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Riverol M, Ríos-Rivera MM, Imaz-Aguayo L, Solis-Barquero SM, Arrondo C, Montoya-Murillo G, Villino-Rodríguez R, García-Eulate R, Domínguez P, Fernández-Seara MA. Structural neuroimaging changes associated with subjective cognitive decline from a clinical sample. Neuroimage Clin 2024; 42:103615. [PMID: 38749146 PMCID: PMC11109886 DOI: 10.1016/j.nicl.2024.103615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Alzheimer's disease (AD) is characterized by progressive deterioration of cognitive functions. Some individuals with subjective cognitive decline (SCD) are in the early phase of the disease and subsequently progress through the AD continuum. Although neuroimaging biomarkers could be used for the accurate and early diagnosis of preclinical AD, the findings in SCD samples have been heterogeneous. This study established the morphological differences in brain magnetic resonance imaging (MRI) findings between individuals with SCD and those without cognitive impairment based on a clinical sample of patients defined according to SCD-Initiative recommendations. Moreover, we investigated baseline structural changes in the brains of participants who remained stable or progressed to mild cognitive impairment or dementia. METHODS This study included 309 participants with SCD and 43 healthy controls (HCs) with high-quality brain MRI at baseline. Among the 99 subjects in the SCD group who were followed clinically, 32 progressed (SCDp) and 67 remained stable (SCDnp). A voxel-wise statistical comparison of gray and white matter (WM) volume was performed between the HC and SCD groups and between the HC, SCDp, and SCDnp groups. XTRACT ATLAS was used to define the anatomical location of WM tract damage. Region-of-interest (ROI) analyses were performed to determine brain volumetric differences. White matter lesion (WML) burden was established in each group. RESULTS Voxel-based morphometry (VBM) analysis revealed that the SCD group exhibited gray matter atrophy in the middle frontal gyri, superior orbital gyri, superior frontal gyri, right rectal gyrus, whole occipital lobule, and both thalami and precunei. Meanwhile, ROI analysis revealed decreased volume in the left rectal gyrus, bilateral medial orbital gyri, middle frontal gyri, superior frontal gyri, calcarine fissure, and left thalamus. The SCDp group exhibited greater hippocampal atrophy (p < 0.001) than the SCDnp and HC groups on ROI analyses. On VBM analysis, however, the SCDp group exhibited increased hippocampal atrophy only when compared to the SCDnp group (p < 0.001). The SCD group demonstrated lower WM volume in the uncinate fasciculus, cingulum, inferior fronto-occipital fasciculus, anterior thalamic radiation, and callosum forceps than the HC group. However, no significant differences in WML number (p = 0.345) or volume (p = 0.156) were observed between the SCD and HC groups. CONCLUSIONS The SCD group showed brain atrophy mainly in the frontal and occipital lobes. However, only the SCDp group demonstrated atrophy in the medial temporal lobe at baseline. Structural damage in the brain regions was anatomically connected, which may contribute to early memory decline.
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Affiliation(s)
- Mario Riverol
- Department of Neurology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona 31008, Navarra, Spain.
| | - Mirla M Ríos-Rivera
- Department of Neurology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain; School of Medicine, Universidad Autónoma de Chiriquí, David 4001, Chiriquí, Panama
| | - Laura Imaz-Aguayo
- Department of Neurology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain
| | | | - Carlota Arrondo
- Department of Neurology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain
| | | | | | - Reyes García-Eulate
- Department of Radiology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain
| | - Pablo Domínguez
- Department of Radiology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona 31008, Navarra, Spain
| | - Maria A Fernández-Seara
- Department of Radiology, Clínica Universidad de Navarra, Pamplona 31008, Navarra, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona 31008, Navarra, Spain
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Jansma A, de Bresser J, Schoones JW, van Heemst D, Akintola AA. Sporadic cerebral small vessel disease and cognitive decline in healthy older adults: A systematic review and meta-analysis. J Cereb Blood Flow Metab 2024; 44:660-679. [PMID: 38415688 DOI: 10.1177/0271678x241235494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
We performed a systematic review and meta-analysis on prospective studies that provided risk estimates for the impact of 3 different MRI markers of small vessel disease (SVD), namely white matter hyperintensities (WMH), cerebral microbleeds (CMB) and lacunes, on cognitive decline in relatively healthy older adults without cognitive deficits at baseline. A total of 23 prospective studies comprising 11,486 participants were included for analysis. Extracted data was pooled, reviewed and meta-analysed separately for global cognition, executive function, memory and attention. The pooled effect size for the association between cerebral SVD and cognitive decline was for global cognition -0.10 [-0.14; -0.05], for executive functioning -0.18 [-0.24; - 0.11], for memory -0.12 [-0.17; -0.07], and for attention -0.17 [-0.23; -0.11]. Results for the association of individual MRI markers of cerebral SVD were statistically significant for WMH and global cognition -0.15 [-0.24; -0.06], WMH and executive function -0.23 [-0.33; -0.13], WMH and memory -0.19 [-0.29; -0.09], WMH and attention -0.24 [-0.39; -0.08], CMB and executive function -0.07 [-0.13; -0.02], CMB and memory -0.11 [-0.21; -0.02] and CMB and attention -0.13 [-0.25; -0.02]. In conclusion, presence of MRI markers of cerebral SVD were found to predict an increased risk of cognitive decline in relatively healthy older adults. While WMH were found to significantly affect all cognitive domains, CMB influenced decline in executive functioning over time as well as (in some studies) decline in memory and attention.
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Affiliation(s)
- Alexander Jansma
- Department of Internal Medicine, Section Geriatrics and Gerontology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jeroen de Bresser
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jan W Schoones
- Directorate of Research Policy (formerly: Walaeus Library), Leiden University Medical Centre, Leiden, The Netherlands
| | - Diana van Heemst
- Department of Internal Medicine, Section Geriatrics and Gerontology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Abimbola A Akintola
- Department of Internal Medicine, Section Geriatrics and Gerontology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
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Badji A, Cedres N, Muehlboeck JS, Khan W, Dhollander T, Barroso J, Ferreira D, Westman E. In vivo microstructural heterogeneity of white matter and cognitive correlates in aging using tissue compositional analysis of diffusion magnetic resonance imaging. Hum Brain Mapp 2024; 45:e26618. [PMID: 38414286 PMCID: PMC10899800 DOI: 10.1002/hbm.26618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/03/2023] [Accepted: 12/24/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Age-related cognitive decline is linked to changes in the brain, particularly the deterioration of white matter (WM) microstructure that accelerates after the age of 60. WM deterioration is associated with mild cognitive impairment and dementia, but the origin and role of white matter signal abnormalities (WMSA) seen in standard MRI remain debated due to their heterogeneity. This study explores the potential of single-shell 3-tissue constrained spherical deconvolution (SS3T-CSD), a novel technique that models diffusion data in terms of gray matter (TG ), white matter (Tw ), and cerebrospinal fluid (TC ), to differentiate WMSA from normal-appearing white matter and better understand the interplay between changes in WM microstructure and decline in cognition. METHODS A total of 189 individuals from the GENIC cohort were included. MRI data, including T1-weighted and diffusion images, were obtained. Preprocessing steps were performed on the diffusion MRI data, followed by the SS3T-CSD. WMSA were segmented using FreeSurfer. Statistical analyses were conducted to assess the association between age, WMSA volume, 3-tissue signal fractions (Tw , TG , and TC ), and neuropsychological variables. RESULTS Participants above 60 years old showed worse cognitive performance and processing speed compared to those below 60 (p < .001). Age was negatively associated with Tw in normal-appearing white matter (p < .001) and positively associated with TG in both WMSA (p < .01) and normal-appearing white matter (p < .001). Age was also significantly associated with WMSA volume (p < .001). Higher processing speed was associated with lower Tw and higher TG , in normal-appearing white matter (p < .01 and p < .001, respectively), as well as increased WMSA volume (p < .001). Similarly, lower MMSE scores correlated with lower Tw and higher TG in normal-appearing white matter (p < .05). High cholesterol and hypertension were associated with higher WMSA volume (p < .05). CONCLUSION The microstructural heterogeneity within normal-appearing white matter and WMSA is associated with increasing age and cognitive variation, in cognitively unimpaired individuals. Furthermore, the 3-tissue signal fractions are more specific to potential white matter alterations than conventional MRI measures such as WMSA volume. These findings also support the view that the WMSA volumes may be more influenced by vascular risk factors than the 3-tissue metrics. Finally, the 3-tissue metrics were able to capture associations with cognitive tests and therefore capable of capturing subtle pathological changes in the brain in individuals who are still within the normal range of cognitive performance.
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Affiliation(s)
- Atef Badji
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Nira Cedres
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Facultad de Ciencias de la Salud, Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, España
| | - J-Sebastian Muehlboeck
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Wasim Khan
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Thijs Dhollander
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Jose Barroso
- Facultad de Ciencias de la Salud, Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, España
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Facultad de Ciencias de la Salud, Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, España
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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van Dinther M, Hooghiemstra AM, Bron EE, Versteeg A, Leeuwis AE, Kalay T, Moonen JE, Kuipers S, Backes WH, Jansen JFA, van Osch MJP, Biessels G, Staals J, van Oostenbrugge RJ. Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment. Alzheimers Dement 2024; 20:136-144. [PMID: 37491840 PMCID: PMC10917014 DOI: 10.1002/alz.13408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Chronic cerebral hypoperfusion is one of the assumed pathophysiological mechanisms underlying vascular cognitive impairment (VCI). We investigated the association between baseline cerebral blood flow (CBF) and cognitive decline after 2 years in patients with VCI and reference participants. METHODS One hundred eighty-one participants (mean age 66.3 ± 7.4 years, 43.6% women) underwent arterial spin labeling (ASL) magnetic resonance imaging (MRI) and neuropsychological assessment at baseline and at 2-year follow-up. We determined the association between baseline global and lobar CBF and cognitive decline with multivariable regression analysis. RESULTS Lower global CBF at baseline was associated with more global cognitive decline in VCI and reference participants. This association was most profound in the domain of attention/psychomotor speed. Lower temporal and frontal CBF at baseline were associated with more cognitive decline in memory. DISCUSSION Our study supports the role of hypoperfusion in the pathophysiological and clinical progression of VCI. HIGHLIGHTS Impaired cerebral blood flow (CBF) at baseline is associated with faster cognitive decline in VCI and normal aging. Our results suggest that low CBF precedes and contributes to the development of vascular cognitive impairment. CBF determined by ASL might be used as a biomarker to monitor disease progression or treatment responses in VCI.
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Affiliation(s)
- Maud van Dinther
- Department of NeurologyMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Astrid M. Hooghiemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Esther E. Bron
- Department of Radiology & Nuclear MedicineErasmus MC—University Medical Center RotterdamRotterdamThe Netherlands
| | - Adriaan Versteeg
- Department of Radiology & Nuclear MedicineErasmus MC—University Medical Center RotterdamRotterdamThe Netherlands
| | - Anna E. Leeuwis
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Old Age PsychiatryGGZ inGeestAmsterdamThe Netherlands
| | - Tugba Kalay
- Department of NeurologySt. Antonius ZiekenhuisNieuwegeinThe Netherlands
| | - Justine E. Moonen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Sanne Kuipers
- Department of NeurologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Walter H. Backes
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Jacobus F. A. Jansen
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Mathias J. P. van Osch
- C.J. Gorter MRI Center, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Geert‐Jan Biessels
- Department of NeurologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Julie Staals
- Department of NeurologyMaastricht University Medical CenterMaastrichtThe Netherlands
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Wang X, Shi Y, Chen Y, Gao Y, Wang T, Li Z, Wang Y. Blood-Brain Barrier Breakdown is a Sensitive Biomarker of Cognitive and Language Impairment in Patients with White Matter Hyperintensities. Neurol Ther 2023; 12:1745-1758. [PMID: 37490234 PMCID: PMC10444912 DOI: 10.1007/s40120-023-00527-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION Similar white matter hyperintensities (WMH) burden may have varied cognitive outcomes in patients with cerebral small vessel disease (CSVD). This study aimed to evaluate whether blood-brain barrier (BBB) permeability is associated with cognitive impairment (CI) heterogeneity in patients with WMH. METHODS We recruited 51 participants with WMH. We evaluated WMH burden using the Fazekas scale and WMH volume on structural magnetic resonance imaging (MRI), and assessed BBB permeability using dynamic contrast-enhanced (DCE)-MRI. We used permeability-surface area product (PS) from the Patlak model to represent BBB permeability. All patients underwent Mini-Mental State Examination (MMSE), Boston Naming Test (BNT) and animal verbal fluency test (VFT) for cognitive assessment. We divided patients into CI and non-CI groups based on their MMSE scores (< 27 or ≥ 27) and used multiple linear regression models to investigate the associations between MRI parameters and cognitive function. RESULTS Patients in the two groups did not differ in Fazekas scores and WMH volume. However, patients in the CI group showed significantly higher PS in the WMH regions than those in non-CI group (1.89 × 10-3 versus 1.00 × 10-3, p = 0.032 in periventricular WMH [PVWMH]; 1.27 × 10-3 versus 0.74 × 10-3, p = 0.043 in deep WMH [DWMH]), indicating the breakdown of BBB in the CI group. In all patients with WMH, increased BBB permeability in PVWMH and DWMH was significantly associated with lower cognitive and language function after adjustment for age, education level (EL) and intracranial volume (ICV). In the CI group, this correlation remained significant. WMH volume was not associated with cognitive performance in either all patients or those with CI. CONCLUSION BBB impairment might be a more sensitive indicator for cognitive and language dysfunction than WMH volume in patients with WMH and possibly explains the heterogeneity of cognitive performance in patients with similar WMH burden.
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Affiliation(s)
- Xing Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, Beijing, 100070, China
- National Centre for Neurological Diseases, Beijing, 100070, China
- Advanced Innovation Centre for Human Brain Protection, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Centre for Neurological Diseases, Beijing, 100070, China
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100070, China
| | - Yulu Shi
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, Beijing, 100070, China
- National Centre for Neurological Diseases, Beijing, 100070, China
- Advanced Innovation Centre for Human Brain Protection, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Centre for Neurological Diseases, Beijing, 100070, China
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100070, China
| | - Yiyi Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, Beijing, 100070, China
- National Centre for Neurological Diseases, Beijing, 100070, China
- Advanced Innovation Centre for Human Brain Protection, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Centre for Neurological Diseases, Beijing, 100070, China
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100070, China
| | - Ying Gao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, Beijing, 100070, China
- National Centre for Neurological Diseases, Beijing, 100070, China
- Advanced Innovation Centre for Human Brain Protection, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Centre for Neurological Diseases, Beijing, 100070, China
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100070, China
| | - Tingting Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, Beijing, 100070, China
- National Centre for Neurological Diseases, Beijing, 100070, China
- Advanced Innovation Centre for Human Brain Protection, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Centre for Neurological Diseases, Beijing, 100070, China
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100070, China
| | - Zhengyang Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- Chinese Institute for Brain Research, Beijing, 100070, China
- National Centre for Neurological Diseases, Beijing, 100070, China
- Advanced Innovation Centre for Human Brain Protection, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Centre for Neurological Diseases, Beijing, 100070, China
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100070, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
- Chinese Institute for Brain Research, Beijing, 100070, China.
- National Centre for Neurological Diseases, Beijing, 100070, China.
- Advanced Innovation Centre for Human Brain Protection, Capital Medical University, Beijing, 100070, China.
- China National Clinical Research Centre for Neurological Diseases, Beijing, 100070, China.
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100070, China.
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Du H, Zheng J, Li X, Dong Y, Cheng Y, Liu C, Hu J, Chen X. The correlation between medial pattern of intracranial arterial calcification and white matter hyperintensities. Atherosclerosis 2023; 381:117247. [PMID: 37634296 DOI: 10.1016/j.atherosclerosis.2023.117247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND AND AIMS Despite reported correlations between intracranial arterial calcification (IAC) and white matter hyperintensities (WMH), little is known about the relationship between IAC pattern and WMH. By differentiating intimal and medial IAC, we aimed to investigate the relationship between IAC pattern and WMH. METHODS Consecutive acute stroke patients were included. IAC pattern was categorized as intimal or medial on plain brain CT. The number of cerebral arteries involved by IAC for each patient was recorded. IAC severity was defined as focal or diffuse. On brain MRI, the burden of WMH was visually graded and classified as absent mild, moderate and severe. Multiple logistic regression was performed to examine the relationship between IAC and WMH. RESULTS Among 265 patients, intimal IAC was detected in 54.7% patients and medial IAC in 48.5% patients. Diffuse IAC was present in 27.9% patients, all of which were medial. WMH was found in 75.5% patients, including 39.6% patients with mild WMH, 26.0% with moderate WMH, and 9.8% with severe WMH. The severity of medial IAC was correlated with WMH occurrence (p < 0.001). Chi-square linear trend suggested the number of arteries involved by medial IAC (p < 0.001) and the severity of medial IAC (p < 0.001) were correlated with WMH burden. Multiple ordinal logistic regression demonstrated a positive correlation of WMH burden with the number of arteries involved by medial IAC (p < 0.001) and the severity of medial IAC (p < 0.001). CONCLUSIONS Medial IAC was correlated with WMH. The dose-effect relationship between medial IAC and WMH suggests underlying shared mechanisms of intracranial large artery disease and small vessel disease.
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Affiliation(s)
- Heng Du
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region of China
| | - Jianrong Zheng
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xuelong Li
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region of China
| | - Yanjing Dong
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region of China
| | - Yajing Cheng
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Cong Liu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Jun Hu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China.
| | - Xiangyan Chen
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region of China.
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Lutshumba J, Wilcock DM, Monson NL, Stowe AM. Sex-based differences in effector cells of the adaptive immune system during Alzheimer's disease and related dementias. Neurobiol Dis 2023; 184:106202. [PMID: 37330146 PMCID: PMC10481581 DOI: 10.1016/j.nbd.2023.106202] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/19/2023] Open
Abstract
Neurological conditions such as Alzheimer's disease (AD) and related dementias (ADRD) present with many challenges due to the heterogeneity of the related disease(s), making it difficult to develop effective treatments. Additionally, the progression of ADRD-related pathologies presents differently between men and women. With two-thirds of the population affected with ADRD being women, ADRD has presented itself with a bias toward the female population. However, studies of ADRD generally do not incorporate sex-based differences in investigating the development and progression of the disease, which is detrimental to understanding and treating dementia. Additionally, recent implications for the adaptive immune system in the development of ADRD bring in new factors to be considered as part of the disease, including sex-based differences in immune response(s) during ADRD development. Here, we review the sex-based differences of pathological hallmarks of ADRD presentation and progression, sex-based differences in the adaptive immune system and how it changes with ADRD, and the importance of precision medicine in the development of a more targeted and personalized treatment for this devastating and prevalent neurodegenerative condition.
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Affiliation(s)
- Jenny Lutshumba
- Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Donna M Wilcock
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, United States of America; Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Nancy L Monson
- Department of Neurology and Immunology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Ann M Stowe
- Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, United States of America; Center for Advanced Translational Stroke Science, University of Kentucky, Lexington, KY, United States of America.
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Almeria M, Alvarez I, Molina-Seguin J, Besora S, Buongiorno M, Romero S, Casas L, Cano C, Castejon J, Arribas S, Krupinski J. Citicoline May Prevent Cognitive Decline in Patients with Cerebrovascular Disease. Clin Interv Aging 2023; 18:1093-1102. [PMID: 37489128 PMCID: PMC10363355 DOI: 10.2147/cia.s409994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/27/2023] [Indexed: 07/26/2023] Open
Abstract
Introduction Neuroprotective drugs such as citicoline could improve cognitive performance and quality of life. We studied the effect of citicoline treatment and its association with Vascular Risk Factors (VRF) and APOE on cognition in patients with Subjective Cognitive Complaints (SCC) and Mild Cognitive Impairment (MCI). Methods This is an observational and prospective study with citicoline during 12 months follow-up. Eighty-one subjects who met criteria for SCC/MCI, aged 50-75 years with VRF were included and prescribed citicoline 1g/day. Subjects with previous cognitive impairment and any other central nervous system affection were excluded. Wilcoxon Signed Ranks test and paired samples t-test were used to analyze the change in neuropsychological performance. Results Mean age of the sample was 68.2 (SD 6.8) years and 26 (32.09%) were females. Fifteen subjects (24.6%) were APOE-ε4 carriers, fifty-six (76.7%) had hypertension, fifty-eight (79.5%) had dyslipidemia, twenty-one (28.8%) had diabetes mellitus and twenty-six (35.6%) had cardiopathy. Thirty-two (43.8%) subjects were diagnosed as SCC and forty-one (56.16%) as MCI. During the follow-up, Tweny-six patients (81.25%) in the group of SCC remained stable, six subjects (18.8%) converted to MCI. Twelve patients (29.9%) with MCI reverted to SCC and twenty-nine patients (70.7%) remained stable. At follow-up, SCC subjects had an improvement in the global language domain (p=0.03), naming (p<0.001), attention (p=0.01) and visuospatial abilities (p<0.01). MCI group showed an improvement in the screening test (p=0.03), delayed memory (p<0.01), global cognition (p=0.04) and in cognitive flexibility (p=0.03). Presence of APOE-ε4 had no impact on the above findings. Discussion SCC subjects showed an improvement in language and attention domains, while those with MCI performed better after 12 months in total scores of MoCA and RBANS domains, some converting back to SCC. This supports the idea that citicoline may prevent cognitive decline in patients with cognitive deficits.
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Affiliation(s)
- Marta Almeria
- Departament de Neurologia, Fundació Assistencial Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
- Fundació per a la Recerca Biomèdica i Social MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Ignacio Alvarez
- Fundació per a la Recerca Biomèdica i Social MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Jessica Molina-Seguin
- Departament de Neurologia, Fundació Assistencial Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Sarah Besora
- Departament de Neurologia, Fundació Assistencial Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Mariateresa Buongiorno
- Departament de Neurologia, Fundació Assistencial Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
- Fundació per a la Recerca Biomèdica i Social MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Silvia Romero
- Departament de Neurologia, Fundació Assistencial Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Laura Casas
- Departament de Neurologia, Fundació Assistencial Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Cristina Cano
- Fundació per a la Recerca Biomèdica i Social MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Judith Castejon
- Fundació per a la Recerca Biomèdica i Social MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Sonia Arribas
- Fundació per a la Recerca Biomèdica i Social MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Jerzy Krupinski
- Departament de Neurologia, Fundació Assistencial Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
- Healthcare Sciences, Manchester Metropolitan University, Manchester, UK
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Rothstein A, Zhang Y, Briggs AQ, Bernard MA, Shao Y, Favilla C, Sloane K, Witsch J, Masurkar AV. Impact of white matter hyperintensities on subjective cognitive decline phenotype in a diverse cohort of cognitively normal older adults. Int J Geriatr Psychiatry 2023; 38:e5948. [PMID: 37291739 DOI: 10.1002/gps.5948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/20/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Subjective cognitive decline (SCD) is a preclinical stage of AD. White matter hyperintensities (WMH), an MRI marker of cerebral small vessel disease, associate with AD biomarkers and progression. The impact of WMH on SCD phenotype is unclear. METHODS/DESIGN A retrospective, cross-sectional analysis was conducted on a diverse cohort with SCD evaluated at the NYU Alzheimer's Disease Research Center between January 2017 and November 2021 (n = 234). The cohort was dichotomized into none-to-mild (n = 202) and moderate-to-severe (n = 32) WMH. Differences in SCD and neurocognitive assessments were evaluated via Wilcoxon or Fisher exact tests, with p-values adjusted for demographics using multivariable logistic regression. RESULTS Moderate-to-severe WMH participants reported more difficulty with decision making on the Cognitive Change Index (1.5 SD 0.7 vs. 1.2 SD 0.5, p = 0.0187) and worse short-term memory (2.2 SD 0.4 vs. 1.9 SD 0.3, p = 0.0049) and higher SCD burden (9.5 SD 1.6 vs. 8.7 SD 1.7, p = 0.0411) on the Brief Cognitive Rating Scale. Moderate-to-severe WMH participants scored lower on the Mini-Mental State Examination (28.0 SD 1.6 vs. 28.5 SD 1.9, p = 0.0491), and on delayed paragraph (7.2 SD 2.0 vs. 8.8 SD 2.9, p = 0.0222) and designs recall (4.5 SD 2.3 vs. 6.1 SD 2.5, p = 0.0373) of the Guild Memory Test. CONCLUSIONS In SCD, WMH impact overall symptom severity, specifically in executive and memory domains, as well as objective performance on global and domain-specific tests in verbal memory and visual working/associative memory.
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Affiliation(s)
- Aaron Rothstein
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yian Zhang
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Anthony Q Briggs
- Center for Cognitive Neurology, Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Mark A Bernard
- Center for Cognitive Neurology, Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Yongzhao Shao
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Christopher Favilla
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kelly Sloane
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jens Witsch
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Arjun V Masurkar
- Center for Cognitive Neurology, Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Neuroscience Institute, NYU Grossman School of Medicine, New York, New York, USA
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Ortner M, Lanz K, Goldhardt O, Müller-Sarnowski F, Diehl-Schmid J, Förstl H, Hedderich DM, Yakushev I, Logan CA, Weinberger JP, Simon M, Grimmer T. Elecsys Cerebrospinal Fluid Immunoassays Accurately Detect Alzheimer's Disease Regardless of Concomitant Small Vessel Disease. J Alzheimers Dis 2023:JAD221187. [PMID: 37212102 DOI: 10.3233/jad-221187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Differentiating dementia due to small vessel disease (SVD) from dementia due to Alzheimer's disease (AD) with concomitant SVD is challenging in clinical practice. Accurate and early diagnosis of AD is critical to delivering stratified patient care. OBJECTIVE We characterized the results of Elecsys ® cerebrospinal fluid (CSF) immunoassays (Roche Diagnostics International Ltd) in patients with early AD, diagnosed using core clinical criteria, with varying extent of SVD. METHODS Frozen CSF samples (n = 84) were measured using Elecsys β-Amyloid(1-42) (Aβ42), Phospho-Tau (181P) (pTau181), and Total-Tau (tTau) CSF immunoassays, adapted for use on the cobas ® e 411 analyzer (Roche Diagnostics International Ltd), and a robust prototype β-Amyloid(1-40) (Aβ40) CSF immunoassay. SVD was assessed by extent of white matter hyperintensities (WMH) using the lesion segmentation tool. Interrelations between WMH, biomarkers, fluorodeoxyglucose F18-positron emission tomography (FDG-PET), and other parameters (including age and Mini-Mental State examinations [MMSE]) were assessed using Spearman's correlation, sensitivity/specificity, and logistic/linear regression analyses. RESULTS The extent of WMH showed significant correlation with Aβ42/Aβ40 ratio (Rho=-0.250; p = 0.040), tTau (Rho = 0.292; p = 0.016), tTau/Aβ42 ratio (Rho = 0.247; p = 0.042), age (Rho = 0.373; p = 0.002), and MMSE (Rho=-0.410; p = 0.001). Sensitivity/specificity point estimates for Elecsys CSF immunoassays versus FDG-PET positivity for underlying AD pathophysiology were mostly comparable or greater in patients with high versus low WMH. WMH were not a significant predictor and did not interact with CSF biomarker positivity but modified the association between pTau181 and tTau. CONCLUSION Elecsys CSF immunoassays detect AD pathophysiology regardless of concomitant SVD and may help to identify patients with early dementia with underlying AD pathophysiology.
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Affiliation(s)
- Marion Ortner
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Korbinian Lanz
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Felix Müller-Sarnowski
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Hans Förstl
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Dennis M Hedderich
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | | | | | - Maryline Simon
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
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Hussein AS, Shawqi M, Bahbah EI, Ragab B, Sunoqrot M, Gadallah A, Ghaith HS, Negida A. Do cerebral microbleeds increase the risk of dementia? A systematic review and meta-analysis. IBRO Neurosci Rep 2022; 14:86-94. [PMID: 36632242 PMCID: PMC9827375 DOI: 10.1016/j.ibneur.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 12/26/2022] [Indexed: 12/29/2022] Open
Abstract
Background Dementia is a neurological disorder that commonly affects the elderly. Cerebral microbleeds (CMBs) are small, tiny lesions of the cerebral blood vessels and have been suggested as a possible risk factor for dementia. However, data about the association between CMBs and dementia risk are inconsistent and inconclusive. Therefore, we conducted this systematic review and meta-analysis to investigate the association between CMBs and dementia and highlight the possible explanations. Methods We followed the standard PRISMA statement and the Cochrane Handbook guidelines to conduct this study. First, we searched medical electronic databases for relevant articles. Then, we screened the retrieved articles for eligibility, extracted the relevant data, and appraised the methodological quality using the Newcastle-Ottawa Scale. Finally, the extracted data were pooled as risk ratios (RR) and hazard ratios (HR) in the random-effects meta-analysis model using the Review Manager software. Results We included nine studies with 14,221 participants and follow-up periods > 18 months. Overall, CMBs significantly increased the risk of developing dementia (RR 1.84, 95% CI [1.27-2.65]). This association was significant in the subgroups of studies on high-risk populations (RR 2.00, 95% CI [1.41-2.83], n = 1657 participants) and those in the general population (RR 2.30, 95% CI [1.25-4.26], n = 12,087 participants) but not in the memory clinic patients. Further, CMBs increased the risk of progressing to incident dementia over time (HR 2, 95% CI [1.54-2.61]). Conclusion Individuals with CMBs have twice the risk of developing dementia or progressing to MCI than those without CMBs. The detection of CMBs will help identify the population at higher risk of developing dementia. Physicians should educate individuals with CMBs and their families on the possibility of progressing to dementia or MCI. Regular cognitive assessments, cognitive training, lifestyle modifications, and controlling other dementia risk factors are recommended for individuals with CMBs to decrease the risk of cognitive decline and dementia development.
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Affiliation(s)
- Ahmed Salah Hussein
- Medical Research Group of Egypt (MRGE), Cairo, Egypt,Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Muhammad Shawqi
- Medical Research Group of Egypt (MRGE), Cairo, Egypt,Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Eshak I. Bahbah
- Medical Research Group of Egypt (MRGE), Cairo, Egypt,Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Basma Ragab
- Medical Research Group of Egypt (MRGE), Cairo, Egypt,Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Mohammad Sunoqrot
- Medical Research Group of Egypt (MRGE), Cairo, Egypt,Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Gadallah
- Medical Research Group of Egypt (MRGE), Cairo, Egypt,Ain Shams University Hospitals, Cairo, Egypt
| | - Hazem S. Ghaith
- Medical Research Group of Egypt (MRGE), Cairo, Egypt,Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Negida
- Medical Research Group of Egypt (MRGE), Cairo, Egypt,Faculty of Medicine, Zagazig University, Egypt,School of Pharmacy and Biomedical Sciences, University of Portsmouth, United Kingdom,Department of Global Health and Social Medicine, Harvard Medical School, MA, USA,Correspondence to: Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115, USA.
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12
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Pitti H, Diaz-Galvan P, Barroso J, Badji A, Olofsson JK, Westman E, Ferreira D, Cedres N. Cerebrovascular damage in subjective cognitive decline: A systematic review and meta-analysis. Ageing Res Rev 2022; 82:101757. [PMID: 36240992 DOI: 10.1016/j.arr.2022.101757] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) has been postulated as an early marker of Alzheimer's Disease (AD) but it can also be associated to other non-AD pathologies such as Vascular Dementia (VaD). Nevertheless, there is scarce data about SCD as a potential harbinger of cerebrovascular pathology. Thus, we conducted a systematic review and meta-analysis on the association between SCD and cerebrovascular damage measured by neuroimaging markers. METHOD This study was performed following the PRISMA guidelines. The search was conducted in 3 databases (PubMed, Scopus and Web of Science) from origin to December 8th, 2021. Primary studies including cognitively unimpaired adults with SCD and neuroimaging markers of cerebrovascular damage (i.e., white matter signal abnormalities, WMSA) were selected. Qualitative synthesis and meta-analysis of studies with a case-control design was performed. RESULTS Of 241 articles identified, 21 research articles were selected. Eight case-control studies were included for the meta-analysis. A significant overall effect-size was observed for the mean WMSA burden in SCD relative to controls, where the WMSA burden was higher in SCD. CONCLUSION Our findings show the potential usefulness of SCD as a harbinger of cerebrovascular disease in cognitively healthy individuals. Further research is needed in order to elucidate the role of SCD as a preclinical marker of vascular cognitive impairment.
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13
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Dadar M, Mahmoud S, Zhernovaia M, Camicioli R, Maranzano J, Duchesne S; CCNA Group. White matter hyperintensity distribution differences in aging and neurodegenerative disease cohorts. Neuroimage Clin 2022; 36:103204. [PMID: 36155321 DOI: 10.1016/j.nicl.2022.103204] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION White matter hyperintensities (WMHs) are common magnetic resonance imaging (MRI) findings in the aging population in general, as well as in patients with neurodegenerative diseases. They are known to exacerbate the cognitive deficits and worsen the clinical outcomes in the patients. However, it is not well-understood whether there are disease-specific differences in prevalence and distribution of WMHs in different neurodegenerative disorders. METHODS Data included 976 participants with cross-sectional T1-weighted and fluid attenuated inversion recovery (FLAIR) MRIs from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) cohort of the Canadian Consortium on Neurodegeneration in Aging (CCNA) with eleven distinct diagnostic groups: cognitively intact elderly (CIE), subjective cognitive impairment (SCI), mild cognitive impairment (MCI), vascular MCI (V-MCI), Alzheimer's dementia (AD), vascular AD (V-AD), frontotemporal dementia (FTD), Lewy body dementia (LBD), cognitively intact elderly with Parkinson's disease (PD-CIE), cognitively impaired Parkinson's disease (PD-CI), and mixed dementias. WMHs were segmented using a previously validated automated technique. WMH volumes in each lobe and hemisphere were compared against matched CIE individuals, as well as each other, and between men and women. RESULTS All cognitively impaired diagnostic groups had significantly greater overall WMH volumes than the CIE group. Vascular groups (i.e. V-MCI, V-AD, and mixed dementia) had significantly greater WMH volumes than all other groups, except for FTD, which also had significantly greater WMH volumes than all non-vascular groups. Women tended to have lower WMH burden than men in most groups and regions, controlling for age. The left frontal lobe tended to have a lower WMH burden than the right in all groups. In contrast, the right occipital lobe tended to have greater WMH volumes than the left. CONCLUSIONS There were distinct differences in WMH prevalence and distribution across diagnostic groups, sexes, and in terms of asymmetry. WMH burden was significantly greater in all neurodegenerative dementia groups, likely encompassing areas exclusively impacted by neurodegeneration as well as areas related to cerebrovascular disease pathology.
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14
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Polyakova M, Mueller K, Arelin K, Lampe L, Rodriguez FS, Luck T, Kratzsch J, Hoffmann KT, Riedel-Heller S, Villringer A, Schoenknecht P, Schroeter ML. Increased Serum NSE and S100B Indicate Neuronal and Glial Alterations in Subjects Under 71 Years With Mild Neurocognitive Disorder/Mild Cognitive Impairment. Front Cell Neurosci 2022; 16:788150. [PMID: 35910248 PMCID: PMC9329528 DOI: 10.3389/fncel.2022.788150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Mild cognitive impairment (MCI) is considered a pre-stage of different dementia syndromes. Despite diagnostic criteria refined by DSM-5 and a new term for MCI – “mild neurocognitive disorder” (mild NCD) – this diagnosis is still based on clinical criteria. Methods To link mild NCD to the underlying pathophysiology we assessed the degree of white matter hyperintensities (WMH) in the brain and peripheral biomarkers for neuronal integrity (neuron-specific enolase, NSE), plasticity (brain-derived neurotrophic factor, BDNF), and glial function (S100B) in 158 community-dwelling subjects with mild NCD and 82 healthy controls. All participants (63–79 years old) were selected from the Leipzig-population-based study of adults (LIFE). Results Serum S100B levels were increased in mild NCD in comparison to controls (p = 0.007). Serum NSE levels were also increased but remained non-significant after Bonferroni-Holm correction (p = 0.04). Furthermore, age by group interaction was significant for S100B. In an age-stratified sub-analysis, NSE and S100B were higher in younger subjects with mild NCD below 71 years of age. Some effects were inconsistent after controlling for potentially confounding factors. The discriminatory power of the two biomarkers NSE and S100B was insufficient to establish a pathologic threshold for mild NCD. In subjects with mild NCD, WMH load correlated with serum NSE levels (r = 0.20, p = 0.01), independently of age. Conclusion Our findings might indicate the presence of neuronal (NSE) and glial (S100B) injury in mild NCD. Future studies need to investigate whether younger subjects with mild NCD with increased biomarker levels are at risk of developing major NCD.
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Affiliation(s)
- Maryna Polyakova
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- University Clinic for Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
- *Correspondence: Maryna Polyakova
| | - Karsten Mueller
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Katrin Arelin
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Leonie Lampe
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Francisca S. Rodriguez
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Research Group Psychosocial Epidemiology and Public Health, German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany
| | - Tobias Luck
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Faculty of Applied Social Sciences, University of Applied Sciences Erfurt, Erfurt, Germany
| | - Jürgen Kratzsch
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | | | - Steffi Riedel-Heller
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig University, Leipzig, Germany
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Institute of Neuroradiology, University Clinic, Leipzig, Germany
| | - Peter Schoenknecht
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- University Clinic for Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Affiliated Hospital Arnsdorf, Technical University of Dresden, Dresden, Germany
| | - Matthias L. Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
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Dhana A, DeCarli C, Dhana K, Desai P, Krueger K, Evans DA, Rajan KB. Association of Subjective Memory Complaints With White Matter Hyperintensities and Cognitive Decline Among Older Adults in Chicago, Illinois. JAMA Netw Open 2022; 5:e227512. [PMID: 35426922 PMCID: PMC9012965 DOI: 10.1001/jamanetworkopen.2022.7512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/28/2022] [Indexed: 11/26/2022] Open
Abstract
Importance Subjective memory complaints (SMCs) are associated with a faster cognitive decline; whether this association is also associated with structural brain alterations, such as white matter hyperintensity (WMH) volumes, requires investigation. Objective To evaluate the association of SMCs with WMH volumes and cognitive decline and investigate the role of WMH volumes in the association between SMCs and cognitive decline. Design, Setting, and Participants The Chicago Health and Aging Project, a population-based cohort study, enrolled adults aged 65 years or older. Data collection occurred in 3-year cycles from 1993 until 2012. Our study comprised 975 participants with magnetic resonance imaging assessments, of which 900 participants had data on SMCs and covariates, and 713 participants provided 2 or more cognitive assessments during the follow-up. Statistical analyses were conducted from May to October 2021. Exposures SMCs were obtained from self-reported questionnaire data during clinical evaluations, and the cycle, when reported, constituted the baseline of our study. Based on the frequency and severity of concerns, we categorized participants into 3 groups, (1) no concerns, (2) moderate concerns, and (3) very worried. Main Outcomes and Measures Volumetric magnetic resonance imaging measures of WMH volume and neuropsychological testing assessments of global cognition. Linear regression analysis was used to investigate the association between SMCs and WMH volumes in a multivariable model adjusted for age, sex, race and ethnicity, education, APOE4 status, and total intracranial volume. The association of SMCs with cognitive decline was investigated using linear mixed-effects models for age, sex, race and ethnicity, education, APOE4 status, follow-up time, and each variable in interaction with time to estimate the annual longitudinal change in cognitive function. Results Of the 900 participants with data on SMCs, covariates, and WMH volumes, 553 (61.4%) were women, 539 (59.9%) were African American, and the mean (SD) age was 79.5 (6.2) years. SMCs were associated with a larger WMH volume and faster cognitive decline. Compared with participants with no concerns, participants who were very worried had higher WMH volumes (β = 0.833; 95% CI, 0.203-1.463) and 174% faster cognitive decline (β = -0.049; 95% CI, -0.076 to -0.022). The association between SMCs and cognitive decline remained statistically significant among individuals with large WMH volumes (ie, within the fourth quartile). Within the fourth quartile of WMH volumes, participants who were very worried had 428% faster cognitive decline (β = -0.077; 95% CI, -0.144 to -0.011) compared with participants with no concerns. Conclusions and Relevance This cohort study suggests that SMCs, frequently reported by older individuals, are an important sign of cognitive impairment, especially among people with abnormalities in brain structure, such as larger WMH volumes.
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Affiliation(s)
- Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Sacramento
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Kristin Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
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Tan CH, Chew J, Zhang L, Gulyás B, Chen C. Differential Effects of White Matter Hyperintensities and Regional Amyloid Deposition on Regional Cortical Thickness. Neurobiol Aging 2022. [DOI: 10.1016/j.neurobiolaging.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/12/2022] [Accepted: 03/17/2022] [Indexed: 11/22/2022]
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17
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Jester DJ, Vyhnálek M, Andel R, Marková H, Nikolai T, Laczó J, Matusková V, Cechová K, Sheardova K, Hort J. Progression from Subjective Cognitive Decline to Mild Cognitive Impairment or Dementia: The Role of Baseline Cognitive Performance. J Alzheimers Dis 2022; 86:1763-1774. [DOI: 10.3233/jad-215291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Older adults with subjective cognitive decline (SCD) are at an increased risk of progression to mild cognitive impairment (MCI) or dementia. However, few have examined the specific cognitive tests that are associated with progression. Objective: This study examined performance on 18 neuropsychological tests among participants with SCD who later progressed to MCI or dementia. Methods: We included 131 participants from the Czech Brain Aging Study that had SCD at baseline. They completed a comprehensive neuropsychological battery including cognitive tests from the Uniform Data Set 2.0 enriched by the verbal memory test Rey Auditory Verbal Learning Test (RAVLT) and Rey-Osterrieth Complex Figure Test (ROCFT). Results: Fifty-five participants progressed: 53% to non-amnestic MCI (naMCI), 44% to amnestic MCI (aMCI), and 4% to dementia. Scoring one SD below the mean at baseline on the RAVLT 1 and RAVLT 1–5 was associated with 133% (RAVLT 1; HR: 2.33 [1.50, 3.62]) and 122% (RAVLT 1–5; HR: 2.22 [1.55, 3.16]) greater risk of progression to MCI or dementia over 3.84 years on average. Worse performance on the RAVLT 5, RAVLT 1–5, RAVLT 30, and ROCFT–Recall was associated with progression to aMCI whereas worse performance on the RAVLT 1, TMT B, and Boston Naming Test was associated with progression to naMCI. Conclusion: At baseline, lower verbal memory performance was most strongly associated with progression to aMCI whereas lower executive or language performance was most strongly associated with progression to naMCI.
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Affiliation(s)
- Dylan J. Jester
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA
| | - Martin Vyhnálek
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Ross Andel
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Hana Marková
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Tomás Nikolai
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Jan Laczó
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Veronika Matusková
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Katerina Cechová
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Katerina Sheardova
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- First Department of Neurology, St. Anne’s University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jakub Hort
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czech Republic
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18
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Montandon ML, Herrmann FR, Garibotto V, Rodriguez C, Haller S, Giannakopoulos P. Microbleeds and Medial Temporal Atrophy Determine Cognitive Trajectories in Normal Aging: A Longitudinal PET-MRI Study. J Alzheimers Dis 2021; 77:1431-1442. [PMID: 32925053 DOI: 10.3233/jad-200559] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The cognitive trajectories in normal aging may be affected by medial temporal atrophy (MTA) and amyloid burden, as well as vascular pathologies such as cortical microbleeds (CMB) and white matter hyperintensities (WMH). OBJECTIVE We addressed here the role of imaging markers in their prediction in a real-world situation. METHODS We performed a 4.5-year longitudinal study in 90 older community-dwellers coupling two neuropsychological assessments, MTA estimated with the Schelten's scale, number of CMB, and WMH evaluated with the Fazekas score at inclusion and follow-up, visual rating of amyloid PET and glucose hypometabolism at follow-up, and APOE genotyping. Regression models were built to explore the association between the continuous cognitive score (CCS) and imaging parameters. RESULTS The number of strictly lobar CMB at baseline (4 or more) was related to a 5.5-fold increase of the risk of cognitive decrement. This association persisted in multivariable models explaining 10.6% of the CCS decrease variance. MTA, and Fazekas score at baseline and amyloid positivity or abnormal FDG PET, were not related to the cognitive outcome. The increase of right MTA at follow-up was the only correlate of CCS decrease both in univariate and multivariable models explaining 9.2% of its variance. CONCLUSION The present data show that the accumulation of more than four CMB is associated with significant cognitive decrement over time in highly educated elderly persons. They also reveal that the progressive deterioration of cognitive performance within the age-adjusted norms is also related to the increase of visually assessed MTA.
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Affiliation(s)
- Marie-Louise Montandon
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Switzerland.,Department of Psychiatry, University of Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals and University of Geneva, Switzerland
| | - Cristelle Rodriguez
- Department of Psychiatry, University of Geneva, Switzerland.,Medical Direction, University of Geneva Hospitals, Geneva, Switzerland
| | - Sven Haller
- CIRD - Centre d'Imagerie Rive Droite in Geneva, Switzerland.,Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Department of Neuroradiology, Faculty of Medicine of the University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Department of Psychiatry, University of Geneva, Switzerland.,Medical Direction, University of Geneva Hospitals, Geneva, Switzerland
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Cedres N, Diaz-Galvan P, Diaz-Flores L, Muehlboeck JS, Molina Y, Barroso J, Westman E, Ferreira D. The interplay between gray matter and white matter neurodegeneration in subjective cognitive decline. Aging (Albany NY) 2021; 13:19963-19977. [PMID: 34433132 PMCID: PMC8436909 DOI: 10.18632/aging.203467] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/14/2021] [Indexed: 01/10/2023]
Abstract
Aims: To investigate the interplay between gray matter (GM) and white matter (WM) neurodegeneration in subjective cognitive decline (SCD), including thickness across the whole cortical mantle, hippocampal volume, and integrity across the whole WM. Methods: We included 225 cognitively unimpaired individuals from a community-based cohort. Subjective cognitive complaints were assessed through 9 questions covering amnestic and non-amnestic cognitive domains. In our cohort, 123 individuals endorsed from one to six subjective cognitive complaints (i.e. they fulfilled the diagnostic criteria for SCD), while 102 individuals reported zero complaints. GM neurodegeneration was assessed through measures of cortical thickness across the whole mantle and hippocampal volume. WM neurodegeneration was assessed through measures of mean diffusivity (MD) across the whole WM skeleton. Mediation analysis and multiple linear regression were conducted to investigate the interplay between the measures of GM and WM neurodegeneration. Results: A higher number of complaints was associated with reduced hippocampal volume, cortical thinning in several frontal and temporal areas and the insula, and higher MD across the WM skeleton, with a tendency to spare the occipital lobe. SCD-related cortical thinning and increased MD were associated with each other and jointly contributed to complaints, but the contribution of cortical thinning to the number of complaints was stronger. Conclusions: Neurodegeneration processes affecting the GM and WM seem to be associated with each other in SCD and include brain areas other than those typically targeted by Alzheimer’s disease. Our findings suggest that SCD may be a sensitive behavioral marker of heterogeneous brain pathologies in individuals recruited from the community.
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Affiliation(s)
- Nira Cedres
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet (KI), Stockholm, Sweden.,Department of Psychology, Sensory Cognitive Interaction Laboratory (SCI-lab), Stockholm University, Stockholm, Sweden
| | - Patricia Diaz-Galvan
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet (KI), Stockholm, Sweden.,Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - J-Sebastian Muehlboeck
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet (KI), Stockholm, Sweden
| | - Yaiza Molina
- Faculty of Health Sciences, University Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - José Barroso
- Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain
| | - Eric Westman
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet (KI), Stockholm, Sweden.,Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet (KI), Stockholm, Sweden.,Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.,Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain
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20
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Ortega G, Espinosa A, Alegret M, Monté-Rubio GC, Sotolongo-Grau O, Sanabria A, Tartari JP, Rodríguez-Gómez O, Marquié M, Vivas A, Gómez-Chiari M, Alarcón-Martín E, Pérez-Cordón A, Roberto N, Hernández I, Rosende-Roca M, Vargas L, Mauleón A, Abdelnour C, Esteban De Antonio E, López-Cuevas R, Alonso-Lana S, Moreno-Grau S, de Rojas I, Orellana A, Montrreal L, Tárraga L, Ruiz A, Boada M, Valero S. Combination of white matter hyperintensities and Aβ burden is related to cognitive composites domain scores in subjective cognitive decline: the FACEHBI cohort. Alzheimers Res Ther 2021; 13:141. [PMID: 34404456 PMCID: PMC8371791 DOI: 10.1186/s13195-021-00877-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/13/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND To explore whether the combination of white matter hyperintensities (WMHs) and amyloid-beta (Aβ) deposition is associated with worse cognitive performance on cognitive composites (CCs) domain scores in individuals with subjective cognitive decline (SCD). METHODS Two hundred participants from the FACEHBI cohort underwent structural magnetic resonance imaging (MRI), 18F-florbetaben positron emission tomography (FBB-PET), and neuropsychological assessment. WMHs were addressed through the Fazekas scale, the Age-Related White Matter Changes (ARWMC) scale, and the FreeSurfer pipeline. Eight CCs domain scores were created using the principal component analysis (PCA). Age, sex, education, and apolipoprotein E (APOE) were used as adjusting variables. RESULTS Adjusted multiple linear regression models showed that FreeSurfer (B - .245; 95% CI - .1.676, - .393, p = .016) and β burden (SUVR) (B - .180; 95% CI - 2.140, - .292; p = .070) were associated with face-name associative memory CCs domain score, although the latest one was not statistically significant after correction for multiple testing (p = .070). There was non-significant interaction of these two factors on this same CCs domain score (p = .54). However, its cumulative effects on face-name associative performance indicated that those individuals with either higher WMH load or higher Aβ burden showed the worst performance on the face-name associative memory CCs domain score. CONCLUSIONS Our results suggest that increased WMH load and increased Aβ are independently associated with poorer episodic memory performance in SCD individuals, indicating a cumulative effect of the combination of these two pathological conditions in promoting lower cognitive performance, an aspect that could help in terms of treatment and prevention.
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Affiliation(s)
- G Ortega
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain.
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
| | - A Espinosa
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Alegret
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - G C Monté-Rubio
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - O Sotolongo-Grau
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Sanabria
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - J P Tartari
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - O Rodríguez-Gómez
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Marquié
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Vivas
- Departament de Diagnòstic Per La Imatge, Clínica Corachan, Barcelona, Spain
| | - M Gómez-Chiari
- Departament de Diagnòstic Per La Imatge, Clínica Corachan, Barcelona, Spain
| | - E Alarcón-Martín
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Pérez-Cordón
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - N Roberto
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - I Hernández
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Rosende-Roca
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - L Vargas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Mauleón
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - C Abdelnour
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - E Esteban De Antonio
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - R López-Cuevas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - S Alonso-Lana
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - S Moreno-Grau
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - I de Rojas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Orellana
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - L Montrreal
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - L Tárraga
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Ruiz
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Boada
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - S Valero
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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Scarth M, Rissanen I, Scholten RJPM, Geerlings MI. Biomarkers of Alzheimer's Disease and Cerebrovascular Lesions and Clinical Progression in Patients with Subjective Cognitive Decline: A Systematic Review. J Alzheimers Dis 2021; 83:1089-1111. [PMID: 34397412 DOI: 10.3233/jad-210218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Early identification of Alzheimer's disease (AD) may be extremely beneficial for delaying disease progression. Subjective cognitive decline (SCD) may be an early indicator of AD pathology. Not all individuals with SCD will eventually develop AD, making it critical to identify biomarkers during the SCD stage which indicate likely clinical progression. OBJECTIVE The present review aims to summarize available data on structural MRI and cerebrospinal fluid (CSF) biomarkers and their association with clinical progression to mild cognitive impairment (MCI) or AD in people with SCD. METHODS Database searches were conducted using Embase and PubMed until June 2020. Longitudinal studies assessing biomarkers in individuals with SCD and assessing clinical progression to MCI/AD were included. Two assessors performed data extraction and assessed the risk of bias in the included studies. Data were synthesized narratively. RESULTS An initial search identified 1,065 papers; after screening and review 14 studies were included. Sample size of the included studies ranged from 28-674, mean age was 60.0-68.6 years, and 10.2%-52%of participants converted to MCI/AD. Lower levels of CSF Aβ 42 were consistently associated with clinical progression. Combination measures identifying an AD-like profile of Aβ 42 and tau levels were strongly associated with clinical progression. Biomarkers identified with structural MRI were less conclusive, as some studies found significant associations while others did not. CONCLUSION Biomarkers may be able to predict clinical progression in those with cognitive complaints. Aβ 42, or combinations of Aβ 42 and tau may be useful biomarkers in identifying individuals with SCD who will progress to MCI/AD.
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Affiliation(s)
- Morgan Scarth
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Ina Rissanen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Rob J P M Scholten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
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22
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Cho I, Kim S, Choi JG, Shin JH. Subjective Memory Complaints and Sensitivity of the Subjective Memory Complaint Questionnaire in Post-Stroke Dementia Patients. Dement Geriatr Cogn Disord 2021; 49:279-285. [PMID: 32781444 DOI: 10.1159/000509083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/01/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Subjective memory complaints (SMCs) among stroke patients are common. To date, reports on SMCs using the Subjective Memory Complaint Questionnaire (SMCQ) are limited. We provided descriptive information on SMCs using the SMCQ alongside objective neuropsychological function assessment in stroke patients and established the sensitivity of SMCQ for post-stroke dementia. METHODS In total, 419 consecutive stroke patients who were admitted to a stroke unit for younger populations (age <65 years) at a rehabilitation hospital from June 1, 2014, to January 1, 2020, were reviewed. SMCs were measured using the SMCQ. Objective neuropsychological function was assessed using protocols of the Vascular Cognitive Impairment Harmonization Standards. RESULTS SMCs were significantly correlated with objective neuropsychological functions including memory, executive function, language, and depression. SMCs were not significantly correlated with visuospatial function. The SMCQ exhibited comparable sensitivity to that of Mini-Mental Status Examination for evaluating post-stroke dementia. CONCLUSIONS The SMCQ may be a valid measure of cognitive function among patients with stroke, is sensitive for post-stroke dementia, and may assume a complementary role for assessing patients with stroke.
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Affiliation(s)
- Inkyoung Cho
- Department of Rehabilitation Medicine, National Rehabilitation Center, Ministry of Health and Welfare, Seoul, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Jeong Gue Choi
- Department of Rehabilitation Medicine, National Rehabilitation Center, Ministry of Health and Welfare, Seoul, Republic of Korea
| | - Joon-Ho Shin
- Department of Rehabilitation Medicine, National Rehabilitation Center, Ministry of Health and Welfare, Seoul, Republic of Korea,
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Wang M, Hu HY, Wang ZT, Ou YN, Qu Y, Ma YH, Dong Q, Tan L, Yu JT. Association of cerebral microbleeds with risks of cognitive impairment and dementia: A systematic review and meta-analysis of prospective studies. Brain Disorders 2021. [DOI: 10.1016/j.dscb.2021.100010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Guevarra AC, Ng SC, Saffari SE, Wong BYX, Chander RJ, Ng KP, Kandiah N. Age Moderates Associations of Hypertension, White Matter Hyperintensities, and Cognition. J Alzheimers Dis 2021; 75:1351-1360. [PMID: 32417773 DOI: 10.3233/jad-191260] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hypertension and white matter hyperintensities (WMH) are mutually associated risk factors for cognitive impairment. However, age may modify the associations between hypertension and WMH, and their links to cognitive impairment. OBJECTIVE We evaluated the interaction between age and hypertension on WMH, and the age-stratified associations of hypertension and WMH with cognition. METHODS Key measures include systolic blood pressure (SBP), WMH (modified Fazekas visual ratings of cranial MRI), and the Montreal Cognitive Assessment (MoCA). Participants (N = 488) with prodromal and mild dementia were age-stratified (≤49, 50-59, 60-69,≥70), and considered hypertensive if their SBP≥140 mmHg. The interaction between age strata and hypertension on WMH, and age-stratified associations of hypertension and WMH with cognition, were evaluated using multiple linear regression analyses. Analyses controlled for other risk factors for WMH and cognitive impairment. RESULTS Age moderated the association between SBP and WMH. Hypertension was associated with higher WMH only in those aged 60-69, and WMH trends across age bands differed between those with and without hypertension. Finally, WMH and SBP≥140 were independently associated with lower MoCA scores within the 50-59 age band, while WMH alone was associated with poorer MoCA scores in the≥70 age band. CONCLUSION In adults with prodromal or mild dementia, hypertension was associated with WMH specifically in the 60-69 age strata. Associations between hypertension and WMH with poorer cognition also differed across age bands. Future studies will be needed to investigate whether blood pressure management to slow cognitive decline by targeting WMH may be age dependent.
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Affiliation(s)
| | - Sheng Chun Ng
- Department of Neurology, National Neuroscience Institute, Singapore
| | | | | | - Russell Jude Chander
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Kok Pin Ng
- Department of Neurology, National Neuroscience Institute, Singapore.,Duke-NUS Medical School, Singapore
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Singapore.,Duke-NUS Medical School, Singapore.,Lee Kong Chian School of Medicine - Imperial College London, Nanyang Technological University, Singapore
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25
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Diaz-Galvan P, Ferreira D, Cedres N, Falahati F, Hernández-Cabrera JA, Ames D, Barroso J, Westman E. Comparing different approaches for operationalizing subjective cognitive decline: impact on syndromic and biomarker profiles. Sci Rep 2021; 11:4356. [PMID: 33623075 PMCID: PMC7902653 DOI: 10.1038/s41598-021-83428-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/01/2021] [Indexed: 01/31/2023] Open
Abstract
Subjective cognitive decline (SCD) has been proposed as a risk factor for future cognitive decline and dementia. Given the heterogeneity of SCD and the lack of consensus about how to classify this condition, different operationalization approaches still need to be compared. In this study, we used the same sample of individuals to compare different SCD operationalization approaches. We included 399 cognitively healthy individuals from a community-based cohort. SCD was assessed through nine questions about memory and non-memory subjective complaints. We applied four approaches to operationalize SCD: two hypothesis-driven approaches and two data-driven approaches. We characterized the resulting groups from each operationalization approach using multivariate methods on comprehensive demographic, clinical, cognitive, and neuroimaging data. We identified two main phenotypes: an amnestic phenotype characterized by an Alzheimer's Disease (AD) signature pattern of brain atrophy; and an anomic phenotype, which was mainly related to cerebrovascular pathology. Furthermore, language complaints other than naming helped to identify a subgroup with subclinical cognitive impairment and difficulties in activities of daily living. This subgroup also showed an AD signature pattern of atrophy. The identification of SCD phenotypes, characterized by different syndromic and biomarker profiles, varies depending on the operationalization approach used. In this study we discuss how these findings may be used in clinical practice and research.
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Affiliation(s)
- Patricia Diaz-Galvan
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Ferreira
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Nira Cedres
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Farshad Falahati
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Juan Andrés Hernández-Cabrera
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain
| | - David Ames
- grid.1008.90000 0001 2179 088XAcademic Unit for Psychiatry of Old Age (St. Vincent’s Health), University of Melbourne, Kew, VIC Australia ,grid.429568.40000 0004 0382 5980National Ageing Research Institute, Parkville, VIC Australia
| | - Jose Barroso
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain
| | - Eric Westman
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden ,grid.13097.3c0000 0001 2322 6764Department of Neuroimaging, Center for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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26
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Clark CE, Thomas D, Llewellyn DJ, Ferrucci L, Bandinelli S, Campbell JL. Systolic inter-arm blood pressure difference and risk of cognitive decline in older people: a cohort study. Br J Gen Pract 2020; 70:e472-80. [PMID: 32366532 DOI: 10.3399/bjgp20X709589] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/08/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Systolic inter-arm difference in blood pressure (IAD) and cognitive decline are both associated with cardiovascular disease; therefore, it was hypothesised that IAD may be predictive of cognitive decline. AIM To examine associations of IAD with cognitive decline in a community population. DESIGN AND SETTING A prospective study of older Italian adults enrolled in the InCHIANTI study. METHOD Univariable and multivariable associations of IAD were explored with declines in mini mental state examination (MMSE) scores, Trail Making Test A and B scores, and a composite outcome representing substantial decline in any of these scores. Backward stepwise regression was used to adjust observed associations of IAD with cognitive decline. RESULTS The rate of decline for MMSE scores in 1133 participants was greater with IAD ≥5 mmHg or ≥10 mmHg. On univariable analyses continuous IAD was associated with the composite outcome (odds ratio [OR] 1.16 per 5 mmHg of IAD, 95% confidence interval [CI] = 1.02 to 1.31). Substantial decline in MMSE score was seen with IAD ≥5 mmHg (OR 1.41, 95% CI = 1.03 to 1.93), and in the composite outcome with IAD ≥5 mmHg (OR 1.44, 95% CI = 1.10 to 1.89) or ≥10 mmHg (OR 1.39, 95% CI = 1.03 to 1.88). After multivariable adjustment, an IAD ≥ 5 mmHg remained associated with reductions in the composite outcome, reflecting declining cognitive performance (OR 1.46, 95% CI = 1.05 to 2.03). CONCLUSION An IAD ≥5 mmHg is associated with cognitive decline in a representative older population. Given that systolic inter-arm differences in blood pressure are easily measured, confirmation of these findings could inform individualised treatment for the prevention of cognitive decline and dementia.
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27
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Fiford CM, Sudre CH, Pemberton H, Walsh P, Manning E, Malone IB, Nicholas J, Bouvy WH, Carmichael OT, Biessels GJ, Cardoso MJ, Barnes J. Automated White Matter Hyperintensity Segmentation Using Bayesian Model Selection: Assessment and Correlations with Cognitive Change. Neuroinformatics 2020; 18:429-449. [PMID: 32062817 PMCID: PMC7338814 DOI: 10.1007/s12021-019-09439-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Accurate, automated white matter hyperintensity (WMH) segmentations are needed for large-scale studies to understand contributions of WMH to neurological diseases. We evaluated Bayesian Model Selection (BaMoS), a hierarchical fully-unsupervised model selection framework for WMH segmentation. We compared BaMoS segmentations to semi-automated segmentations, and assessed whether they predicted longitudinal cognitive change in control, early Mild Cognitive Impairment (EMCI), late Mild Cognitive Impairment (LMCI), subjective/significant memory concern (SMC) and Alzheimer's (AD) participants. Data were downloaded from the Alzheimer's disease Neuroimaging Initiative (ADNI). Magnetic resonance images from 30 control and 30 AD participants were selected to incorporate multiple scanners, and were semi-automatically segmented by 4 raters and BaMoS. Segmentations were assessed using volume correlation, Dice score, and other spatial metrics. Linear mixed-effect models were fitted to 180 control, 107 SMC, 320 EMCI, 171 LMCI and 151 AD participants separately in each group, with the outcomes being cognitive change (e.g. mini-mental state examination; MMSE), and BaMoS WMH, age, sex, race and education used as predictors. There was a high level of agreement between BaMoS' WMH segmentation volumes and a consensus of rater segmentations, with a median Dice score of 0.74 and correlation coefficient of 0.96. BaMoS WMH predicted cognitive change in: control, EMCI, and SMC groups using MMSE; LMCI using clinical dementia rating scale; and EMCI using Alzheimer's disease assessment scale-cognitive subscale (p < 0.05, all tests). BaMoS compares well to semi-automated segmentation, is robust to different WMH loads and scanners, and can generate volumes which predict decline. BaMoS can be applicable to further large-scale studies.
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Affiliation(s)
- Cassidy M. Fiford
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Carole H. Sudre
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Hugh Pemberton
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Phoebe Walsh
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Emily Manning
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Ian B. Malone
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | | | - Willem H Bouvy
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - M. Jorge Cardoso
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Josephine Barnes
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - for the Alzheimer’s Disease Neuroimaging Initiative
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
- Pennington Biomedical Research Center, Baton Rouge, LA USA
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28
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Leeuwis AE, Hooghiemstra AM, Bron EE, Kuipers S, Oudeman EA, Kalay T, Brunner-La Rocca HP, Kappelle LJ, van Oostenbrugge RJ, Greving JP, Niessen WJ, van Buchem MA, van Osch MJP, van Rossum AC, Prins ND, Biessels GJ, Barkhof F, van der Flier WM. Cerebral blood flow and cognitive functioning in patients with disorders along the heart-brain axis: Cerebral blood flow and the heart-brain axis. Alzheimers Dement (N Y) 2020; 6:e12034. [PMID: 32995468 PMCID: PMC7507476 DOI: 10.1002/trc2.12034] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/06/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION We examined the role of hemodynamic dysfunction in cognition by relating cerebral blood flow (CBF), measured with arterial spin labeling (ASL), to cognitive functioning, in patients with heart failure (HF), carotid occlusive disease (COD), and patients with cognitive complaints and vascular brain injury on magnetic resonance imaging (MRI; ie, possible vascular cognitive impairment [VCI]). METHODS We included 439 participants (124 HF; 75 COD; 127 possible VCI; 113 reference participants) from the Dutch multi-center Heart-Brain Study. We used pseudo-continuous ASL to estimate whole-brain and regional partial volume-corrected CBF. Neuropsychological tests covered global cognition and four cognitive domains. RESULTS CBF values were lowest in COD, followed by VCI and HF, compared to reference participants. This did not explain cognitive impairment, as we did not find an association between CBF and cognitive functioning. DISCUSSION We found that reduced CBF is not the major explanatory factor underlying cognitive impairment in patients with hemodynamic dysfunction along the heart-brain axis.
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Affiliation(s)
- Anna E Leeuwis
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC VU University Medical Center Amsterdam the Netherlands
| | - Astrid M Hooghiemstra
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC VU University Medical Center Amsterdam the Netherlands
- Department of Medical Humanities Amsterdam UMC Amsterdam Public Health Research Institute VU University Medical Center Amsterdam the Netherlands
| | - Esther E Bron
- Biomedical Imaging Group Rotterdam Erasmus MC Departments of Medical Informatics and Radiology & Nuclear Medicine Rotterdam the Netherlands
| | - Sanne Kuipers
- Department of Neurology UMC Utrecht Brain Center University Medical Center Utrecht Utrecht the Netherlands
| | - Eline A Oudeman
- Department of Neurology UMC Utrecht Brain Center University Medical Center Utrecht Utrecht the Netherlands
| | - Tugba Kalay
- Department of Neurology Maastricht University Medical Center Maastricht the Netherlands
| | | | - L Jaap Kappelle
- Department of Neurology UMC Utrecht Brain Center University Medical Center Utrecht Utrecht the Netherlands
| | | | - Jacoba P Greving
- Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht the Netherlands
| | - Wiro J Niessen
- Biomedical Imaging Group Rotterdam Erasmus MC Departments of Medical Informatics and Radiology & Nuclear Medicine Rotterdam the Netherlands
- Imaging Physics Applied Sciences Delft University of Technology Delft the Netherlands
| | - Mark A van Buchem
- Department of Radiology Leiden University Medical Center Leiden the Netherlands
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI Department of Radiology Leiden University Medical Center Leiden the Netherlands
| | - Albert C van Rossum
- Department of Cardiology Amsterdam UMC VU University Medical Center Amsterdam the Netherlands
| | - Niels D Prins
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC VU University Medical Center Amsterdam the Netherlands
| | - Geert-Jan Biessels
- Department of Neurology UMC Utrecht Brain Center University Medical Center Utrecht Utrecht the Netherlands
| | - Frederik Barkhof
- UCL Institutes of Neurology and Healthcare Engineering London United Kingdom
- Department of Radiology and Nuclear Medicine Amsterdam UMC VU University Medical Center Amsterdam the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC VU University Medical Center Amsterdam the Netherlands
- Department of Epidemiology Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam the Netherlands
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29
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Garnier-Crussard A, Desestret V, Cotton F, Chételat G, Krolak-Salmon P. [White matter hyperintensities in ageing: Pathophysiology, associated cognitive disorders and prevention]. Rev Med Interne 2020; 41:475-484. [PMID: 32122680 DOI: 10.1016/j.revmed.2020.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/30/2020] [Accepted: 02/01/2020] [Indexed: 01/02/2023]
Abstract
White matter hyperintensities (WMH), also known as leukoaraïosis are very common neuroradiological manifestations in the elderly. The main risk factors for WMH are age and high blood pressure. The vascular origin of these lesions is classically accepted and WMH are considered as one feature of the small vessel disease. WMH may be associated with clinical symptoms, depending notably on their importance according to age. They are associated with increased mortality, strokes and changes in cognition with a higher risk of dementia (vascular dementia or Alzheimer's disease). Modification of vascular risk factors could have a beneficial effect, but few evidences from controlled trials are available.
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Affiliation(s)
- A Garnier-Crussard
- Centre mémoire ressource et recherche de Lyon (CMRR), hôpital des Charpennes, institut du vieillissement I-Vie, hospices civils de Lyon, 69002 Lyon, France; Université Claude-Bernard Lyon 1, 69008 Lyon, France; Université de Normandie, Unicaen, Inserm, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", institut Blood-and-Brain @ Caen-Normandie, Cyceron, 14000 Caen, France.
| | - V Desestret
- Service de neurocognition et de neuro-ophtalmologie, hôpital Pierre-Wertheimer, hospices civils de Lyon, Lyon, France; Institut NeuroMyogène, Inserm U1217/CNRS UMR 5310, université de Lyon - université Claude-Bernard-Lyon 1, Lyon, France; Centre de recherche clinique CRC - VCF (vieillissement-cerveau - fragilité), hôpital des Charpennes, hospices civils de Lyon, 69100 Villeurbanne, France.
| | - F Cotton
- Centre de recherche clinique CRC - VCF (vieillissement-cerveau - fragilité), hôpital des Charpennes, hospices civils de Lyon, 69100 Villeurbanne, France; Service de radiologie, centre hospitalier Lyon-Sud, hospices civils de Lyon, Pierre-Bénite, France; CRÉATIS - CNRS UMR 5220 & Inserm U1044, université Claude-Bernard-Lyon 1, Lyon, France.
| | - G Chételat
- Université de Normandie, Unicaen, Inserm, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", institut Blood-and-Brain @ Caen-Normandie, Cyceron, 14000 Caen, France.
| | - P Krolak-Salmon
- Centre mémoire ressource et recherche de Lyon (CMRR), hôpital des Charpennes, institut du vieillissement I-Vie, hospices civils de Lyon, 69002 Lyon, France; Université Claude-Bernard Lyon 1, 69008 Lyon, France; Centre de recherche clinique CRC - VCF (vieillissement-cerveau - fragilité), hôpital des Charpennes, hospices civils de Lyon, 69100 Villeurbanne, France.
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Scarapicchia V, Garcia-Barrera M, MacDonald S, Gawryluk JR. Resting State BOLD Variability Is Linked to White Matter Vascular Burden in Healthy Aging but Not in Older Adults With Subjective Cognitive Decline. Front Hum Neurosci 2019; 13:429. [PMID: 31920589 PMCID: PMC6936515 DOI: 10.3389/fnhum.2019.00429] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/18/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Alzheimer's disease (AD) is the leading cause of dementia. A lack of curative treatments and a rapidly aging global population have amplified the need for early biomarkers of the disease process. Recent advances suggest that subjective cognitive decline (SCD) may be one of the earliest symptomatic markers of the AD cascade. Previous studies have identified changes in variability in the blood-oxygen-level-dependent (BOLD) signal in patients with AD, with a possible association between BOLD variability and cerebrovascular factors in the aging brain. The objective of the current study was to determine whether changes in BOLD variability can be identified in individuals with SCD, and whether this signal may be associated with markers of cerebrovascular integrity in SCD and older adults without memory complaints. Method: Data were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database from 19 participants with SCD and 19 similarly-aged controls. For each participant, a map of BOLD signal variability (SDBOLD) was computed as the standard deviation of the BOLD time-series at each voxel. Group comparisons were performed to examine differences in resting-state SDBOLD in SCD vs. healthy controls. Relationships were then examined between participant SDBOLD maps and neuroimaging markers of white matter vascular infarcts in each group separately. Results: Between-group comparisons showed no significant differences in whole-brain SDBOLD in individuals with SCD and controls. In the healthy aging group, higher white matter hyperintensity (WMH) burden was associated with greater SDBOLD in right temporal regions (p < 0.05), and lower scores on a measure of global executive functioning. These associations were not identified in individuals with SCD. Conclusion: The current study underscores previous evidence for a relationship between SDBOLD and white matter vascular infarcts in the healthy aging brain. The findings also provide evidence for a dissociable relationship between healthy aging and SCD, such that in healthy controls, increased WMH is associated with declines in executive function that is not observed in older adults who present with memory complaints. Further multimodal work is needed to better understand the contributions of vascular pathology to the BOLD signal, and its potential relationship with pathological aging.
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Affiliation(s)
- Vanessa Scarapicchia
- Department Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Mauricio Garcia-Barrera
- Department Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Stuart MacDonald
- Department Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Jodie R. Gawryluk
- Department Psychology, University of Victoria, Victoria, BC, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
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Hooghiemstra AM, Leeuwis AE, Bertens AS, Biessels GJ, Bots ML, Brunner-La Rocca HP, Greving JP, Kappelle LJ, van Oostenbrugge RJ, van Rossum AC, van der Flier WM. Frequent Cognitive Impairment in Patients With Disorders Along the Heart-Brain Axis. Stroke 2019; 50:3369-3375. [DOI: 10.1161/strokeaha.119.026031] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background and Purpose—
Patients with cardiovascular disease are at increased risk for cognitive decline. We studied the occurrence and profile of cognitive impairment in 3 patient groups as exemplar conditions of hemodynamic disturbances at different levels of the heart-brain axis, including patients with heart failure (HF), carotid occlusive disease (COD), and patients with cognitive complaints and vascular brain injury on magnetic resonance imaging (possible vascular cognitive impairment [VCI]).
Methods—
In 555 participants (160 HF, 107 COD, 160 possible VCI, 128 reference participants; 68±9 years; 36% F; Mini-Mental State Examination 28±2), we assessed cognitive functioning with a comprehensive test battery. Test scores were transformed into
z
-scores. Compound
z
-scores were constructed for: memory, language, attention/psychomotor speed, executive functioning, and global cognitive functioning. We rated cognitive domains as impaired when
z
-score≤−1.5. Based on the number of impaired domains, patients were classified as cognitively normal, minor, or major cognitive impairment. We used general linear models and χ
2
tests to compare cognitive functioning between patient groups and the reference group.
Results—
Age, sex, and education adjusted global cognitive functioning z-score was lower in patients with COD (β [SE]=−0.46 [0.10],
P
<0.001) and possible VCI (β [SE]=−0.80 [0.09],
P
<0.001) compared with reference participants. On all domains,
z
-scores were lower in patients with COD and possible VCI compared with reference participants. Patients with HF had lower z-scores on attention/speed and language compared with reference participants. Cognitive impairment was observed in 18% of HF, 36% of COD, and 45% possible VCI. There was no difference in profile of impaired cognitive domains between patient groups. Memory and attention-psychomotor speed were most commonly affected, followed by executive functioning and language.
Conclusions—
A substantial part of patients with HF and COD had cognitive impairment, which warrants vigilance for the occurrence of cognitive impairment. These results underline the importance of an integrative approach in medicine in patients presenting with disorders in the heart-brain axis.
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Affiliation(s)
- Astrid M. Hooghiemstra
- From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience (A.M.H., A.E.L., W.M.v.d.F.), Amsterdam UMC, location VUmc, the Netherlands
- Department of Medical Humanities, Amsterdam Public Health Research Institute (A.M.H.), Amsterdam UMC, location VUmc, the Netherlands
| | - Anna E. Leeuwis
- From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience (A.M.H., A.E.L., W.M.v.d.F.), Amsterdam UMC, location VUmc, the Netherlands
| | - Anne Suzannne Bertens
- Department of Radiology (A.S.B.)
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands (A.S.B.)
| | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht Brain Center (G.J.B., L.J.K.), University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Michiel L. Bots
- Julius Center for Health Sciences and Primary Care (M.L.B., J.P.G.), University Medical Center Utrecht, Utrecht University, the Netherlands
| | | | - Jacoba P. Greving
- Julius Center for Health Sciences and Primary Care (M.L.B., J.P.G.), University Medical Center Utrecht, Utrecht University, the Netherlands
| | - L. Jaap Kappelle
- Department of Neurology, UMC Utrecht Brain Center (G.J.B., L.J.K.), University Medical Center Utrecht, Utrecht University, the Netherlands
| | | | - Albert C. van Rossum
- Department of Cardiology (A.C.v.R.), Amsterdam UMC, location VUmc, the Netherlands
| | - Wiesje M. van der Flier
- From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience (A.M.H., A.E.L., W.M.v.d.F.), Amsterdam UMC, location VUmc, the Netherlands
- Department of Epidemiology (W.M.v.d.F.) Amsterdam UMC, location VUmc, the Netherlands
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van Rooden S, van den Berg-Huysmans AA, Croll PH, Labadie G, Hayes JM, Viviano R, van der Grond J, Rombouts SARB, Damoiseaux JS. Subjective Cognitive Decline Is Associated with Greater White Matter Hyperintensity Volume. J Alzheimers Dis 2019; 66:1283-1294. [PMID: 30412485 PMCID: PMC6294575 DOI: 10.3233/jad-180285] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Research in older adults with subjective cognitive decline (SCD) has mainly focused on Alzheimer's disease (AD)-related MRI markers, such as hippocampal volume. However, small vessel disease (SVD) is currently established as serious comorbidity in dementia and its preliminary stages. It is therefore important to examine SVD markers in addition to AD markers in older adults presenting with SCD. OBJECTIVE The aim of our study was to elucidate the role of SVD markers in late middle-aged to older adults with and without SCD in addition to the commonly found role of AD markers (hippocampal volume). METHODS 67 healthy late middle-aged to older adults participated in this study (mean age 68 years); 25 participants with SCD and 42 participants without SCD. We evaluated quantitative as well as qualitative AD markers (i.e., hippocampal volume and medial temporal lobe atrophy (MTA) scale) and SVD markers (i.e., white matter hyperintensities (WMH) volume, Fazekas scale, microbleeds, and lacunar infarcts), and neuropsychological function and amount of memory complaints. RESULTS We found a significant effect of SCD on hippocampal atrophy, as assessed using the MTA scale, but not on hippocampal volume. In addition, we found a significant effect of SCD, and amount of memory complaints, on WMH volume and Fazekas score, suggesting larger WMH volumes in participants with SCD. CONCLUSION SVD MRI markers are related to amount of memory complaints, in addition to the commonly observed AD MRI markers, as demonstrated by the greater WMHs in healthy late middle-aged to older adults with SCD.
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Affiliation(s)
- Sanneke van Rooden
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | | | - Pauline H Croll
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gerda Labadie
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jessica M Hayes
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Raymond Viviano
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Jessica S Damoiseaux
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, MI, USA.,Institute of Psychology, Leiden University, Leiden, The Netherlands
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Vibha D, Tiemeier H, Mirza SS, Adams HHH, Niessen WJ, Hofman A, Prasad K, van der Lugt A, Vernooij MW, Ikram MA. Brain Volumes and Longitudinal Cognitive Change: A Population-based Study. Alzheimer Dis Assoc Disord 2018; 32:43-9. [PMID: 29278559 DOI: 10.1097/WAD.0000000000000235] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the association of brain volumes, white matter lesion (WML) volumes, and lacunes, with cognitive decline in a population-based cohort of nondemented persons. METHODS Within the Rotterdam Study, 3624 participants underwent brain magnetic resonance imaging. Cognition was evaluated at baseline (2005 to 2009) and at the follow-up visit (2011 to 2013). We used a test battery that tapped into domains of executive function, information processing speed, motor speed, and memory. The volumetric measures assessed were total brain volume, lobar (gray matter and white matter) volumes, and hippocampal volumes. We also studied the association of WML volumes and lacunes with cognitive decline using linear regression models. RESULTS Total brain volume was associated with decline in global cognition, information processing, and motor speed (P<0.001) in analyses controlled for demographic and vascular factors. Specifically, smaller frontal and parietal lobes were associated with decline in information processing and motor speed, and smaller temporal and parietal lobes were associated with decline in general cognition and motor speed (P<0.001 for all tests). Total WML volume was associated with decline in executive function. Lobar WML volume, hippocampal volume, and lacunes were not associated with cognitive decline. CONCLUSIONS Lower brain volume is associated with subsequent cognitive decline. Although lower total brain volume was significantly associated with decline in global cognition, specific lobar volumes were associated with decline in certain cognitive domains.
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Zhang S, Luo Y, Dong Z, Chen X, Cheng X, Dong Q, Wu D. Impact of periventricular hyperintensities and cystatin C on different cognitive domains in the population of non-demented elderly Chinese. J Clin Neurosci 2019; 68:201-210. [PMID: 31307855 DOI: 10.1016/j.jocn.2019.05.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 05/27/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To investigate the impact of periventricular hyperintensities and serum cystatin C on mild cognitive impairment to provide a basis for the investigation of the pathogenesis. METHOD 286 patients enrolled the study and underwent an examination in Shanghai Fifth People's Hospital from June 2017 to June 2018. The participants' cognitive function was evaluated by different cognitive domains using of mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), auditory verbal learning test, Huashan version (AVLT-H), digit span test (DST), symbol digit modalities test (SDMT), trail making test (TMT) and verbal fluency test (VFT). We measured the levels of serum cystatin C at the department of clinical laboratory in Shanghai Fifth People's Hospital and each subject took an MRI examination in the Department of Radiology of Shanghai Fifth People's Hospital. Multivariate linear regression analyses were used to assess the relationship of cognitive score and the level of cystatin C and periventricular hyperintensities severity. All statistical analyses were performed using the SPSS system. RESULTS Among 286 eligible participants, 203 (71.0%) were enrolled to further analysis, including 69 male and 134 female (Mean age 67.93 ± 6.19 years). Significant predictors of severe periventricular hyperintensities (PVH) were older age and hypertension. Significant predictors of severe deep white matter hyperintensities (DWMH) were older age only. PVH severity was independently associated with mild cognitive impairment and that the primary impairment was executive function and processing speed. DWMH had no significant effect on cognitive function. Cystatin C only affected the overall cognitive level, and the relationship with WMH severity was not significant. CONCLUSIONS We demonstrated that in the chinese non-demented elderly, the severity of PVH was independent and significant associated with mild cognitive impairment and that the primary impairment was executive capacity and processing speed, while cystatin C may be an independent risk factor for overall cognitive impairment.
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Affiliation(s)
- Shufan Zhang
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Yufan Luo
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Zhiyuan Dong
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China.
| | - Xin Chen
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Xin Cheng
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qiang Dong
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Danhong Wu
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China.
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Edwards III GA, Gamez N, Escobedo Jr. G, Calderon O, Moreno-Gonzalez I. Modifiable Risk Factors for Alzheimer's Disease. Front Aging Neurosci 2019; 11:146. [PMID: 31293412 PMCID: PMC6601685 DOI: 10.3389/fnagi.2019.00146] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 05/31/2019] [Indexed: 01/03/2023] Open
Abstract
Since first described in the early 1900s, Alzheimer's disease (AD) has risen exponentially in prevalence and concern. Research still drives to understand the etiology and pathogenesis of this disease and what risk factors can attribute to AD. With a majority of AD cases being of sporadic origin, the increasing exponential growth of an aged population and a lack of treatment, it is imperative to discover an easy accessible preventative method for AD. Some risk factors can increase the propensity of AD such as aging, sex, and genetics. Moreover, there are also modifiable risk factors-in terms of treatable medical conditions and lifestyle choices-that play a role in developing AD. These risk factors have their own biological mechanisms that may contribute to AD etiology and pathological consequences. In this review article, we will discuss modifiable risk factors and discuss the current literature of how each of these factors interplay into AD development and progression and if strategically analyzed and treated, could aid in protection against this neurodegenerative disease.
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Affiliation(s)
- George A. Edwards III
- The Mitchell Center for Alzheimer’s Disease and Related Brain Disorders, Department of Neurology, The University of Texas Houston Health Science Center at Houston, Houston, TX, United States
| | - Nazaret Gamez
- The Mitchell Center for Alzheimer’s Disease and Related Brain Disorders, Department of Neurology, The University of Texas Houston Health Science Center at Houston, Houston, TX, United States
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Department of Cell Biology, Facultad Ciencias, Universidad de Malaga, Malaga, Spain
| | - Gabriel Escobedo Jr.
- The Mitchell Center for Alzheimer’s Disease and Related Brain Disorders, Department of Neurology, The University of Texas Houston Health Science Center at Houston, Houston, TX, United States
| | - Olivia Calderon
- The Mitchell Center for Alzheimer’s Disease and Related Brain Disorders, Department of Neurology, The University of Texas Houston Health Science Center at Houston, Houston, TX, United States
| | - Ines Moreno-Gonzalez
- The Mitchell Center for Alzheimer’s Disease and Related Brain Disorders, Department of Neurology, The University of Texas Houston Health Science Center at Houston, Houston, TX, United States
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Department of Cell Biology, Facultad Ciencias, Universidad de Malaga, Malaga, Spain
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Dey AK, Stamenova V, Bacopulos A, Jeyakumar N, Turner GR, Black SE, Levine B. Cognitive heterogeneity among community-dwelling older adults with cerebral small vessel disease. Neurobiol Aging 2019; 77:183-193. [DOI: 10.1016/j.neurobiolaging.2018.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 12/16/2018] [Accepted: 12/26/2018] [Indexed: 10/27/2022]
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Shi Z, Zheng H, Hu J, Jiang L, Cao X, Chen Y, Mei X, Li C, Shen Y. Retinal Nerve Fiber Layer Thinning Is Associated With Brain Atrophy: A Longitudinal Study in Nondemented Older Adults. Front Aging Neurosci 2019; 11:69. [PMID: 31031615 PMCID: PMC6470389 DOI: 10.3389/fnagi.2019.00069] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/12/2019] [Indexed: 12/11/2022] Open
Abstract
Backgrounds: Abnormal retinal nerve fiber layer (RNFL) thickness has been observed in patients with Alzheimer’s disease (AD) and therefore suggested to be a potential biomarker of AD. However, whether the changes in RNFL thickness are associated with the atrophy of brain structure volumes remains unknown. We, therefore, set out a prospective investigation to determine the association between longitudinal changes of RNFL thickness and brain atrophy in nondemented older participants over a period of 12 months. Materials and Methods: We measured the RNFL thickness using optical coherence tomography (OCT) and brain structure volumes by 3T magnetic resonance imaging (MRI) before and after 12 months. Cognitive function was assessed using the Chinese version of Mini-Mental State Examination (CMMSE) and Repeatable Battery for the Assessment of Neurological Status. Associations among the changes of RNFL, brain structures and cognitive function were analyzed with Spearman correlation and multiple linear regression models adjusting for the confounding factors. Results: Fifty old participants were screened and 40 participants (mean age 71.8 ± 3.9 years, 60% were male) were enrolled at baseline. Among them, 28 participants completed the follow-up assessments. The average reduction of RNFL thickness was inversely associated with the decrease of central cingulate cortex volume after the adjustment of age and total intracranial volume (β = −0.41, P = 0.039). Specifically, the reduction of RNFL thickness in the inferior, not other quadrants, was independently associated with the decline of central cingulate cortex volume after the adjustment (β = −0.52, P = 0.006). Moreover, RNFL thinning, central cingulate cortex atrophy and the aggregation of white matter hyperintensities (WMH) were found associated with episodic memory in these older adults with normal cognition. Conclusions: RNFL thinning was associated with cingulate cortex atrophy and episodic memory decline in old participants. The longitudinal changes of RNFL thickness are suggested to be a useful complementary index of neurocognitive aging or neurodegeneration.
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Affiliation(s)
- Zhongyong Shi
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Hailin Zheng
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Jingxiao Hu
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Lijuan Jiang
- Shanghai Key Laboratory of Psychiatric Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyi Cao
- Shanghai Key Laboratory of Psychiatric Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yupeng Chen
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Xinchun Mei
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychiatric Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Yuan Shen
- Department of Psychiatry, Shanghai 10th People's Hospital, Tongji University, Shanghai, China.,Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, China
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Salvadó G, Brugulat-Serrat A, Sudre CH, Grau-Rivera O, Suárez-Calvet M, Falcon C, Fauria K, Cardoso MJ, Barkhof F, Molinuevo JL, Gispert JD. Spatial patterns of white matter hyperintensities associated with Alzheimer's disease risk factors in a cognitively healthy middle-aged cohort. Alzheimers Res Ther 2019; 11:12. [PMID: 30678723 PMCID: PMC6346579 DOI: 10.1186/s13195-018-0460-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/18/2018] [Indexed: 11/17/2022]
Abstract
Background White matter hyperintensities (WMH) of presumed vascular origin have been associated with an increased risk of Alzheimer’s disease (AD). This study aims to describe the patterns of WMH associated with dementia risk estimates and individual risk factors in a cohort of middle-aged/late middle-aged individuals (mean 58 (interquartile range 51–64) years old). Methods Magnetic resonance imaging and AD risk factors were collected from 575 cognitively unimpaired participants. WMH load was automatically calculated in each brain lobe and in four equidistant layers from the ventricular surface to the cortical interface. Global volumes and regional patterns of WMH load were analyzed as a function of the Cardiovascular Risk Factors, Aging and Incidence of Dementia (CAIDE) dementia risk score, as well as family history of AD and Apolipoprotein E (APOE) genotype. Additional analyses were performed after correcting for the effect of age and hypertension. Results The studied cohort showed very low WMH burden (median 1.94 cm3) and 20-year dementia risk estimates (median 1.47 %). Even so, higher CAIDE scores were significantly associated with increased global WMH load. The main drivers of this association were age and hypertension, with hypercholesterolemia and body mass index also displaying a minor, albeit significant, influence. Regionally, CAIDE scores were positively associated with WMH in anterior areas, mostly in the frontal lobe. Age and hypertension showed significant association with WMH in almost all regions analyzed. The APOE-ε2 allele showed a protective effect over global WMH with a pattern that comprised juxtacortical temporo-occipital and fronto-parietal deep white matter regions. Participants with maternal family history of AD had higher WMH load than those without, especially in temporal and occipital lobes. Conclusions WMH load is associated with AD risk factors even in cognitively unimpaired subjects with very low WMH burden and dementia risk estimates. Our results suggest that tight control of modifiable risk factors in middle-age/late middle-age could have a significant impact on late-life dementia. Electronic supplementary material The online version of this article (10.1186/s13195-018-0460-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gemma Salvadó
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
| | - Carole H Sudre
- Engineering and Imaging Sciences, King's College London, London, UK.,Dementia Research Centre, University College London, London, UK.,Centre for Medical Imaging Computing, Faculty of Engineering, University College London, London, UK
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - M Jorge Cardoso
- Engineering and Imaging Sciences, King's College London, London, UK.,Dementia Research Centre, University College London, London, UK
| | - Frederik Barkhof
- Centre for Medical Imaging Computing, Faculty of Engineering, University College London, London, UK.,Brain Repair and Rehabilitation, University College London, London, UK.,Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, Netherlands
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain. .,Universitat Pompeu Fabra, Barcelona, Spain.
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Li RR, He YS, Liu M, Nie ZY, Huang LH, Lu Z, Jin LJ, Li YX. Analysis of correlation between cerebral perfusion and KIM score of white matter lesions in patients with Alzheimer's disease. Neuropsychiatr Dis Treat 2019; 15:2705-2714. [PMID: 31571886 PMCID: PMC6756364 DOI: 10.2147/ndt.s207069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/05/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aimed to characterize white matter lesions (WMLs) and regional cerebral perfusion, and evaluate their correlations with cognitive deficits in Alzheimer's disease (AD) patients. PATIENT AND METHODS One hundred and twenty-eight patients with AD (AD group) and 75 subjects without AD (control group) were recruited. The medical information was collected from each subject. Montreal cognitive assessment (MoCA) was employed for the assessment of cognition. Cranial MRI was performed, and the KIM scoring system was used to evaluate the white matter hyperintensity. The CT perfusion (CTP) imaging was employed to assess the whole cerebral perfusion, and the region of interest (ROI) was selected to determine the blood perfusion at different parts. RESULTS The education level and MoCA score in AD group were significantly lower than in control group (P<0.001). The KIM score of juxtaventricular WML (JVWMLs) was significantly different between two groups (P<0.05) and AD group showed a higher incidence of severe JVWML and periventricular WML (PVWMLs); in AD group, the total KIM score and KIM scores of JVWMLs, PVWMLs and deep WML (DWMLs) showed negative relationships with the MoCA score (P<0.001). As compared to control group, the blood perfusion of either whole brain or different parts in the AD group reduced significantly (P<0.05). In the AD group, there was a negative correlations of blood perfusion at JVWM and PVWM with corresponding KIM scores (P<0.05 or 0.01). In the AD group, the blood perfusions of the whole brain, JVWMLs, PVWMLs and deep WML were negatively related to MoCA score (P<0.05). CONCLUSION In conclusion, the cognitive deficits in the AD patients are associated with the degree of WMLs, especially the JVWML, PVWML and DWML as well as with the reduced perfusion of JVWM, PVWM and deep WM.
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Affiliation(s)
- Ren-Ren Li
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Yu-Sheng He
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Meng Liu
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Zhi-Yu Nie
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Li-He Huang
- School of Foreign Languages, Research Center for Ageing, Language and Care, Tongji University, Shanghai 200092, People's Republic of China
| | - Zheng Lu
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Ling-Jing Jin
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Yun-Xia Li
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
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Parfenov VA, Zhivolupov SA, Nikulina KV, Poverennova IE, Lapatuhin VG, Zhestikova MG, Zhukova NG, Glazunov AB. [Diagnosis and treatment of cognitive impairment in patients with chronic cerebral ischemia: the results of observational Russian program DIAMANT]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:15-23. [PMID: 30040796 DOI: 10.17116/jnevro20181186115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIM To investigate the efficacy of divaza in outpatients with cognitive disorders and chronic brain ischemia (CBI). MATERIAL AND METHODS The non-interventional observational program included the data of 2583 outpatients with CBI from 30 cities (8 federal okrugs of the Russian Federation) who were on outpatient neurological treatment and received divaza in a dose of 2 tablets three times a day from Oct 2016 to Jan 2017. Cognitive functions were evaluated using the MoCA scale before and after 3 months of treatment. RESULTS AND CONCLUSION Cognitive disorders were identified in 90.7% of patients (<26 MoCA scores). After treatment, the mean MoCA score increased from 19.58±5.13 to 23.99±4.21 (p<0.0001), the number of patients with normal cognitive functions rate (≥26 scores) increased from 9.3 to 41.3%, the number of patients with marked cognitive impairment decreased. The drug was well-tolerated by old and very old patients, adverse events were observed rarely (0.6% of cases). The majority of doctors (88.4%) noticed the effect of divaza as significant improvement or improvement, and 89.6% of patients valued the effect to be excellent or good. The use of divaza, the drug with endothelioprotective and nootropic effects, is pathogenetically justified and promising in patients with cognitive disorders of vascular etiology.
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Affiliation(s)
- V A Parfenov
- Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | | | - K V Nikulina
- OOO 'NPF "Materia Medica Holding"', Moscow, Russia
| | | | - V G Lapatuhin
- Penza Institute of Improvement of Doctors, Penza, Russia
| | - M G Zhestikova
- Novokuznetsk State Institute of Postgraduate Medicine, Novokuznetsk, Russia
| | - N G Zhukova
- Siberian State Medical University, Tomsk, Russia
| | - A B Glazunov
- Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
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Nylander R, Kilander L, Ahlström H, Lind L, Larsson EM. Small Vessel Disease on Neuroimaging in a 75-Year-Old Cohort (PIVUS): Comparison With Cognitive and Executive Tests. Front Aging Neurosci 2018; 10:217. [PMID: 30061827 PMCID: PMC6054972 DOI: 10.3389/fnagi.2018.00217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/26/2018] [Indexed: 12/28/2022] Open
Abstract
Background and Purpose: Signs of small vessel disease (SVD) are commonly seen on magnetic resonance imaging (MRI) of the brain in cognitively healthy elderly individuals, and the clinical relevance of these are often unclear. We have previously described three different MRI manifestations of SVD as well as cerebral perfusion in a longitudinal study of non-demented 75-year-old subjects. The purpose of the present study was to evaluate the relationship of these findings to cognition and executive function at age 75 and changes after 5 years. Methods: In all, 406 subjects from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study were examined with MRI of the brain at age 75 years. Two-hundred and fifty of the subjects were re-examined 5 years later. White matter hyperintensities (WMHs) and lacunar infarcts (LIs) were assessed on both occasions, but microbleeds (MBs) and perfusion only at age 75. Cognitive function was screened by the Mini Mental State Examination (MMSE). Trail Making Test A and B (TMT-A and TMT-B) were performed at baseline and at follow-up at age 80. Results: At baseline, 93% performed >27 points in the MMSE. The TMT-B at age 75 was significantly related to WMH visual scoring after adjustment for sex, education and cerebrovascular disease risk factors (+80 s (95% CI 0.3-161 s), P < 0.05 for grade 2-3 vs. grade 0). Neither MMSE nor TMT-A was significantly related to WMH scoring. There was no relation between any test performance and WMH volume, white matter volume, number of MBs or brain perfusion at age 75. Subjects who had sustained a new LI (n = 26) showed a greater increase of the time to perform TMT-A at the 5-year follow-up (+25 s vs. +4 s in LI-free subjects, P = 0.003). Changes in MMSE or TMT-A and -B test performance between ages 75 and 80 were not related to changes in WMH scoring or volume during the 5 years follow-up, or to brain perfusion at age 75. Conclusion: In this cognitively healthy community-based population, moderate-severe WMHs and incident LIs on brain MRI in individuals aged 75-80 years were associated with a mild impairment of processing speed and executive function.
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Affiliation(s)
- Ruta Nylander
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden
| | - Håkan Ahlström
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Elna-Marie Larsson
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
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Lange C, Suppa P, Mäurer A, Ritter K, Pietrzyk U, Steinhagen-Thiessen E, Fiebach JB, Spies L, Buchert R. Mental speed is associated with the shape irregularity of white matter MRI hyperintensity load. Brain Imaging Behav 2018; 11:1720-1730. [PMID: 27796731 DOI: 10.1007/s11682-016-9647-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Brain MRI white matter hyperintensities (WMHs) are common in elderly subjects. Their impact on cognition, however, appears highly variable. Complementing conventional scoring of WMH load (volume and location) by quantitative characterization of the shape irregularity of WMHs might improve the understanding of the relationship between WMH load and cognitive performance. Here we propose the "confluency sum score" (COSU) as a marker of the total shape irregularity of WMHs in the brain. The study included two independent patient samples: 87 cognitively impaired geriatric inpatients from a prospective neuroimaging study (iDSS) and 198 subjects from the National Alzheimer's Coordinating Center (NACC) database (132 with, 66 w/o cognitive impairment). After automatic segmentation and clustering of the WMHs on FLAIR (LST toolbox, SPM8), the confluency of the i-th contiguous WMH cluster was computed as confluencyi = [1/(36π)∙surfacei3/volumei2]1/3-1. The COSU was obtained by summing the confluency over all WMH clusters. COSU was tested for correlation with CERAD-plus subscores. Correlation analysis was restricted to subjects with at least moderate WMH load (≥ 13.5 ml; iDSS / NACC: n = 52 / 80). In the iDSS sample, among the 12 CERAD-plus subtests the trail making test A (TMT-A) was most strongly correlated with the COSU (Spearman rho = -0.345, p = 0.027). TMT-A performance was not associated with total WMH volume (rho = 0.147, p = 0.358). This finding was confirmed in the NACC sample (rho = -0.261, p = 0.023 versus rho = -0.040, p = 0.732). Cognitive performance in specific domains including mental speed and fluid abilities seems to be more strongly associated with the shape irregularity of white matter MRI hyperintensities than with their volume.
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Affiliation(s)
- Catharina Lange
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.,School of Mathematics and Natural Science, University of Wuppertal, Wuppertal, Germany
| | - Per Suppa
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.,jung diagnostics GmbH, Hamburg, Germany
| | - Anja Mäurer
- Evangelisches Geriatriezentrum Berlin, Berlin, Germany
| | - Kerstin Ritter
- Berlin Center for Advanced Neuroimaging, Bernstein Center for Computational Neuroscience, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Uwe Pietrzyk
- School of Mathematics and Natural Science, University of Wuppertal, Wuppertal, Germany.,Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Jülich, Germany
| | | | - Jochen B Fiebach
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Ralph Buchert
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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Kynast J, Lampe L, Luck T, Frisch S, Arelin K, Hoffmann KT, Loeffler M, Riedel-Heller SG, Villringer A, Schroeter ML. White matter hyperintensities associated with small vessel disease impair social cognition beside attention and memory. J Cereb Blood Flow Metab 2018; 38:996-1009. [PMID: 28685621 PMCID: PMC5999004 DOI: 10.1177/0271678x17719380] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Age-related white matter hyperintensities (WMH) are a manifestation of white matter damage seen on magnetic resonance imaging (MRI). They are related to vascular risk factors and cognitive impairment. This study investigated the cognitive profile at different stages of WMH in a large community-dwelling sample; 849 subjects aged 21 to 79 years were classified on the 4-stage Fazekas scale according to hyperintense lesions seen on individual T2-weighted fluid-attenuated inversion recovery MRI scans. The evaluation of cognitive functioning included seven domains of cognitive performance and five domains of subjective impairment, as proposed by the DSM-5. For the first time, the impact of age-related WMH on Theory of Mind was investigated. Differences between Fazekas groups were analyzed non-parametrically and effect sizes were computed. Effect sizes revealed a slight overall cognitive decline in Fazekas groups 1 and 2 relative to healthy subjects. Fazekas group 3 presented substantial decline in social cognition, attention and memory, although characterized by a high inter-individual variability. WMH groups reported subjective cognitive decline. We demonstrate that extensive WMH are associated with specific impairment in attention, memory, social cognition, and subjective cognitive performance. The detailed neuropsychological characterization of WMH offers new therapeutic possibilities for those affected by vascular cognitive decline.
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Affiliation(s)
- Jana Kynast
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
| | - Leonie Lampe
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
| | - Tobias Luck
- 2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,3 Institute for Social Medicine, Occupational Medicine and Public Health, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Stefan Frisch
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,4 Department of Neurology, University Hospital Frankfurt/Goethe University, Frankfurt am Main, Germany
| | - Katrin Arelin
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
| | - Karl-Titus Hoffmann
- 2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,5 Department of Neuroradiology, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Markus Loeffler
- 2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,6 Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- 2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,3 Institute for Social Medicine, Occupational Medicine and Public Health, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Arno Villringer
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,7 Clinic for Cognitive Neurology, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,7 Clinic for Cognitive Neurology, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
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Mimenza-Alvarado A, Aguilar-Navarro SG, Yeverino-Castro S, Mendoza-Franco C, Ávila-Funes JA, Román GC. Neuroimaging Characteristics of Small-Vessel Disease in Older Adults with Normal Cognition, Mild Cognitive Impairment, and Alzheimer Disease. Dement Geriatr Cogn Dis Extra 2018; 8:199-206. [PMID: 29928288 PMCID: PMC6006607 DOI: 10.1159/000488705] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 03/23/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Cerebral small-vessel disease (SVD) represents the most frequent type of vascular brain lesions, often coexisting with Alzheimer disease (AD). By quantifying white matter hyperintensities (WMH) and hippocampal and parietal atrophy, we aimed to describe the prevalence and severity of SVD among older adults with normal cognition (NC), mild cognitive impairment (MCI), and probable AD and to describe associated risk factors. Methods This study included 105 older adults evaluated with magnetic resonance imaging and clinical and neuropsychological tests. We used the Fazekas scale (FS) for quantification of WMH, the Scheltens scale (SS) for hippocampal atrophy, and the Koedam scale (KS) for parietal atrophy. Logistic regression models were performed to determine the association between FS, SS, and KS scores and the presence of NC, MCI, or probable AD. Results Compared to NC subjects, SVD was more prevalent in MCI and probable AD subjects. After adjusting for confounding factors, logistic regression showed a positive association between higher scores on the FS and probable AD (OR = 7.6, 95% CI 2.7–20, p < 0.001). With the use of the SS and KS (OR = 4.5, 95% CI 3.5–58, p = 0.003 and OR = 8.9, 95% CI 1–72, p = 0.04, respectively), the risk also remained significant for probable AD. Conclusions These results suggest an association between severity of vascular brain lesions and neurodegeneration.
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Affiliation(s)
- Alberto Mimenza-Alvarado
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sara G Aguilar-Navarro
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sara Yeverino-Castro
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - César Mendoza-Franco
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José Alberto Ávila-Funes
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Gustavo C Román
- Department of Neurology, Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA
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45
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Claus JJ, Coenen M, Staekenborg SS, Schuur J, Tielkes CE, Koster P, Scheltens P. Cerebral White Matter Lesions have Low Impact on Cognitive Function in a Large Elderly Memory Clinic Population. J Alzheimers Dis 2018; 63:1129-1139. [DOI: 10.3233/jad-171111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Jules J. Claus
- Department of Neurology, Tergooi Hospitals, Blaricum, The Netherlands
| | - Mirthe Coenen
- Department of Neurology, Tergooi Hospitals, Blaricum, The Netherlands
| | - Salka S. Staekenborg
- Department of Neurology, Tergooi Hospitals, Blaricum, The Netherlands
- Department of Neurology, Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Jacqueline Schuur
- Department of Geriatrics, Tergooi Hospitals, Blaricum, The Netherlands
| | | | - Pieter Koster
- Department of Radiology, Tergooi Hospitals, Blaricum, The Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
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Osborn KE, Liu D, Samuels LR, Moore EE, Cambronero FE, Acosta LMY, Bell SP, Babicz MA, Gordon EA, Pechman KR, Davis LT, Gifford KA, Hohman TJ, Blennow K, Zetterberg H, Jefferson AL. Cerebrospinal fluid β-amyloid 42 and neurofilament light relate to white matter hyperintensities. Neurobiol Aging 2018; 68:18-25. [PMID: 29702372 DOI: 10.1016/j.neurobiolaging.2018.03.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 03/20/2018] [Accepted: 03/27/2018] [Indexed: 12/12/2022]
Abstract
White matter hyperintensities (WMHs) are associated with poorer brain health, but their pathophysiological substrates remain elusive. To better understand the mechanistic underpinnings of WMHs among older adults, this study examined in vivo cerebrospinal fluid biomarkers of β-amyloid42 deposition (Aβ42), hyperphosphorylated tau pathology, neurodegeneration (total tau), and axonal injury (neurofilament light [NFL]) in relation to log-transformed WMHs volume. Participants free of clinical stroke and dementia were drawn from the Vanderbilt Memory & Aging Project (n = 148, 72 ± 6 years). Linear regression models adjusted for age, sex, race/ethnicity, education, intracranial volume, modified Framingham Stroke Risk Profile (excluding points assigned for age), cognitive diagnosis, and APOE-ε4 carrier status. Aβ42 (β = -0.001, p = 0.007) and NFL (β = 0.0003, p = 0.01) concentrations related to WMHs but neither hyperphosphorylated tau nor total tau associations with WMHs reached statistical significance (p-values > 0.21). In a combined model, NFL accounted for 3.2% of unique variance in WMHs and Aβ42 accounted for an additional 4.3% beyond NFL, providing novel evidence of the co-occurrence of at least 2 distinct pathways for WMHs among older adults, including amyloid deposition and axonal injury.
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Affiliation(s)
- Katie E Osborn
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dandan Liu
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lauren R Samuels
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elizabeth E Moore
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Francis E Cambronero
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lealani Mae Y Acosta
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Susan P Bell
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Divisions of Cardiovascular and Geriatric Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michelle A Babicz
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elizabeth A Gordon
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kimberly R Pechman
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Taylor Davis
- Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine A Gifford
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Timothy J Hohman
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Angela L Jefferson
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
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47
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Verfaillie SCJ, Slot RER, Dicks E, Prins ND, Overbeek JM, Teunissen CE, Scheltens P, Barkhof F, van der Flier WM, Tijms BM. A more randomly organized grey matter network is associated with deteriorating language and global cognition in individuals with subjective cognitive decline. Hum Brain Mapp 2018; 39:3143-3151. [PMID: 29602212 PMCID: PMC6055627 DOI: 10.1002/hbm.24065] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 03/12/2018] [Accepted: 03/20/2018] [Indexed: 11/23/2022] Open
Abstract
Objectives Grey matter network disruptions in Alzheimer's disease (AD) are associated with worse cognitive impairment cross‐sectionally. Our aim was to investigate whether indications of a more random network organization are associated with longitudinal decline in specific cognitive functions in individuals with subjective cognitive decline (SCD). Experimental design: We included 231 individuals with SCD who had annually repeated neuropsychological assessment (3 ± 1 years; n = 646 neuropsychological investigations) available from the Amsterdam Dementia Cohort (54% male, age: 63 ± 9, MMSE: 28 ± 2). Single‐subject grey matter networks were extracted from baseline 3D‐T1 MRI scans and we computed basic network (size, degree, connectivity density) and higher‐order (path length, clustering, betweenness centrality, normalized path length [lambda] and normalized clustering [gamma]) parameters at whole brain and/or regional levels. We tested associations of network parameters with baseline and annual cognition (memory, attention, executive functioning, language composite scores, and global cognition [all domains with MMSE]) using linear mixed models, adjusted for age, sex, education, scanner and total gray matter volume. Principal observations: Lower network size was associated with steeper decline in language (β ± SE = 0.12 ± 0.05, p < 0.05FDR). Higher‐order network parameters showed no cross‐sectional associations. Lower gamma and lambda values were associated with steeper decline in global cognition (gamma: β ± SE = 0.06 ± 0.02); lambda: β ± SE = 0.06 ± 0.02), language (gamma: β ± SE = 0.11 ± 0.04; lambda: β ± SE = 0.12 ± 0.05; all p < 0.05FDR). Lower path length values in precuneus and fronto‐temporo‐occipital cortices were associated with a steeper decline in global cognition. Conclusions A more randomly organized grey matter network was associated with a steeper decline of cognitive functioning, possibly indicating the start of cognitive impairment.
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Affiliation(s)
- Sander C J Verfaillie
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Rosalinde E R Slot
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Ellen Dicks
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Niels D Prins
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Jozefien M Overbeek
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Department of Clinical Chemistry, VU University Medical Center Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Institutes of Neurology and Healthcare Engineering, UCL, London, United Kingdom
| | - Wiesje M van der Flier
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands.,Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Betty M Tijms
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
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48
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Jaswal G, Swardfager W, Gao FQ, Nestor SM, Ganda A, Cogo-Moreira H, Sahlas DJ, Stuss DT, Moody A, Black SE. Reduced substantia innominata volume mediates contributions of microvascular and macrovascular disease to cognitive deficits in Alzheimer's disease. Neurobiol Aging 2018; 66:23-31. [PMID: 29505952 DOI: 10.1016/j.neurobiolaging.2018.01.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 01/06/2023]
Abstract
The relationships between cholinergic system damage and cerebrovascular disease are not entirely understood. Here, we investigate associations between atrophy of the substantia innominata (SI; the origin of cortical cholinergic projections) and measures of large and small vessel disease; specifically, elongation of the juxtaposed internal carotid artery termination and Cholinergic Pathways Hyperintensity scores (CHIPS). The study (n = 105) consisted of patients with Alzheimer's disease (AD) and/or subcortical ischemic vasculopathy, and elderly controls. AD and subcortical ischemic vasculopathy groups showed greater impingement of the carotid termination on the SI and smaller SI volumes. Both carotid termination elongation and CHIPS were associated independently with smaller SI volumes in those with and without AD. Atrophy of the SI mediated effects of carotid termination elongation on language and memory functions and the effect of CHIPS on attention/working memory. In conclusion, SI atrophy was related to cerebrovascular disease of the large and small vessels and to cognitive deficits in people with and without AD.
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49
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Charidimou A, Shams S, Romero JR, Ding J, Veltkamp R, Horstmann S, Eiriksdottir G, van Buchem MA, Gudnason V, Himali JJ, Gurol ME, Viswanathan A, Imaizumi T, Vernooij MW, Seshadri S, Greenberg SM, Benavente OR, Launer LJ, Shoamanesh A. Clinical significance of cerebral microbleeds on MRI: A comprehensive meta-analysis of risk of intracerebral hemorrhage, ischemic stroke, mortality, and dementia in cohort studies (v1). Int J Stroke 2018; 13:454-468. [PMID: 29338604 DOI: 10.1177/1747493017751931] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Cerebral microbleeds can confer a high risk of intracerebral hemorrhage, ischemic stroke, death and dementia, but estimated risks remain imprecise and often conflicting. We investigated the association between cerebral microbleeds presence and these outcomes in a large meta-analysis of all published cohorts including: ischemic stroke/TIA, memory clinic, "high risk" elderly populations, and healthy individuals in population-based studies. Methods Cohorts (with > 100 participants) that assessed cerebral microbleeds presence on MRI, with subsequent follow-up (≥3 months) were identified. The association between cerebral microbleeds and each of the outcomes (ischemic stroke, intracerebral hemorrhage, death, and dementia) was quantified using random effects models of (a) unadjusted crude odds ratios and (b) covariate-adjusted hazard rations. Results We identified 31 cohorts ( n = 20,368): 19 ischemic stroke/TIA ( n = 7672), 4 memory clinic ( n = 1957), 3 high risk elderly ( n = 1458) and 5 population-based cohorts ( n = 11,722). Cerebral microbleeds were associated with an increased risk of ischemic stroke (OR: 2.14; 95% CI: 1.58-2.89 and adj-HR: 2.09; 95% CI: 1.71-2.57), but the relative increase in future intracerebral hemorrhage risk was greater (OR: 4.65; 95% CI: 2.68-8.08 and adj-HR: 3.93; 95% CI: 2.71-5.69). Cerebral microbleeds were an independent predictor of all-cause mortality (adj-HR: 1.36; 95% CI: 1.24-1.48). In three population-based studies, cerebral microbleeds were independently associated with incident dementia (adj-HR: 1.35; 95% CI: 1.00-1.82). Results were overall consistent in analyses stratified by different populations, but with different degrees of heterogeneity. Conclusions Our meta-analysis shows that cerebral microbleeds predict an increased risk of stroke, death, and dementia and provides up-to-date effect sizes across different clinical settings. These pooled estimates can inform clinical decisions and trials, further supporting cerebral microbleeds role as biomarkers of underlying subclinical brain pathology in research and clinical settings.
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Affiliation(s)
- Andreas Charidimou
- 1 Department of Neurology, Harvard Medical School, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA.,2 Cochrane Methods, Individual Patient Data Meta-analysis Group
| | - Sara Shams
- 3 Department of Clinical Science, Intervention, and Technology, Division of Medical Imaging and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Jose R Romero
- 4 Department of Neurology, Boston University School of Medicine, and the NHLBI's Framingham Heart Study, Framingham, Massachusetts
| | - Jie Ding
- 5 Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Roland Veltkamp
- 6 Department of Neurology, University of Heidelberg, Heidelberg, Germany.,7 Department of Stroke Medicine, Division of Brain Sciences, Imperial College London, London, UK
| | - Solveig Horstmann
- 6 Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | | | - Mark A van Buchem
- 9 Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Jayandra J Himali
- 4 Department of Neurology, Boston University School of Medicine, and the NHLBI's Framingham Heart Study, Framingham, Massachusetts.,10 Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - M Edip Gurol
- 1 Department of Neurology, Harvard Medical School, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Anand Viswanathan
- 1 Department of Neurology, Harvard Medical School, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Toshio Imaizumi
- 11 Department of Neurosurgery, Kushiro City General Hospital, Kushiro, Japan
| | - Meike W Vernooij
- 12 Department of Epidemiology and Department of Radiology and Nuclear Medicine; Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Sudha Seshadri
- 4 Department of Neurology, Boston University School of Medicine, and the NHLBI's Framingham Heart Study, Framingham, Massachusetts
| | - Steven M Greenberg
- 1 Department of Neurology, Harvard Medical School, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Oscar R Benavente
- 13 Division of Neurology, Department of Medicine, Stroke and Cerebrovascular Health Program, University of British Columbia, UBC Hospital, Vancouver, British Columbia, Canada
| | - Lenore J Launer
- 5 Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Ashkan Shoamanesh
- 14 Department of Medicine (Neurology), McMaster University and Population Health Research Institute, Hamilton, Ontario, Canada
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50
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Abstract
White matter hyperintensities (WMHs) that arise with age and/or atherosclerosis constitute a heterogeneous disorder in the white matter of the brain. However, the relationship between age-related risk factors and the prevalence of WMHs is still obscure. More clinical data is needed to confirm the relationship between age and the prevalence of WMHs. We collected 836 patients, who were treated in the Renmin Hospital, Hubei University of Medicine, China from January 2015 to February 2016, for a case-controlled retrospective analysis. According to T2-weighted magnetic resonance imaging results, all patients were divided into a WMHs group (n = 333) and a non-WMHs group (n = 503). The WMHs group contained 159 males and 174 females. The prevalence of WMHs increased with age and was associated with age-related risk factors, such as cardiovascular diseases, smoking, drinking, diabetes, hypertension and history of cerebral infarction. There was no significant difference in sex, education level, hyperlipidemia and hyperhomocysteinemia among the different age ranges. These findings confirm that age is an independent risk factor for the prevalence and severity of WMHs. The age-related risk factors enhance the occurrence of WMHs.
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Affiliation(s)
- Feng-Juan Zhuang
- Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Yan Chen
- Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Wen-Bo He
- Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Zhi-You Cai
- Department of Neurology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, China
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