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Fujita K, Sugimoto T, Noma H, Kuroda Y, Matsumoto N, Uchida K, Kishino Y, Sakurai T. Postural Control Characteristics in Alzheimer's Disease, Dementia With Lewy Bodies, and Vascular Dementia. J Gerontol A Biol Sci Med Sci 2024; 79:glae061. [PMID: 38412449 PMCID: PMC10949438 DOI: 10.1093/gerona/glae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Dementia often results in postural control impairment, which could signify central nervous system dysfunction. However, no studies have compared postural control characteristics among various types of dementia. This study aimed to compare static postural control in patients with Alzheimer's disease (AD), dementia with Lewy bodies (DLB), and vascular dementia (VaD). METHODS Cross-sectional relationship between the clinical diagnoses (AD, DLB, VaD, or normal cognition [NC]) of outpatients at a memory clinic and their upright postural control characteristics were examined. In the postural control test, participants were instructed to maintain a static upright standing on a stabilometer for 60 seconds under the eyes-open and eyes-closed conditions. Forty postural control parameters, including distance, position, and velocity in the anterior-posterior and medio-lateral directions, derived from the trajectory of the center of mass sway, were calculated. The characteristics of each type of dementia were compared to those of NC, and the differences among the 3 types of dementia were evaluated using linear regression models. RESULTS The study included 1 789 participants (1 206 with AD, 111 with DLB, 49 with VaD, and 423 with NC). Patients with AD exhibited distinct postural control characteristics, particularly in some distance and velocity parameters, only in the eyes-closed condition. Those with DLB exhibited features in the mean position in the anterior-posterior direction. In patients with VaD, significant differences were observed in most parameters, except the power spectrum. CONCLUSIONS Patients with AD, DLB, and VaD display disease-specific postural control characteristics when compared to cognitively normal individuals.
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Affiliation(s)
- Kosuke Fujita
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Morioka, Obu, Aichi, Japan
- Japan Society for the Promotion of Science, Kojimachi, Chiyoda, Tokyo, Japan
| | - Taiki Sugimoto
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Morioka, Obu, Aichi, Japan
| | - Hisashi Noma
- Department of Data Science, Institute of Statistical Mathematics, Midori-cho, Tachikawa, Tokyo, Japan
| | - Yujiro Kuroda
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Morioka, Obu, Aichi, Japan
| | - Nanae Matsumoto
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Morioka, Obu, Aichi, Japan
| | - Kazuaki Uchida
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Morioka, Obu, Aichi, Japan
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Tomogaoka, Suma, Kobe, Hyogo, Japan
| | - Yoshinobu Kishino
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Morioka, Obu, Aichi, Japan
- Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Furo, Chikusa, Nagoya, Aichi, Japan
| | - Takashi Sakurai
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Morioka, Obu, Aichi, Japan
- Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Furo, Chikusa, Nagoya, Aichi, Japan
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Qaisar R, Karim A, Iqbal MS, Ahmad F, Shaikh A, Kamli H, Khamjan NA. A leaky gut contributes to postural dysfunction in patients with Alzheimer's disease. Heliyon 2023; 9:e19485. [PMID: 37662779 PMCID: PMC10472051 DOI: 10.1016/j.heliyon.2023.e19485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/19/2023] [Accepted: 08/23/2023] [Indexed: 09/05/2023] Open
Abstract
Background Postural dysfunction is a common problem in patients with Alzheimer's disease (AD) and may lead to functional dependency and increasing morbidity and mortality. However, the pathophysiology of postural dysfunction in AD patients remains poorly understood. Objectives Elevated intestinal permeability is an underlying contributor to multiple diseases, including AD. We aimed to investigate the association of elevated intestinal permeability with postural dysfunction in AD patients. Design Setting Participants Measurements We conducted a cross-sectional, observational study on older adults, including controls and AD patients. We investigated the associations of postural balance with plasma zonulin, a marker of elevated intestinal permeability in geriatric controls (n = 74) and patients with mild (n = 71) and moderate (n = 66) AD. We used a standardized physical performance battery to measure balance in supine, tandem, and semi-tandem positions. We also measured handgrip strength (HGS), and gait speed as markers of physical capacity. Results AD patients exhibited lower balance scores, HGS, and gait speed and higher plasma zonulin than in controls (all p < 0.05). Plasma zonulin levels demonstrated significant areas under the curves in diagnosing poor balance in AD patients (all p < 0.05). Moderate AD was associated with lower balance and physical capacity, and higher zonulin than mild AD (ALL P < 0.05). Poor scores on balance scale were associated with higher expressions of markers of inflammation, oxidative stress, and muscle damage providing a mechanistic link between increased intestinal permeability and postural dysfunction in AD patients. Conclusion The results of our study show that plasma zonulin measurement may be used to diagnose postural dysfunction in AD patients. The study is relevant to non-ambulant and/or comatose AD patients with postural dysfunction. Our findings also highlight the therapeutic potential of repairing the intestinal leak to improve postural control and reduce the risk of falls in AD patients.
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Affiliation(s)
- Rizwan Qaisar
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Asima Karim
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - M. Shahid Iqbal
- Department of Neurology and Stroke Medicine, Rehman Medical Institute, Peshawar, Pakistan
| | - Firdos Ahmad
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Biomedical Sciences, College of Health Sciences, Abu Dhabi University, Abu Dhabi, 59911, United Arab Emirates
| | - Ahmad Shaikh
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Hossam Kamli
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Nizar A. Khamjan
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Jazan University, Jazan, 45142, Saudi Arabia
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Avraham O, Chamessian A, Feng R, Yang L, Halevi AE, Moore AM, Gereau RW, Cavalli V. Profiling the molecular signature of satellite glial cells at the single cell level reveals high similarities between rodents and humans. Pain 2022; 163:2348-2364. [PMID: 35503034 PMCID: PMC9522926 DOI: 10.1097/j.pain.0000000000002628] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 02/23/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT Peripheral sensory neurons located in dorsal root ganglia relay sensory information from the peripheral tissue to the brain. Satellite glial cells (SGCs) are unique glial cells that form an envelope completely surrounding each sensory neuron soma. This organization allows for close bidirectional communication between the neuron and its surrounding glial coat. Morphological and molecular changes in SGC have been observed in multiple pathological conditions such as inflammation, chemotherapy-induced neuropathy, viral infection, and nerve injuries. There is evidence that changes in SGC contribute to chronic pain by augmenting the neuronal activity in various rodent pain models. Satellite glial cells also play a critical role in axon regeneration. Whether findings made in rodent model systems are relevant to human physiology have not been investigated. Here, we present a detailed characterization of the transcriptional profile of SGC in mice, rats, and humans at the single cell level. Our findings suggest that key features of SGC in rodent models are conserved in humans. Our study provides the potential to leverage rodent SGC properties and identify potential targets in humans for the treatment of nerve injuries and alleviation of painful conditions.
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Affiliation(s)
- Oshri Avraham
- Department of Neuroscience, Washington University School of Medicine, St Louis 63110, Missouri, USA
| | - Alexander Chamessian
- Washington University Pain Center and Department of Anesthesiology, Washington University School of Medicine, St Louis 63110, Missouri, USA
- Department of Neurology, Washington University School of Medicine, St Louis 63110, Missouri, USA
| | - Rui Feng
- Department of Neuroscience, Washington University School of Medicine, St Louis 63110, Missouri, USA
| | - Lite Yang
- Washington University Pain Center and Department of Anesthesiology, Washington University School of Medicine, St Louis 63110, Missouri, USA
- Neuroscience Program, Washington University School of Medicine, St Louis 63110, Missouri, USA
| | - Alexandra E. Halevi
- Department of Plastic and Reconstructive Surgery, Washington University School of Medicine, St Louis 63110, Missouri, USA
| | - Amy M. Moore
- Department of Plastic and Reconstructive Surgery, The Ohio State University, Columbus Ohio, USA
| | - Robert W. Gereau
- Washington University Pain Center and Department of Anesthesiology, Washington University School of Medicine, St Louis 63110, Missouri, USA
| | - Valeria Cavalli
- Department of Neuroscience, Washington University School of Medicine, St Louis 63110, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri 63110, USA
- Center of Regenerative Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Michalak KP, Przekoracka K. A new approach to body balance analysis based on the eight-phase posturographic signal decomposition. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Koppelmans V, Silvester B, Duff K. Neural Mechanisms of Motor Dysfunction in Mild Cognitive Impairment and Alzheimer’s Disease: A Systematic Review. J Alzheimers Dis Rep 2022; 6:307-344. [PMID: 35891638 PMCID: PMC9277676 DOI: 10.3233/adr-210065] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/23/2022] [Indexed: 12/20/2022] Open
Abstract
Background: Despite the prevalence of motor symptoms in mild cognitive impairment (MCI) and Alzheimer’s disease (AD), their underlying neural mechanisms have not been thoroughly studied. Objective: This review summarizes the neural underpinnings of motor deficits in MCI and AD. Methods: We searched PubMed up until August of 2021 and identified 37 articles on neuroimaging of motor function in MCI and AD. Study bias was evaluated based on sample size, availability of control samples, and definition of the study population in terms of diagnosis. Results: The majority of studies investigated gait, showing that slower gait was associated with smaller hippocampal volume and prefrontal deactivation. Less prefrontal activation was also observed during cognitive-motor dual tasking, while more activation in cerebellar, cingulate, cuneal, somatosensory, and fusiform brain regions was observed when performing a hand squeezing task. Excessive subcortical white matter lesions in AD were associated with more signs of parkinsonism, poorer performance during a cognitive and motor dual task, and poorer functional mobility. Gait and cognitive dual-tasking was furthermore associated with cortical thickness of temporal lobe regions. Most non-gait motor measures were only reported in one study in relation to neural measures. Conclusion: Cross-sectional designs, lack of control groups, mixing amnestic- and non-amnestic MCI, disregard of sex differences, and small sample sizes limited the interpretation of several studies, which needs to be addressed in future research to progress the field.
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Affiliation(s)
- Vincent Koppelmans
- Department of Psychiatry, University of Utah, SaltLake City, UT, USA
- Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA
| | - Benjamin Silvester
- Department of Psychiatry, University of Utah, SaltLake City, UT, USA
- Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Department of Neurology, University of Utah, SaltLake City, UT, USA
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Teh CSL, Mah MC, Rahmat K, Prepageran N. Neuroimaging Systematic Review in Persistent Postural-Perceptual Dizziness: The Elaborate Alterations in the Delicate Network to Remain Balanced. Otol Neurotol 2022; 43:12-22. [PMID: 34669685 DOI: 10.1097/mao.0000000000003389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder that may have normal physical examination, clinical laboratory testing and vestibular evaluation. However, advances in neuroimaging have provided new insights in brain functional connectivity and structure in patients with PPPD. This systematic review was aimed at identifying significant structural or alterations in functional connectivity in patients with PPPD. DATABASES REVIEWED Science Direct, Pubmed, Embase via Ovid databases, and Cochrane library. METHODS This review following the guidelines of PRISMA, systematically and independently examined papers published up to March 2021 which fulfilled the predetermined criteria. PROSPERO Registration (CRD42020222334). RESULTS A total of 15 studies were included (MRI = 4, SPECT = 1, resting state fMRI = 4, task-based fMRI = 5, task-based fMRI + MRI = 1). Significant changes in the gray matter volume, cortical folding, blood flow, and connectivity were seen at different brain regions involved in vestibular, visual, emotion, and motor processing. CONCLUSION There is a multisensory dimension to the impairment resulting in chronic compensatory changes in PPPD that is evident by the significant alterations in multiple networks involved in maintaining balance. These changes observed offer some explanation for the symptoms that a PPPD patient may experience.Systematic Review Registration: This study is registered with PROSPERO (CRD42020222334).
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Affiliation(s)
- Carren Sui-Lin Teh
- Department of Otorhinolaryngology, Hospital Sungai Buloh, Selangor, Malaysia
| | - Michelle Clare Mah
- Center for Oral and Maxillofacial Surgery Studies, Faculty of Dentistry, University Teknologi MARA, Selangor, Malaysia
| | - Kartini Rahmat
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya
| | - Narayanan Prepageran
- Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Ashiri M, Francisco C, Winkler J, Lithgow B, Moussavi Z. Postural Sway Characteristics Are Affected by Alzheimer's Disease. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:7219-7222. [PMID: 34892765 DOI: 10.1109/embc46164.2021.9630746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The vestibular system, responsible for balance, is affected by Alzheimer's disease (AD). In this paper, linear and non-linear balance features were used to assess the postural stability of 13 AD individuals at mild stages in comparison with 16 healthy controls. Utilizing two accelerometers, the anterior-posterior (AP) and medial-lateral (ML) sways were recorded from the T2 vertebrae and lateral malleolus of participants standing on a solid and soft foam surface under both eyes-open and eyes-closed conditions. From the recorded signals, four features were extracted and used for statistical analysis: Number of Position Changes (NPC), Number of Non-Zero Accelerations (NNZA), Katz, and Higuchi fractal dimensions (KFD and HFD, respectively). The results show: 1) postural stability is significantly worse for the eyes-closed compared to eyes-open condition (P<0.05 for all features except HFD) as well as whilst standing on soft foam compared to the solid surface (P<0.05 for all features) in both groups; 2) balance perturbations were larger for AP sway than ML on both solid and foam surfaces in both groups (P<0.05 for NPC and NNZA); and 3) stationary balance is significantly poorer for AD individuals compared to controls (P<0.05 for all features). These observations show that both linear and non-linear characteristics of postural stability data have the potentials to be used as objective diagnostic aids for the detection of AD.
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Poirier G, Ohayon A, Juranville A, Mourey F, Gaveau J. Deterioration, Compensation and Motor Control Processes in Healthy Aging, Mild Cognitive Impairment and Alzheimer's Disease. Geriatrics (Basel) 2021; 6:33. [PMID: 33807008 PMCID: PMC8006018 DOI: 10.3390/geriatrics6010033] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 01/07/2023] Open
Abstract
Aging is associated with modifications of several brain structures and functions. These modifications then manifest as modified behaviors. It has been proposed that some brain function modifications may compensate for some other deteriorated ones, thus maintaining behavioral performance. Through the concept of compensation versus deterioration, this article reviews the literature on motor function in healthy and pathological aging. We first highlight mechanistic studies that used paradigms, allowing us to identify precise compensation mechanisms in healthy aging. Subsequently, we review studies investigating motor function in two often-associated neurological conditions, i.e., mild cognitive impairment and Alzheimer's disease. We point out the need to expand the knowledge gained from descriptive studies with studies targeting specific motor control processes. Teasing apart deteriorated versus compensating processes represents precious knowledge that could significantly improve the prevention and rehabilitation of age-related loss of mobility.
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Affiliation(s)
- Gabriel Poirier
- INSERM U1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000 Dijon, France; (A.O.); (A.J.); (F.M.); (J.G.)
- Espace d’Étude du Mouvement—Étienne Jules MAREY, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000 Dijon, France
| | - Alice Ohayon
- INSERM U1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000 Dijon, France; (A.O.); (A.J.); (F.M.); (J.G.)
| | - Adrien Juranville
- INSERM U1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000 Dijon, France; (A.O.); (A.J.); (F.M.); (J.G.)
| | - France Mourey
- INSERM U1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000 Dijon, France; (A.O.); (A.J.); (F.M.); (J.G.)
- Espace d’Étude du Mouvement—Étienne Jules MAREY, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000 Dijon, France
| | - Jeremie Gaveau
- INSERM U1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000 Dijon, France; (A.O.); (A.J.); (F.M.); (J.G.)
- Espace d’Étude du Mouvement—Étienne Jules MAREY, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21000 Dijon, France
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9
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Fifteen Years of Wireless Sensors for Balance Assessment in Neurological Disorders. SENSORS 2020; 20:s20113247. [PMID: 32517315 PMCID: PMC7308812 DOI: 10.3390/s20113247] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/25/2020] [Accepted: 06/03/2020] [Indexed: 12/12/2022]
Abstract
Balance impairment is a major mechanism behind falling along with environmental hazards. Under physiological conditions, ageing leads to a progressive decline in balance control per se. Moreover, various neurological disorders further increase the risk of falls by deteriorating specific nervous system functions contributing to balance. Over the last 15 years, significant advancements in technology have provided wearable solutions for balance evaluation and the management of postural instability in patients with neurological disorders. This narrative review aims to address the topic of balance and wireless sensors in several neurological disorders, including Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, stroke, and other neurodegenerative and acute clinical syndromes. The review discusses the physiological and pathophysiological bases of balance in neurological disorders as well as the traditional and innovative instruments currently available for balance assessment. The technical and clinical perspectives of wearable technologies, as well as current challenges in the field of teleneurology, are also examined.
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Jenkins LM, Garner CR, Kurian S, Higgins JP, Parrish TB, Sedaghat S, Nemeth AJ, Lloyd-Jones DM, Launer LJ, Hausdorff JM, Wang L, Sorond FA. Cumulative Blood Pressure Exposure, Basal Ganglia, and Thalamic Morphology in Midlife. Hypertension 2020; 75:1289-1295. [PMID: 32223376 DOI: 10.1161/hypertensionaha.120.14678] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
High blood pressure (BP) negatively affects brain structure and function. Hypertension is associated with white matter hyperintensities, cognitive and mobility impairment in late-life. However, the impact of BP exposure from young adulthood on brain structure and function in mid-life is unclear. Identifying early brain structural changes associated with BP exposure, before clinical onset of cognitive dysfunction and mobility impairment, is essential for understanding mechanisms and developing interventions. We examined the effect of cumulative BP exposure from young adulthood on brain structure in a substudy of 144 (61 female) individuals from the CARDIA (Coronary Artery Risk Development in Young Adults) study. At year 30 (Y30, ninth visit), participants (56±4 years old) completed brain magnetic resonance imaging and gait measures (pace, rhythm, and postural control). Cumulative systolic and diastolic BP (cumulative systolic blood pressure, cDBP) over 9 visits were calculated, multiplying mean values between 2 consecutive visits by years between visits. Surface-based analysis of basal ganglia and thalamus was achieved using FreeSurfer-initiated Large Deformation Diffeomorphic Metric Mapping. Morphometric changes were regressed onto cumulative BP to localize regions of shape variation. Y30 white matter hyperintensity volumes were small and positively correlated with cumulative BP but not gait. Negative morphometric associations with cumulative systolic blood pressure were seen in the caudate, putamen, nucleus accumbens, pallidum, and thalamus. A concave right medial putamen shape mediated the relationship between cumulative systolic blood pressure and stride width. Basal ganglia and thalamic morphometric changes, rather than volumes, may be earlier manifestation of gray matter structural signatures of BP exposure that impact midlife gait.
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Affiliation(s)
- Lisanne M Jenkins
- From the Department of Psychiatry and Behavioral Sciences (L.M.J., L.W.), Northwestern University, Chicago, IL
| | - Chaney R Garner
- Department of Neurology (C.R.G., S.K., S.S., A.J.N., F.A.S.), Northwestern University, Chicago, IL
| | - Shawn Kurian
- Department of Neurology (C.R.G., S.K., S.S., A.J.N., F.A.S.), Northwestern University, Chicago, IL
| | - James P Higgins
- Department of Radiology (J.P.H., T.B.P., A.J.N., L.W.), Northwestern University, Chicago, IL
| | - Todd B Parrish
- Department of Radiology (J.P.H., T.B.P., A.J.N., L.W.), Northwestern University, Chicago, IL
| | - Sanaz Sedaghat
- Department of Neurology (C.R.G., S.K., S.S., A.J.N., F.A.S.), Northwestern University, Chicago, IL.,Department of Preventive Medicine (S.S., D.M.L.-J.), Northwestern University, Chicago, IL
| | - Alexander J Nemeth
- Department of Neurology (C.R.G., S.K., S.S., A.J.N., F.A.S.), Northwestern University, Chicago, IL.,Department of Radiology (J.P.H., T.B.P., A.J.N., L.W.), Northwestern University, Chicago, IL
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine (S.S., D.M.L.-J.), Northwestern University, Chicago, IL
| | | | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center (J.M.H.)
| | - Lei Wang
- From the Department of Psychiatry and Behavioral Sciences (L.M.J., L.W.), Northwestern University, Chicago, IL.,Department of Radiology (J.P.H., T.B.P., A.J.N., L.W.), Northwestern University, Chicago, IL
| | - Farzaneh A Sorond
- Department of Neurology (C.R.G., S.K., S.S., A.J.N., F.A.S.), Northwestern University, Chicago, IL
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Sparto PJ, Rosso AL, Divecha AA, Metti AL, Rosano C. Shared neural substrates of cognitive function and postural control in older adults. Alzheimers Dement 2020; 16:621-629. [PMID: 32147950 DOI: 10.1002/alz.12053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 10/04/2019] [Accepted: 12/05/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Poor cognitive function and postural control co-occur in older adults. It is unclear whether they share neural substrates. METHODS Postural sway error during a novel visual tracking (VT) condition and gray matter volume (GMV) were compared between participants with normal cognition (NC), mild cognitive impairment (MCI), or dementia (n = 179, mean age 82, 56% females, 56% white). Associations between VT error, cognitive function, and GMV were examined. RESULTS Greater VT error was associated with having dementia compared to NC or MCI (odds ratio [95% CI] = 2.15 [1.38, 3.36] and 1.58 [1.05, 2.38]). Regions with lower GMV related to greater VT error and worse cognition were: bilateral hippocampi, parahippocampi, entorhinal, and parietal cortices (all P ≤0.05). GMV of bilateral hippocampi and left parahippocampus explained >20% of VT error between dementia and NC. DISCUSSION Postural control during visuospatial tasks and dementia may share neural substrates, specifically memory-related regions.
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Affiliation(s)
- Patrick J Sparto
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School, of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ayushi A Divecha
- Department of Epidemiology, Graduate School, of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea L Metti
- Department of Epidemiology, Graduate School, of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Caterina Rosano
- Department of Epidemiology, Graduate School, of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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12
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Surgent OJ, Dadalko OI, Pickett KA, Travers BG. Balance and the brain: A review of structural brain correlates of postural balance and balance training in humans. Gait Posture 2019; 71:245-252. [PMID: 31082657 PMCID: PMC6594858 DOI: 10.1016/j.gaitpost.2019.05.011] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 05/03/2019] [Accepted: 05/05/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Balance challenges are associated with not only the aging process but also a wide variety of psychiatric and neurological disorders. However, relatively little is known regarding the neural basis of balance and the effects of balance interventions on the brain. RESEARCH QUESTION This review synthesizes the existing literature to answer the question: What are the key brain structures associated with balance? METHODS This review examined 37 studies that assessed brain structures in relation to balance assessment or intervention. These studies provided 234 findings implicating 71 brain structures. The frequency of implication for each structure was examined based upon specific methodological parameters, including study design (assessment/intervention), type of balance measured (static/dynamic), population (clinical/non-clinical), and imaging analysis technique (region of interest [ROI]/voxel-based morphometry [VBM]). RESULTS Although a number of structures were associated with balance across the brain, the most frequently implicated structures included the cerebellum, basal ganglia, thalamus, hippocampus, inferior parietal cortex, and frontal lobe regions. Findings in the cerebellum and brainstem were most common in studies with clinical populations, studies that used an ROI approach, and studies that measured dynamic balance. Findings in the frontal, occipital, and parietal regions were also more common in studies that measured dynamic compared to static balance. SIGNIFICANCE While balance appears to be a whole-brain phenomenon, a subset of structures appear to play a key role in balance and are likely implicated in balance disorders. Some of these structures (i.e., the cerebellum, basal ganglia and thalamus) have a well-appreciated role in balance, whereas other regions (i.e., hippocampus and inferior parietal cortex) are not commonly thought to be associated with balance and therefore may provide alternative explanations for the neural basis of balance. Key avenues for future research include understanding the roles of all regions involved in balance across the lifespan and in different clinical populations.
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Affiliation(s)
- Olivia J. Surgent
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA.,Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI 53705, USA.,Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, Wisconsin, 53719, USA
| | - Olga I. Dadalko
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA
| | - Kristen A. Pickett
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI 53706, USA.,Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Brittany G. Travers
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA.,Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI 53706, USA
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13
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Morasso P, Cherif A, Zenzeri J. Quiet standing: The Single Inverted Pendulum model is not so bad after all. PLoS One 2019; 14:e0213870. [PMID: 30897124 PMCID: PMC6428281 DOI: 10.1371/journal.pone.0213870] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/01/2019] [Indexed: 11/19/2022] Open
Abstract
In the study of balance and postural control the (Single) Inverted Pendulum model (SIP) has been taken for a long time as an acceptable paradigm, with the implicit assumption that only ankle rotations are relevant for describing and explaining sway movements. However, more recent kinematic analysis of quiet standing revealed that hip motion cannot be neglected at all and that ankle-hip oscillatory patterns are characterized by complex in-phase and anti-phase interactions, suggesting that the SIP model should be substituted by a DIP (Double Inverted Pendulum) model. It was also suggested that DIP control could be characterized as a kind of optimal bi-axial active controller whose goal is minimizing the acceleration of the global CoM (Center of Mass). We propose here an alternative where active feedback control is applied in an intermittent manner only to the ankle joint, whereas the hip joint is stabilized by a passive stiffness mechanism. The active control impulses are delivered to the ankle joint as a function of the delayed state vector (tilt rotation angle + tilt rotational speed) of a Virtual Inverted Pendulum (VIP), namely a pendulum that links the ankle to the CoM, embedded in the real DIP. Simulations of such DIP/VIP model, with the hybrid control mechanism, show that it can reproduce the in-phase/anti-phase interaction patterns of the two joints described by several experimental studies. Moreover, the simulations demonstrate that the DIP/VIP model can also reproduce the measured minimization of the CoM acceleration, as an indirect biomechanical consequence of the dynamic interaction between the active control of the ankle joint and the passive control of the hip joint. We suggest that although the SIP model is literally false, because it ignores the ankle-hip coordination, it is functionally correct and practically acceptable for experimental studies that focus on the postural oscillations of the CoM.
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Affiliation(s)
- Pietro Morasso
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Amel Cherif
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
- Department of Informatics, Bioengineering, Robotics, and System Engineering, University of Genoa, Genoa, Italy
| | - Jacopo Zenzeri
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
- * E-mail:
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14
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Sekhon H, Launay CP, Chabot J, Allali G, Beauchet O. Motoric Cognitive Risk Syndrome: Could It Be Defined Through Increased Five-Times-Sit-to-Stand Test Time, Rather Than Slow Walking Speed? Front Aging Neurosci 2019; 10:434. [PMID: 30766485 PMCID: PMC6366305 DOI: 10.3389/fnagi.2018.00434] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/19/2018] [Indexed: 11/22/2022] Open
Abstract
Background: Slow walking speed, time to perform the five-times-sit-to-stand (FTSS) test and motoric cognitive risk syndrome (MCR; defined as slow gait speed combined with subjective cognitive complaint) have been separately used to screen older individuals at risk of cognitive decline. This study seeks to (1) compare the characteristics of older individuals with MCR, as defined through slow walking speed and/or increased FTSS time; and (2) examine the relationship between MCR and its motor components as well as amnestic (a-MCI) and non-amnestic (na-MCI) Mild Cognitive Impairment. Methods: A total of 633, individuals free of dementia, were selected from the cross-sectional “Gait and Alzheimer Interactions Tracking” study. Slow gait speed and increased FTSS time were used as criteria for the definition of MCR. Participants were separated into five groups, according to MCR status: MCR as defined by (1) slow gait speed exclusively (MCRs); (2) increased FTSS time exclusively (MCRf); (3) slow gait speed and increased FTSS time (MCRsaf); (4) MCR; irrespective of the mobility test used (MCRsof); and (5) the absence of MCR. Cognitive status (i.e., a-MCI, na-MCI, cognitively healthy) was also determined. Results: The prevalence of MCRs was higher, when compared to the prevalence of MCRf (12.0% versus 6.2% with P ≤ 0.001). There existed infrequent overlap (2.4%) between individuals exhibiting MCRs and MCRf, and frequent overlap between individuals exhibiting MCRs and na-MCI (up to 50%). a-MCI and na-MCI were negatively [odd ratios (OR) ≤ 0.17 with P ≤ 0.019] and positively (OR ≥ 2.41 with P ≤ 0.019) related to MCRs, respectively. Conclusion: Individuals with MCRf are distinct from those with MCRs. MCRf status does not relate to MCI status in the same way that MCRs does. MCRs is related negatively to a-MCI and positively to na-MCI. These results suggest that FTTS cannot be used to define MCR when the goal is to predict the risk of cognitive decline, such as future dementia.
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Affiliation(s)
- Harmehr Sekhon
- Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.,Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Cyrille P Launay
- Geriatric Medicine and Geriatric Rehabilitation Service, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Julia Chabot
- Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.,Division of Geriatric Medicine, Department of Medicine, St. Mary's Hospital Center, McGill University, Montreal, QC, Canada
| | - Gilles Allali
- Department of Neurology, Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Olivier Beauchet
- Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.,Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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15
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Kautzky A, Seiger R, Hahn A, Fischer P, Krampla W, Kasper S, Kovacs GG, Lanzenberger R. Prediction of Autopsy Verified Neuropathological Change of Alzheimer's Disease Using Machine Learning and MRI. Front Aging Neurosci 2018; 10:406. [PMID: 30618713 PMCID: PMC6295575 DOI: 10.3389/fnagi.2018.00406] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/26/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Alzheimer’s disease (AD) is the most common form of dementia. While neuropathological changes pathognomonic for AD have been defined, early detection of AD prior to cognitive impairment in the clinical setting is still lacking. Pioneer studies applying machine learning to magnetic-resonance imaging (MRI) data to predict mild cognitive impairment (MCI) or AD have yielded high accuracies, however, an algorithm predicting neuropathological change is still lacking. The objective of this study was to compute a prediction model supporting a more distinct diagnostic criterium for AD compared to clinical presentation, allowing identification of hallmark changes even before symptoms occur. Methods: Autopsy verified neuropathological changes attributed to AD, as described by a combined score for Aβ-peptides, neurofibrillary tangles and neuritic plaques issued by the National Institute on Aging – Alzheimer’s Association (NIAA), the ABC score for AD, were predicted from structural MRI data with RandomForest (RF). MRI scans were performed at least 2 years prior to death. All subjects derive from the prospective Vienna Trans-Danube Aging (VITA) study that targeted all 1750 inhabitants of the age of 75 in the starting year of 2000 in two districts of Vienna and included irregular follow-ups until death, irrespective of clinical symptoms or diagnoses. For 68 subjects MRI as well as neuropathological data were available and 49 subjects (mean age at death: 82.8 ± 2.9, 29 female) with sufficient MRI data quality were enrolled for further statistical analysis using nested cross-validation (CV). The decoding data of the inner loop was used for variable selection and parameter optimization with a fivefold CV design, the new data of the outer loop was used for model validation with optimal settings in a fivefold CV design. The whole procedure was performed ten times and average accuracies with standard deviations were reported. Results: The most informative ROIs included caudal and rostral anterior cingulate gyrus, entorhinal, fusiform and insular cortex and the subcortical ROIs anterior corpus callosum and the left vessel, a ROI comprising lacunar alterations in inferior putamen and pallidum. The resulting prediction models achieved an average accuracy for a three leveled NIAA AD score of 0.62 within the decoding sets and of 0.61 for validation sets. Higher accuracies of 0.77 for both sets, respectively, were achieved when predicting presence or absence of neuropathological change. Conclusion: Computer-aided prediction of neuropathological change according to the categorical NIAA score in AD, that currently can only be assessed post-mortem, may facilitate a more distinct and definite categorization of AD dementia. Reliable detection of neuropathological hallmarks of AD would enable risk stratification at an earlier level than prediction of MCI or clinical AD symptoms and advance precision medicine in neuropsychiatry.
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Affiliation(s)
- Alexander Kautzky
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Rene Seiger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Andreas Hahn
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Peter Fischer
- Department of Psychiatry, Danube Hospital, Medical Research Society Vienna D.C., Vienna, Austria
| | | | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Gabor G Kovacs
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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