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Koutsonida M, Koskeridis F, Markozannes G, Kanellopoulou A, Mousas A, Ntotsikas E, Ioannidis P, Aretouli E, Tsilidis KK. Metabolic syndrome and cognitive deficits in the Greek cohort of Epirus Health Study. Neurol Sci 2023; 44:3523-3533. [PMID: 37162663 PMCID: PMC10495510 DOI: 10.1007/s10072-023-06835-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/28/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Metabolic syndrome is considered an important risk factor for cognitive decline and dementia. However, the evidence in middle-aged individuals is still conflicting. The aim of the study was to explore the association between metabolic syndrome and its individual components with cognitive function and to investigate possible interaction between sex, age and genetic predisposition for metabolic syndrome and Alzheimer's disease in a middle-aged Greek cohort. METHODS A total of 2,077 healthy adults (mean age: 46.7 years) were included in the primary cross-sectional analysis and 305 of them in secondary prospective analyses. Metabolic syndrome was defined by the revised National Cholesterol Education-Adult Treatment Panel III and the International Diabetes Federation criteria. Cognitive function was measured primarily with the Trail Making, Verbal fluency and Logical Memory test, and in secondary prospective analyses with online versions of Posner cueing task, an emotional recognition task, Corsi block-tapping task and Stroop task. RESULTS Multivariable linear regressions showed an association of metabolic syndrome with lower performance in attention (β=1.62 seconds, 95% CI=0.20, 3.04) and memory (β=-0.62 words, 95% CI=-1.19, -0.05) that could be driven by associations with elevated fasting glucose and abdominal obesity. Similar associations were observed in the secondary prospective analyses. CONCLUSION In summary, metabolic syndrome was associated with cognitive deficits in domains related with the cognitive profile of vascular cognitive impairment.
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Affiliation(s)
- Myrto Koutsonida
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Fotios Koskeridis
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Georgios Markozannes
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Afroditi Kanellopoulou
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Abdou Mousas
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Evangelos Ntotsikas
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Panagiotis Ioannidis
- B' Department of Neurology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Aretouli
- Department of Psychology, School of Social Sciences, University of Ioannina, Ioannina, Greece.
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
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2
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Murray AM, Thao LTP, Ryan J, Wolfe R, Wetmore JB, Woods RL, Polkinghorne KR. CKD Biomarkers, Cognitive Impairment, and Incident Dementia in an Older Healthy Cohort. KIDNEY360 2022; 3:435-445. [PMID: 35582189 PMCID: PMC9034805 DOI: 10.34067/kid.0005672021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/06/2021] [Indexed: 01/10/2023]
Abstract
Background CKD is a risk factor for cognitive impairment (CI), but reports of individual associations of eGFR and albuminuria with CI and incident dementia in healthier, older, longitudinal populations are lacking. Our goal was to estimate these associations in a large cohort of older healthy persons. Methods In a longitudinal cohort study of older persons without prior cardiovascular disease, we estimated the associations between baseline eGFR (in ml/min per 1.73 m2) and albuminuria, measured as urine albumin-creatinine ratio (UACR; in mg/mmol) and cognitive test scores, declines in cognitive test scores, and incident dementia using adjusted linear and linear mixed models. Cox proportional hazards regression models assessed the association between baseline kidney function and incident CI no dementia (CIND) or dementia at a median of 4.7 years. Results At baseline, among 18,131 participants, median age was 74 years, eGFR was 74 (IQR, 63-84) ml/min per 1.73 m2, UACR was 0.8 (IQR, 0.5-1.5) mg/mmol (7.1 [4.4-13.3] mg/g), and 56% were female. Baseline eGFR was not associated with performance on any cognitive tests in cross-sectional analysis, nor was incident CIND or dementia over a median follow-up of 4.7 years. However, baseline UACR ≥3 mg/mmol (≥26.6 mg/g) was significantly associated with lower baseline scores and larger declines on the Modified Mini-Mental State Exam, verbal memory and processing speed tests, and with incident CIND (hazard ratio [HR], 1.19; 95% CI, 1.07 to 1.33) and dementia (HR, 1.32; 95% CI, 1.06 to 1.66). Conclusion Mild albuminuria was associated with worse baseline cognitive function, cognitive decline, and increased risk for incident CIND and dementia. Screening global cognitive tests for older persons with UACR ≥3 mg/mmol could identify those at elevated risk of cognitive decline and dementia.
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Affiliation(s)
- Anne M. Murray
- The Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, Minnesota
- Department of Medicine, Geriatrics Division, Hennepin Healthcare, Minneapolis, Minnesota
- Departments of Medicine and Neurology, University of Minnesota, Minneapolis, Minnesota
| | - Le Thi Phuong Thao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rory Wolfe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - James B. Wetmore
- Nephrology Division, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
| | - Robyn L. Woods
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kevan R. Polkinghorne
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Nephrology, Monash Medical Centre, Monash Health, Clayton, Victoria, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
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3
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Angoff R, Himali JJ, Maillard P, Aparicio HJ, Vasan RS, Seshadri S, Beiser AS, Tsao CW. Relations of Metabolic Health and Obesity to Brain Aging in Young to Middle-Aged Adults. J Am Heart Assoc 2022; 11:e022107. [PMID: 35229662 PMCID: PMC9075324 DOI: 10.1161/jaha.121.022107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 01/18/2022] [Indexed: 11/23/2022]
Abstract
Background We aimed to evaluate the association between metabolic health and obesity and brain health measured via magnetic resonance imaging and neurocognitive testing in community dwelling adults. Methods and Results Framingham Heart Study Third Generation Cohort members (n=2170, 46±9 years of age, 54% women) without prevalent diabetes, stroke, dementia, or other neurologic conditions were grouped by metabolic unhealthiness (≥2 criteria for metabolic syndrome) and obesity (body mass index ≥30 kg/m2): metabolically healthy (MH) nonobese, MH obese, metabolically unhealthy (MU) nonobese, and MU obese. We evaluated the relationships of these groups with brain structure (magnetic resonance imaging) and function (neurocognitive tests). In multivariable-adjusted analyses, metabolically unhealthy individuals (MU nonobese and MU obese) had lower total cerebral brain volume compared with the MH nonobese referent group (both P<0.05). Additionally, the MU obese group had greater white matter hyperintensity volume (P=0.004), whereas no association was noted between white matter hyperintensity volume and either groups of metabolic health or obesity alone. Obese individuals had less favorable cognitive scores: MH obese had lower scores on global cognition, Logical Memory-Delayed Recall and Similarities tests, and MU obese had lower scores on Similarities and Visual Reproductions-Delayed tests (all P≤0.04). MU and obese groups had higher free water content and lower fractional anisotropy in several brain regions, consistent with loss of white matter integrity. Conclusions In this cross-sectional cohort study of younger to middle-aged adults, poor metabolic health and obesity were associated with structural and functional evidence of brain aging. Improvement in metabolic health and obesity may present opportunities to improve long-term brain health.
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Affiliation(s)
- Rebecca Angoff
- Cardiovascular DivisionBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMA
| | - Jayandra J. Himali
- Department of NeurologySchool of MedicineBoston UniversityBostonMA
- The Department of BiostatisticsBoston UniversityBostonMA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative DiseasesUniversity of Texas Health Sciences CenterSan AntonioTX
- The Framingham Heart StudyFraminghamMA
| | - Pauline Maillard
- Department of Neurology and Center for NeuroscienceUniversity of California at DavisDavisCA
| | - Hugo J. Aparicio
- Department of NeurologySchool of MedicineBoston UniversityBostonMA
- The Framingham Heart StudyFraminghamMA
| | - Ramachandran S. Vasan
- Department of MedicineSchool of MedicineBoston UniversityBostonMA
- Department of EpidemiologyBoston UniversityBostonMA
- The Framingham Heart StudyFraminghamMA
| | - Sudha Seshadri
- Department of NeurologySchool of MedicineBoston UniversityBostonMA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative DiseasesUniversity of Texas Health Sciences CenterSan AntonioTX
- Department of Population Health SciencesUniversity of Texas Health Science CenterSan AntonioTX
- The Framingham Heart StudyFraminghamMA
| | - Alexa S. Beiser
- Department of NeurologySchool of MedicineBoston UniversityBostonMA
- The Department of BiostatisticsBoston UniversityBostonMA
- The Framingham Heart StudyFraminghamMA
| | - Connie W. Tsao
- Cardiovascular DivisionBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMA
- The Framingham Heart StudyFraminghamMA
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4
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Randers L, Jepsen JRM, Fagerlund B, Nordholm D, Krakauer K, Hjorthøj C, Glenthøj B, Nordentoft M. Generalized neurocognitive impairment in individuals at ultra-high risk for psychosis: The possible key role of slowed processing speed. Brain Behav 2021; 11:e01962. [PMID: 33486897 PMCID: PMC7994693 DOI: 10.1002/brb3.1962] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 10/06/2020] [Accepted: 10/25/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Widespread neurocognitive impairment is well-established in individuals at ultra-high risk (UHR) for developing psychoses, but it is unknown whether slowed processing speed may underlie impairment in other neurocognitive domains, as found in schizophrenia. The study delineated domain functioning in a UHR sample and examined if neurocognitive slowing might account for deficits across domains. METHODS The cross-sectional study included 50 UHR individuals with no (n = 38) or minimal antipsychotic exposure (n = 12; mean lifetime dose of haloperidol equivalent = 17.56 mg; SD = 13.04) and 50 matched healthy controls. Primary analyses compared group performance across neurocognitive domains before and after covarying for processing speed. To examine the specificity of processing speed effects, post hoc analyses examined the impact of the other neurocognitive domains and intelligence as covariates. RESULTS UHR individuals exhibited significant impairment across all neurocognitive domains (all ps ≤ .010), with medium to large effect sizes (Cohen's ds = -0.53 to -1.12). Only processing speed used as covariate eliminated significant between-group differences in all other domains, reducing unadjusted Cohen's d values with 68% on average, whereas the other domains used as covariates averagely reduced unadjusted Cohen's d values with 20% to 48%. When covarying each of the other domains after their shared variance with speed of processing was removed, all significant between-group domain differences remained (all ps ≤ .024). CONCLUSION Slowed processing speed may underlie generalized neurocognitive impairment in UHR individuals and represent a potential intervention target.
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Affiliation(s)
- Lasse Randers
- Copenhagen Research Center for Mental Health ‐ COREMental Health Center CopenhagenCopenhagen University HospitalCopenhagenDenmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS)Mental Health Center GlostrupCopenhagen University HospitalGlostrupDenmark
- Faculty of Health and Medical SciencesDepartment of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Jens Richardt Møllegaard Jepsen
- Copenhagen Research Center for Mental Health ‐ COREMental Health Center CopenhagenCopenhagen University HospitalCopenhagenDenmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS)Mental Health Center GlostrupCopenhagen University HospitalGlostrupDenmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR)Mental Health Center GlostrupCopenhagen University HospitalGlostrupDenmark
- Child and Adolescent Mental Health CenterMental Health Services Capital Region of DenmarkCopenhagen University HospitalDenmark
| | - Birgitte Fagerlund
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS)Mental Health Center GlostrupCopenhagen University HospitalGlostrupDenmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR)Mental Health Center GlostrupCopenhagen University HospitalGlostrupDenmark
- Faculty of Social SciencesDepartment of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Dorte Nordholm
- Copenhagen Research Center for Mental Health ‐ COREMental Health Center CopenhagenCopenhagen University HospitalCopenhagenDenmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS)Mental Health Center GlostrupCopenhagen University HospitalGlostrupDenmark
- Functional Imaging UnitDepartment of Clinical Physiology, Nuclear Medicine and PETCopenhagen University Hospital RigshospitaletGlostrupDenmark
| | - Kristine Krakauer
- Copenhagen Research Center for Mental Health ‐ COREMental Health Center CopenhagenCopenhagen University HospitalCopenhagenDenmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS)Mental Health Center GlostrupCopenhagen University HospitalGlostrupDenmark
- Functional Imaging UnitDepartment of Clinical Physiology, Nuclear Medicine and PETCopenhagen University Hospital RigshospitaletGlostrupDenmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health ‐ COREMental Health Center CopenhagenCopenhagen University HospitalCopenhagenDenmark
- Faculty of Health and Medical SciencesDepartment of Public HealthSection of EpidemiologyUniversity of CopenhagenCopenhagenDenmark
| | - Birte Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS)Mental Health Center GlostrupCopenhagen University HospitalGlostrupDenmark
- Faculty of Health and Medical SciencesDepartment of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR)Mental Health Center GlostrupCopenhagen University HospitalGlostrupDenmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health ‐ COREMental Health Center CopenhagenCopenhagen University HospitalCopenhagenDenmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS)Mental Health Center GlostrupCopenhagen University HospitalGlostrupDenmark
- Faculty of Health and Medical SciencesDepartment of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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5
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Kazlauskaite R, Janssen I, Wilson RS, Appelhans BM, Evans DA, Arvanitakis Z, El Khoudary SR, Kravitz HM. Is Midlife Metabolic Syndrome Associated With Cognitive Function Change? The Study of Women's Health Across the Nation. J Clin Endocrinol Metab 2020; 105:5735651. [PMID: 32083676 PMCID: PMC7059989 DOI: 10.1210/clinem/dgaa067] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/11/2020] [Indexed: 02/08/2023]
Abstract
CONTEXT Metabolic syndrome (MetS) affects cognitive function in late life, particularly in women. But longitudinal research is scarce on associations of MetS with cognitive function during midlife. OBJECTIVE To determine associations between MetS exposure and cognitive function trajectories in midlife women. DESIGN AND SETTING This is a 17-year prospective, longitudinal study of multiracial/ethnic women in 7 US communities, with annual/biennial assessments. PARTICIPANTS Participants were 2149 US women traversing menopause. EXPOSURE Exposure consisted of MetS assessments (median 4 assessments over 4 years). MAIN OUTCOME MEASURES Main outcome measures were assessments of cognitive function in 3 domains: perceptual speed (symbol digit modalities test, SDMT), episodic memory (East Boston Memory Test, EBMT), and working memory (Digit Span Backward Test, DSB). RESULTS By their first cognitive assessment (age 50.7 ± 2.9 years), 29.5% met the criteria for MetS. Women completed a median (interquartile range [IQR]) of 6 (IQR 4-7) follow-up cognitive assessments over 11.2 (IQR 9.2-11.5) years. Women with MetS, compared with those without, had a larger 10-year decline in SDMT z-score (estimate -0.087, 95% confidence interval, -0.150 to -0.024; P = 0.007), after adjustment for cognitive testing practice effects, sociodemographics, lifestyle, mood, and menopause factors. As such, MetS accelerated the 10-year loss of perceptual speed by 24%. MetS did not differentially affect the rate of decline in either immediate (P = 0.534) or delayed (P = 0.740) episodic memory or in working memory (P = 0.584). CONCLUSIONS In midlife women MetS exposure was associated with accelerated decline in perceptual speed, but not episodic or working memory.
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Affiliation(s)
- Rasa Kazlauskaite
- Department of Medicine, Rush University Medical Center, Chicago, Illinois
- Correspondence and Reprint Requests: Rasa Kazlauskaite, MD, Rush University Medical Center, 1750 W. Harrison St. (Jelke) Ste. 604w | Chicago, IL 60612. E-mail:
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
| | - Robert S Wilson
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Denis A Evans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Zoe Arvanitakis
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Samar R El Khoudary
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Howard M Kravitz
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
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6
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Tu MC, Lo CP, Huang CF, Huang WH, Deng JF, Hsu YH. Visual Attention Performances and Related Cerebral Microstructural Integrity Among Subjects With Subjective Cognitive Decline and Mild Cognitive Impairment. Front Aging Neurosci 2018; 10:268. [PMID: 30245626 PMCID: PMC6137332 DOI: 10.3389/fnagi.2018.00268] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/21/2018] [Indexed: 01/09/2023] Open
Abstract
Objective: To compare visual attention performances and diffusion tensor imaging (DTI) between subjects with subjective cognitive decline (SCD) and mild cognitive impairment (MCI), and to discover neuronal substrates related to visual attention performances. Methods: Thirty-nine subjects with SCD and 15 with MCI, diagnosed following neuropsychological tests and conventional brain magnetic resonance imaging, were recruited. All subjects were further examined by the Conners Continuous Performance Test 3 (CPT3) and DTI including fractional anisotropy (FA) and mean diffusivity (MD), in which group comparisons and stepwise linear regression were made. Results: Subjects with MCI had a worse performance in all retrieval indices of verbal/nonverbal memory tests than those with SCD in the context of comparable general cognition and demographic status. In the CPT3, subjects with MCI had a significant longer hit reaction time (HRT) by univariate but not multivariate comparisons. Further analysis suggested that a longer HRT across all interstimuli intervals and at the point of fourth to sixth blocks were noted among MCI subjects. In DTI evaluations, FA value within the left forceps major was the only hotspot with significant between-group differences after the Bonferroni correction of FA and MD values. On the basis that HRT had significant inverse correlations with FA value within the genu of the corpus callosum and left forceps minor, regression analysis was conducted, showing HRT was best predicted by the FA value within the left forceps minor. Area under receiver operative characteristic curve was 0.70; the optimum cut-off for HRT was 515.8 ms, with a sensitivity of 85% but specificity of 47%. Conclusions: Our report suggested that impaired sustained attention and vigilance to be an early cognitive marker in differentiating MCI from SCD, where MCI subjects had a longer HRT across all interstimuli intervals and more profoundly in later blocks. FA measures appeared to be more sensitive DTI parameters than MD values in detecting microstructural changes between SCD and MCI. The role of the anterior interhemispheric fibers in sustained attention implementation during visual signal detection task was highlighted.
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Affiliation(s)
- Min-Chien Tu
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chung-Ping Lo
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Radiology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Ching-Feng Huang
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Wen-Hui Huang
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Jie Fu Deng
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Yen-Hsuan Hsu
- Department of Psychology, National Chung Cheng University, Chiayi, Taiwan.,Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, Chiayi, Taiwan
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7
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Alfaro FJ, Gavrieli A, Saade-Lemus P, Lioutas VA, Upadhyay J, Novak V. White matter microstructure and cognitive decline in metabolic syndrome: a review of diffusion tensor imaging. Metabolism 2018; 78:52-68. [PMID: 28920863 PMCID: PMC5732847 DOI: 10.1016/j.metabol.2017.08.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/18/2017] [Accepted: 08/22/2017] [Indexed: 12/13/2022]
Abstract
Metabolic syndrome is a cluster of cardiovascular risk factors defined by the presence of abdominal obesity, glucose intolerance, hypertension and/or dyslipidemia. It is a major public health epidemic worldwide, and a known risk factor for the development of cognitive dysfunction and dementia. Several studies have demonstrated a positive association between the presence of metabolic syndrome and worse cognitive outcomes, however, evidence of brain structure pathology is limited. Diffusion tensor imaging has offered new opportunities to detect microstructural white matter changes in metabolic syndrome, and a possibility to detect associations between functional and structural abnormalities. This review analyzes the impact of metabolic syndrome on white matter microstructural integrity, brain structure abnormalities and their relationship to cognitive function. Each of the metabolic syndrome components exerts a specific signature of white matter microstructural abnormalities. Metabolic syndrome and its components exert both additive/synergistic, as well as, independent effects on brain microstructure thus accelerating brain aging and cognitive decline.
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Affiliation(s)
- Freddy J Alfaro
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Anna Gavrieli
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Patricia Saade-Lemus
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Vasileios-Arsenios Lioutas
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Jagriti Upadhyay
- Department of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215,USA.
| | - Vera Novak
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
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8
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Santos PP, Silveira PSD, Souza-Duran FL, Tamashiro-Duran JH, Scazufca M, Menezes PR, Leite CDC, Lotufo PA, Vallada H, Wajngarten M, De Toledo Ferraz Alves TC, Rzezak P, Busatto GF. Prefrontal-Parietal White Matter Volumes in Healthy Elderlies Are Decreased in Proportion to the Degree of Cardiovascular Risk and Related to Inhibitory Control Deficits. Front Psychol 2017; 8:57. [PMID: 28184203 PMCID: PMC5266720 DOI: 10.3389/fpsyg.2017.00057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 01/10/2017] [Indexed: 01/05/2023] Open
Abstract
Cardiovascular risk (CVR) factors may be associated with poor cognitive functioning in elderlies and impairments in brain structure. Using MRI and voxel-based morphometry (VBM), we assessed regional white matter (WM) volumes in a population-based sample of individuals aged 65–75 years (n = 156), subdivided in three CVR subgroups using the Framingham Risk Score. Cognition was assessed using the Short Cognitive Performance Test. In high-risk subjects, we detected significantly reduced WM volume in the right juxtacortical dorsolateral prefrontal region compared to both low and intermediate CVR subgroups. Findings remained significant after accounting for the presence of the APOEε4 allele. Inhibitory control performance was negatively related to right prefrontal WM volume, proportionally to the degree of CVR. Significantly reduced deep parietal WM was also detected bilaterally in the high CVR subgroup. This is the first large study documenting the topography of CVR-related WM brain volume deficits. The significant association regarding poor response inhibition indicates that prefrontal WM deficits related to CVR are clinically meaningful, since inhibitory control is known to rely on prefrontal integrity.
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Affiliation(s)
- Pedro P Santos
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
| | - Paula S Da Silveira
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
| | - Fabio L Souza-Duran
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
| | - Jaqueline H Tamashiro-Duran
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
| | - Márcia Scazufca
- Department and Institute of Psychiatry, University of São Paulo São Paulo, Brazil
| | - Paulo R Menezes
- Department of Preventive Medicine, Faculty of Medicine, University of São PauloSão Paulo, Brazil; Center of Research in Mental Health Population, University of São PauloSão Paulo, Brazil
| | - Claudia Da Costa Leite
- Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil; Laboratory of Magnetic Resonance in Neuroradiology, Institute and Department of Radiology, University of São PauloSão Paulo, Brazil
| | - Paulo A Lotufo
- Department of Internal Medicine, Center for Clinical and Epidemiologic Research, University of São Paulo São Paulo, Brazil
| | - Homero Vallada
- Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil; Department and Institute of Psychiatry, University of São PauloSão Paulo, Brazil
| | - Maurício Wajngarten
- Department of Cardiopneumology, Heart Institute, General Hospital of University of São Paulo Medical School São Paulo, Brazil
| | - Tânia C De Toledo Ferraz Alves
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
| | - Patricia Rzezak
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil; Laboratory of Clinical Neurophysiology, Institute of Psychiatry, University of São Paulo Medical School (IPq-HC-FMUSP)São Paulo, Brazil
| | - Geraldo F Busatto
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
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Bai YM, Li CT, Tsai SJ, Tu PC, Chen MH, Su TP. Metabolic syndrome and adverse clinical outcomes in patients with bipolar disorder. BMC Psychiatry 2016; 16:448. [PMID: 27978821 PMCID: PMC5159954 DOI: 10.1186/s12888-016-1143-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 11/25/2016] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is highly prevalent among patients with bipolar disorder. MetS may cause complications in the brain, but studies investigating MetS-associated clinical psychiatric outcomes remain scant. METHODS We enrolled clinically stable outpatients with bipolar disorder aged 18-65 years and performed anthropometric and fasting biochemical assessments to investigate MetS prevalence. We then performed clinical assessments by using the Young Mania Rating Scale for manic symptoms, the Montgomery-Åsberg Depression Rating Scale for depressive symptoms, the Positive and Negative Symptom Scale for psychotic symptoms, the Involuntary Movement Scale for tardive dyskinesia, the Barnes Akathisia Rating Scale for akathisia, the Udvalg for Kliniske Undersogelser for general side effects, the Schedule for Assessment of Insight for insight, the Global Assessment of Functioning scale for global functioning, and the Wisconsin Card Sorting Test (WCST) for cognitive executive function. RESULTS In total, 143 patients were enrolled and had a MetS prevalence of 29.4%. The patients treated with atypical antipsychotics plus mood stabilizers (36.3%) and atypical antipsychotics alone (36.0%) had a significantly higher prevalence of MetS than did those treated with mood stabilizers alone (10.5%; p = 0.012). According to multivariate regression analyses adjusted for age, sex, smoking status, bipolar disorder subtype (I or II), pharmacological treatment duration, and psychiatric medication, compared with patients without MetS, those with MetS had significantly more previous hospitalizations (p = 0.036), severer tardive dyskinesia (p = 0.030), poorer insight (p = 0.036), poorer global function (p = 0.046), and more impaired executive function (conceptual level response on the WCST; p = 0.042). CONCLUSIONS Our results indicated that patients with comorbid bipolar disorder and MetS have more adverse clinical outcomes than those without, with more hospitalizations, severer tardive dyskinesia, poorer insight, poorer global function, and more impaired executive function. Monitoring MetS is crucial for assessing not only physical burden, but also psychiatric outcomes.
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Affiliation(s)
- Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan. .,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan ,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan ,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan ,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan ,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan ,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
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Alfaro FJ, Lioutas VA, Pimentel DA, Chung CC, Bedoya F, Yoo WK, Novak V. Cognitive decline in metabolic syndrome is linked to microstructural white matter abnormalities. J Neurol 2016; 263:2505-2514. [PMID: 27730376 DOI: 10.1007/s00415-016-8292-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/19/2016] [Accepted: 09/20/2016] [Indexed: 01/21/2023]
Abstract
Subjects with metabolic syndrome (MetS) often show worse cognitive performance compared with the healthy population. We investigated whether microstructural white matter abnormalities are associated with cognitive performance in adults with MetS using diffusion tensor MR imaging. A total of 32 subjects with MetS (age 64.8 ± 7.8, 56.25 % female) and 23 age-, gender-, and education-matched healthy controls completed a battery of neuropsychological tests and diffusion tensor imaging (DTI) at 3-T MRI. Brain global and regional volumes, white matter fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (LD) were calculated. The least-square models adjusted for age, sex, HbA1c, hypertension, body mass index, hyperlipidemia, and white matter hyperintensities were used to evaluate the relationship between cognitive function and DTI. The MetS group had worse performance in verbal fluency (VF) and learning and memory function (total VF: T score (p = 0.01), VF: animals T score (p = 0.0001), Hopkins Verbal Learning Test (HVLT): Total recall T score (p = 0.0001), and HVLT: delayed recall T score (p = 0.002), as compared with controls. In the MetS group, abnormalities in diffusivity measures were associated with worse cognitive performance [VF: animals T score and left post-central gyrus-LD (p = 0.0007, r adj 0.4), R angular gyrus-RD (p = 0.0008, r adj 0.3), L supra-marginal gyrus-RD (p = 0.009, r adj 0.2) after adjusting for age, sex, HbA1c, 24 h mean BP, presence of hyperlipidemia, and global white matter hyperintensities]. Microstructural white matter abnormalities in the MetS group might be the underlying mechanisms of worse verbal learning and memory performance.
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Affiliation(s)
- Freddy J Alfaro
- Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA
| | - Vasileios-Arsenios Lioutas
- Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA
| | - Daniela A Pimentel
- Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA
| | - Chen-Chih Chung
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Francisco Bedoya
- Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA
| | - Woo-Kyoung Yoo
- Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Chooncheon, Korea
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Vera Novak
- Department of Neurology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 127, Boston, MA, 02215, USA.
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Kievit RA, Davis SW, Griffiths J, Correia MM, Cam-Can, Henson RN. A watershed model of individual differences in fluid intelligence. Neuropsychologia 2016; 91:186-198. [PMID: 27520470 PMCID: PMC5081064 DOI: 10.1016/j.neuropsychologia.2016.08.008] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 06/23/2016] [Accepted: 08/09/2016] [Indexed: 12/14/2022]
Abstract
Fluid intelligence is a crucial cognitive ability that predicts key life outcomes across the lifespan. Strong empirical links exist between fluid intelligence and processing speed on the one hand, and white matter integrity and processing speed on the other. We propose a watershed model that integrates these three explanatory levels in a principled manner in a single statistical model, with processing speed and white matter figuring as intermediate endophenotypes. We fit this model in a large (N=555) adult lifespan cohort from the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) using multiple measures of processing speed, white matter health and fluid intelligence. The model fit the data well, outperforming competing models and providing evidence for a many-to-one mapping between white matter integrity, processing speed and fluid intelligence. The model can be naturally extended to integrate other cognitive domains, endophenotypes and genotypes.
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Affiliation(s)
- Rogier A Kievit
- MRC Cognition and Brain Sciences Unit, 15 Chaucer Rd, Cambridge CB2 7EF, United Kingdom.
| | - Simon W Davis
- Department of Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, United Kingdom; Center for Cognitive Neuroscience, Duke University, Durham, NC 27708, United States
| | - John Griffiths
- Department of Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, United Kingdom; Rotman Research Institute, Baycrest, Toronto, Ontario, Canada M6A 2E1
| | - Marta M Correia
- MRC Cognition and Brain Sciences Unit, 15 Chaucer Rd, Cambridge CB2 7EF, United Kingdom
| | - Cam-Can
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, United Kingdom
| | - Richard N Henson
- MRC Cognition and Brain Sciences Unit, 15 Chaucer Rd, Cambridge CB2 7EF, United Kingdom
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12
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Liu H, Wang L, Geng Z, Zhu Q, Song Z, Chang R, Lv H. A voxel-based morphometric study of age- and sex-related changes in white matter volume in the normal aging brain. Neuropsychiatr Dis Treat 2016; 12:453-65. [PMID: 26966366 PMCID: PMC4771405 DOI: 10.2147/ndt.s90674] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To carry out a cross-sectional study of 187 cognitively normal Chinese adults using the voxel-based morphometry (VBM) approach to delineate age-related changes in the white matter volume of regions of interest in the brain and further analyze their correlation with age. MATERIALS AND METHODS A total of 187 cognitively normal adults were divided into the young, middle, and old age-groups. Conventional magnetic resonance imaging was performed with the Achieva 3.0 T system. Structural images were processed using VBM8 and statistical parametric mapping 8. Regions of interest were obtained by WFU PickAtlas, and all realigned images were spatially normalized. RESULTS Females showed significantly greater total white matter volume than males (t=2.36, P=0.0096, false-discovery rate [FDR] corrected). VBM demonstrated statistically significant age-related differences in white matter volume between the young age-group and the middle age-group (P<0.05, FDR corrected) and between the middle age-group and the old age-group (P<0.05, FDR corrected). No interaction was found between age and sex on white matter volume (P<0.05, FDR corrected). Logistic regression analysis revealed nonlinear correlation between total white matter volume and age (R (2)=0.124, P<0.001). White matter volume gradually increased before 40 years of age, peaked around 50 years of age, and rapidly declined after 60 years of age. CONCLUSION Significant age-related differences are present in white matter volume across multiple brain regions during aging. The VBM approach may help differentiate underlying normal neurobiological aging changes of specific brain regions from neurodegenerative impairments.
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Affiliation(s)
- Haijing Liu
- Department of Radiology, Second Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Lixin Wang
- Department of Radiology, Second Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Zuojun Geng
- Department of Radiology, Second Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Qingfeng Zhu
- Department of Radiology, Second Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Zhenhu Song
- Department of Radiology, Second Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Ruiting Chang
- Department of Radiology, Second Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Huandi Lv
- Department of Radiology, Second Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
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13
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Friedman JI, Tang CY, de Haas HJ, Changchien L, Goliasch G, Dabas P, Wang V, Fayad ZA, Fuster V, Narula J. Brain imaging changes associated with risk factors for cardiovascular and cerebrovascular disease in asymptomatic patients. JACC Cardiovasc Imaging 2015; 7:1039-53. [PMID: 25323165 DOI: 10.1016/j.jcmg.2014.06.014] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 11/27/2022]
Abstract
Reviews of imaging studies assessing the brain effects of vascular risk factors typically include a substantial number of studies with subjects with a history of symptomatic cardiovascular or cerebrovascular disease and/or events, limiting our ability to disentangle the primary brain effects of vascular risk factors from those of resulting brain and cardiac damage. The objective of this study was to perform a systematic review of brain changes from imaging studies in patients with vascular risk factors but without clinically manifest cardiovascular or cerebrovascular disease or events. The 77 studies included in this review demonstrate that in persons without symptomatic cardiovascular, cerebrovascular, or peripheral vascular disease, the vascular risk factors of hypertension, diabetes mellitus, obesity, hyperlipidemia, and smoking are all independently associated with brain imaging changes before the clinical manifestation of cardiovascular or cerebrovascular disease. We conclude that the identification of brain changes associated with vascular risk factors, before the manifestation of clinically significant cerebrovascular damage, presents a window of opportunity wherein adequate treatment of these modifiable vascular risk factors may prevent the development of irreversible deleterious brain changes and potentially alter patients' clinical course.
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Affiliation(s)
- Joseph I Friedman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York; Clinical Neuroscience Center, Pilgrim Psychiatric Center, West Brentwood, New York.
| | - Cheuk Y Tang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Hans J de Haas
- Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York
| | - Lisa Changchien
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Clinical Neuroscience Center, Pilgrim Psychiatric Center, West Brentwood, New York
| | - Georg Goliasch
- Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York
| | - Puneet Dabas
- Clinical Neuroscience Center, Pilgrim Psychiatric Center, West Brentwood, New York
| | - Victoria Wang
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Zahi A Fayad
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Valentin Fuster
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jagat Narula
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York
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14
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Arboix A. Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke. World J Clin Cases 2015; 3:418-429. [PMID: 25984516 PMCID: PMC4419105 DOI: 10.12998/wjcc.v3.i5.418] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 01/14/2015] [Accepted: 02/12/2015] [Indexed: 02/05/2023] Open
Abstract
Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients.
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15
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Premorbid obesity and metabolic disturbances as promising clinical targets for the prevention and early screening of bipolar disorder. Med Hypotheses 2015; 84:285-93. [DOI: 10.1016/j.mehy.2015.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 01/11/2015] [Indexed: 12/12/2022]
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Mohades SG, Van Schuerbeek P, Rosseel Y, Van De Craen P, Luypaert R, Baeken C. White-matter development is different in bilingual and monolingual children: a longitudinal DTI study. PLoS One 2015; 10:e0117968. [PMID: 25706865 PMCID: PMC4338107 DOI: 10.1371/journal.pone.0117968] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/23/2014] [Indexed: 12/15/2022] Open
Abstract
Although numerous people grow up speaking more than one language, the impact of bilingualism on brain developing neuroanatomy is still poorly understood. This study aimed to determine whether the changes in the mean fractional-anisotropy (MFA) of language pathways are different between bilingual and monolingual children. Simultaneous-bilinguals, sequential-bilinguals and monolingual, male and female 10–13 years old children participated in this longitudinal study over a period of two years. We used diffusion tensor tractography to obtain mean fractional-anisotropy values of four language related pathways and one control bundle: 1-left-inferior-occipitofrontal fasciculus/lIFOF, 2-left-arcuate fasciculus/lAF/lSLF, 3-bundle arising from the anterior part of corpus-callosum and projecting to orbital lobe/AC-OL, 4-fibres emerging from anterior-midbody of corpus-callosum (CC) to motor cortices/AMB-PMC, 5- right-inferior-occipitofrontal fasciculus rIFOF as the control pathway unrelated to language. These values and their rate of change were compared between 3 groups. FA-values did not change significantly over two years for lAF/lSLF and AC-OL. Sequential-bilinguals had the highest degree of change in the MFA value of lIFOF, and AMB-PMC did not present significant group differences. The comparison of MFA of lIFOF yielded a significantly higher FA-value in simultaneous bilinguals compared to monolinguals. These findings acknowledge the existing difference of the development of the semantic processing specific pathway between children with different semantic processing procedure. These also support the hypothesis that age of second language acquisition affects the maturation and myelination of some language specific white-matter pathways.
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Affiliation(s)
| | | | - Yves Rosseel
- Department of Data Analysis, Ghent University, Ghent, Belgium
| | | | - Robert Luypaert
- Vrije Universiteit Brussel (VUB), Brussels, Belgium; Radiology, Universitair Ziekenhuis Brussel (UZBrussel), Brussels, Belgium
| | - Chris Baeken
- Department of Psychiatry University Hospital, Brussels, Belgium; Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
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Rouch I, Trombert B, Kossowsky MP, Laurent B, Celle S, Ntougou Assoumou G, Roche F, Barthelemy JC. Metabolic syndrome is associated with poor memory and executive performance in elderly community residents: the PROOF study. Am J Geriatr Psychiatry 2014; 22:1096-104. [PMID: 24534523 DOI: 10.1016/j.jagp.2014.01.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 01/10/2014] [Accepted: 01/16/2014] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Aging is associated with a loss of cognitive performance and an increasing occurrence of cardiovascular events. Moreover, cardiovascular risk factors are linked to cognitive impairment and dementia. Whereas individual components of metabolic syndrome (Met S) have been reported to be linked to cognitive decline and dementia, there are very few studies on Met S as a whole. The present study aims to assess the relationship between Met S and its components and cognitive functioning in a cohort of elderly non-demented community residents. DESIGN Population-based cohort study (PROOF study). Cross-sectional analysis. PARTICIPANTS Dementia-free community-dwellers aged 65. MEASURES The PROOF participants underwent an extensive neuropsychological battery at baseline. Summary cognitive measures including memory, attention, and executive performance were created by converting the individual test results to Z scores and computing the average scores within each domain. Each of the three cognitive scores was individually compared between groups as a function of Met S. The cognitive scores and the covariates which were significant in univariate analyses were then included in logistic regression models. RESULTS A significant association was observed between the presence of metabolic syndrome, poor memory, and executive function even after adjusting for confounding factors (memory: odds ratio: 1.77, p = 0.008; executive functions: odds ratio: 1.91, p = 0.002). CONCLUSIONS Our study showed that in a sample of elderly community dwellers, Met S was associated with poor memory and executive performance. These results underline the importance of detecting and managing metabolic syndrome components to prevent cognitive impairment and dementia.
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Affiliation(s)
- Isabelle Rouch
- Neurology Unit, University Hospital of Saint-Etienne, Saint Etienne, France; Geriatrics Unit, Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.
| | - Béatrice Trombert
- SSPIM, University Hospital of Saint-Etienne, Saint Etienne, France; EA SNA-EPIS, PRES Lyon, Saint Etienne, France
| | | | - Bernard Laurent
- Neurology Unit, University Hospital of Saint-Etienne, Saint Etienne, France
| | - Sébastien Celle
- EA SNA-EPIS, PRES Lyon, Saint Etienne, France; Clinical and Exercise Physiology Laboratory, University Hospital of Saint-Etienne, Saint Etienne, France
| | | | - Frédéric Roche
- EA SNA-EPIS, PRES Lyon, Saint Etienne, France; Clinical and Exercise Physiology Laboratory, University Hospital of Saint-Etienne, Saint Etienne, France
| | - Jean-Claude Barthelemy
- EA SNA-EPIS, PRES Lyon, Saint Etienne, France; Clinical and Exercise Physiology Laboratory, University Hospital of Saint-Etienne, Saint Etienne, France
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Viscogliosi G, Andreozzi P, Ettorre E, Marigliano V. Arterial aging impacts on the risk of late-life depressive and cognitive disorders. Is it time for prevention? Geriatr Gerontol Int 2014; 14:227-8. [DOI: 10.1111/ggi.12118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Giovanni Viscogliosi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; “Sapienza” University of Rome; Rome Italy
| | - Paola Andreozzi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; “Sapienza” University of Rome; Rome Italy
| | - Evaristo Ettorre
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; “Sapienza” University of Rome; Rome Italy
| | - Vincenzo Marigliano
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences; “Sapienza” University of Rome; Rome Italy
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Miller JL, Linville TD, Dykens EM. Effects of metformin in children and adolescents with Prader-Willi syndrome and early-onset morbid obesity: a pilot study. J Pediatr Endocrinol Metab 2014; 27:23-9. [PMID: 23893676 PMCID: PMC3864175 DOI: 10.1515/jpem-2013-0116] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 06/03/2013] [Indexed: 12/14/2022]
Abstract
Prader-Willi syndrome (PWS) is one of the most commonly recognized causes of early-onset childhood obesity. Individuals with PWS have significant hyperphagia and decreased recognition of satiety. The exact etiology of the hyperphagia remains unknown and, therefore, untreatable. We conducted a pilot, open-label study of response to metformin in 21 children with PWS and six with early morbid obesity (EMO). Participants had significant insulin resistance and glucose intolerance on oral glucose tolerance testing (OGTT) and were started on metformin for these biochemical findings. We administered the Hyperphagia Questionnaire to parents of patients before and after starting metformin treatment. Both the PWS and EMO groups showed significant improvements in food-related distress, anxiety, and ability to be redirected away from food on the Hyperphagia Questionnaire. In the PWS group, improvements were predominantly seen in females. Within the PWS group, responders to metformin had higher 2-h glucose levels on OGTT (7.48 mmol/L vs. 4.235 mmol/L; p=0.003) and higher fasting insulin levels (116 pmol/L vs. 53.5 pmol/L; p=0.04). Additionally, parents of 5/13 individuals with PWS and 5/6 with EMO reported that their child was able to feel full while on metformin (for many this was the first time they had ever described a feeling of fullness). Metformin may improve sense of satiety and decrease anxiety about food in some individuals with PWS and EMO. Positive response to metformin may depend on the degree of hyperinsulinism and glucose intolerance. Nonetheless, the results of this pilot study bear further investigation.
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Watts AS, Vidoni ED, Loskutova N, Johnson DK, Burns JM. Measuring Physical Activity in Older Adults with and without Early Stage Alzheimer's Disease. Clin Gerontol 2013; 36:356-374. [PMID: 24062599 PMCID: PMC3778925 DOI: 10.1080/07317115.2013.788116] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We compared subjective reports of physical activity with objective measures of physical fitness including cardiorespiratory capacity, body composition, and physical performance in 146 older adults with and without early stage Alzheimer's disease (ESAD). Respondents reported primarily unstructured and low-intensity activities, including walking and housework. Individuals with ESAD participated in fewer and lower intensity physical activities than those without ESAD. In those without ESAD, housework was related to lower body mass index, leisure walking was related to faster speed on a timed walking test, and participation in sports was related to higher peak oxygen intake. In individuals with ESAD, reported physical activities did not predict any of the physical fitness, body composition, or physical performance measures. We conclude that measures of physical activity require expansion of unstructured and low intensity activities to improve sensitivity in sedentary populations, especially in older adults with ESAD.
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Affiliation(s)
- Amber S Watts
- Lifespan Institute, Gerontology Center, University of Kansas ; Center for Research Methods and Data Analysis, University of Kansas ; Department of Psychology, University of Kansas
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21
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Verstynen TD, Weinstein A, Erickson KI, Sheu LK, Marsland AL, Gianaros PJ. Competing physiological pathways link individual differences in weight and abdominal adiposity to white matter microstructure. Neuroimage 2013; 79:129-37. [PMID: 23639257 DOI: 10.1016/j.neuroimage.2013.04.075] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 04/02/2013] [Accepted: 04/16/2013] [Indexed: 01/04/2023] Open
Abstract
Being overweight or obese is associated with reduced white matter integrity throughout the brain. It is not yet clear which physiological systems mediate the association between inter-individual variation in adiposity and white matter. We tested whether composite indicators of cardiovascular, lipid, glucose, and inflammatory factors would mediate the adiposity-related variation in white matter microstructure, measured with diffusion tensor imaging on a group of neurologically healthy adults (N=155). A composite factor representing adiposity (comprised of body mass index and waist circumference) was associated with smaller fractional anisotropy and greater radial diffusivity throughout the brain, a pattern previously linked to myelin structure changes in non-human animal models. A similar global negative association was found for factors representing inflammation and, to a lesser extent, glucose regulation. In contrast, factors for blood pressure and dyslipidemia had positive associations with white matter in isolated brain regions. Taken together, these competing influences on the diffusion signal were significant mediators linking adiposity to white matter and explained up to fifty-percent of the adiposity-white matter variance. These results provide the first evidence for contrasting physiological pathways, a globally distributed immunity-linked negative component and a more localized vascular-linked positive component, that associate adiposity to individual differences in the microstructure of white matter tracts in otherwise healthy adults.
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Affiliation(s)
- Timothy D Verstynen
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA.
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Shimoji K, Abe O, Uka T, Yasmin H, Kamagata K, Asahi K, Hori M, Nakanishi A, Tamura Y, Watada H, Kawamori R, Aoki S. White matter alteration in metabolic syndrome: diffusion tensor analysis. Diabetes Care 2013; 36:696-700. [PMID: 23172976 PMCID: PMC3579365 DOI: 10.2337/dc12-0666] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We explored the regional pattern of white matter alteration in subjects with metabolic syndrome. We also investigated whether white matter alteration was correlated with BMI. RESEARCH DESIGN AND METHODS Seven middle-aged men with metabolic syndrome and seven without metabolic syndrome underwent diffusion tensor imaging with a 3T magnetic resonance imaging imager. We analyzed the fractional anisotropy (FA) values by using a tract-based spatial statistics technique (whole-brain analysis). We subsequently focused on measuring the mean FA values of the right inferior fronto-occipital fasciculus (IFOF) of all subjects by tract-specific analysis (regional brain analysis). We used a Pearson correlation coefficient to evaluate the relationship between BMI and mean FA values of the right IFOF. RESULTS In the whole-brain analysis, subjects with metabolic syndrome had significantly lower FA values than control subjects in part of the right external capsule (part of the right IFOF), the entire corpus callosum, and part of the deep white matter of the right frontal lobe. In the regional brain analysis, the mean FA value of the right IFOF was 0.41 ± 0.03 for subjects with metabolic syndrome and 0.44 ± 0.05 for control subjects. A significant negative correlation was observed between BMI and FA values in the right IFOF (r = -0.56, P < 0.04). CONCLUSIONS Our results show that microstructural white matter changes occur in patients with metabolic syndrome. FA values may be useful indices of white matter alterations in patients with metabolic syndrome.
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Affiliation(s)
- Keigo Shimoji
- Department of Radiology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
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Xie F, Fu H, Hou JF, Jiao K, Costigan M, Chen J. High energy diets-induced metabolic and prediabetic painful polyneuropathy in rats. PLoS One 2013; 8:e57427. [PMID: 23451227 PMCID: PMC3581455 DOI: 10.1371/journal.pone.0057427] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 01/22/2013] [Indexed: 12/16/2022] Open
Abstract
To establish the role of the metabolic state in the pathogenesis of polyneuropathy, an age- and sex-matched, longitudinal study in rats fed high-fat and high-sucrose diets (HFSD) or high-fat, high-sucrose and high-salt diets (HFSSD) relative to controls was performed. Time courses of body weight, systolic blood pressure, fasting plasma glucose (FPG), insulin, free fatty acids (FFA), homeostasis model assessment-insulin resistance index (HOMA-IR), thermal and mechanical sensitivity and motor coordination were measured in parallel. Finally, large and small myelinated fibers (LMF, SMF) as well as unmyelinated fibers (UMF) in the sciatic nerves and ascending fibers in the spinal dorsal column were quantitatively assessed under electron microscopy. The results showed that early metabolic syndrome (hyperinsulinemia, dyslipidemia, and hypertension) and prediabetic conditions (impaired fasting glucose) could be induced by high energy diet, and these animals later developed painful polyneuropathy characterized by myelin breakdown and LMF loss in both peripheral and central nervous system. In contrast SMF and UMF in the sciatic nerves were changed little, in the same animals. Therefore the phenomenon that high energy diets induce bilateral mechanical, but not thermal, pain hypersensitivity is reflected by severe damage to LMF, but mild damage to SMF and UMF. Moreover, dietary sodium (high-salt) deteriorates the neuropathic pathological process induced by high energy diets, but paradoxically high salt consumption, may reduce, at least temporarily, chronic pain perception in these animals.
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Affiliation(s)
- Fang Xie
- Institute for Biomedical Sciences of Pain and Institute for Functional Brain Disorders, Tangdu Hospital, The Fourth Military Medical University, Xi'an, P. R. China
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24
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Tang CY, Narula J, Friedman JI. Novel imaging strategies for assessment of cerebrovascular involvement. ACTA ACUST UNITED AC 2012; 79:674-82. [PMID: 23239206 DOI: 10.1002/msj.21354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There is an important correlation between vascular risk factors and nonspecific imaging findings in the brain such as white-matter hyperintensities. These vascular risk factors are also associated with dementia and lesser forms of cognitive impairment. One hypothesis is that these vascular risk factors lead to disruption of connective networks in the central nervous system that are supported by myelinated white-matter fibers, which in turn lead to deficits in functional signaling between various brain regions. Another possibility is an alteration of the neurovascular coupling due to vascular risk factors. This reduced functional signaling contributes to the cognitive deficits in persons harboring these vascular risk factors. Lifestyle changes may restore some of these functional deficits through brain plasticity. It is imperative that preclinical diagnostic techniques are developed to identify these early brain changes in persons harboring vascular risk factors, as such efforts may improve primary and secondary prevention efforts. Recently developed imaging techniques may provide objective imaging biomarkers to measure the structural and functional brain changes in persons with vascular risk factors and resulting subclinical atherosclerotic disease. This article reviews a few of these novel imaging techniques.
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Viscogliosi G, Andreozzi P, Chiriac IM, Cipriani E, Servello A, Ettorre E, Marigliano V. Screening cognition in the elderly with metabolic syndrome. Metab Syndr Relat Disord 2012; 10:358-62. [PMID: 22784389 DOI: 10.1089/met.2012.0043] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Metabolic syndrome reaches its highest prevalence in the elderly, and evidence suggests that metabolic syndrome could be an independent risk factor for cognitive impairment. The aims of this study were to detect whether patients with metabolic syndrome have lower cognition and to investigate whether there is a relationship with cognition and single metabolic syndrome components. METHODS We assessed fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDL-C), triglycerides, high-sensitivity C-reactive protein (hsCRP), and anthropometric measurements. Metabolic syndrome was diagnosed according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. The population sample was divided into two groups according to the presence of metabolic syndrome. Cognitive function was investigated through the Mini-Mental State Examination (MMSE). RESULTS We enrolled 159 elderly subjects (mean age, 69.8±4.8 years). Seventy had metabolic syndrome. Metabolic syndrome subjects had higher hsCRP values (P<0.0001) and lower MMSE scores (P<0.0001) than those without metabolic syndrome. MMSE scores were significantly correlated with body mass index (BMI), hsCRP, metabolic syndrome, the number of metabolic syndrome components, and each of them. However, at multivariate regression analysis, only fasting blood glucose [FBG; B=-0.046; 95% confidence interval (CI) -0.066 to -0.028; P<0.0001] and the number of metabolic syndrome components (B=-0.317; 95% CI -0.572 to -0.010; P=0.042) were found to be independent predictors of lower MMSE scores. CONCLUSION We found that subjects with metabolic syndrome have lower MMSE scores than those without, even without symptomatic cognitive impairment, and that the number of metabolic abnormalities is independently associated to lower MMSE scores. We suggest that these patients should always undergo cognitive screening to prevent more severe outcomes.
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Mohades SG, Struys E, Van Schuerbeek P, Mondt K, Van De Craen P, Luypaert R. DTI reveals structural differences in white matter tracts between bilingual and monolingual children. Brain Res 2011; 1435:72-80. [PMID: 22197702 DOI: 10.1016/j.brainres.2011.12.005] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 11/03/2011] [Accepted: 12/02/2011] [Indexed: 11/24/2022]
Abstract
The impact of bilingualism on the microstructure of the white matter pathways related to language processing is assessed in elementary school children by magnetic resonance diffusion tensor imaging (MR-DTI). Forty children, 8-11 years old, subdivided into 3 different groups (15 simultaneous bilinguals, 15 sequential bilinguals and 10 monolinguals), were scanned. The hypothesis was that the starting age and the manner of second language acquisition would affect the characteristics of language circuitry. In each subject the mean fractional anisotropy (FA) was obtained for four major white matter pathways: 1 - the left arcuate fasciculus/superior longitudinal fasciculus (lAF/lSLF) that connects Broca's area in the opercular and triangular regions of the left inferior frontal gyrus to the posterior language zone, 2 - the left inferior occipitofrontal fasciculus (lIFOF), connecting anterior regions in the frontal lobe with posterior regions in the temporal occipital lobes, 3 - the bundle arising from the anterior part of the corpus callosum projecting to the orbital lobe (AC-OL) and 4 - the fibers emerging from the anterior midbody (AMB) of the corpus callosum that associate with the premotor and supplementary motor cortices (AMB-PMC). The three groups did not show significant differences in mean FA over the lAF/lSLF or AMB-PMC tracts. In simultaneous bilingual subjects the lIFOF tracts had higher mean FA value compared to monolinguals and also sequential bilinguals, whereas the comparison for the AC-OL fibers yielded a significantly lower mean FA value in simultaneous bilingual subjects compared to monolinguals. In both cases the FA value for sequential bilinguals was intermediate to that of the other two groups. To our knowledge, this study provides the first evidence of bilingualism related adaptation of white matter microstructure in the human brain.
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Cohen J, Cazettes F, Convit A. Abnormal Cholesterol is Associated with Prefrontal White Matter Abnormalities among Obese Adults: A Diffusion Tensor Imaging Study. Neuroradiol J 2011; 24:854-61. [DOI: 10.1177/197140091102400604] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 09/16/2011] [Indexed: 11/16/2022] Open
Abstract
The brain is the most cholesterol-rich organ in the body. Although most of the cholesterol in the brain is produced endogenously, some studies suggest that systemic cholesterol may be able to enter the brain. We investigated whether abnormal cholesterol profiles correlated with diffusion-tensor-imaging-based estimates of white matter microstructural integrity of lean and overweight/obese (o/o) adults. Twenty-two lean and 39 obese adults underwent magnetic resonance imaging, kept a three-day food diary, and had a standardized assessment of fasting blood lipids. The lean group ate less cholesterol-rich food than o/o although both groups ate equivalent servings of food per day. Voxelwise correlational analyses controlling for age, diabetes, and white matter hyperintensities, resulted in two significant clusters of negative associations between abnormal cholesterol profile and fractional anisotropy, located in the left and right prefrontal lobes. When the groups were split, the lean subjects showed no associations, whereas the o/o group expanded the association to three significant clusters, still in the frontal lobes. These findings suggest that cholesterol profile abnormalities may explain some of the reductions in white matter microstructural integrity that are reported in obesity.
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Affiliation(s)
- J.I. Cohen
- Department of Psychiatry, New York University School of Medicine; New York, NY, USA
| | - F. Cazettes
- Department of Psychiatry, New York University School of Medicine; New York, NY, USA
| | - A. Convit
- Department of Psychiatry, New York University School of Medicine; New York, NY, USA
- Department of Medicine, New York University School of Medicine; New York, NY, USA
- Nathan Kline Institute for Psychiatric Research; Orangeburg, NY, USA
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Cohen JI, Cazettes F, Convit A. Abnormal cholesterol is associated with prefrontal white matter abnormalities among obese adults, a diffusion tensor imaging study. Neuroradiol J 2011; 1:989-997. [PMID: 22163070 PMCID: PMC3234114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
The brain is the most cholesterol-rich organ in the body. Although most of the cholesterol in the brain is produced endogenously, some studies suggest that systemic cholesterol may be able to enter the brain. We investigated whether abnormal cholesterol profiles correlated with diffusion-tensor-imaging-based estimates of white matter microstructural integrity of lean and overweight/obese (o/o) adults. Twenty-two lean and 39 obese adults underwent magnetic resonance imaging, kept a 3-day food diary, and had a standardized assessment of fasting blood lipids. The lean group ate less cholesterol rich food than o/o although both groups ate equivalent servings of food per day. Voxelwise correlational analyses controlling for age, diabetes, and white matter hyperintensities, resulted in two significant clusters of negative associations between abnormal cholesterol profile and fractional anisotropy, located in the left and right prefrontal lobes. When the groups were split, the lean subjects showed no associations, whereas the o/o group expanded the association to three significant clusters, still in the frontal lobes. These findings suggest that cholesterol profile abnormalities may explain some of the reductions in white matter microstructural integrity that are reported in obesity.
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Affiliation(s)
- Jessica I. Cohen
- Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA
| | - Fanny Cazettes
- Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA
| | - Antonio Convit
- Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA
- Department of Medicine, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA
- Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd. Orangeburg NY 10962, USA
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Miralbell J, Soriano JJ, Spulber G, López-Cancio E, Arenillas JF, Bargalló N, Galán A, Barrios MT, Cáceres C, Alzamora MT, Pera G, Kivipelto M, Wahlund LO, Dávalos A, Mataró M. Structural brain changes and cognition in relation to markers of vascular dysfunction. Neurobiol Aging 2011; 33:1003.e9-17. [PMID: 22014619 DOI: 10.1016/j.neurobiolaging.2011.09.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 09/05/2011] [Accepted: 09/10/2011] [Indexed: 10/16/2022]
Abstract
The aim was to investigate the relationship between blood markers of vascular dysfunction with brain microstructural changes and cognition. Eighty-six participants from the Barcelona-Asymptomatic Intracranial Atherosclerosis (AsIA) neuropsychology study were included. Subjects were 50-65 years old, free from dementia and without history of vascular disease. We assessed correlations of blood levels of inflammatory biomarkers (C-reactive protein [CRP] and resistin) and fibrinolysis inhibitors (plasminogen activator inhibitor-1 [PAI-1] and A-lipoprotein (Lp (a)) with fractional anisotropy (FA) measurements of diffusion tensor images (DTI), regional gray matter (GM) volumes and performance in several cognitive domains. Increasing levels of C-reactive protein and PAI-1 levels were associated with white matter (WM) integrity loss in corticosubcortical pathways and association fibers of frontal and temporal lobes, independently of age, sex and vascular risk factors. PAI-1 was also related to lower speed and visuomotor/coordination. None of the biomarkers were related to gray matter volume changes. Our findings suggest that inflammation and dysregulation of the fibrynolitic system may be involved in the pathological mechanisms underlying the WM damage seen in cerebrovascular disease and subsequent cognitive impairment.
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Affiliation(s)
- Julia Miralbell
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
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