier
| | - Karen Ritchie
- Neuropsychiatrie : Recherche Epidémiologique et Clinique
Institut National de la Santé et de la Recherche Médicale - U1061Université Montpellier 1 - Hôpital La Colombière 39 avenue Charles Flahault BP 34493 -pavillon 42 Calixte Cavalier 34093 Cedex 5 Montpellier,Faculty of Medicine
Imperial College London - W12 0NN, Londres
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Abstract
There are many reports of relations between age and cognitive variables and of relations between age and variables representing different aspects of brain structure and a few reports of relations between brain structure variables and cognitive variables. These findings have sometimes led to inferences that the age-related brain changes cause the age-related cognitive changes. Although this conclusion may well be true, it is widely recognized that simple correlations are not sufficient to warrant causal conclusions, and other types of correlational information, such as mediation and correlations between longitudinal brain changes and longitudinal cognitive changes, also have limitations with respect to causal inferences. These issues are discussed, and the existing results on relations of regional volume, white matter hyperintensities, and diffusion tensor imaging measures of white matter integrity to age and to measures of cognitive functioning are reviewed. It is concluded that at the current time the evidence that these aspects of brain structure are neuroanatomical substrates of age-related cognitive decline is weak. The final section contains several suggestions concerning measurement and methodology that may lead to stronger conclusions in the future.
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Affiliation(s)
- Timothy A Salthouse
- Department of Psychology, University of Virginia, Charlottesville, VA 22904-4400, USA.
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Bartrés-Faz D, Arenaza-Urquijo EM. Structural and functional imaging correlates of cognitive and brain reserve hypotheses in healthy and pathological aging. Brain Topogr 2011; 24:340-57. [PMID: 21853422 DOI: 10.1007/s10548-011-0195-9] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 07/25/2011] [Indexed: 10/17/2022]
Abstract
In the field of ageing and dementia, brain- or cognitive reserve refers to the capacity of the brain to manage pathology or age-related changes thereby minimizing clinical manifestations. The brain reserve capacity (BRC) hypothesis argues that this capacity derives from an individual's unique neural profile (e.g., cell count, synaptic connections, brain volume, etc.). Complimentarily, the cognitive reserve (CR) hypothesis emphasizes inter-individual differences in the effective recruitment of neural networks and cognitive processes to compensate for age-related effects or pathology. Despite an abundance of research, there is scarce literature attempting to synthesize the BRC the CR models. In this paper, we will review important aging and dementia studies using structural and functional neuroimaging techniques to investigate and attempt to assimilate both reserve hypotheses. The possibility to conceptualize reserve as reflecting indexes of brain plasticity will be proposed and novel data suggesting an intimate and complex correspondence between active and passive components of reserve will be presented.
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Affiliation(s)
- David Bartrés-Faz
- Department of Psychiatry and Clinical Psychobiology, Faculty of Medicine, University of Barcelona, Casanova 143, Barcelona, Spain.
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Influence of education on subcortical hyperintensities and global cognitive status in vascular dementia. J Int Neuropsychol Soc 2011; 17:531-6. [PMID: 21385518 PMCID: PMC5370165 DOI: 10.1017/s1355617711000324] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Subcortical hyperintensities (SH) on neuroimaging are a prominent feature of vascular dementia (VaD) and SH severity correlates with cognitive impairment in this population. Previous studies demonstrated that SH burden accounts for a degree of the cognitive burden among VaD patients, although it remains unclear if individual factors such as cognitive reserve influence cognitive status in VaD. To address this issue, we examined 36 individuals diagnosed with probable VaD (age = 77.56; education = 12). All individuals underwent MMSE evaluations and MRI brain scans. We predicted that individuals with higher educational attainment would exhibit less cognitive difficulty despite similar levels of SH volume, compared to individuals with less educational attainment. A regression analysis revealed that greater SH volume was associated with lower scores on the MMSE. Additionally, education moderated the relationship between SH volume and MMSE score, demonstrating that individuals with higher education had higher scores on the MMSE despite similar degrees of SH burden. These results suggest that educational attainment buffers the deleterious effects of SH burden on cognitive status among VaD patients.
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Specific anatomic associations between white matter integrity and cognitive reserve in normal and cognitively impaired elders. Am J Geriatr Psychiatry 2011; 19:33-42. [PMID: 20808130 DOI: 10.1097/jgp.0b013e3181e448e1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES to investigate the associations between white matter (WM) integrity and cognitive reserve (CR) in healthy elders (HE), amnestic mild cognitive impairment (a-MCI), and Alzheimer's disease (AD). The authors studied correlations between CR and WM integrity in regions showing WM age-related effects or pathologic changes and tested the differences of slopes between groups. METHODS diffusion tensor images (DTIs) were obtained from 18 young individuals, 15 HE, 16 a-MCI cases, and 15 AD cases. Tract-based spatial statistics was used to process DTI data. Areas showing age-related fractional anisotropy (FA) shrinkages (HE < young) and pathology-related FA network "(AD < HE)" were defined. Correlations between CR and WM integrity were adjusted for age, gender, memory performance and brain volumes. RESULTS he presented more negative correlations between CR and WM integrity than patients with a-MCI and AD in age-related areas, such as the genum of the corpus callosum. However, these results were mediated by normal variability in memory function and brain volumes. For patients with a-MCI, negative associations between CR and FA were found in several major tracts, being more robust than in AD group. Although longitudinal results need to be interpreted with caution because of the reduced sample of patients with MCI, after 2 years of follow-up, all patients who progressed to AD had high-CR scores, suggesting a putative link between reduced WM integrity (maximal in patients with high CR) and risk of progression to AD. CONCLUSIONS CR correlates are implemented in different anatomic WM areas in HE and patients with a-MCI. Healthy elders with high CR may present better tolerance of typical age-related effects on WM integrity; in patients with a-MCI, the association may reflect increased capacity to cope with incipient cerebral damage.
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Taki Y, Kinomura S, Sato K, Goto R, Wu K, Kawashima R, Fukuda H. Correlation between degree of white matter hyperintensities and global gray matter volume decline rate. Neuroradiology 2010; 53:397-403. [PMID: 20625706 DOI: 10.1007/s00234-010-0746-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 06/28/2010] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Whether the degree of white matter hyperintensities (WMHs) shows a significant correlation with the rate of global gray matter volume decline over a period following initial baseline measurement remains unclear. The purpose of the present study was to reveal the relationship between the degree of WMHs at baseline and the rate of global gray matter volume decline by applying a longitudinal design. METHODS Using a 6-year longitudinal design and magnetic resonance images of the brains of 160 healthy individuals aged over 50 years and living in the community, we analyzed the correlation between degree of WMHs using Fazekas scaling at baseline and rate of global gray matter volume decline 6 years later. To obtain the rate of global gray matter volume decline, we calculated global gray matter volume and intracranial volume at baseline and at follow-up using a fully automated method. RESULTS The annual percentage change in the gray matter ratio (GMR, APC(GMR)), in which GMR represents the percentage of gray matter volume in the intracranial volume, showed a significant positive correlation with the degree of deep WMHs and periventricular WMHs at baseline, after adjusting for age, gender, present history of hypertension, and diabetes mellitus. CONCLUSION Our results suggest that degree of WMHs at baseline predicts the rate of gray matter volume decline 6 years later and that simple visual scaling of WMHs could contribute to predicting the rate of global gray matter volume decline.
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Affiliation(s)
- Yasuyuki Taki
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Aobaku, Sendai, Japan.
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Parks CM, DeCarli C, Jacoby LL, Yonelinas AP. Aging effects on recollection and familiarity: the role of white matter hyperintensities. AGING NEUROPSYCHOLOGY AND COGNITION 2010; 17:422-38. [PMID: 20175007 DOI: 10.1080/13825580903469838] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Previous studies have indicated that aging is associated with declines in recollection whereas familiarity-based recognition is left largely unaffected. The brain changes underlying these recollection declines are yet not well understood. In the current study we examined the role of white matter integrity as measured by white matter hyperintensities (WMH) on age-related changes in recollection and familiarity. Recognition was measured using a remember/know procedure (Experiment 1) and a source-memory process-dissociation procedure (Experiment 2). Robust age related declines in recollection were observed, but there was no evidence that white matter damage was related to the observed memory declines. Although future studies with larger samples will be necessary to fully characterize the role of WMH in normal age-related declines in different types of memory, the results suggest that declines in recollection are not strongly related to the brain changes indexed by WMHs.
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Affiliation(s)
- Colleen M Parks
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA.
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Aizenstein HJ, Nebes RD, Saxton JA, Price JC, Mathis CA, Tsopelas ND, Ziolko SK, James JA, Snitz BE, Houck PR, Bi W, Cohen AD, Lopresti BJ, DeKosky ST, Halligan EM, Klunk WE. Frequent amyloid deposition without significant cognitive impairment among the elderly. ACTA ACUST UNITED AC 2008; 65:1509-17. [PMID: 19001171 DOI: 10.1001/archneur.65.11.1509] [Citation(s) in RCA: 757] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To characterize the prevalence of amyloid deposition in a clinically unimpaired elderly population, as assessed by Pittsburgh Compound B (PiB) positron emission tomography (PET) imaging, and its relationship to cognitive function, measured with a battery of neuropsychological tests. DESIGN Subjects underwent cognitive testing and PiB PET imaging (15 mCi for 90 minutes with an ECAT HR+ scanner). Logan graphical analysis was applied to estimate regional PiB retention distribution volume, normalized to a cerebellar reference region volume, to yield distribution volume ratios (DVRs). SETTING University medical center. PARTICIPANTS From a community-based sample of volunteers, 43 participants aged 65 to 88 years who did not meet diagnostic criteria for Alzheimer disease or mild cognitive impairment were included. MAIN OUTCOME MEASURES Regional PiB retention and cognitive test performance. RESULTS Of 43 clinically unimpaired elderly persons imaged, 9 (21%) showed evidence of early amyloid deposition in at least 1 brain area using an objectively determined DVR cutoff. Demographic characteristics did not differ significantly between amyloid-positive and amyloid-negative participants, and neurocognitive performance was not significantly worse among amyloid-positive compared with amyloid-negative participants. CONCLUSIONS Amyloid deposition can be identified among cognitively normal elderly persons during life, and the prevalence of asymptomatic amyloid deposition may be similar to that of symptomatic amyloid deposition. In this group of participants without clinically significant impairment, amyloid deposition was not associated with worse cognitive function, suggesting that an elderly person with a significant amyloid burden can remain cognitively normal. However, this finding is based on relatively small numbers and needs to be replicated in larger cohorts. Longitudinal follow-up of these subjects will be required to support the potential of PiB imaging to identify preclinical Alzheimer disease, or, alternatively, to show that amyloid deposition is not sufficient to cause Alzheimer disease within some specified period.
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Affiliation(s)
- Howard Jay Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Gordon BA, Rykhlevskaia EI, Brumback CR, Lee Y, Elavsky S, Konopack JF, Mcauley E, Kramer AF, Colcombe S, Gratton G, Fabiani M. Neuroanatomical correlates of aging, cardiopulmonary fitness level, and education. Psychophysiology 2008; 45:825-38. [PMID: 18627534 PMCID: PMC5287394 DOI: 10.1111/j.1469-8986.2008.00676.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Fitness and education may protect against cognitive impairments in aging. They may also counteract age-related structural changes within the brain. Here we analyzed volumetric differences in cerebrospinal fluid and gray and white matter, along with neuropsychological data, in adults differing in age, fitness, and education. Cognitive performance was correlated with fitness and education. Voxel-based morphometry was used for a whole-brain analysis of structural magnetic resonance images. We found age-related losses in gray and white matter in medial-temporal, parietal, and frontal areas. As in previous work, fitness within the old correlated with preserved gray matter in the same areas. In contrast, higher education predicted preserved white matter in inferior frontal areas. These data suggest that fitness and education may both be predictive of preserved cognitive function in aging through separable effects on brain structure.
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Affiliation(s)
- Brian A. Gordon
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, Illinois 61820, USA
- Beckman Institute, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
| | - Elena I. Rykhlevskaia
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, Illinois 61820, USA
- Beckman Institute, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
| | - Carrie R. Brumback
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, Illinois 61820, USA
- Beckman Institute, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
| | - Yukyung Lee
- Beckman Institute, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
| | - Steriani Elavsky
- Department of Kinesiology, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
| | - James F. Konopack
- Department of Kinesiology, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
| | - Edward Mcauley
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, Illinois 61820, USA
- Department of Kinesiology, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
| | - Arthur F. Kramer
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, Illinois 61820, USA
- Beckman Institute, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
| | - Stanley Colcombe
- Beckman Institute, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
| | - Gabriele Gratton
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, Illinois 61820, USA
- Beckman Institute, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
| | - Monica Fabiani
- Department of Psychology, University of Illinois at Urbana–Champaign, Champaign, Illinois 61820, USA
- Beckman Institute, University of Illinois at Urbana–Champaign, Urbana, Illinois 61801, USA
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Postural sway reduction in aging men and women: relation to brain structure, cognitive status, and stabilizing factors. Neurobiol Aging 2007; 30:793-807. [PMID: 17920729 DOI: 10.1016/j.neurobiolaging.2007.08.021] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2007] [Revised: 08/10/2007] [Accepted: 08/21/2007] [Indexed: 11/24/2022]
Abstract
Postural stability becomes compromised with advancing age, but the neural mechanisms contributing to instability have not been fully explicated. Accordingly, this quantitative physiological and MRI study of sex differences across the adult age range examined the association between components of postural control and the integrity of brain structure and function under different conditions of sensory input and stance stabilization manipulation. The groups comprised 28 healthy men (age 30-73 years) and 38 healthy women (age 34-74 years), who completed balance platform testing, cognitive assessment, and structural MRI. The results supported the hypothesis that excessive postural sway would be greater in older than younger healthy individuals when standing without sensory or stance aids, and that introduction of such aids would reduce sway in both principal directions (anterior-posterior and medial-lateral) and in both the open-loop and closed-loop components of postural control even in older individuals. Sway reduction with stance stabilization, that is, standing with feet apart, was greater in men than women, probably because older men were less stable than women when standing with their feet together. Greater sway was related to evidence for greater brain structural involutional changes, indexed as ventricular and sulcal enlargement and white matter hyperintensity burden. In women, poorer cognitive test performance related to less sway reduction with the use of sensory aids. Thus, aging men and women were shown to have diminished postural control, associated with cognitive and brain structural involution, in unstable stance conditions and with diminished sensory input.
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Haut MW, Moran MT, Lancaster MA, Kuwabara H, Parsons MW, Puce A. White Matter Correlates of Cognitive Capacity Studied With Diffusion Tensor Imaging: Implications for Cognitive Reserve. Brain Imaging Behav 2007. [DOI: 10.1007/s11682-007-9008-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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de Souza-Talarico JN, Caramelli P, Nitrini R, Chaves EC. The influence of schooling on working memory performance in elderly individuals without cognitive decline. Dement Neuropsychol 2007; 1:276-281. [PMID: 29213401 PMCID: PMC5619006 DOI: 10.1590/s1980-57642008dn10300009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Over recent decades, research on cognition has been developed rapidly toward
better understanding the cognitive changes that usually occur during normal
aging. There is evidence that elderly individuals have worse working memory
performance than young adults. However, the effect of education on this
cognitive function remains unclear.
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Affiliation(s)
- Juliana Nery de Souza-Talarico
- MSc, Nursing School Post-Graduation Program, Department of Medical-Surgical Nursing of the University of São Paulo Nursing School and Behavioral and Cognitive Neurology Unit, Department of Neurology, Hospital das Clinicas of the University of São Paulo School Medicine., São Paulo, SP, Brazil
| | - Paulo Caramelli
- MD, PhD, Behavioral and Cognitive Neurology Unit, Department of Internal Medicine, Faculty of Medicine of the Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ricardo Nitrini
- MD, PhD, Behavioral and Cognitive Neurology Unit, Department of Neurology and Cognitive Disorders Reference Center (CEREDIC). Hospital das Clinicas of the University of São Paulo School Medicine, São Paulo, SP, Brazil
| | - Eliane Corrêa Chaves
- PhD, Department of Medical-Surgical Nursing of the University of São Paulo Nursing School, São Paulo, SP, Brazil
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