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Hu H, Wang L, Abdul S, Tang X, Feng Q, Mu Y, Ge X, Liao Z, Ding Z. Frequency-dependent alterations in functional connectivity in patients with Alzheimer's Disease spectrum disorders. Front Aging Neurosci 2024; 16:1375836. [PMID: 38605859 PMCID: PMC11007178 DOI: 10.3389/fnagi.2024.1375836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/04/2024] [Indexed: 04/13/2024] Open
Abstract
Background In the spectrum of Alzheimer's Disease (AD) and related disorders, the resting-state functional magnetic resonance imaging (rs-fMRI) signals within the cerebral cortex may exhibit distinct characteristics across various frequency ranges. Nevertheless, this hypothesis has not yet been substantiated within the broader context of whole-brain functional connectivity. This study aims to explore potential modifications in degree centrality (DC) and voxel-mirrored homotopic connectivity (VMHC) among individuals with amnestic mild cognitive impairment (aMCI) and AD, while assessing whether these alterations differ across distinct frequency bands. Methods This investigation encompassed a total of 53 AD patients, 40 aMCI patients, and 40 healthy controls (HCs). DC and VMHC values were computed within three distinct frequency bands: classical (0.01-0.08 Hz), slow-4 (0.027-0.073 Hz), and slow-5 (0.01-0.027 Hz) for the three respective groups. To discern differences among these groups, ANOVA and subsequent post hoc two-sample t-tests were employed. Cognitive function assessment utilized the mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA). Pearson correlation analysis was applied to investigate the associations between MMSE and MoCA scores with DC and VMHC. Results Significant variations in degree centrality (DC) were observed among different groups across diverse frequency bands. The most notable differences were identified in the bilateral caudate nucleus (CN), bilateral medial superior frontal gyrus (mSFG), bilateral Lobule VIII of the cerebellar hemisphere (Lobule VIII), left precuneus (PCu), right Lobule VI of the cerebellar hemisphere (Lobule VI), and right Lobule IV and V of the cerebellar hemisphere (Lobule IV, V). Likewise, disparities in voxel-mirrored homotopic connectivity (VMHC) among groups were predominantly localized to the posterior cingulate gyrus (PCG) and Crus II of the cerebellar hemisphere (Crus II). Across the three frequency bands, the brain regions exhibiting significant differences in various parameters were most abundant in the slow-5 frequency band. Conclusion This study enhances our understanding of the pathological and physiological mechanisms associated with AD continuum. Moreover, it underscores the importance of researchers considering various frequency bands in their investigations of brain function.
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Affiliation(s)
- Hanjun Hu
- The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Luoyu Wang
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
- School of Biomedical Engineering, Shanghai Tech University, Shanghai, China
| | - Sammad Abdul
- International Education College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xue Tang
- School of Medical Imaging, Hangzhou Medical College, Hangzhou, China
| | - Qi Feng
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Yuzhu Mu
- The Fourth Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Xiuhong Ge
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
| | - Zhengluan Liao
- Department of Psychiatry, Zhejiang Provincial People’s Hospital/People’s Hospital of Hangzhou Medical College, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology, Hangzhou First People's Hospital, Hangzhou, China
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Iskusnykh IY, Zakharova AA, Kryl’skii ED, Popova TN. Aging, Neurodegenerative Disorders, and Cerebellum. Int J Mol Sci 2024; 25:1018. [PMID: 38256091 PMCID: PMC10815822 DOI: 10.3390/ijms25021018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
An important part of the central nervous system (CNS), the cerebellum is involved in motor control, learning, reflex adaptation, and cognition. Diminished cerebellar function results in the motor and cognitive impairment observed in patients with neurodegenerative disorders such as Alzheimer's disease (AD), vascular dementia (VD), Parkinson's disease (PD), Huntington's disease (HD), spinal muscular atrophy (SMA), amyotrophic lateral sclerosis (ALS), Friedreich's ataxia (FRDA), and multiple sclerosis (MS), and even during the normal aging process. In most neurodegenerative disorders, impairment mainly occurs as a result of morphological changes over time, although during the early stages of some disorders such as AD, the cerebellum also serves a compensatory function. Biological aging is accompanied by changes in cerebellar circuits, which are predominantly involved in motor control. Despite decades of research, the functional contributions of the cerebellum and the underlying molecular mechanisms in aging and neurodegenerative disorders remain largely unknown. Therefore, this review will highlight the molecular and cellular events in the cerebellum that are disrupted during the process of aging and the development of neurodegenerative disorders. We believe that deeper insights into the pathophysiological mechanisms of the cerebellum during aging and the development of neurodegenerative disorders will be essential for the design of new effective strategies for neuroprotection and the alleviation of some neurodegenerative disorders.
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Affiliation(s)
- Igor Y. Iskusnykh
- Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Anastasia A. Zakharova
- Department of Medical Biochemistry, Faculty of Biomedicine, Pirogov Russian National Research Medical University, Ostrovitianov St. 1, Moscow 117997, Russia
| | - Evgenii D. Kryl’skii
- Department of Medical Biochemistry, Molecular and Cell Biology, Voronezh State University, Universitetskaya Sq. 1, Voronezh 394018, Russia; (E.D.K.)
| | - Tatyana N. Popova
- Department of Medical Biochemistry, Molecular and Cell Biology, Voronezh State University, Universitetskaya Sq. 1, Voronezh 394018, Russia; (E.D.K.)
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Chen H, Li M, Qin Z, Yang Z, Lv T, Yao W, Hu Z, Qin R, Zhao H, Bai F. Functional network connectivity patterns predicting the efficacy of repetitive transcranial magnetic stimulation in the spectrum of Alzheimer's disease. Eur Radiol Exp 2023; 7:63. [PMID: 37872457 PMCID: PMC10593644 DOI: 10.1186/s41747-023-00376-3] [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: 05/12/2023] [Accepted: 08/17/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Neuro-navigated repetitive transcranial magnetic stimulation (rTMS) is potentially effective in enhancing cognitive performance in the spectrum of Alzheimer's disease (AD). We explored the effect of rTMS-induced network reorganization and its predictive value for individual treatment response. METHODS Sixty-two amnestic mild cognitive impairment (aMCI) and AD patients were recruited. These subjects were assigned to multimodal magnetic resonance imaging scanning before and after a 4-week stimulation. Then, we investigated the neural mechanism underlying rTMS treatment based on static functional network connectivity (sFNC) and dynamic functional network connectivity (dFNC) analyses. Finally, the support vector regression was used to predict the individual rTMS treatment response through these functional features at baseline. RESULTS We found that rTMS at the left angular gyrus significantly induced cognitive improvement in multiple cognitive domains. Participants after rTMS treatment exhibited significantly the increased sFNC between the right frontoparietal network (rFPN) and left frontoparietal network (lFPN) and decreased sFNC between posterior visual network and medial visual network. We revealed remarkable dFNC characteristics of brain connectivity, which was increased mainly in higher-order cognitive networks and decreased in primary networks or between primary networks and higher-order cognitive networks. dFNC characteristics in state 1 and state 4 could further predict individual higher memory improvement after rTMS treatment (state 1, R = 0.58; state 4, R = 0.54). CONCLUSION Our findings highlight that neuro-navigated rTMS could suppress primary network connections to compensate for higher-order cognitive networks. Crucially, dynamic regulation of brain networks at baseline may serve as an individualized predictor of rTMS treatment response. RELEVANCE STATEMENT Dynamic reorganization of brain networks could predict the efficacy of repetitive transcranial magnetic stimulation in the spectrum of Alzheimer's disease. KEY POINTS • rTMS at the left angular gyrus could induce cognitive improvement. • rTMS could suppress primary network connections to compensate for higher-order networks. • Dynamic reorganization of brain networks could predict individual treatment response to rTMS.
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Affiliation(s)
- Haifeng Chen
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Mengyun Li
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhiming Qin
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhiyuan Yang
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Tingyu Lv
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Weina Yao
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zheqi Hu
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Ruomeng Qin
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Hui Zhao
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Feng Bai
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.
- Geriatric Medicine Center, Affiliated Hospital of Medical School, Taikang Xianlin Drum Tower Hospital, Nanjing University, Nanjing, China.
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Ruan Z, Gao L, Li S, Yu M, Rao B, Sun W, Zhou X, Li Y, Song X, Xu H. Functional abnormalities of the cerebellum in vascular mild cognitive impairment. Brain Imaging Behav 2023; 17:530-540. [PMID: 37433970 DOI: 10.1007/s11682-023-00783-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVES The alterations in cerebellar activity that occur in vascular mild cognitive impairment remain largely unexplored. This study aimed to investigate potential associations between abnormal cerebellar functional connectivity (FC) and changes in cognitive function by examining intracerebellar and cerebellar-cerebral FC. METHODS MRI data were collected from seventy-two patients with vascular mild cognitive impairment (VMCI), comprising 38 patients with small vessel mild cognitive impairment (SVMCI) and 34 with poststroke mild cognitive impairment (PSMCI), and from 43 demographically matched healthy controls (HCs). Changes in FC between subregions within the cerebellum and from each cerebellar subregion to the selected cerebral seed points in VMCI patients were calculated, and the association of these changes with cognitive function was examined. RESULTS Compared with HCs, we found that VMCI patients had 11 cerebellar subregions showing significant differences (mainly decreases) in FC with brain regions in the default-mode network (DMN), sensory-motor network (SMN), and frontoparietal network (FPN). In the intracerebellar FC analysis, 47 (8%) cerebellar connections had significant intergroup differences, mainly a reduced magnitude of FC in VMCI patients. In the correlation analysis, higher Montreal Cognitive Assessment (MoCA) scores were correlated with stronger intracerebellar FC (left crus II-right lobule VI, left crus II-right lobule VIIb) and cerebellar-cerebral FC (right lobule X-left precuneus, vermal lobule IX-right inferior parietal lobule) in both the SVMCI and PSMCI groups. CONCLUSION These findings suggest prominent intracerebellar and cerebellar-cerebral FC abnormalities in VMCI patients, contributing evidence for a possible role of the cerebellum in cognitive processes.
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Affiliation(s)
- Zhao Ruan
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, 430071, China
| | - Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, 430071, China
| | - Sirui Li
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, 430071, China
| | - Minhua Yu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, 430071, China
| | - Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, 430071, China
| | - Wenbo Sun
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, 430071, China
| | - Xiaoli Zhou
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, 430071, China
| | - Yidan Li
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, 430071, China
| | - Xiaopeng Song
- Department of Biomedical Engineering, College of Engineering, Peking University, No. 5 Yiheyuan Road, Haidian District, Beijing, 100871, China.
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, 430071, China.
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de Paula França Resende E, Lara VP, Santiago ALC, Friedlaender CV, Rosen HJ, Brown JA, Cobigo Y, Silva LLG, de Souza LC, Rincon L, Grinberg LT, Maciel FIP, Caramelli P. Literacy, but not memory, is associated with hippocampal connectivity in illiterate adults. RESEARCH SQUARE 2023:rs.3.rs-3053775. [PMID: 37398238 PMCID: PMC10312990 DOI: 10.21203/rs.3.rs-3053775/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background The influence of hippocampal connectivity on memory performance is well established in individuals with high educational attainment. However, the role of hippocampal connectivity in illiterate populations remains poorly understood. Methods Thirty-five illiterate adults were administered a literacy assessment (Test of Functional Health Literacy in Adults - TOFHLA), structural and resting state functional MRI and an episodic memory test (Free and Cued Selective Reminding Test). Illiteracy was defined as a TOFHLA score below 53. We evaluated the correlation between hippocampal connectivity at rest and both free recall and literacy scores. Results Participants were mostly female (57.1%) and Black (84.8%), with a median age of 50 years. The median TOFHLA literacy score was 28.0 [21.0;42.5] out of 100 points and the median free recall score was 30.0 [26.2;35] out of 48 points. The median gray matter volume of both the left and right hippocampi was 2.3 [2.1; 2.4] cm3. We observed a significant connectivity between both hippocampi and the precuneus and the ventral medial prefrontal cortex. Interestingly, the right hippocampal connectivity positively correlated with the literacy scores (β = 0.58, p = 0.008). There was no significant association between episodic memory and hippocampal connectivity. Neither memory nor literacy scores correlated with hippocampal gray matter volume. Conclusions Low literacy levels correlate with hippocampal connectivity in illiterate adults. The lack of association with memory scores might be associated with low brain reserve in illiterate adults.
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Yang M, Chen B, Zhou H, Mai N, Zhang M, Wu Z, Peng Q, Wang Q, Liu M, Zhang S, Lin G, Lao J, Zeng Y, Zhong X, Ning Y. Relationships Among Short Self-Reported Sleep Duration, Cognitive Impairment, and Insular Functional Connectivity in Late-Life Depression. J Alzheimers Dis 2023:JAD220968. [PMID: 37182865 DOI: 10.3233/jad-220968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Both late-life depression (LLD) and short sleep duration increase the risk of cognitive impairment. Increased insular resting-state functional connectivity (FC) has been reported in individuals with short sleep duration and dementia. OBJECTIVE This study aimed to investigate whether short sleep duration is associated with impaired cognition and higher insular FC in patients with LLD. METHODS This case- control study recruited 186 patients with LLD and 83 normal controls (NC), and comprehensive psychometric assessments, sleep duration reports and resting-state functional MRI scans (81 LLD patients and 54 NC) were conducted. RESULTS Patients with LLD and short sleep duration (LLD-SS patients) exhibited more severe depressive symptoms and worse cognitive function than those with normal sleep duration (LLD-NS patients) and NC. LLD-SS patients exhibited higher FC between the bilateral insula and inferior frontal gyrus (IFG) pars triangularis than LLD-NS patients and NC, while LLD-NS patients exhibited lower FC than NC. Increased insular FC was correlated with short sleep duration, severe depressive symptoms, and slower information processing speeds. Furthermore, an additive effect was found between sleep duration and LLD on global cognition and insular FC. CONCLUSION LLD-SS patients exhibited impaired cognition and increased insular FC. Abnormal FC in LLD-SS patients may be a therapeutic target for neuromodulation to improve sleep and cognitive performance and thus decrease the risk of dementia.
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Affiliation(s)
- Mingfeng Yang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
- The first School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Ben Chen
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Huarong Zhou
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Naikeng Mai
- Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Min Zhang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Zhangying Wu
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Qi Peng
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Qiang Wang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Meiling Liu
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Si Zhang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Gaohong Lin
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Jingyi Lao
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Yijie Zeng
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Xiaomei Zhong
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Yuping Ning
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
- The first School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
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7
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Zhu B, Li Q, Xi Y, Li X, Yang Y, Guo C. Local Brain Network Alterations and Olfactory Impairment in Alzheimer's Disease: An fMRI and Graph-Based Study. Brain Sci 2023; 13:brainsci13040631. [PMID: 37190596 DOI: 10.3390/brainsci13040631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/10/2023] [Accepted: 03/25/2023] [Indexed: 05/17/2023] Open
Abstract
Alzheimer's disease (AD) is associated with the abnormal connection of functional networks. Olfactory impairment occurs in early AD; therefore, exploring alterations in olfactory-related regions is useful for early AD diagnosis. We combined the graph theory of local brain network topology with olfactory performance to analyze the differences in AD brain network characteristics. A total of 23 patients with AD and 18 normal controls were recruited for resting-state functional magnetic resonance imaging (fMRI), clinical neuropsychological examinations and the University of Pennsylvania Smell Identification Test (UPSIT). Between-group differences in the topological properties of the local network were compared. Pearson correlations were explored based on differential brain regions and olfactory performance. Statistical analysis revealed a correlation of the degree of cognitive impairment with olfactory recognition function. Local node topological properties were significantly altered in many local brain regions in the AD group. The nodal clustering coefficients of the bilateral temporal pole: middle temporal gyrus (TPOmid), degree centrality of the left insula (INS.L), degree centrality of the right middle temporal gyrus (MTG.R), and betweenness centrality of the left middle temporal gyrus (MTG.L) were related to olfactory performance. Alterations in local topological properties combined with the olfactory impairment can allow early identification of abnormal olfactory-related regions, facilitating early AD screening.
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Affiliation(s)
- Bing Zhu
- School of Computer Science and Technology, Changchun University of Science and Technology, Changchun 130022, China
- Jilin Provincial Key Laboratory for Numerical Simulation, Jilin Normal University, Siping 136000, China
| | - Qi Li
- School of Computer Science and Technology, Changchun University of Science and Technology, Changchun 130022, China
- Zhongshan Institute of Changchun University of Science and Technology, Zhongshan 528437, China
| | - Yang Xi
- Zhongshan Institute of Changchun University of Science and Technology, Zhongshan 528437, China
- School of Computer Science, Northeast Electric Power University, Jilin 132012, China
| | - Xiujun Li
- School of Computer Science and Technology, Changchun University of Science and Technology, Changchun 130022, China
| | - Yu Yang
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun 130021, China
| | - Chunjie Guo
- Department of Radiology, The First Hospital of Jilin University, Changchun 130021, China
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8
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Lista S, Vergallo A, Teipel SJ, Lemercier P, Giorgi FS, Gabelle A, Garaci F, Mercuri NB, Babiloni C, Gaire BP, Koronyo Y, Koronyo-Hamaoui M, Hampel H, Nisticò R. Determinants of approved acetylcholinesterase inhibitor response outcomes in Alzheimer's disease: relevance for precision medicine in neurodegenerative diseases. Ageing Res Rev 2023; 84:101819. [PMID: 36526257 DOI: 10.1016/j.arr.2022.101819] [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: 06/13/2022] [Revised: 11/11/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
Acetylcholinesterase inhibitors (ChEI) are the global standard of care for the symptomatic treatment of Alzheimer's disease (AD) and show significant positive effects in neurodegenerative diseases with cognitive and behavioral symptoms. Although experimental and large-scale clinical evidence indicates the potential long-term efficacy of ChEI, primary outcomes are generally heterogeneous across outpatient clinics and regional healthcare systems. Sub-optimal dosing or slow tapering, heterogeneous guidelines about the timing for therapy initiation (prodromal versus dementia stages), healthcare providers' ambivalence to treatment, lack of disease awareness, delayed medical consultation, prescription of ChEI in non-AD cognitive disorders, contribute to the negative outcomes. We present an evidence-based overview of determinants, spanning genetic, molecular, and large-scale networks, involved in the response to ChEI in patients with AD and other neurodegenerative diseases. A comprehensive understanding of cerebral and retinal cholinergic system dysfunctions along with ChEI response predictors in AD is crucial since disease-modifying therapies will frequently be prescribed in combination with ChEI. Therapeutic algorithms tailored to genetic, biological, clinical (endo)phenotypes, and disease stages will help leverage inter-drug synergy and attain optimal combined response outcomes, in line with the precision medicine model.
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Affiliation(s)
- Simone Lista
- Memory Resources and Research Center (CMRR), Neurology Department, Gui de Chauliac University Hospital, Montpellier, France; School of Pharmacy, University of Rome "Tor Vergata", Rome, Italy.
| | - Andrea Vergallo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Pablo Lemercier
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Filippo Sean Giorgi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Audrey Gabelle
- Memory Resources and Research Center (CMRR), Neurology Department, Gui de Chauliac University Hospital, Montpellier, France
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy; Casa di Cura "San Raffaele Cassino", Cassino, Italy
| | - Nicola B Mercuri
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; IRCCS Santa Lucia Foundation, Rome, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy; Hospital San Raffaele Cassino, Cassino, Italy
| | - Bhakta Prasad Gaire
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Yosef Koronyo
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Biomedical Sciences, Division of Applied Cell Biology and Physiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Harald Hampel
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Robert Nisticò
- School of Pharmacy, University of Rome "Tor Vergata", Rome, Italy; Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, Rome, Italy.
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9
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Wang D, Xu C, Wang W, Lu H, Zhang J, Liang F, Li X. The Effect of APOE ɛ4 on the Functional Connectivity in Frontoparietal Network in Hypertensive Patients. Brain Sci 2022; 12:brainsci12050515. [PMID: 35624902 PMCID: PMC9138811 DOI: 10.3390/brainsci12050515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/06/2022] [Accepted: 04/15/2022] [Indexed: 02/01/2023] Open
Abstract
Allele 4 of the apolipoprotein E gene (APOE ε4) and hypertension are considered risk factors for Alzheimer’s Disease (AD). The detection of differences in cognitive function and brain networks between hypertensive patients who are APOE ε4 carriers and non-carriers may help in understanding how hypertension and risk genes cumulatively impair brain function, which could provide critical insights into the genetic mechanism by which hypertension serves as a potential risk factor for cognitive decline and even AD. Using behavioral data from 233 elderly hypertensive patients and neuroimaging data from 38 of them from Beijing, China; the study aimed to assess the effects of APOE ε4 on cognition and to explore related changes in functional connectivity. Cognitively, the patients with APOE ε4 showed decreased executive function, memory and language. In the MRI sub-cohort, the frontoparietal networks in the APOE ε4 carrier group exhibited an altered pattern, mainly in the left precentral regions, inferior frontal lobe and angular gyrus. More importantly, the decline of cognitive function was correlated with abnormal FC in the left precentral regions in APOE ε4 carriers. APOE ε4 aggravated the dysfunction in frontal and parietal regions in hypertensive patients. This highlights the importance of brain protection in hypertensive patients, especially those with a genetic risk of AD.
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Affiliation(s)
- Dandan Wang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; (D.W.); (C.X.); (W.W.); (H.L.)
- Beijing Aging Brain Rejuvenation Initiative (BABRI) Center, Beijing Normal University, Beijing 100875, China
| | - Chang Xu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; (D.W.); (C.X.); (W.W.); (H.L.)
- Beijing Aging Brain Rejuvenation Initiative (BABRI) Center, Beijing Normal University, Beijing 100875, China
| | - Wenxiao Wang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; (D.W.); (C.X.); (W.W.); (H.L.)
- Beijing Aging Brain Rejuvenation Initiative (BABRI) Center, Beijing Normal University, Beijing 100875, China
| | - Hui Lu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; (D.W.); (C.X.); (W.W.); (H.L.)
- Beijing Aging Brain Rejuvenation Initiative (BABRI) Center, Beijing Normal University, Beijing 100875, China
| | - Junying Zhang
- Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing 100700, China;
| | - Furu Liang
- Department of Neurology, Baotou Central Hospital, Baotou 014040, China;
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; (D.W.); (C.X.); (W.W.); (H.L.)
- Beijing Aging Brain Rejuvenation Initiative (BABRI) Center, Beijing Normal University, Beijing 100875, China
- Correspondence:
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10
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Lower novelty-related locus coeruleus function is associated with Aβ-related cognitive decline in clinically healthy individuals. Nat Commun 2022; 13:1571. [PMID: 35322012 PMCID: PMC8943159 DOI: 10.1038/s41467-022-28986-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 02/23/2022] [Indexed: 12/15/2022] Open
Abstract
Animal and human imaging research reported that the presence of cortical Alzheimer’s Disease’s (AD) neuropathology, beta-amyloid and neurofibrillary tau, is associated with altered neuronal activity and circuitry failure, together facilitating clinical progression. The locus coeruleus (LC), one of the initial subcortical regions harboring pretangle hyperphosphorylated tau, has widespread connections to the cortex modulating cognition. Here we investigate whether LC’s in-vivo neuronal activity and functional connectivity (FC) are associated with cognitive decline in conjunction with beta-amyloid. We combined functional MRI of a novel versus repeated face-name paradigm, beta-amyloid-PET and longitudinal cognitive data of 128 cognitively unimpaired older individuals. We show that LC activity and LC-FC with amygdala and hippocampus was higher during novelty. We also demonstrated that lower novelty-related LC activity and LC-FC with hippocampus and parahippocampus were associated with steeper beta-amyloid-related cognitive decline. Our results demonstrate the potential of LC’s functional properties as a gauge to identify individuals at-risk for AD-related cognitive decline. Older individuals exhibiting diminished function of the locus coeruleus while learning new information show faster cognitive decline that is typical for Alzheimer’s disease.
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11
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He Y, Li L, Liu J. The whole-brain voxel-based morphometry study in early stage of T2DM patients. Brain Behav 2022; 12:e2497. [PMID: 35138040 PMCID: PMC8933776 DOI: 10.1002/brb3.2497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/26/2021] [Accepted: 01/02/2022] [Indexed: 11/11/2022] Open
Abstract
AIM This study aimed to investigate the alterations in whole-brain gray matter density in early stage type 2 diabetes mellitus (T2DM) patients with cognitive impairment using magnetic resonance imaging. METHODS Thirty-six cases of early stage T2DM patients with cognitive impairment (T2DM-CI), 34 cases of early stage T2DM patients without cognitive impairment (T2DM) and 30 cases of healthy controls (HC) were enrolled. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores were used to identify the cognitive impairment. The whole-brain gray matter density was analyzed using 3D-T1 BRAVO imaging, using the voxel-based morphometry method on T1 structure imaging of two groups. RESULTS The correlation analysis of total gray matter density with MMSE and MoCA scores in the T2DM-CI group was performed. There were no significant differences in MMSE and MoCA scores between the HC and T2DM groups. However, the MMSE and MoCA scores in the T2DM-CI group were significantly reduced compared with the T2DM group. There were no significant differences in age, gender, education, body mass index (BMI) or blood pressure among the three groups. Voxel-based morphometry (VBM) results showed that the density of left triangle part of inferior frontal gyrus, orbital part of inferior frontal gyrus and opercular part of inferior frontal gyrus and left insula in the T2DM-CI group decreased compared with the T2DM group. Correlation analysis results showed that there was a significant positive correlation between total gray matter density and scores of MMSE and MoCA scores in the T2DM-CI group. CONCLUSION In conclusion, total gray matter density is positively correlated with the scores of MMSE and MoCA in T2DM patients, which may be an early sign of cognitive impairment in patients with T2DM.
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Affiliation(s)
- Yana He
- Department of Medical Imaging, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Liang Li
- Department of Medical Imaging, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jihua Liu
- Department of Medical Imaging, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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12
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Puttaert D, Wens V, Fery P, Rovai A, Trotta N, Coquelet N, De Breucker S, Sadeghi N, Coolen T, Goldman S, Peigneux P, Bier JC, De Tiège X. Decreased Alpha Peak Frequency Is Linked to Episodic Memory Impairment in Pathological Aging. Front Aging Neurosci 2021; 13:711375. [PMID: 34475819 PMCID: PMC8406997 DOI: 10.3389/fnagi.2021.711375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/21/2021] [Indexed: 12/04/2022] Open
Abstract
The Free and Cued Selective Reminding Test (FCSRT) is a largely validated neuropsychological test for the identification of amnestic syndrome from the early stage of Alzheimer's disease (AD). Previous electrophysiological data suggested a slowing down of the alpha rhythm in the AD-continuum as well as a key role of this rhythmic brain activity for episodic memory processes. This study therefore investigates the link between alpha brain activity and alterations in episodic memory as assessed by the FCSRT. For that purpose, 37 patients with altered FCSRT performance underwent a comprehensive neuropsychological assessment, supplemented by 18F-fluorodeoxyglucose positron emission tomography/structural magnetic resonance imaging (18FDG-PET/MR), and 10 min of resting-state magnetoencephalography (MEG). The individual alpha peak frequency (APF) in MEG resting-state data was positively correlated with patients' encoding efficiency as well as with the efficacy of semantic cues in facilitating patients' retrieval of previous stored word. The APF also correlated positively with patients' hippocampal volume and their regional glucose consumption in the posterior cingulate cortex. Overall, this study demonstrates that alterations in the ability to learn and store new information for a relatively short-term period are related to a slowing down of alpha rhythmic activity, possibly due to altered interactions in the extended mnemonic system. As such, a decreased APF may be considered as an electrophysiological correlate of short-term episodic memory dysfunction accompanying pathological aging.
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Affiliation(s)
- Delphine Puttaert
- Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
- Neuropsychology and Functional Neuroimaging Research Unit (UR2NF), Center for Research in Cognition and Neurosciences, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Vincent Wens
- Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
- Clinic of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Patrick Fery
- Neuropsychology and Functional Neuroimaging Research Unit (UR2NF), Center for Research in Cognition and Neurosciences, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
- Service of Neuropsychology and Speech Therapy, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Antonin Rovai
- Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
- Clinic of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicola Trotta
- Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
- Clinic of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Coquelet
- Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Sandra De Breucker
- Department of Geriatrics, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Niloufar Sadeghi
- Department of Radiology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Tim Coolen
- Department of Radiology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Serge Goldman
- Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
- Clinic of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Philippe Peigneux
- Neuropsychology and Functional Neuroimaging Research Unit (UR2NF), Center for Research in Cognition and Neurosciences, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean-Christophe Bier
- Department of Neurology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Xavier De Tiège
- Laboratoire de Cartographie Fonctionnelle du Cerveau, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
- Clinic of Functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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13
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Tang F, Zhu D, Ma W, Yao Q, Li Q, Shi J. Differences Changes in Cerebellar Functional Connectivity Between Mild Cognitive Impairment and Alzheimer's Disease: A Seed-Based Approach. Front Neurol 2021; 12:645171. [PMID: 34220669 PMCID: PMC8248670 DOI: 10.3389/fneur.2021.645171] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Recent studies have discovered that functional connections are impaired among patients with Alzheimer's disease (AD), even at the preclinical stage. The cerebellum has been implicated as playing a role in cognitive processes. However, functional connectivity (FC) among cognitive sub-regions of the cerebellum in patients with AD and mild cognitive impairment (MCI) remains to be further elucidated. Objective: Our study aims to investigate the FC changes of the cerebellum among patients with AD and MCI, compared to healthy controls (HC). Additionally, we explored the role of cerebellum FC changes in the cognitive performance of all subjects. Materials: Resting-state functional magnetic resonance imaging (rs-fMRI) data from three different groups (28 AD patients, 26 MCI patients, and 30 HC) was collected. We defined cerebellar crus II and lobule IX as seed regions to assess the intragroup differences of cortico-cerebellar connectivity. Bias correlational analysis was performed to investigate the relationship between changes in FC and neuropsychological performance. Results: Compared to HC, AD patients had decreased FC within the caudate, limbic lobe, medial frontal gyrus (MFG), middle temporal gyrus, superior frontal gyrus, parietal lobe/precuneus, inferior temporal gyrus, and posterior cingulate gyrus. Interestingly, MCI patients demonstrated increased FC within inferior parietal lobe, and MFG, while they had decreased FC in the thalamus, inferior frontal gyrus, and superior frontal gyrus. Further analysis indicated that FC changes between the left crus II and the right thalamus, as well as between left lobule IX and the right parietal lobe, were both associated with cognitive decline in AD. Disrupted FC between left crus II and right thalamus, as well as between left lobule IX and right parietal lobe, was associated with attention deficit among subjects with MCI. Conclusion: These findings indicate that cortico-cerebellar FC in MCI and AD patients was significantly disrupted with different distributions, particularly in the default mode networks (DMN) and fronto-parietal networks (FPN) region. Increased activity within the fronto-parietal areas of MCI patients indicated a possible compensatory role for the cerebellum in cognitive impairment. Therefore, alterations in the cortico-cerebellar FC represent a novel approach for early diagnosis and a potential therapeutic target for early intervention.
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Affiliation(s)
- Fanyu Tang
- Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Donglin Zhu
- Department of Neurology, Affiliated to Nanjing Medical University, Nanjing, China
| | - Wenying Ma
- Nanjing Medical University, Nanjing, China
| | - Qun Yao
- Department of Neurology, Affiliated to Nanjing Medical University, Nanjing, China
| | - Qian Li
- Nanjing Medical University, Nanjing, China
| | - Jingping Shi
- Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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14
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Spallazzi M, Michelini G, Barocco F, Dieci F, Copelli S, Messa G, Scarlattei M, Pavesi G, Ruffini L, Caffarra P. The Role of Free and Cued Selective Reminding Test in Predicting [18F]Florbetaben PET Results in Mild Cognitive Impairment and Mild Dementia. J Alzheimers Dis 2021; 73:1647-1659. [PMID: 31958094 DOI: 10.3233/jad-190950] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Free and Cued Selective Reminding Test (FCSRT) is a reliable cognitive marker for Alzheimer's disease (AD), and the identification of neuropsychological tests sensitive to the early signs of AD pathology is crucial both in research and clinical practice. OBJECTIVE The study aimed to ascertain the ability of FCSRT in predicting the amyloid load as determined from amyloid PET imaging (Amy-PET) in patients with cognitive disorders. METHODS For our purpose, 79 patients (71 MCI, 8 mild dementia) underwent a complete workup for dementia, including the FCSRT assessment and a [18F]florbetaben PET scan. FCSRT subitem scores were used as predictors in different binomial regression models. RESULTS Immediate free recall and delayed free recall were the best predictors overall in the whole sample; whereas in patients <76 years, all models further improved with immediate total recall (ITR) and Index of Sensitivity of Cueing (ISC) resulting the most accurate in anticipating Amy-PET results, with a likelihood of being Amy-PET positive greater than 85% for ITR and ISC scores of less than 25 and 0.5, respectively. CONCLUSION FCSRT proved itself to be a valid tool in dementia diagnosis, also being able to correlate with amyloid pathology. The possibility to predict Amy-PET results through a simple and reliable neuropsychological test might be helpful for clinicians in the dementia field, adding value to a paper and pencil tool compared to most costly biomarkers.
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Affiliation(s)
- Marco Spallazzi
- Department of Medicine and Surgery, Unit of Neurology, Azienda Ospedaliero-Universitaria, Parma, Italy
| | - Giovanni Michelini
- Sigmund Freud University, Milano, Italy.,Department of Disability, Fondazione Istituto Ospedaliero di Sospiro - Onlus, Cremona, Italy
| | - Federica Barocco
- Alzheimer Center, FERB, Briolini Hospital, Gazzaniga, Bergamo, Italy
| | | | - Sandra Copelli
- Center for Cognitive Disorders, AUSL Parma, Parma, Italy
| | - Giovanni Messa
- Center for Cognitive Disorders, AUSL Parma, Parma, Italy
| | - Maura Scarlattei
- Department of Nuclear Medicine, Azienda Ospedaliero-Universitaria, Parma, Italy
| | - Giovanni Pavesi
- Department of Medicine and Surgery, Section of Neuroscience, Unit of Neurology, University of Parma, Parma, Italy
| | - Livia Ruffini
- Department of Nuclear Medicine, Azienda Ospedaliero-Universitaria, Parma, Italy
| | - Paolo Caffarra
- Department of Medicine and Surgery, Section of Neuroscience, Unit of Neurology, University of Parma, Parma, Italy
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15
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Lan F, Lin G, Cao G, Li Z, Ma D, Liu F, Duan M, Fu H, Xiao W, Qi Z, Wang T. Altered Intrinsic Brain Activity and Functional Connectivity Before and After Knee Arthroplasty in the Elderly: A Resting-State fMRI Study. Front Neurol 2020; 11:556028. [PMID: 33133006 PMCID: PMC7550714 DOI: 10.3389/fneur.2020.556028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/18/2020] [Indexed: 12/03/2022] Open
Abstract
Objective: This study aimed to investigate the brain functional alterations with resting-state functional magnetic resonance imaging (rs-fMRI) in older patients with knee osteoarthritis (KOA) before and after total knee arthroplasty (TKA) and to assess the causal relationship of the brain function and neuropsychological changes. Methods: We performed rs-fMRI to investigate brain function of 23 patients aged ≥65 with KOA and 23 healthy matched controls. Of the KOA patients, 15 completed postoperative rs-fMRI examinations. Analyzes of the amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) were used to estimate differences in brain functional parameters between KOA patients, postoperative patients, and the controls. The relationship between changes of pre- and post-surgical status in ALFF and neuropsychological test results was analyzed. Results: Compared with the controls, all patients with KOA exhibited decreased ALFF in the default mode network (bilateral angular gyrus, precuneus gyrus, medial superior frontal gyrus) and increased ALFF in the bilateral amygdala and cerebellum posterior lobe before surgery (P < 0.001). Altered ALFF persisted in the same brain regions 1 week postoperatively. The decreased ALFF in the left precuneus gyrus and middle temporal gyrus was found after surgery when compared with preoperative data (P < 0.01). Preoperatively, the KOA patients exhibited increased FC between the left precuneus gyrus and the right supplementary motor area compared to the controls (P < 0.001), but this connectivity became no significant difference after TKA. The left Cerebelum_9 was found to have decreased FC with the right precuneus gyrus postoperatively (P < 0.001) although this was not significantly different before surgery. The significantly altered ALFF values were not correlated with changes in cognitive assessment scores. Conclusion: In older patients with end-stage KOA, functional alterations in important brain regions were detected with the persistence and further changes observed at an early stage after knee replacement. Our data further our understanding of brain functional abnormalities and cognitive impairment in older patients following knee replacement, which may provide therapeutic targets for preventive/treatment strategy to be developed. Trial registration: Clinical Trial Registration: http://www.chictr.org.cn/index.aspx, ChiCTR1800016437; Registered June 1, 2018.
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Affiliation(s)
- Fei Lan
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing Institute for Brain Disorders, Beijing, China
| | - Guanwen Lin
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing Institute for Brain Disorders, Beijing, China.,Department of Anesthesiology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Guanglei Cao
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zheng Li
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Daqing Ma
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Anaesthesia Research of the Section of Anaesthetics, Pain Medicine and Intensive Care, Chelsea and Westminster Hospital, London, United Kingdom
| | - Fangyan Liu
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing Institute for Brain Disorders, Beijing, China
| | - Mei Duan
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing Institute for Brain Disorders, Beijing, China
| | - Huiqun Fu
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing Institute for Brain Disorders, Beijing, China
| | - Wei Xiao
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing Institute for Brain Disorders, Beijing, China
| | - Zhigang Qi
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Tianlong Wang
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing Institute for Brain Disorders, Beijing, China
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16
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Quevenco FC, van Bergen JM, Treyer V, Studer ST, Kagerer SM, Meyer R, Gietl AF, Kaufmann PA, Nitsch RM, Hock C, Unschuld PG. Functional Brain Network Connectivity Patterns Associated With Normal Cognition at Old-Age, Local β-amyloid, Tau, and APOE4. Front Aging Neurosci 2020; 12:46. [PMID: 32210782 PMCID: PMC7075450 DOI: 10.3389/fnagi.2020.00046] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 02/10/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Integrity of functional brain networks is closely associated with maintained cognitive performance at old age. Consistently, both carrier status of Apolipoprotein E ε4 allele (APOE4), and age-related aggregation of Alzheimer’s disease (AD) pathology result in altered brain network connectivity. The posterior cingulate and precuneus (PCP) is a node of particular interest due to its role in crucial memory processes. Moreover, the PCP is subject to the early aggregation of AD pathology. The current study aimed at characterizing brain network properties associated with unimpaired cognition in old aged adults. To determine the effects of age-related brain change and genetic risk for AD, pathological proteins β-amyloid and tau were measured by Positron-emission tomography (PET), PCP connectivity as a proxy of cognitive network integrity, and genetic risk by APOE4 carrier status. Methods: Fifty-seven cognitively unimpaired old-aged adults (MMSE = 29.20 ± 1.11; 73 ± 8.32 years) were administered 11C Pittsburgh Compound B and 18F Flutemetamol PET for assessing β-amyloid, and 18F AV-1451 PET for tau. Individual functional connectivity seed maps of the PCP were obtained by resting-state multiband BOLD functional MRI at 3-Tesla for increased temporal resolution. Voxelwise correlations between functional connectivity, β-amyloid- and tau-PET were explored by Biological Parametric Mapping (BPM). Results: Local β-amyloid was associated with increased connectivity in frontal and parietal regions of the brain. Tau was linked to increased connectivity in more spatially distributed clusters in frontal, parietal, occipital, temporal, and cerebellar regions. A positive interaction was observable for APOE4 carrier status and functional connectivity with brain regions characterized by increased local β-amyloid and tau tracer retention. Conclusions: Our data suggest an association between spatially differing connectivity systems and local β-amyloid, and tau aggregates in cognitively normal, old-aged adults, which is moderated by APOE4. Additional longitudinal studies may determine protective connectivity patterns associated with healthy aging trajectories of AD-pathology aggregation.
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Affiliation(s)
- Frances C Quevenco
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Jiri M van Bergen
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Valerie Treyer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University of Zurich, Zurich, Switzerland
| | - Sandro T Studer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Sonja M Kagerer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland.,Neurimmune, Schlieren, Switzerland
| | - Rafael Meyer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Anton F Gietl
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, University of Zurich, Zurich, Switzerland
| | - Roger M Nitsch
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland.,Neurimmune, Schlieren, Switzerland
| | - Christoph Hock
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland.,Neurimmune, Schlieren, Switzerland
| | - Paul G Unschuld
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland.,Department of Psychogeriatric Medicine, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland.,Zurich Neuroscience Center (ZNZ), Zurich, Switzerland
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17
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Cheng CH, Hsiao FJ, Hsieh YW, Wang PN. Dysfunction of Inferior Parietal Lobule During Sensory Gating in Patients With Amnestic Mild Cognitive Impairment. Front Aging Neurosci 2020; 12:39. [PMID: 32158387 PMCID: PMC7052059 DOI: 10.3389/fnagi.2020.00039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 02/06/2020] [Indexed: 12/19/2022] Open
Abstract
Patients with amnestic mild cognitive impairment (aMCI) demonstrate significant cognitive deficits, especially in the memory aspect. The memory deficiency might be attributed to the difficulties in the inhibitory function to suppress redundant stimuli. Sensory gating (SG) refers to the attenuation of neural responses to the second identical stimulus in a paired-click paradigm, in which auditory stimuli are delivered in pairs with inter-stimulus intervals (ISI) of 500 ms and inter-pair intervals of 6-8 s. It is considered as an electrophysiological signal to reflect the brain's automatic response to gate out repetitive sensory inputs. However, there has been no study systematically investigating SG function in aMCI patients. Thus, the present study used magnetoencephalography (MEG) to record neuromagnetic responses to a paired-click paradigm in 23 healthy controls (HC) and 26 aMCI patients. The Stimulus 2/Stimulus 1 (S2/S1) amplitude ratio was used to represent the SG function. Compared to HC, aMCI patients showed M50 SG deficits in the left inferior frontal gyrus (IFG) and right inferior parietal lobule (IPL). M100 SG defects were also observed in the right IPL. Based on the ROIs showing significant between-group SG differences, we found that a more deficient M50 SG function in the right IPL was associated with poorer performance in the immediate recall of Logic Memory (LM), Chinese Version Verbal Learning Test (CVVLT) and Digit Span Backward (DSB) Test. Furthermore, the M50 SG ratios of the right IPL together with the neuropsychological performance of LM and CVVLT demonstrated very good accuracy in the discrimination of aMCI from HC. In conclusion, compared to HC, aMCI patients showed a significant SG deficit in the right IPL, which was correlated with the auditory short-term memory function. We suggest the combination of SG in the right IPL, LM and CVVLT to be sensitive indicators to differentiate aMCI patients from HC.
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Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan.,Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan
| | - Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Wei Hsieh
- Department of Occupational Therapy, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Pei-Ning Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Division of General Neurology, Department of Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang-Ming University, Taipei, Taiwan
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18
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Zeng Q, Luo X, Li K, Wang S, Zhang R, Hong H, Huang P, Jiaerken Y, Xu X, Xu J, Wang C, Zhou J, Zhang M. Distinct Spontaneous Brain Activity Patterns in Different Biologically-Defined Alzheimer's Disease Cognitive Stage: A Preliminary Study. Front Aging Neurosci 2019; 11:350. [PMID: 32009939 PMCID: PMC6980867 DOI: 10.3389/fnagi.2019.00350] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 12/02/2019] [Indexed: 12/26/2022] Open
Abstract
Background: The National Institute on Aging-Alzheimer's Association (NIA-AA) has proposed a biological definition of Alzheimer's disease (AD): individuals with both abnormal amyloid and tau biomarkers (A+T+) would be defined as AD. It remains unclear why different cognitive status is present in subjects with biological AD. Resting-state functional magnetic resonance imaging (rsfMRI) has provided an opportunity to reveal the brain activity patterns in a biologically-defined AD cohort. Accordingly, we aimed to investigate distinct brain activity patterns in subjects with existed AD pathology but in the different cognitive stages. Method: We selected individuals with AD pathology (A+T+) and healthy controls (HC, A-T-) based on the cerebrospinal fluid (CSF) biomarkers. According to the cognitive stage, we divided the A+T+ cohort into three groups: (1) preclinical AD; (2) prodromal AD; and (3) AD with dementia (d-AD). We compared spontaneous brain activity measured by a fractional amplitude of low-frequency fluctuation (fALFF) approach among four groups. Results: The analysis of covariance (ANCOVA) results showed significant differences in fALFF in the posterior cingulate cortex/precuneus (PCC/PCu). Further, compared to HC, we found increased fALFF values in the right inferior frontal gyrus (IFG) in the preclinical AD stage, whereas prodromal AD patients showed reduced fALFF in the bilateral precuneus, right middle frontal gyrus (MFG), right precentral gyrus, and postcentral gyrus. Within the d-AD group, both hyperactivity (right fusiform gyrus, right parahippocampal gyrus (PHG)/hippocampus, and inferior temporal gyrus) and hypoactivity (bilateral precuneus, left posterior cingulate cortex, left cuneus and superior occipital gyrus) were detected. Conclusion: We found the distinct brain activity patterns in different cognitive stages among the subjects defined as AD biologically. Our findings may be helpful in understanding mechanisms leading to cognitive changes in the AD pathophysiological process.
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Affiliation(s)
- Qingze Zeng
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Luo
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Kaicheng Li
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Shuyue Wang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ruiting Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Hong
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yeerfan Jiaerken
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Xu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Chao Wang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jiong Zhou
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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19
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Jacobs HIL, Hopkins DA, Mayrhofer HC, Bruner E, van Leeuwen FW, Raaijmakers W, Schmahmann JD. The cerebellum in Alzheimer's disease: evaluating its role in cognitive decline. Brain 2019; 141:37-47. [PMID: 29053771 DOI: 10.1093/brain/awx194] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 06/12/2017] [Indexed: 12/12/2022] Open
Abstract
The cerebellum has long been regarded as essential only for the coordination of voluntary motor activity and motor learning. Anatomical, clinical and neuroimaging studies have led to a paradigm shift in the understanding of the cerebellar role in nervous system function, demonstrating that the cerebellum appears integral also to the modulation of cognition and emotion. The search to understand the cerebellar contribution to cognitive processing has increased interest in exploring the role of the cerebellum in neurodegenerative and neuropsychiatric disorders. Principal among these is Alzheimer's disease. Here we review an already sizeable existing literature on the neuropathological, structural and functional neuroimaging studies of the cerebellum in Alzheimer's disease. We consider these observations in the light of the cognitive deficits that characterize Alzheimer's disease and in so doing we introduce a new perspective on its pathophysiology and manifestations. We propose an integrative hypothesis that there is a cerebellar contribution to the cognitive and neuropsychiatric deficits in Alzheimer's disease. We draw on the dysmetria of thought theory to suggest that this cerebellar component manifests as deficits in modulation of the neurobehavioural deficits. We provide suggestions for future studies to investigate this hypothesis and, ultimately, to establish a comprehensive, causal clinicopathological disease model.
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Affiliation(s)
- Heidi I L Jacobs
- School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, PO BOX 616, 6200 MD, AQ220 Maastricht, The Netherlands.,Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, PO BOX 616, 6200 MD Maastricht, The Netherlands.,Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - David A Hopkins
- School for Mental Health and Neuroscience, Department of Neuroscience, Maastricht University, PO BOX 616, 6200 MD Maastricht, The Netherlands.,Department of Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Helen C Mayrhofer
- Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, PO BOX 616, 6200 MD Maastricht, The Netherlands
| | - Emiliano Bruner
- Centro Nacional de Investigación sobre la Evolución Humana, Burgos, Spain
| | - Fred W van Leeuwen
- School for Mental Health and Neuroscience, Department of Neuroscience, Maastricht University, PO BOX 616, 6200 MD Maastricht, The Netherlands
| | - Wijnand Raaijmakers
- Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, PO BOX 616, 6200 MD Maastricht, The Netherlands
| | - Jeremy D Schmahmann
- Ataxia Unit, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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20
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Liang KJ, Carlson ES. Resistance, vulnerability and resilience: A review of the cognitive cerebellum in aging and neurodegenerative diseases. Neurobiol Learn Mem 2019; 170:106981. [PMID: 30630042 DOI: 10.1016/j.nlm.2019.01.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/14/2018] [Accepted: 01/03/2019] [Indexed: 12/12/2022]
Abstract
In the context of neurodegeneration and aging, the cerebellum is an enigma. Genetic markers of cellular aging in cerebellum accumulate more slowly than in the rest of the brain, and it generates unknown factors that may slow or even reverse neurodegenerative pathology in animal models of Alzheimer's Disease (AD). Cerebellum shows increased activity in early AD and Parkinson's disease (PD), suggesting a compensatory function that may mitigate early symptoms of neurodegenerative pathophysiology. Perhaps most notably, different parts of the brain accumulate neuropathological markers of AD in a recognized progression and generally, cerebellum is the last brain region to do so. Taken together, these data suggest that cerebellum may be resistant to certain neurodegenerative mechanisms. On the other hand, in some contexts of accelerated neurodegeneration, such as that seen in chronic traumatic encephalopathy (CTE) following repeated traumatic brain injury (TBI), the cerebellum appears to be one of the most susceptible brain regions to injury and one of the first to exhibit signs of pathology. Cerebellar pathology in neurodegenerative disorders is strongly associated with cognitive dysfunction. In neurodegenerative or neurological disorders associated with cerebellar pathology, such as spinocerebellar ataxia, cerebellar cortical atrophy, and essential tremor, rates of cognitive dysfunction, dementia and neuropsychiatric symptoms increase. When the cerebellum shows AD pathology, such as in familial AD, it is associated with earlier onset and greater severity of disease. These data suggest that when neurodegenerative processes are active in the cerebellum, it may contribute to pathological behavioral outcomes. The cerebellum is well known for comparing internal representations of information with observed outcomes and providing real-time feedback to cortical regions, a critical function that is disturbed in neuropsychiatric disorders such as intellectual disability, schizophrenia, dementia, and autism, and required for cognitive domains such as working memory. While cerebellum has reciprocal connections with non-motor brain regions and likely plays a role in complex, goal-directed behaviors, it has proven difficult to establish what it does mechanistically to modulate these behaviors. Due to this lack of understanding, it's not surprising to see the cerebellum reflexively dismissed or even ignored in basic and translational neuropsychiatric literature. The overarching goals of this review are to answer the following questions from primary literature: When the cerebellum is affected by pathology, is it associated with decreased cognitive function? When it is intact, does it play a compensatory or protective role in maintaining cognitive function? Are there theoretical frameworks for understanding the role of cerebellum in cognition, and perhaps, illnesses characterized by cognitive dysfunction? Understanding the role of the cognitive cerebellum in neurodegenerative diseases has the potential to offer insight into origins of cognitive deficits in other neuropsychiatric disorders, which are often underappreciated, poorly understood, and not often treated.
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Affiliation(s)
- Katharine J Liang
- University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, Seattle, WA, United States
| | - Erik S Carlson
- University of Washington School of Medicine, Seattle, WA, United States.
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21
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22
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Cummings J. The Role of Biomarkers in Alzheimer's Disease Drug Development. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1118:29-61. [PMID: 30747416 DOI: 10.1007/978-3-030-05542-4_2] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Biomarkers have a key role in Alzheimer's disease (AD) drug development. Biomarkers can assist in diagnosis, demonstrate target engagement, support disease modification, and monitor for safety. The amyloid (A), tau (T), neurodegeneration (N) Research Framework emphasizes brain imaging and CSF measures relevant to disease diagnosis and staging and can be applied to drug development and clinical trials. Demonstration of target engagement in Phase 2 is critical before advancing a treatment candidate to Phase 3. Trials with biomarker outcomes are shorter and smaller than those required to show clinical benefit and are important to understanding the biological impact of an agent and inform go/no-go decisions. Companion diagnostics are required for safe and effective use of treatments and may emerge in AD drug development programs. Complementary biomarkers inform the use of therapies but are not mandatory for use. Biomarkers promise to de-risk AD drug development, attract sponsors to AD research, and accelerate getting new drugs to those with or at risk for AD.
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Affiliation(s)
- Jeffrey Cummings
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA.
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23
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Guo H, Grajauskas L, Habash B, D'Arcy RCN, Song X. Functional MRI technologies in the study of medication treatment effect on Alzheimer's disease. Aging Med (Milton) 2018; 1:75-95. [PMID: 31942484 PMCID: PMC6880690 DOI: 10.1002/agm2.12017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 04/02/2018] [Indexed: 12/14/2022] Open
Abstract
Alzheimer's disease (AD) is the most common cause of late-life dementia. Characterized by progressive neurodegeneration, the disease is expressed as gradual memory loss together with decline in cognitive abilities and other brain functions. Despite extensive research over the past decade, the cause and cure of AD both remain largely unknown. Several AD-associated deficits have been targeted for interventions, including those based on amyloid-beta, tau, and inflammation hypotheses. Only 2 types of medications-cholinesterase inhibitors and memantine-have been approved, to control the cognitive symptoms of AD such as the loss of memory, language, and executive function. Noninvasive in vivo functional magnetic resonance imaging (MRI) technologies, including the blood oxygen level-dependent functional MRI, arterial spin labeling-based perfusion MRI, and the proton magnetic resonance spectroscopy have been used to study the effect of ChEIs and memantine in the brain. Most of these studies have demonstrated increased functional activation and connectivity, increased regional brain blood flow and volume post-treatment, and positive responses of critical brain metabolites reflecting neuronal status and functionality in patients with AD and mild cognitive impairment. The findings have contributed to the understanding of the mechanisms underlying the medication treatments and support the crucial role of functional MRI technologies in the development and refinement of AD medication therapies.
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Affiliation(s)
- Hui Guo
- SFU ImageTech LaboratorySurrey Memorial HospitalSurreyBCCanada
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBCCanada
- Department of Diagnostic ImagingTianjin Medical University General HospitalTianjinChina
| | - Lukas Grajauskas
- SFU ImageTech LaboratorySurrey Memorial HospitalSurreyBCCanada
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBCCanada
| | - Baraa Habash
- SFU ImageTech LaboratorySurrey Memorial HospitalSurreyBCCanada
- Department of Engineering ScienceSimon Fraser UniversityBurnabyBCCanada
| | - Ryan CN D'Arcy
- SFU ImageTech LaboratorySurrey Memorial HospitalSurreyBCCanada
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBCCanada
- Department of Engineering ScienceSimon Fraser UniversityBurnabyBCCanada
- Department of Computing ScienceSimon Fraser UniversityBurnabyBCCanada
| | - Xiaowei Song
- SFU ImageTech LaboratorySurrey Memorial HospitalSurreyBCCanada
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBCCanada
- Department of Engineering ScienceSimon Fraser UniversityBurnabyBCCanada
- Department of Computing ScienceSimon Fraser UniversityBurnabyBCCanada
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24
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Lin F, Ren P, Lo RY, Chapman BP, Jacobs A, Baran TM, Porsteinsson AP, Foxe JJ. Insula and Inferior Frontal Gyrus' Activities Protect Memory Performance Against Alzheimer's Disease Pathology in Old Age. J Alzheimers Dis 2018; 55:669-678. [PMID: 27716674 DOI: 10.3233/jad-160715] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Apolipoprotein E (APOE) ɛ4 carriers and patients with amnestic mild cognitive impairment (MCI) have high risk of developing Alzheimer's disease (AD). The Scaffolding Theory of Aging and Cognition proposes that recruitment of additional frontal brain regions can protect cognition against aging. This thesis has yet to be fully tested in older adults at high risk for AD. In the present study, 75 older participants (mean age: 74 years) were included. Applying a voxel-wise approach, fractional amplitude of low-frequency fluctuations (fALFF) in resting-state functional neuroimaging data were analyzed as a function of APOEɛ4 status (carrier versus noncarrier) and clinical status (healthy control [HC] versus MCI) using a 2×2 analysis of covariance (ANCOVA). Measures of cognition and cerebrospinal fluid levels of amyloid- β were also obtained. Three frontal regions were identified with significant interaction effects using ANCOVA (corrected p < 0.01): left-insula, left-inferior frontal gyrus (IFG), and right-precentral gyrus. The HC/APOEɛ4 carrier group had significantly higher fALFF in all three regions than other groups. In the entire sample, for two regions (left insula and left IFG), a significant positive relationship between amyloid-β and memory was only observed among individuals with low fALFF. Our results suggest higher activity in frontal regions may explain being cognitively normal among a subgroup of APOEɛ4 carriers and protect against the negative impact of AD-associated pathology on memory. This is an observation with potential implications for AD therapeutics.
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Affiliation(s)
- Feng Lin
- School of Nursing, University of Rochester Medical Center, Rochester, NY, USA.,Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.,Department of Brain and Cognitive Science, University of Rochester, Rochester, NY, USA
| | - Ping Ren
- School of Nursing, University of Rochester Medical Center, Rochester, NY, USA
| | - Raymond Y Lo
- Department of Neurology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Taiwan, Taipai
| | - Benjamin P Chapman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.,Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Alanna Jacobs
- School of Nursing, University of Rochester Medical Center, Rochester, NY, USA.,Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Timothy M Baran
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Anton P Porsteinsson
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.,Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - John J Foxe
- Department of Neuroscience & The Ernest J. Del Monte Institute for Neuromedicine, University of Rochester Medical Center, Rochester, NY, USA
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25
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Sankar T, Park MTM, Jawa T, Patel R, Bhagwat N, Voineskos AN, Lozano AM, Chakravarty MM. Your algorithm might think the hippocampus grows in Alzheimer's disease: Caveats of longitudinal automated hippocampal volumetry. Hum Brain Mapp 2017; 38:2875-2896. [PMID: 28295799 DOI: 10.1002/hbm.23559] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 01/31/2017] [Accepted: 02/27/2017] [Indexed: 11/10/2022] Open
Abstract
Hippocampal atrophy rate-measured using automated techniques applied to structural MRI scans-is considered a sensitive marker of disease progression in Alzheimer's disease, frequently used as an outcome measure in clinical trials. Using publicly accessible data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), we examined 1-year hippocampal atrophy rates generated by each of five automated or semiautomated hippocampal segmentation algorithms in patients with Alzheimer's disease, subjects with mild cognitive impairment, or elderly controls. We analyzed MRI data from 398 and 62 subjects available at baseline and at 1 year at MRI field strengths of 1.5 T and 3 T, respectively. We observed a high rate of hippocampal segmentation failures across all algorithms and diagnostic categories, with only 50.8% of subjects at 1.5 T and 58.1% of subjects at 3 T passing stringent segmentation quality control. We also found that all algorithms identified several subjects (between 2.94% and 48.68%) across all diagnostic categories showing increases in hippocampal volume over 1 year. For any given algorithm, hippocampal "growth" could not entirely be explained by excluding patients with flawed hippocampal segmentations, scan-rescan variability, or MRI field strength. Furthermore, different algorithms did not uniformly identify the same subjects as hippocampal "growers," and showed very poor concordance in estimates of magnitude of hippocampal volume change over time (intraclass correlation coefficient 0.319 at 1.5 T and 0.149 at 3 T). This precluded a meaningful analysis of whether hippocampal "growth" represents a true biological phenomenon. Taken together, our findings suggest that longitudinal hippocampal volume change should be interpreted with considerable caution as a biomarker. Hum Brain Mapp 38:2875-2896, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Tejas Sankar
- Division of Neurosurgery, Department of Surgery, University of Alberta, Alberta, Canada
| | - Min Tae M Park
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Tasha Jawa
- Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Raihaan Patel
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - Nikhil Bhagwat
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Kimel Family Translational Imaging Genetics Research Laboratory, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Kimel Family Translational Imaging Genetics Research Laboratory, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Andres M Lozano
- Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - M Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada
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26
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Grober E, Wakefield D, Ehrlich AR, Mabie P, Lipton RB. Identifying memory impairment and early dementia in primary care. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2017; 6:188-195. [PMID: 28289701 PMCID: PMC5338866 DOI: 10.1016/j.dadm.2017.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION This study examined the operating characteristics of two-stage case finding to identify memory impairment and very mild dementia. METHODS Primary care patients underwent two-stage testing and a subsequent diagnostic assessment to assess outcomes. Patients who screen positive for subjective cognitive decline on the Informant Questionnaire on Cognitive Decline in the Elderly undergo memory testing with the Free and Cued Selective Reminding Test with Immediate Recall. Outcomes were determined without access to these data. A split-half design with discovery and confirmatory samples was used. RESULTS One hundred seventeen of 563 (21%) patients had dementia and 68 (12%) had memory impairment but not dementia. Operating characteristics were similar in the discovery and confirmatory samples. In the pooled sample, combined, patients with memory impairment or dementia were identified with good sensitivity (72%) and high specificity (90%). Differences in ethnicity, educational level, or age (≤75, >75) did not affect classification accuracy. DISCUSSION Two-stage screening facilitates the efficient identification of older adults with memory impairment or dementia.
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Affiliation(s)
- Ellen Grober
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | | | - Amy R. Ehrlich
- Division of Geriatrics, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Peter Mabie
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
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Caffarra P, Ghetti C, Ruffini L, Spallazzi M, Spotti A, Barocco F, Guzzo C, Marchi M, Gardini S. Brain Metabolism Correlates of The Free and Cued Selective Reminding Test in Mild Cognitive Impairment. J Alzheimers Dis 2016; 51:27-31. [DOI: 10.3233/jad-150418] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Paolo Caffarra
- Department of Neurosciences, University of Parma, Parma, Italy
- Dipartimento di Emergenza-Urgenza e Area Medica Generale e Specialistica, Azienda Ospedaliero-Universitaria, Parma, Italy
- Centre of Cognitive Disorders and Dementia (CDCD), AUSL, Parma, Italy
| | - Caterina Ghetti
- Department of Medical Physic, Azienda Ospedaliero-Universitaria, Parma, Italy
| | - Livia Ruffini
- Department of Nuclear Medicine Department, Azienda Ospedaliero-Universitaria, Parma, Italy
| | - Marco Spallazzi
- Dipartimento di Emergenza-Urgenza e Area Medica Generale e Specialistica, Azienda Ospedaliero-Universitaria, Parma, Italy
| | | | - Federica Barocco
- Dipartimento di Emergenza-Urgenza e Area Medica Generale e Specialistica, Azienda Ospedaliero-Universitaria, Parma, Italy
| | - Caterina Guzzo
- Department of Neurosciences, University of Parma, Parma, Italy
| | - Massimo Marchi
- Department of Neurosciences, University of Parma, Parma, Italy
| | - Simona Gardini
- Department of Neurosciences, University of Parma, Parma, Italy
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28
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fMRI in Neurodegenerative Diseases: From Scientific Insights to Clinical Applications. NEUROMETHODS 2016. [DOI: 10.1007/978-1-4939-5611-1_23] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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29
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PCC characteristics at rest in 10-year memory decliners. Neurobiol Aging 2015; 36:2812-20. [DOI: 10.1016/j.neurobiolaging.2015.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 06/29/2015] [Accepted: 07/02/2015] [Indexed: 01/31/2023]
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30
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Recognition of faces and names: multimodal physiological correlates of memory and executive function. Brain Imaging Behav 2015; 10:408-23. [PMID: 26116280 DOI: 10.1007/s11682-015-9420-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We sought to characterize electrophysiological, eye-tracking and behavioral correlates of face-name recognition memory in healthy younger adults using high-density electroencephalography (EEG), infrared eye-tracking (ET), and neuropsychological measures. Twenty-one participants first studied 40 face-name (FN) pairs; 20 were presented four times (4R) and 20 were shown once (1R). Recognition memory was assessed by asking participants to make old/new judgments for 80 FN pairs, of which half were previously studied items and half were novel FN pairs (N). Simultaneous EEG and ET recording were collected during recognition trials. Comparisons of event-related potentials (ERPs) for correctly identified FN pairs were compared across the three item types revealing classic ERP old/new effects including 1) relative positivity (1R > N) bi-frontally from 300 to 500 ms, reflecting enhanced familiarity, 2) relative positivity (4R > 1R and 4R > N) in parietal areas from 500 to 800 ms, reflecting enhanced recollection, and 3) late frontal effects (1R > N) from 1000 to 1800 ms in right frontal areas, reflecting post-retrieval monitoring. ET analysis also revealed significant differences in eye movements across conditions. Exploration of cross-modality relationships suggested associations between memory and executive function measures and the three ERP effects. Executive function measures were associated with several indicators of saccadic eye movements and fixations, which were also associated with all three ERP effects. This novel characterization of face-name recognition memory performance using simultaneous EEG and ET reproduced classic ERP and ET effects, supports the construct validity of the multimodal FN paradigm, and holds promise as an integrative tool to probe brain networks supporting memory and executive functioning.
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Daulatzai MA. “Boomerang Neuropathology” of Late-Onset Alzheimer’s Disease is Shrouded in Harmful “BDDS”: Breathing, Diet, Drinking, and Sleep During Aging. Neurotox Res 2015; 28:55-93. [DOI: 10.1007/s12640-015-9528-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 04/03/2015] [Accepted: 04/03/2015] [Indexed: 12/12/2022]
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Zimmerman ME, Katz MJ, Wang C, Burns LC, Berman RM, Derby CA, L'Italien G, Budd D, Lipton RB. Comparison of "Word" vs. "Picture" Version of the Free and Cued Selective Reminding Test (FCSRT) in Older Adults. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:94-100. [PMID: 25870860 PMCID: PMC4392402 DOI: 10.1016/j.dadm.2014.11.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background This study examined the psychometric relationship between the Word and Picture versions of the Free and Cued Selective Reminding Test (FCSRT) and developed an equation for score conversion. Methods One hundred and eight-seven participants were administered the FCSRT-Picture and FCSRT-Word on two visits using a randomized counterbalanced design. Results Participants had a mean age of 82.1 (standard deviation or SD = 5.4) and mean education of 14.5 (SD = 3.3) years. Mean FCSRT-Picture Free Recall score (mean 33.0 years, range: 17–44 years) was 7.9 points higher than the Word score (mean 25.1 years, range: 3–43 years). The Picture and Word FCSRT correlations for Free Recall and Total Recall were r = 0.56, P < .01 and r = 0.46, P < .01, respectively. Discussion The Picture and Word versions of the FCSRT were moderately associated in a sample of cognitively normal older adults. The score mean differences and variability between FCSRT-Picture and FCSRT-Word indicate that their scores should not be considered equivalent.
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Affiliation(s)
- Molly E. Zimmerman
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Psychology, Fordham University, Bronx, NY, USA
- Corresponding author. Tel.: 718-430-3919; Fax: 718-430-3870.
| | - Mindy J. Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Cuiling Wang
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Leah C. Burns
- Global Health Economics & Outcomes Research, Bristol-Myers Squibb, Lawrenceville, NJ, USA
| | - Robert M. Berman
- Former employee of Global Clinical Research, Bristol-Myers Squibb, Wallingford, CT, USA
| | - Carol A. Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Gilbert L'Italien
- Global Health Economics & Outcomes Research, Bristol-Myers Squibb, Lawrenceville, NJ, USA
| | - David Budd
- Global Health Economics & Outcomes Research, Bristol-Myers Squibb, Lawrenceville, NJ, USA
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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Abstract
The purpose was to compare the Spanish language picture version of the Free and Cued Selective Reminding Test with Immediate Recall (pFCSRT+IR) and the Mini Mental State Exam (MMSE) in identifying very mild dementia among Spanish speaking Latino patients. The tests and an independent diagnostic assessment were administered to 112 Latino patients free of medically diagnosed dementia from an urban primary care clinic. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to examine differences in the operating characteristics of the pFCSRT+IR and the MMSE. Cut scores were manipulated to equate sensitivities (specificities) at clinically relevant values to compare differences in specificities (sensitivities) using the Pearson Chi Square test. Youden's index was used to select the optimal cut scores. Twenty-four of the 112 primary care patients (21%) received a research dementia diagnosis, indicating a substantial burden of unrecognized dementia. MMSE scores but not free recall scores were associated with years of education in patients free of dementia. AUC was significantly higher for free recall than for MMSE. Free recall performed significantly better than the MMSE in sensitivity and in specificity. Using optimal cut scores, patients with impaired free recall were 10 times more likely to have dementia than patients with intact recall, and patients with impaired MMSE scores were 4.5 times more likely to have dementia than patients with intact scores. These results suggest that the Spanish language pFCSRT+IR may be an effective tool for dementia screening in educationally diverse Latino primary care populations.
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McLaren DG, Sperling RA, Atri A. Flexible modulation of network connectivity related to cognition in Alzheimer's disease. Neuroimage 2014; 100:544-57. [PMID: 24852459 DOI: 10.1016/j.neuroimage.2014.05.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 05/06/2014] [Accepted: 05/07/2014] [Indexed: 11/26/2022] Open
Abstract
Functional neuroimaging tools, such as fMRI methods, may elucidate the neural correlates of clinical, behavioral, and cognitive performance. Most functional imaging studies focus on regional task-related activity or resting state connectivity rather than how changes in functional connectivity across conditions and tasks are related to cognitive and behavioral performance. To investigate the promise of characterizing context-dependent connectivity-behavior relationships, this study applies the method of generalized psychophysiological interactions (gPPI) to assess the patterns of associative-memory-related fMRI hippocampal functional connectivity in Alzheimer's disease (AD) associated with performance on memory and other cognitively demanding neuropsychological tests and clinical measures. Twenty-four subjects with mild AD dementia (ages 54-82, nine females) participated in a face-name paired-associate encoding memory study. Generalized PPI analysis was used to estimate the connectivity between the hippocampus and the whole brain during encoding. The difference in hippocampal-whole brain connectivity between encoding novel and encoding repeated face-name pairs was used in multiple-regression analyses as an independent predictor for 10 behavioral, neuropsychological and clinical tests. The analysis revealed connectivity-behavior relationships that were distributed, dynamically overlapping, and task-specific within and across intrinsic networks; hippocampal-whole brain connectivity-behavior relationships were not isolated to single networks, but spanned multiple brain networks. Importantly, these spatially distributed performance patterns were unique for each measure. In general, out-of-network behavioral associations with encoding novel greater than repeated face-name pairs hippocampal-connectivity were observed in the default-mode network, while correlations with encoding repeated greater than novel face-name pairs hippocampal-connectivity were observed in the executive control network (p<0.05, cluster corrected). Psychophysiological interactions revealed significantly more extensive and robust associations between paired-associate encoding task-dependent hippocampal-whole brain connectivity and performance on memory and behavioral/clinical measures than previously revealed by standard activity-behavior analysis. Compared to resting state and task-activation methods, gPPI analyses may be more sensitive to reveal additional complementary information regarding subtle within- and between-network relations. The patterns of robust correlations between hippocampal-whole brain connectivity and behavioral measures identified here suggest that there are 'coordinated states' in the brain; that the dynamic range of these states is related to behavior and cognition; and that these states can be observed and quantified, even in individuals with mild AD.
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Affiliation(s)
- Donald G McLaren
- Department of Neurology, Massachusetts General Hospital, 15 Parkman Street, WACC 715, Boston, MA 02114, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, 149 Thirteenth Street, Charlestown, MA 02129, USA; Geriatric Research, Education and Clinical Center, ENRM VA Medical Center, 200 Springs Road, Bedford, MA 01730, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, 15 Parkman Street, WACC 715, Boston, MA 02114, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, 149 Thirteenth Street, Charlestown, MA 02129, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA.
| | - Alireza Atri
- Department of Neurology, Massachusetts General Hospital, 15 Parkman Street, WACC 715, Boston, MA 02114, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, 149 Thirteenth Street, Charlestown, MA 02129, USA; Geriatric Research, Education and Clinical Center, ENRM VA Medical Center, 200 Springs Road, Bedford, MA 01730, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
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Daulatzai MA. Chronic functional bowel syndrome enhances gut-brain axis dysfunction, neuroinflammation, cognitive impairment, and vulnerability to dementia. Neurochem Res 2014; 39:624-44. [PMID: 24590859 DOI: 10.1007/s11064-014-1266-6] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 02/10/2014] [Accepted: 02/25/2014] [Indexed: 12/15/2022]
Abstract
The irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder world wide that lasts for decades. The human gut harbors a diverse population of microbial organisms which is symbiotic and important for well being. However, studies on conventional, germ-free, and obese animals have shown that alteration in normal commensal gut microbiota and an increase in pathogenic microbiota-termed "dysbiosis", impact gut function, homeostasis, and health. Diarrhea, constipation, visceral hypersensitivity, and abdominal pain arise in IBS from the gut-induced dysfunctional metabolic, immune, and neuro-immune communication. Dysbiosis in IBS is associated with gut inflammation. Gut-related inflammation is pivotal in promoting endotoxemia, systemic inflammation, and neuroinflammation. A significant proportion of IBS patients chronically consume alcohol, non-steroidal anti-inflammatories, and fatty diet; they may also suffer from co-morbid respiratory, neuromuscular, psychological, sleep, and neurological disorders. The above pathophysiological substrate is underpinned by dysbiosis, and dysfunctional bidirectional "Gut-Brain Axis" pathways. Pathogenic gut microbiota-related systemic inflammation (due to increased lipopolysaccharide and pro-inflammatory cytokines, and barrier dysfunction), may trigger neuroinflammation enhancing dysfunctional brain regions including hippocampus and cerebellum. These as well as dysfunctional vago-vagal gut-brain axis may promote cognitive impairment. Indeed, inflammation is characteristic of a broad spectrum of neurodegenerative diseases that manifest demntia. It is argued that an awareness of pathophysiological impact of IBS and implementation of appropriate therapeutic measures may prevent cognitive impairment and minimize vulnerability to dementia.
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Affiliation(s)
- Mak Adam Daulatzai
- Sleep Disorders Group, EEE Department, Melbourne School of Engineering, The University of Melbourne, Grattan Street, 3rd Floor, Room No. 344, Parkville, VIC, 3010, Australia,
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Risacher SL, Wang Y, Wishart HA, Rabin LA, Flashman LA, McDonald BC, West JD, Santulli RB, Saykin AJ. Cholinergic Enhancement of Brain Activation in Mild Cognitive Impairment during Episodic Memory Encoding. Front Psychiatry 2013; 4:105. [PMID: 24062699 PMCID: PMC3775540 DOI: 10.3389/fpsyt.2013.00105] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 08/30/2013] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine the physiological impact of treatment with donepezil (Aricept) on neural circuitry supporting episodic memory encoding in patients with amnestic mild cognitive impairment (MCI) using functional magnetic resonance imaging (fMRI). METHODS Eighteen patients with MCI and 20 age-matched healthy controls (HC) were scanned twice while performing an event-related verbal episodic encoding task. MCI participants were scanned before treatment and after approximately 3 months on donepezil; HC were untreated but rescanned at the same interval. Voxel-level analyses assessed treatment effects on activation profiles in MCI patients relative to retest changes in non-treated HC. Changes in task-related connectivity in medial temporal circuitry were also evaluated, as were associations between brain activation, task-related functional connectivity, task performance, and clinical measures of cognition. RESULTS At baseline, the MCI group showed reduced activation during encoding relative to HC in the right medial temporal lobe (MTL; hippocampal/parahippocampal) and additional regions, as well as attenuated task-related deactivation, relative to rest, in a medial parietal lobe cluster. After treatment, the MCI group showed normalized MTL activation and improved parietal deactivation. These changes were associated with cognitive performance. After treatment, the MCI group also demonstrated increased task-related functional connectivity from the right MTL cluster seed region to a network of other sites including the basal nucleus/caudate and bilateral frontal lobes. Increased functional connectivity was associated with improved task performance. CONCLUSION Pharmacologic enhancement of cholinergic function in amnestic MCI is associated with changes in brain activation and functional connectivity during episodic memory processing which are in turn related to increased cognitive performance. fMRI is a promising biomarker for assessing treatment related changes in brain function.
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Affiliation(s)
- Shannon L Risacher
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine , Indianapolis, IN , USA ; Indiana Alzheimer Disease Center, Indiana University School of Medicine , Indianapolis, IN , USA
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