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Mohs R, Bakker A, Rosenzweig‐Lipson S, Rosenblum M, Barton RL, Albert MS, Cohen S, Zeger S, Gallagher M. The HOPE4MCI study: A randomized double-blind assessment of AGB101 for the treatment of MCI due to AD. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2024; 10:e12446. [PMID: 38356475 PMCID: PMC10865488 DOI: 10.1002/trc2.12446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/25/2023] [Accepted: 12/27/2023] [Indexed: 02/16/2024]
Abstract
INTRODUCTION In addition to the accumulation of amyloid plaques and neurofibrillary tangles, the presence of excess neural activity is a pathological hallmark of Alzheimer's disease (AD) and a prognostic indicator for progression of AD pathology and clinical/cognitive worsening in mild cognitive impairment due to Alzheimer's disease (MCI due to AD). The HOPE4MCI clinical study tested the efficacy of a therapeutic with demonstrated ability to normalize heightened neural activity in the hippocampus in a randomized controlled trial of 78 weeks duration in patients with MCI due to AD. METHODS One hundred and sixty-four participants were randomized to placebo (n = 83) or AGB101 (n = 81), an extended-release formulation of low dose (220 mg) levetiracetam. The primary endpoint was the change in Clinical Dementia Rating Scale Sum of Boxes score (CDR-SB) comparing follow up at 18 months to baseline. The goal of the primary efficacy analysis was to estimate the difference between the AGB101 and placebo arms in the mean change of the primary endpoint. RESULTS The mean change in CDR-SB was estimated to be 1.12 (95% confidence interval [CI]: 0.66, 1.69) for the AGB101 arm and 1.22 (95% CI: 0.75, 1.78) for the placebo arm. The estimated difference between arms is -0.10 (95% CI: -0.85, 0.58), which was not statistically significant. In a prespecified analysis, the difference was -0.45 (95% CI: -1.43, 0.53) for ApoE-4 noncarriers and -0.10 (95% CI: -0.92, 0.72) for apolipoprotein E (ApoE)-4 carriers. DISCUSSION The possibility that ApoE-4 carriers and noncarriers will respond differently to therapeutic intervention is consistent with recently reported findings from biologics and the present results show further testing of AGB101 in patients with MCI due to AD who are noncarriers of the ApoeE-4 allele is warranted. Conclusions from the HOPE4MCI study are limited primarily due to the small sample size and results can only be regarded as a guide to future research.
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Affiliation(s)
| | - Arnold Bakker
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Psychological and Brain SciencesJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | - Michael Rosenblum
- Department of BiostatisticsJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | | | - Marilyn S. Albert
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | | | - Scott Zeger
- Department of BiostatisticsJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Michela Gallagher
- AgeneBio, Inc.BaltimoreMarylandUSA
- Department of Psychological and Brain SciencesJohns Hopkins UniversityBaltimoreMarylandUSA
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Reiter K, Butts AM, Janecek JK, Correro AN, Nencka A, Agarwal M, Franczak M, Glass Umfleet L. Relationship between cognitive reserve, brain volume, and neuropsychological performance in amnestic and nonamnestic MCI. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:940-956. [PMID: 36573001 DOI: 10.1080/13825585.2022.2161462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022]
Abstract
Cognitive Reserve (CR) is a theoretical construct that influences the onset and course of cognitive and structural changes that occur with aging and mild cognitive impairment (MCI). There is a paucity of research that examines the relationship of CR and brain volumes in amnestic (aMCI) and nonamnestic (naMCI) separately. This study is a retrospective chart review of MCI patients who underwent neuropsychological evaluation and brain MRI with NeuroReader™ (NR). NR is an FDA-cleared software that standardizes MRI volumes to a control sample. Classifications of aMCI and naMCI were based on Petersen criteria. CR was measured as education, occupation, and word reading. Data analysis included bivariate correlations between CR, neuropsychological test scores, and NR-brain volumes by MCI subtype. The Benjamini-Hochberg method corrected for multiple comparisons. The sample included 91 participants with aMCI and 41 with naMCI. Within naMCI, positive correlations were observed between CR and whole brain volume, total gray matter, bifrontal, left parietal, left occipital, and bilateral cerebellum. Within aMCI, no significant correlations were observed between CR and brain volumes. Positive correlations with CR were observed in language, attention, and visual learning in both aMCI and naMCI groups. The current study adds to the minimal literature on CR and naMCI. Results revealed that CR is associated with volumetrics in naMCI only, though cognitive findings were similar in both MCI groups. Possible explanations include heterogeneous disease pathologies, disease stage, or a differential influence of CR on volumetrics in MCI. Additional longitudinal and biomarker studies will better elucidate this relationship.
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Affiliation(s)
- K Reiter
- Cleveland Clinic, Neurological Institute, Cleveland, OH, USA
| | - A M Butts
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - J K Janecek
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - A N Correro
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Nencka
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Agarwal
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Franczak
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - L Glass Umfleet
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
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Hu X, Meier M, Pruessner J. Challenges and opportunities of diagnostic markers of Alzheimer's disease based on structural magnetic resonance imaging. Brain Behav 2023; 13:e2925. [PMID: 36795041 PMCID: PMC10013953 DOI: 10.1002/brb3.2925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/04/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES This article aimed to carry out a narrative literature review of early diagnostic markers of Alzheimer's disease (AD) based on both micro and macro levels of pathology, indicating the shortcomings of current biomarkers and proposing a novel biomarker of structural integrity that associates the hippocampus and adjacent ventricle together. This could help to reduce the influence of individual variety and improve the accuracy and validity of structural biomarker. METHODS This review was based on presenting comprehensive background of early diagnostic markers of AD. We have compiled those markers into micro level and macro level, and discussed the advantages and disadvantages of them. Eventually the ratio of gray matter volume to ventricle volume was put forward. RESULTS The costly methodologies and related high patient burden of "micro" biomarkers (cerebrospinal fluid biomarkers) hinder the implementation in routine clinical examination. In terms of "macro" biomarkers- hippocampal volume (HV), there is a large variation of it among population, which undermines its validity Considering the gray matter atrophies while the adjacent ventricular volume enlarges, we assume the hippocampal to ventricle ratio (HVR) is a more reliable marker than HV alone the emerging evidence showed hippocampal to ventricle ratio predicts memory functions better than HV alone in elderly sample. CONCLUSIONS The ratio between gray matter structures and adjacent ventricular volumes counts as a promising superior diagnostic marker of early neurodegeneration.
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Affiliation(s)
- Xiang Hu
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Maria Meier
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Jens Pruessner
- Department of Psychology, University of Konstanz, Konstanz, Germany
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Yang J, Wang Z, Fu Y, Xu J, Zhang Y, Qin W, Zhang Q. Prediction value of the genetic risk of type 2 diabetes on the amnestic mild cognitive impairment conversion to Alzheimer’s disease. Front Aging Neurosci 2022; 14:964463. [PMID: 36185474 PMCID: PMC9521369 DOI: 10.3389/fnagi.2022.964463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Amnestic mild cognitive impairment (aMCI) and Type 2 diabetes mellitus (T2DM) are both important risk factors for Alzheimer’s disease (AD). We aimed to investigate whether a T2DM-specific polygenic risk score (PRSsT2DM) can predict the conversion of aMCI to AD and further explore the underlying neurological mechanism. All aMCI patients were from the Alzheimer’s disease Neuroimaging Initiative (ADNI) database and were divided into conversion (aMCI-C, n = 164) and stable (aMCI-S, n = 222) groups. PRSsT2DM was calculated by PRSice-2 software to explore the predictive efficacy of the aMCI conversion to AD. We found that PRSsT2DM could independently predict the aMCI conversion to AD after removing the common variants of these two diseases. PRSsT2DM was significantly negatively correlated with gray matter volume (GMV) of the right superior frontal gyrus in the aMCI-C group. In all aMCI patients, PRSsT2DM was significantly negatively correlated with the cortical volume of the right superior occipital gyrus. The cortical volume of the right superior occipital gyrus could significantly mediate the association between PRSsT2DM and aMCI conversion. Gene-based analysis showed that T2DM-specific genes are highly expressed in cortical neurons and involved in ion and protein binding, neural development and generation, cell junction and projection, and PI3K-Akt and MAPK signaling pathway, which might increase the aMCI conversion by affecting the Tau phosphorylation and amyloid-beta (Aβ) accumulation. Therefore, the PRSsT2DM could be used as a measure to predict the conversion of aMCI to AD.
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Pérez-Millan A, Contador J, Tudela R, Niñerola-Baizán A, Setoain X, Lladó A, Sánchez-Valle R, Sala-Llonch R. Evaluating the performance of Bayesian and frequentist approaches for longitudinal modeling: application to Alzheimer's disease. Sci Rep 2022; 12:14448. [PMID: 36002550 PMCID: PMC9402558 DOI: 10.1038/s41598-022-18129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/05/2022] [Indexed: 11/09/2022] Open
Abstract
Linear mixed effects (LME) modelling under both frequentist and Bayesian frameworks can be used to study longitudinal trajectories. We studied the performance of both frameworks on different dataset configurations using hippocampal volumes from longitudinal MRI data across groups—healthy controls (HC), mild cognitive impairment (MCI) and Alzheimer’s disease (AD) patients, including subjects that converted from MCI to AD. We started from a big database of 1250 subjects from the Alzheimer’s disease neuroimaging initiative (ADNI), and we created different reduced datasets simulating real-life situations using a random-removal permutation-based approach. The number of subjects needed to differentiate groups and to detect conversion to AD was 147 and 115 respectively. The Bayesian approach allowed estimating the LME model even with very sparse databases, with high number of missing points, which was not possible with the frequentist approach. Our results indicate that the frequentist approach is computationally simpler, but it fails in modelling data with high number of missing values.
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Affiliation(s)
- Agnès Pérez-Millan
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca Biomèdica, Universitat de Barcelona, 08036, Barcelona, Spain.,Institute of Neurosciences. Department of Biomedicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, 08036, Barcelona, Spain
| | - José Contador
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca Biomèdica, Universitat de Barcelona, 08036, Barcelona, Spain
| | - Raúl Tudela
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - Aida Niñerola-Baizán
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain.,Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - Xavier Setoain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain.,Nuclear Medicine Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca Biomèdica, Universitat de Barcelona, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca Biomèdica, Universitat de Barcelona, 08036, Barcelona, Spain
| | - Roser Sala-Llonch
- Institute of Neurosciences. Department of Biomedicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, 08036, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain.
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Fu Z, Zhao M, He Y, Wang X, Li X, Kang G, Han Y, Li S. Aberrant topological organization and age-related differences in the human connectome in subjective cognitive decline by using regional morphology from magnetic resonance imaging. Brain Struct Funct 2022; 227:2015-2033. [PMID: 35579698 DOI: 10.1007/s00429-022-02488-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 03/24/2022] [Indexed: 11/25/2022]
Abstract
Subjective cognitive decline (SCD) is characterized by self-experienced deficits in cognitive capacity with normal performance in objective cognitive tests. Previous structural covariance studies showed specific insights into understanding the structural alterations of the brain in neurodegenerative diseases. Moreover, in subjects with neurodegenerative diseases, accelerated brain degeneration with aging was shown. However, the age-related variations in coordinated topological patterns of morphological networks in individuals with SCD remain poorly understood. In this study, 77 individual morphological networks were constructed, including 42 normal controls (NCs) and 35 SCD individuals, from structural magnetic resonance imaging (sMRI). A stepwise linear regression model and partial correlation analysis were constructed to evaluate the differences in age-related alterations of the network properties in individuals with SCD compared with NCs. Compared with NC, the properties of integration and segregation in individuals with SCD were lower, and the aberrant metrics were negatively correlated with age in SCD. The rich-club connections persevered, but the paralimbic system connections were disrupted in individuals with SCD compared with NCs. In addition, age-related differences in nodal global efficiency are distributed mainly in prefrontal cortex regions. In conclusion, the age-related disruption of topological organizations in individuals with SCD may indicate that the degeneration of brain efficiency with aging was accelerated in individuals with SCD.
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Affiliation(s)
- Zhenrong Fu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science & Medical Engineering, Beihang University, Beijing, China
| | - Mingyan Zhao
- Department of Neurology, Tangshan Gongren Hospital, Tangshan, Hebei, China
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Yirong He
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science & Medical Engineering, Beihang University, Beijing, China
| | - Xuetong Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science & Medical Engineering, Beihang University, Beijing, China
| | - Xin Li
- School of Electrical Engineering, Yanshan University, Qinhuangdao, China
- Measurement Technology and Instrumentation Key Lab of Hebei Province, Qinhuangdao, China
| | - Guixia Kang
- School of Information and Communication Engineering, Beijing University of Posts and Telecommunications, Beijing, China
| | - Ying Han
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
- Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
- Biomedical Engineering Institute, Hainan University, Haikou, China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Shuyu Li
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science & Medical Engineering, Beihang University, Beijing, China.
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Wei X, Du X, Xie Y, Suo X, He X, Ding H, Zhang Y, Ji Y, Chai C, Liang M, Yu C, Liu Y, Qin W. Mapping cerebral atrophic trajectory from amnestic mild cognitive impairment to Alzheimer's disease. Cereb Cortex 2022; 33:1310-1327. [PMID: 35368064 PMCID: PMC9930625 DOI: 10.1093/cercor/bhac137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/13/2022] [Accepted: 03/13/2022] [Indexed: 11/14/2022] Open
Abstract
Alzheimer's disease (AD) patients suffer progressive cerebral atrophy before dementia onset. However, the region-specific atrophic processes and the influences of age and apolipoprotein E (APOE) on atrophic trajectory are still unclear. By mapping the region-specific nonlinear atrophic trajectory of whole cerebrum from amnestic mild cognitive impairment (aMCI) to AD based on longitudinal structural magnetic resonance imaging data from Alzheimer's disease Neuroimaging Initiative (ADNI) database, we unraveled a quadratic accelerated atrophic trajectory of 68 cerebral regions from aMCI to AD, especially in the superior temporal pole, caudate, and hippocampus. Besides, interaction analyses demonstrated that APOE ε4 carriers had faster atrophic rates than noncarriers in 8 regions, including the caudate, hippocampus, insula, etc.; younger patients progressed faster than older patients in 32 regions, especially for the superior temporal pole, hippocampus, and superior temporal gyrus; and 15 regions demonstrated complex interaction among age, APOE, and disease progression, including the caudate, hippocampus, etc. (P < 0.05/68, Bonferroni correction). Finally, Cox proportional hazards regression model based on the identified region-specific biomarkers could effectively predict the time to AD conversion within 10 years. In summary, cerebral atrophic trajectory mapping could help a comprehensive understanding of AD development and offer potential biomarkers for predicting AD conversion.
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Affiliation(s)
| | | | | | | | - Xiaoxi He
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Hao Ding
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China,School of Medical Imaging, Tianjin Medical University, Tianjin 300070, China
| | - Yu Zhang
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yi Ji
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Chao Chai
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Meng Liang
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China,School of Medical Imaging, Tianjin Medical University, Tianjin 300070, China
| | - Chunshui Yu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China,School of Medical Imaging, Tianjin Medical University, Tianjin 300070, China
| | - Yong Liu
- Corresponding author: Wen Qin, Department of Radiology, and Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Anshan Road No 154, Heping District, Tianjin 300052, China. ; Yong Liu, School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China.
| | - Wen Qin
- Corresponding author: Wen Qin, Department of Radiology, and Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Anshan Road No 154, Heping District, Tianjin 300052, China. ; Yong Liu, School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China.
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Li L, Ding G, Zhang L, Davoodi-Bojd E, Chopp M, Li Q, Zhang ZG, Jiang Q. Aging-Related Alterations of Glymphatic Transport in Rat: In vivo Magnetic Resonance Imaging and Kinetic Study. Front Aging Neurosci 2022; 14:841798. [PMID: 35360203 PMCID: PMC8960847 DOI: 10.3389/fnagi.2022.841798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/18/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Impaired glymphatic waste clearance function during brain aging leads to the accumulation of metabolic waste and neurotoxic proteins (e.g., amyloid-β, tau) which contribute to neurological disorders. However, how the age-related glymphatic dysfunction exerts its effects on different cerebral regions and affects brain waste clearance remain unclear. Methods We investigated alterations of glymphatic transport in the aged rat brain using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and advanced kinetic modeling. Healthy young (3–4 months) and aged (18–20 months) male rats (n = 12/group) underwent the identical MRI protocol, including T2-weighted imaging and 3D T1-weighted imaging with intracisternal administration of contrast agent (Gd-DTPA). Model-derived parameters of infusion rate and clearance rate, characterizing the kinetics of cerebrospinal fluid (CSF) tracer transport via the glymphatic system, were evaluated in multiple representative brain regions. Changes in the CSF-filled cerebral ventricles were measured using contrast-induced time signal curves (TSCs) in conjunction with structural imaging. Results Compared to the young brain, an overall impairment of glymphatic transport function was detected in the aged brain, evidenced by the decrease in both infusion and clearance rates throughout the brain. Enlarged ventricles in parallel with reduced efficiency in CSF transport through the ventricular regions were present in the aged brain. While the age-related glymphatic dysfunction was widespread, our kinetic quantification demonstrated that its impact differed considerably among cerebral regions with the most severe effect found in olfactory bulb, indicating the heterogeneous and regional preferential alterations of glymphatic function. Conclusion The robust suppression of glymphatic activity in the olfactory bulb, which serves as one of major efflux routes for brain waste clearance, may underlie, in part, age-related neurodegenerative diseases associated with neurotoxic substance accumulation. Our data provide new insight into the cerebral regional vulnerability to brain functional change with aging.
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Affiliation(s)
- Lian Li
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
| | - Guangliang Ding
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
| | - Li Zhang
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
| | | | - Michael Chopp
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
- Department of Physics, Oakland University, Rochester, MI, United States
| | - Qingjiang Li
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
| | - Zheng Gang Zhang
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
| | - Quan Jiang
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
- *Correspondence: Quan Jiang,
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Brodtmann A, Werden E, Khlif MS, Bird LJ, Egorova N, Veldsman M, Pardoe H, Jackson G, Bradshaw J, Darby D, Cumming T, Churilov L, Donnan G. Neurodegeneration Over 3 Years Following Ischaemic Stroke: Findings From the Cognition and Neocortical Volume After Stroke Study. Front Neurol 2021; 12:754204. [PMID: 34744989 PMCID: PMC8570373 DOI: 10.3389/fneur.2021.754204] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/27/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Stroke survivors are at high risk of dementia, associated with increasing age and vascular burden and with pre-existing cognitive impairment, older age. Brain atrophy patterns are recognised as signatures of neurodegenerative conditions, but the natural history of brain atrophy after stroke remains poorly described. We sought to determine whether stroke survivors who were cognitively normal at time of stroke had greater total brain (TBV) and hippocampal volume (HV) loss over 3 years than controls. We examined whether stroke survivors who were cognitively impaired (CI) at 3 months following their stroke had greater brain volume loss than cognitively normal (CN) stroke participants over the next 3 years. Methods: Cognition And Neocortical Volume After Stroke (CANVAS) study is a multi-centre cohort study of first-ever or recurrent adult ischaemic stroke participants compared to age- and sex-matched community controls. Participants were followed with MRI and cognitive assessments over 3 years and were free of a history of cognitive impairment or decline at inclusion. Our primary outcome measure was TBV change between 3 months and 3 years; secondary outcomes were TBV and HV change comparing CI and CN participants. We investigated associations between group status and brain volume change using a baseline-volume adjusted linear regression model with robust standard error. Results: Ninety-three stroke (26 women, 66.7 ± 12 years) and 39 control participants (15 women, 68.7 ± 7 years) were available at 3 years. TBV loss in stroke patients was greater than controls: stroke mean (M) = 20.3 cm3 ± SD 14.8 cm3; controls M = 14.2 cm3 ± SD 13.2 cm3; [adjusted mean difference 7.88 95%CI (2.84, 12.91) p-value = 0.002]. TBV decline was greater in those stroke participants who were cognitively impaired (M = 30.7 cm3; SD = 14.2 cm3) at 3 months (M = 19.6 cm3; SD = 13.8 cm3); [adjusted mean difference 10.42; 95%CI (3.04, 17.80), p-value = 0.006]. No statistically significant differences in HV change were observed. Conclusions: Ischaemic stroke survivors exhibit greater neurodegeneration compared to stroke-free controls. Brain atrophy is greater in stroke participants who were cognitively impaired early after their stroke. Early cognitive impairment was associated greater subsequent atrophy, reflecting the combined impacts of stroke and vascular brain burden. Atrophy rates could serve as a useful biomarker for trials testing interventions to reduce post-stroke secondary neurodegeneration. Clinical Trail Registration:http://www.clinicaltrials.gov, identifier: NCT02205424.
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Affiliation(s)
- Amy Brodtmann
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Dementia Research Centre, Florey Institute and University of Melbourne, Parkville, VIC, Australia.,Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | - Emilio Werden
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Mohamed Salah Khlif
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Laura J Bird
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Natalia Egorova
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Dementia Research Centre, Florey Institute and University of Melbourne, Parkville, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Michele Veldsman
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Heath Pardoe
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States
| | - Graeme Jackson
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | - Jennifer Bradshaw
- Department of Clinical Neuropsychology, Austin Health, Heidelberg, VIC, Australia
| | - David Darby
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Dementia Research Centre, Florey Institute and University of Melbourne, Parkville, VIC, Australia
| | - Toby Cumming
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Leonid Churilov
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | - Geoffrey Donnan
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
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10
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Zhou X, Song X. Mediation analysis for mixture Cox proportional hazards cure models. Stat Methods Med Res 2021; 30:1554-1572. [PMID: 33834919 DOI: 10.1177/09622802211003113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mediation analysis aims to decompose a total effect into specific pathways and investigate the underlying causal mechanism. Although existing methods have been developed to conduct mediation analysis in the context of survival models, none of these methods accommodates the existence of a substantial proportion of subjects who never experience the event of interest, even if the follow-up is sufficiently long. In this study, we consider mediation analysis for the mixture of Cox proportional hazards cure models that cope with the cure fraction problem. Path-specific effects on restricted mean survival time and survival probability are assessed by introducing a partially latent group indicator and applying the mediation formula approach in a three-stage mediation framework. A Bayesian approach with P-splines for approximating the baseline hazard function is developed to conduct analysis. The satisfactory performance of the proposed method is verified through simulation studies. An application of the Alzheimer's disease (AD) neuroimaging initiative dataset investigates the causal effects of APOE-ϵ4 allele on AD progression.
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Affiliation(s)
- Xiaoxiao Zhou
- Department of Statistics, 26451Chinese University of Hong Kong, Hong Kong
| | - Xinyuan Song
- Department of Statistics, 26451Chinese University of Hong Kong, Hong Kong
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11
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Li X, Xia J, Ma C, Chen K, Xu K, Zhang J, Chen Y, Li H, Wei D, Zhang Z. Accelerating Structural Degeneration in Temporal Regions and Their Effects on Cognition in Aging of MCI Patients. Cereb Cortex 2021; 30:326-338. [PMID: 31169867 DOI: 10.1093/cercor/bhz090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/06/2019] [Accepted: 03/28/2019] [Indexed: 12/20/2022] Open
Abstract
Age is the major risk factor for Alzheimer's disease (AD) and for mild cognitive impairment (MCI). However, there is limited evidence about MCI-specific aging-related simultaneous changes of the brain structure and their impact on cognition. We analyzed the brain imaging data from 269 subjects (97 MCI patients and 172 cognitively normal [CN] elderly) using voxel-based morphometry and tract-based spatial statistics procedures to explore the special structural pattern during aging. We found that the patients with MCI showed accelerated age-related reductions in gray matter volume in the left planum temporale, thalamus, and posterior cingulate gyrus. The similar age×group interaction effect was found in the fractional anisotropy of the bilateral parahippocampal cingulum white matter tract, which connects the temporal regions. Importantly, the age-related temporal gray matter and white matter alterations were more significantly related to performance in memory and attention tasks in MCI patients. The accelerated degeneration patterns in the brain structure provide evidence for different neural mechanisms underlying aging in MCI patients. Temporal structural degeneration may serve as a potential imaging marker for distinguishing the progression of the preclinical AD stage from normal aging.
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Affiliation(s)
- Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China
| | - Jianan Xia
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China
| | - Chao Ma
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China.,School of Electrical and Information Engineering, Tianjin University, Tianjin, P. R. China
| | - Kewei Chen
- BABRI Centre, Beijing Normal University, Beijing, P. R. China.,Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Kai Xu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China
| | - Junying Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China.,Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing, P. R. China
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China
| | - He Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China.,Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing, P. R. China
| | - Dongfeng Wei
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China.,Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing, P. R. China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China
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12
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Josephs KA, Martin PR, Weigand SD, Tosakulwong N, Buciuc M, Murray ME, Petrucelli L, Senjem ML, Spychalla AJ, Knopman DS, Boeve BF, Petersen RC, Parisi JE, Dickson DW, Jack CR, Whitwell JL. Protein contributions to brain atrophy acceleration in Alzheimer's disease and primary age-related tauopathy. Brain 2021; 143:3463-3476. [PMID: 33150361 DOI: 10.1093/brain/awaa299] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/10/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022] Open
Abstract
Alzheimer's disease is characterized by the presence of amyloid-β and tau deposition in the brain, hippocampal atrophy and increased rates of hippocampal atrophy over time. Another protein, TAR DNA binding protein 43 (TDP-43) has been identified in up to 75% of cases of Alzheimer's disease. TDP-43, tau and amyloid-β have all been linked to hippocampal atrophy. TDP-43 and tau have also been linked to hippocampal atrophy in cases of primary age-related tauopathy, a pathological entity with features that strongly overlap with those of Alzheimer's disease. At present, it is unclear whether and how TDP-43 and tau are associated with early or late hippocampal atrophy in Alzheimer's disease and primary age-related tauopathy, whether either protein is also associated with faster rates of atrophy of other brain regions and whether there is evidence for protein-associated acceleration/deceleration of atrophy rates. We therefore aimed to model how these proteins, particularly TDP-43, influence non-linear trajectories of hippocampal and neocortical atrophy in Alzheimer's disease and primary age-related tauopathy. In this longitudinal retrospective study, 557 autopsied cases with Alzheimer's disease neuropathological changes with 1638 ante-mortem volumetric head MRI scans spanning 1.0-16.8 years of disease duration prior to death were analysed. TDP-43 and Braak neurofibrillary tangle pathological staging schemes were constructed, and hippocampal and neocortical (inferior temporal and middle frontal) brain volumes determined using longitudinal FreeSurfer. Bayesian bivariate-outcome hierarchical models were utilized to estimate associations between proteins and volume, early rate of atrophy and acceleration in atrophy rates across brain regions. High TDP-43 stage was associated with smaller cross-sectional brain volumes, faster rates of brain atrophy and acceleration of atrophy rates, more than a decade prior to death, with deceleration occurring closer to death. Stronger associations were observed with hippocampus compared to temporal and frontal neocortex. Conversely, low TDP-43 stage was associated with slower early rates but later acceleration. This later acceleration was associated with high Braak neurofibrillary tangle stage. Somewhat similar, but less striking, findings were observed between TDP-43 and neocortical rates. Braak stage appeared to have stronger associations with neocortex compared to TDP-43. The association between TDP-43 and brain atrophy occurred slightly later in time (∼3 years) in cases of primary age-related tauopathy compared to Alzheimer's disease. The results suggest that TDP-43 and tau have different contributions to acceleration and deceleration of brain atrophy rates over time in both Alzheimer's disease and primary age-related tauopathy.
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Affiliation(s)
- Keith A Josephs
- Department of Neurology (Behavioral Neurology), Mayo Clinic, Rochester, MN, USA
| | - Peter R Martin
- Department of Health Science Research (Biostatistics), Mayo Clinic, Rochester, MN, USA
| | - Stephen D Weigand
- Department of Health Science Research (Biostatistics), Mayo Clinic, Rochester, MN, USA
| | - Nirubol Tosakulwong
- Department of Health Science Research (Biostatistics), Mayo Clinic, Rochester, MN, USA
| | - Marina Buciuc
- Department of Neurology (Behavioral Neurology), Mayo Clinic, Rochester, MN, USA
| | - Melissa E Murray
- Department of Neuroscience (Neuropathology), Mayo Clinic, Jacksonville, FL, USA
| | - Leonard Petrucelli
- Department of Neuroscience (Molecular Neuroscience), Mayo Clinic, Jacksonville, FL, USA
| | - Matthew L Senjem
- Department of Radiology (Radiology Research) Mayo Clinic, Rochester, MN, USA.,Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Anthony J Spychalla
- Department of Radiology (Radiology Research) Mayo Clinic, Rochester, MN, USA.,Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - David S Knopman
- Department of Neurology (Behavioral Neurology), Mayo Clinic, Rochester, MN, USA
| | - Bradley F Boeve
- Department of Neurology (Behavioral Neurology), Mayo Clinic, Rochester, MN, USA
| | - Ronald C Petersen
- Department of Neurology (Behavioral Neurology), Mayo Clinic, Rochester, MN, USA
| | - Joseph E Parisi
- Department of Laboratory Medicine and Pathology (Neuropathology), Mayo Clinic, Rochester, MN, USA
| | - Dennis W Dickson
- Department of Neuroscience (Neuropathology), Mayo Clinic, Jacksonville, FL, USA
| | - Clifford R Jack
- Department of Radiology (Radiology Research) Mayo Clinic, Rochester, MN, USA
| | - Jennifer L Whitwell
- Department of Radiology (Radiology Research) Mayo Clinic, Rochester, MN, USA
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13
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Fu Z, Zhao M, Wang X, He Y, Tian Y, Yang Y, Han Y, Li S. Altered Neuroanatomical Asymmetries of Subcortical Structures in Subjective Cognitive Decline, Amnestic Mild Cognitive Impairment, and Alzheimer's Disease. J Alzheimers Dis 2021; 79:1121-1132. [PMID: 33386805 DOI: 10.3233/jad-201116] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Individuals with subjective cognitive decline (SCD), defined by self-reported memory complaints but normal performance in objective neuropsychological tests, may be at higher risk of worsening or more frequent memory loss until conversion to Alzheimer's disease (AD) or related dementia. Asymmetry in two hemispheres is a cardinal character of human brain's structure and function, and altered brain asymmetry has also been connected with AD. OBJECTIVE This study aimed to determine whether the asymmetry of subcortical structures in individuals with SCD and amnestic mild cognitive impairment (aMCI) and AD patients are altered compared with normal controls (NC). METHODS We investigated neuroanatomical alterations in 35 SCD, 43 aMCI, and 41 AD subjects compared with 42 NC, focusing on asymmetrical changes in subcortical structures based on structural magnetic resonance images (sMRI). General linear model was conducted to test group differences, and partial correlation was used to model the interaction between asymmetry measurements and cognitive tests. RESULTS Individuals with SCD (lateral ventricle and cerebellum-WM), aMCI patients (lateral ventricle, pallidum, hippocampus, amygdala, accumbens, and ventral DC), and AD patients (lateral-ventricle, cerebellum-cortical pallidum, thalamus, hippocampus, amygdala, accumbens, and ventral DC) exhibited significant altered neuroanatomical asymmetries of volume, surface area, and shape compared with NC. Significant associations between shape asymmetry and neuropsychological examinations were found in the hippocampus and accumbens. CONCLUSION Altered neuroanatomical asymmetries of subcortical structures were significantly detected in SCD individuals and aMCI patients as well AD patients, and these specific asymmetry alterations are potential to be used as neuroimaging markers and for monitoring disease progression.
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Affiliation(s)
- Zhenrong Fu
- School of Biological Science & Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
| | - Mingyan Zhao
- Department of Neurology, Tangshan Gongren Hospital, Tangshan, Hebei, China.,Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Xuetong Wang
- School of Biological Science & Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
| | - Yirong He
- School of Biological Science & Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
| | - Yuan Tian
- School of Biological Science & Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
| | - Yujing Yang
- School of Biological Science & Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
| | - Ying Han
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Institute of Geriatrics, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Shuyu Li
- School of Biological Science & Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
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14
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Predicting brain atrophy from tau pathology: a summary of clinical findings and their translation into personalized models. BRAIN MULTIPHYSICS 2021. [DOI: 10.1016/j.brain.2021.100039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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15
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Roberts DR, Inglesby DC, Brown TR, Collins HR, Eckert MA, Asemani D. Longitudinal change in ventricular volume is accelerated in astronauts undergoing long-duration spaceflight. AGING BRAIN 2021; 1:100017. [PMID: 36911514 PMCID: PMC9997154 DOI: 10.1016/j.nbas.2021.100017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/12/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
An 11-25% increase in total ventricular volume has been documented in astronauts following spaceflight on the ISS. Given the approximately 2-year time interval between pre- and post-flight MRI, it is unknown if ventricular enlargement simply reflects normal aging or is unique to spaceflight exposure. Therefore, we compared percent ventricular volume change per year (PVVC/yr) documented on pre- to post-flight MRI in a group of NASA ISS astronauts (n = 18, 16.7% women, mean age (SD) 48.43 (4.35) years) with two groups who underwent longitudinal MRI: (1.) healthy age- and sex-matched adults (n = 18, 16.7% women, mean age (SD) 51.26 (3.88) years), and (2.) healthy older adults (n = 79, 16.5% women, mean age (SD) 73.26 (5.34) years). The astronauts, who underwent a mean (SD) 173.4 (51.3) days in spaceflight, showed a greater increase in PVVC/yr than the control (6.86 vs 2.23%, respectively, p < .001) and older adult (4.18%, p = 0.04) groups. These results highlight that on top of physiologically ventricular volume changes due to normal aging, NASA astronauts undergoing ISS missions experience an additional 4.63% PVVC/yr and underscore the need to perform post-flight follow-up scans to determine the time course of PVVC in astronauts over time back on Earth along with monitoring to determine if the PVVC is ultimately clinically relevant. One sentence summary NASA astronauts who were exposed to prolonged spaceflight experienced an annual rate of ventricular expansion more than three times that expected from normal aging.
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Affiliation(s)
- Donna R. Roberts
- Department of Radiology and Radiological Science, Medical University of South Carolina, United States
- Corresponding author at: 96 Jonathan Lucas Street, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29425, United States.
| | - Dani C. Inglesby
- Department of Radiology and Radiological Science, Medical University of South Carolina, United States
| | - Truman R. Brown
- Department of Radiology and Radiological Science, Medical University of South Carolina, United States
| | - Heather R. Collins
- Department of Radiology and Radiological Science, Medical University of South Carolina, United States
| | - Mark A. Eckert
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, United States
| | - Davud Asemani
- Department of Radiology and Radiological Science, Medical University of South Carolina, United States
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16
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Dong Q, Zhang W, Stonnington CM, Wu J, Gutman BA, Chen K, Su Y, Baxter LC, Thompson PM, Reiman EM, Caselli RJ, Wang Y. Applying surface-based morphometry to study ventricular abnormalities of cognitively unimpaired subjects prior to clinically significant memory decline. NEUROIMAGE-CLINICAL 2020; 27:102338. [PMID: 32683323 PMCID: PMC7371915 DOI: 10.1016/j.nicl.2020.102338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/15/2020] [Accepted: 07/02/2020] [Indexed: 12/31/2022]
Abstract
A completely automated surface-based ventricular morphometry system. Generate a whole connected 3D ventricular shape model. Test-retest the system in two independent CU subject cohorts. Subregional ventricular abnormalities prior to clinically memory decline.
Ventricular volume (VV) is a widely used structural magnetic resonance imaging (MRI) biomarker in Alzheimer’s disease (AD) research. Abnormal enlargements of VV can be detected before clinically significant memory decline. However, VV does not pinpoint the details of subregional ventricular expansions. Here we introduce a ventricular morphometry analysis system (VMAS) that generates a whole connected 3D ventricular shape model and encodes a great deal of ventricular surface deformation information that is inaccessible by VV. VMAS contains an automated segmentation approach and surface-based multivariate morphometry statistics. We applied VMAS to two independent datasets of cognitively unimpaired (CU) groups. To our knowledge, it is the first work to detect ventricular abnormalities that distinguish normal aging subjects from those who imminently progress to clinically significant memory decline. Significant bilateral ventricular morphometric differences were first shown in 38 members of the Arizona APOE cohort, which included 18 CU participants subsequently progressing to the clinically significant memory decline within 2 years after baseline visits (progressors), and 20 matched CU participants with at least 4 years of post-baseline cognitive stability (non-progressors). VMAS also detected significant differences in bilateral ventricular morphometry in 44 Alzheimer’s Disease Neuroimaging Initiative (ADNI) subjects (18 CU progressors vs. 26 CU non-progressors) with the same inclusion criterion. Experimental results demonstrated that the ventricular anterior horn regions were affected bilaterally in CU progressors, and more so on the left. VMAS may track disease progression at subregional levels and measure the effects of pharmacological intervention at a preclinical stage.
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Affiliation(s)
- Qunxi Dong
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Wen Zhang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | | | - Jianfeng Wu
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Boris A Gutman
- Armour College of Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Leslie C Baxter
- Human Brain Imaging Laboratory, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Paul M Thompson
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, USA
| | | | | | - Yalin Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA.
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17
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Cerbone B, Massman PJ, Kulesz PA, Woods SP, York MK. Predictors of rate of cognitive decline in patients with amnestic mild cognitive impairment. Clin Neuropsychol 2020; 36:138-164. [DOI: 10.1080/13854046.2020.1773933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Brittany Cerbone
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Paul J. Massman
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Steven P. Woods
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michele K. York
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
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18
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Smith CD, Van Eldik LJ, Jicha GA, Schmitt FA, Nelson PT, Abner EL, Kryscio RJ, Murphy RR, Andersen AH. Brain structure changes over time in normal and mildly impaired aged persons. AIMS Neurosci 2020; 7:120-135. [PMID: 32607416 PMCID: PMC7321765 DOI: 10.3934/neuroscience.2020009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/08/2020] [Indexed: 01/25/2023] Open
Abstract
Structural brain changes in aging are known to occur even in the absence of dementia, but the magnitudes and regions involved vary between studies. To further characterize these changes, we analyzed paired MRI images acquired with identical protocols and scanner over a median 5.8-year interval. The normal study group comprised 78 elders (25M 53F, baseline age range 70–78 years) who underwent an annual standardized expert assessment of cognition and health and who maintained normal cognition for the duration of the study. We found a longitudinal grey matter (GM) loss rate of 2.56 ± 0.07 ml/year (0.20 ± 0.04%/year) and a cerebrospinal fluid (CSF) expansion rate of 2.97 ± 0.07 ml/year (0.22 ± 0.04%/year). Hippocampal volume loss rate was higher than the GM and CSF global rates, 0.0114 ± 0.0004 ml/year (0.49 ± 0.04%/year). Regions of greatest GM loss were posterior inferior frontal lobe, medial parietal lobe and dorsal cerebellum. Rates of GM loss and CSF expansion were on the low end of the range of other published values, perhaps due to the relatively good health of the elder volunteers in this study. An additional smaller group of 6 subjects diagnosed with MCI at baseline were followed as well, and comparisons were made with the normal group in terms of both global and regional GM loss and CSF expansion rates. An increased rate of GM loss was found in the hippocampus bilaterally for the MCI group.
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Affiliation(s)
- Charles D Smith
- Department of Neurology, University of Kentucky College of Medicine, Lexington, Kentucky, USA.,Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, Kentucky, USA
| | - Linda J Van Eldik
- Alzheimer's Disease Center, Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA.,Department of Neuroscience, University of Kentucky, Lexington, Kentucky, USA
| | - Gregory A Jicha
- Department of Neurology, University of Kentucky College of Medicine, Lexington, Kentucky, USA.,Alzheimer's Disease Center, Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
| | - Frederick A Schmitt
- Department of Neurology, University of Kentucky College of Medicine, Lexington, Kentucky, USA.,Alzheimer's Disease Center, Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
| | - Peter T Nelson
- Alzheimer's Disease Center, Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA.,Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Erin L Abner
- Alzheimer's Disease Center, Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA.,Department of Epidemiology, University of Kentucky, Lexington, Kentucky, USA
| | - Richard J Kryscio
- Alzheimer's Disease Center, Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA.,Department of Statistics, University of Kentucky, Lexington, Kentucky, USA
| | - Ronan R Murphy
- Department of Neurology, University of Kentucky College of Medicine, Lexington, Kentucky, USA.,Alzheimer's Disease Center, Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
| | - Anders H Andersen
- Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, Kentucky, USA.,Department of Neuroscience, University of Kentucky, Lexington, Kentucky, USA
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19
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Kong D, Fan Y, Hao J, Zhang X, Su Q, Yao T, Zhang C, Xiao L, Wang G. Cortical thickness computation by solving tetrahedron-based harmonic field. Comput Biol Med 2020; 120:103727. [PMID: 32250856 DOI: 10.1016/j.compbiomed.2020.103727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 03/11/2020] [Accepted: 03/21/2020] [Indexed: 11/30/2022]
Abstract
Cortical thickness computation in magnetic resonance imaging (MRI) is an important method to study the brain morphological changes induced by neurodegenerative diseases. This paper presents an algorithm of thickness measurement based on a volumetric Laplacian operator (VLO), which is able to capture accurately the geometric information of brain images. The proposed algorithm is a novel three-step method: 1) The rule of parity and the shrinkage strategy are combined to detect and fix the intersection error regions between the cortical surface meshes separated by FreeSurfer software and the tetrahedral mesh is constructed which reflects the original morphological features of the cerebral cortex, 2) VLO and finite element method are combined to compute the temperature distribution in the cerebral cortex under the Dirichlet boundary conditions, and 3) the thermal gradient line is determined based on the constructed local isothermal surfaces and linear geometric interpolation results. Combined with half-face data storage structure, the cortical thickness can be computed accurately and effectively from the length of each gradient line. With the obtained thickness, we set experiments to study the group differences among groups of Alzheimer's disease (AD, N = 110), mild cognitive impairment (MCI, N = 101) and healthy control people (CTL, N = 128) by statistical analysis. The results show that the q-value associated with the group differences is 0.0458 between AD and CTL, 0.0371 between MCI and CTL, and 0.0044 between AD and MCI. Practical tests demonstrate that the algorithm of thickness measurement has high efficiency and is generic to be applied to various biological structures that have internal and external surfaces.
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Affiliation(s)
- Deping Kong
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Yonghui Fan
- School of Computing, Informatics, And Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Jinguang Hao
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Xiaofeng Zhang
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Qingtang Su
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Tao Yao
- School of Information and Electrical Engineering, Ludong University, Yantai, China
| | - Caiming Zhang
- Shandong Co-Innovation Center of Future Intelligent Computing, Yantai, China
| | - Liang Xiao
- School of Computer Science and Engineering, Nanjing University of Science & Technology, Nanjing, China
| | - Gang Wang
- School of Information and Electrical Engineering, Ludong University, Yantai, China; School of Computing, Informatics, And Decision Systems Engineering, Arizona State University, Tempe, AZ, USA.
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20
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Lombardi G, Crescioli G, Cavedo E, Lucenteforte E, Casazza G, Bellatorre A, Lista C, Costantino G, Frisoni G, Virgili G, Filippini G. Structural magnetic resonance imaging for the early diagnosis of dementia due to Alzheimer's disease in people with mild cognitive impairment. Cochrane Database Syst Rev 2020; 3:CD009628. [PMID: 32119112 PMCID: PMC7059964 DOI: 10.1002/14651858.cd009628.pub2] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) due to Alzheimer's disease is the symptomatic predementia phase of Alzheimer's disease dementia, characterised by cognitive and functional impairment not severe enough to fulfil the criteria for dementia. In clinical samples, people with amnestic MCI are at high risk of developing Alzheimer's disease dementia, with annual rates of progression from MCI to Alzheimer's disease estimated at approximately 10% to 15% compared with the base incidence rates of Alzheimer's disease dementia of 1% to 2% per year. OBJECTIVES To assess the diagnostic accuracy of structural magnetic resonance imaging (MRI) for the early diagnosis of dementia due to Alzheimer's disease in people with MCI versus the clinical follow-up diagnosis of Alzheimer's disease dementia as a reference standard (delayed verification). To investigate sources of heterogeneity in accuracy, such as the use of qualitative visual assessment or quantitative volumetric measurements, including manual or automatic (MRI) techniques, or the length of follow-up, and age of participants. MRI was evaluated as an add-on test in addition to clinical diagnosis of MCI to improve early diagnosis of dementia due to Alzheimer's disease in people with MCI. SEARCH METHODS On 29 January 2019 we searched Cochrane Dementia and Cognitive Improvement's Specialised Register and the databases, MEDLINE, Embase, BIOSIS Previews, Science Citation Index, PsycINFO, and LILACS. We also searched the reference lists of all eligible studies identified by the electronic searches. SELECTION CRITERIA We considered cohort studies of any size that included prospectively recruited people of any age with a diagnosis of MCI. We included studies that compared the diagnostic test accuracy of baseline structural MRI versus the clinical follow-up diagnosis of Alzheimer's disease dementia (delayed verification). We did not exclude studies on the basis of length of follow-up. We included studies that used either qualitative visual assessment or quantitative volumetric measurements of MRI to detect atrophy in the whole brain or in specific brain regions, such as the hippocampus, medial temporal lobe, lateral ventricles, entorhinal cortex, medial temporal gyrus, lateral temporal lobe, amygdala, and cortical grey matter. DATA COLLECTION AND ANALYSIS Four teams of two review authors each independently reviewed titles and abstracts of articles identified by the search strategy. Two teams of two review authors each independently assessed the selected full-text articles for eligibility, extracted data and solved disagreements by consensus. Two review authors independently assessed the quality of studies using the QUADAS-2 tool. We used the hierarchical summary receiver operating characteristic (HSROC) model to fit summary ROC curves and to obtain overall measures of relative accuracy in subgroup analyses. We also used these models to obtain pooled estimates of sensitivity and specificity when sufficient data sets were available. MAIN RESULTS We included 33 studies, published from 1999 to 2019, with 3935 participants of whom 1341 (34%) progressed to Alzheimer's disease dementia and 2594 (66%) did not. Of the participants who did not progress to Alzheimer's disease dementia, 2561 (99%) remained stable MCI and 33 (1%) progressed to other types of dementia. The median proportion of women was 53% and the mean age of participants ranged from 63 to 87 years (median 73 years). The mean length of clinical follow-up ranged from 1 to 7.6 years (median 2 years). Most studies were of poor methodological quality due to risk of bias for participant selection or the index test, or both. Most of the included studies reported data on the volume of the total hippocampus (pooled mean sensitivity 0.73 (95% confidence interval (CI) 0.64 to 0.80); pooled mean specificity 0.71 (95% CI 0.65 to 0.77); 22 studies, 2209 participants). This evidence was of low certainty due to risk of bias and inconsistency. Seven studies reported data on the atrophy of the medial temporal lobe (mean sensitivity 0.64 (95% CI 0.53 to 0.73); mean specificity 0.65 (95% CI 0.51 to 0.76); 1077 participants) and five studies on the volume of the lateral ventricles (mean sensitivity 0.57 (95% CI 0.49 to 0.65); mean specificity 0.64 (95% CI 0.59 to 0.70); 1077 participants). This evidence was of moderate certainty due to risk of bias. Four studies with 529 participants analysed the volume of the total entorhinal cortex and four studies with 424 participants analysed the volume of the whole brain. We did not estimate pooled sensitivity and specificity for the volume of these two regions because available data were sparse and heterogeneous. We could not statistically evaluate the volumes of the lateral temporal lobe, amygdala, medial temporal gyrus, or cortical grey matter assessed in small individual studies. We found no evidence of a difference between studies in the accuracy of the total hippocampal volume with regards to duration of follow-up or age of participants, but the manual MRI technique was superior to automatic techniques in mixed (mostly indirect) comparisons. We did not assess the relative accuracy of the volumes of different brain regions measured by MRI because only indirect comparisons were available, studies were heterogeneous, and the overall accuracy of all regions was moderate. AUTHORS' CONCLUSIONS The volume of hippocampus or medial temporal lobe, the most studied brain regions, showed low sensitivity and specificity and did not qualify structural MRI as a stand-alone add-on test for an early diagnosis of dementia due to Alzheimer's disease in people with MCI. This is consistent with international guidelines, which recommend imaging to exclude non-degenerative or surgical causes of cognitive impairment and not to diagnose dementia due to Alzheimer's disease. In view of the low quality of most of the included studies, the findings of this review should be interpreted with caution. Future research should not focus on a single biomarker, but rather on combinations of biomarkers to improve an early diagnosis of Alzheimer's disease dementia.
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Affiliation(s)
- Gemma Lombardi
- University of FlorenceDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA)Largo Brambilla, 3FlorenceItaly50134
| | - Giada Crescioli
- University of FlorenceDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA)Largo Brambilla, 3FlorenceItaly50134
| | - Enrica Cavedo
- Pitie‐Salpetriere Hospital, Sorbonne UniversityAlzheimer Precision Medicine (APM), AP‐HP47 boulevard de l'HopitalParisFrance75013
| | - Ersilia Lucenteforte
- University of PisaDepartment of Clinical and Experimental MedicineVia Savi 10PisaItaly56126
| | - Giovanni Casazza
- Università degli Studi di MilanoDipartimento di Scienze Biomediche e Cliniche "L. Sacco"via GB Grassi 74MilanItaly20157
| | | | - Chiara Lista
- Fondazione I.R.C.C.S. Istituto Neurologico Carlo BestaNeuroepidemiology UnitVia Celoria, 11MilanoItaly20133
| | - Giorgio Costantino
- Ospedale Maggiore Policlinico, Università degli Studi di MilanoUOC Pronto Soccorso e Medicina D'Urgenza, Fondazione IRCCS Ca' GrandaMilanItaly
| | | | - Gianni Virgili
- University of FlorenceDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA)Largo Brambilla, 3FlorenceItaly50134
| | - Graziella Filippini
- Carlo Besta Foundation and Neurological InstituteScientific Director’s Officevia Celoria, 11MilanItaly20133
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21
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Bhasin H, Agrawal RK. A combination of 3-D discrete wavelet transform and 3-D local binary pattern for classification of mild cognitive impairment. BMC Med Inform Decis Mak 2020; 20:37. [PMID: 32085774 PMCID: PMC7035729 DOI: 10.1186/s12911-020-1055-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 02/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The detection of Alzheimer's Disease (AD) in its formative stages, especially in Mild Cognitive Impairments (MCI), has the potential of helping the clinicians in understanding the condition. The literature review shows that the classification of MCI-converts and MCI-non-converts has not been explored profusely and the maximum classification accuracy reported is rather low. Thus, this paper proposes a Machine Learning approach for classifying patients of MCI into two groups one who converted to AD and the others who are not diagnosed with any signs of AD. The proposed algorithm is also used to distinguish MCI patients from controls (CN). This work uses the Structural Magnetic Resonance Imaging data. METHODS This work proposes a 3-D variant of Local Binary Pattern (LBP), called LBP-20 for extracting features. The method has been compared with 3D-Discrete Wavelet Transform (3D-DWT). Subsequently, a combination of 3D-DWT and LBP-20 has been used for extracting features. The relevant features are selected using the Fisher Discriminant Ratio (FDR) and finally the classification has been carried out using the Support Vector Machine. RESULTS The combination of 3D-DWT with LBP-20 results in a maximum accuracy of 88.77. Similarly, the proposed combination of methods is also applied to distinguish MCI from CN. The proposed method results in the classification accuracy of 90.31 in this data. CONCLUSION The proposed combination is able to extract relevant distribution of microstructures from each component, obtained with the use of DWT and thereby improving the classification accuracy. Moreover, the number of features used for classification is significantly less as compared to those obtained by 3D-DWT. The performance of the proposed method is measured in terms of accuracy, specificity and sensitivity and is found superior in comparison to the existing methods. Thus, the proposed method may contribute to effective diagnosis of MCI and may prove advantageous in clinical settings.
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Affiliation(s)
- Harsh Bhasin
- School of Computer and Systems Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Ramesh Kumar Agrawal
- School of Computer and Systems Sciences, Jawaharlal Nehru University, New Delhi, India
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22
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Raji CA, Ly M, Benzinger TLS. Overview of MR Imaging Volumetric Quantification in Neurocognitive Disorders. Top Magn Reson Imaging 2019; 28:311-315. [PMID: 31794503 DOI: 10.1097/rmr.0000000000000224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This review article provides a general overview on the various methodologies for quantifying brain structure on magnetic resonance images of the human brain. This overview is followed by examples of applications in Alzheimer dementia and mild cognitive impairment. Other examples will include traumatic brain injury and other neurodegenerative dementias. Finally, an overview of general principles for protocol acquisition of magnetic resonance imaging for volumetric quantification will be discussed along with the current choices of FDA cleared algorithms for use in clinical practice.
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Affiliation(s)
- Cyrus A Raji
- Division of Neuroradiology, Department of Radiology, Mallinckrodt Institute of Radiology at Washington University, St. Louis, MO
| | - Maria Ly
- University of Pittsburgh Medical Scientist Training Program, Pittsburgh, PA
| | - Tammie L S Benzinger
- Division of Neuroradiology, Department of Radiology, Mallinckrodt Institute of Radiology at Washington University, St. Louis, MO
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23
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Barnes J, Bartlett JW, Wolk DA, van der Flier WM, Frost C. Disease Course Varies According to Age and Symptom Length in Alzheimer's Disease. J Alzheimers Dis 2019; 64:631-642. [PMID: 29914016 DOI: 10.3233/jad-170841] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Health-care professionals, patients, and families seek as much information as possible about prognosis for patients with Alzheimer's disease (AD); however, we do not yet have a robust understanding of how demographic factors predict prognosis. We evaluated associations between age at presentation, age of onset, and symptom length with cognitive decline as measured using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating sum-of-boxes (CDR-SOB) in a large dataset of AD patients. Age at presentation was associated with post-presentation decline in MMSE (p < 0.001), with younger patients showing faster decline. There was little evidence of an association with change in CDR-SOB. Symptom length, rather than age, was the strongest predictor of MMSE and CDR-SOB at presentation, with increasing symptom length associated with worse outcomes. The evidence that younger AD patients have a more aggressive disease course implies that early diagnosis is essential.
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Affiliation(s)
- Josephine Barnes
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | | | - David A Wolk
- Penn Memory Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Wiesje M van der Flier
- Alzheimer Center, Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Chris Frost
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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24
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Marizzoni M, Ferrari C, Macis A, Jovicich J, Albani D, Babiloni C, Cavaliere L, Didic M, Forloni G, Galluzzi S, Hoffmann KT, Molinuevo JL, Nobili F, Parnetti L, Payoux P, Pizzini F, Rossini PM, Salvatore M, Schönknecht P, Soricelli A, Del Percio C, Hensch T, Hegerl U, Tsolaki M, Visser PJ, Wiltfang J, Richardson JC, Bordet R, Blin O, Frisoni GB. Biomarker Matrix to Track Short Term Disease Progression in Amnestic Mild Cognitive Impairment Patients with Prodromal Alzheimer’s Disease. J Alzheimers Dis 2019; 69:49-58. [DOI: 10.3233/jad-181016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Moira Marizzoni
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ambra Macis
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences, University of Trento, Italy
| | - Diego Albani
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Rome, Italy
- Hospital San Raffaele Cassino, Cassino (FR), Italy
| | - Libera Cavaliere
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mira Didic
- Aix-Marseille Université, Inserm, INS UMR_S 1106, Marseille, France
- APHM, Timone, Service de Neurologie et Neuropsychologie, APHM Hôpital Timone Adultes, Marseille, France
| | - Gianluigi Forloni
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Samantha Galluzzi
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - José Luis Molinuevo
- Alzheimer’s Disease Unit and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucilla Parnetti
- Clinica Neurologica, Università di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - Pierre Payoux
- INSERM; Imagerie cérébrale et handicaps neurologiques UMR 825, Toulouse, France
| | - Francesca Pizzini
- Department of Diagnostics and Pathology, Neuroradiology, Verona University Hospital, Italy
| | - Paolo Maria Rossini
- Department of Gerontology, Area of Neuroscience, Neurosciences & Orthopedics, Catholic University, Policlinic A. Gemelli Foundation Rome, Italy
| | | | - Peter Schönknecht
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | | | | | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Magda Tsolaki
- 3rd Neurologic Clinic, Medical School, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pieter Jelle Visser
- Department of Neurology, Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Goettingen, Germany
- iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Jill C. Richardson
- Neurosciences Therapeutic Area, GlaxoSmithKline R&D, Gunnels Wood Road, Stevenage, UK
| | - Régis Bordet
- University of Lille, Inserm, CHU Lille, U1171-Degenerative and vascular cognitive disorders, Lille, France
| | - Olivier Blin
- Aix Marseille University, UMR-CNRS 7289, Service de Pharmacologie Clinique, AP-HM, Marseille, France
| | - Giovanni B. Frisoni
- Laboratory of Neuroimaging and Alzheimer’s Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
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25
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Armstrong NM, Huang CW, Williams OA, Bilgel M, An Y, Doshi J, Erus G, Davatzikos C, Wong DF, Ferrucci L, Resnick SM. Sex differences in the association between amyloid and longitudinal brain volume change in cognitively normal older adults. NEUROIMAGE-CLINICAL 2019; 22:101769. [PMID: 30927602 PMCID: PMC6444285 DOI: 10.1016/j.nicl.2019.101769] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/22/2019] [Accepted: 03/10/2019] [Indexed: 01/19/2023]
Abstract
Objective Amyloid positivity is a biomarker of AD pathology, yet the associations between amyloid positivity and brain volumetric changes, especially in the hippocampus, are inconsistent. We hypothesize that sex differences in associations may contribute to inconsistent findings among cognitively normal older adults. Methods Using linear mixed effects models, we examined the association of amyloid positivity with prospective volumetric changes (mean = 3.3 visits) of parahippocampal gyrus (phg), hippocampus, entorhinal cortex (erc), precuneus, and fusiform gyrus among 171 Baltimore Longitudinal Study of Aging participants aged ≥55 years. Amyloid positivity was defined by a mean 11C-Pittsburgh Compound B (PiB) distribution volume ratio (DVR) cut-off of 1.062. All analyses included age, race, sex, education, APOE e4 carrier status, and two-way interactions of these covariates with time. Two-way interaction between sex and PiB+/− status and three-way interaction of sex and PiB+/− status with time were added to assess whether sex modified associations. Results PiB+ status was associated with greater volumetric declines in the phg (β = −0.036, SE = 0.011, p = 0.001) and erc (β = −0.019, SE = 0.009, p = 0.045). Sex modified the association of PiB+ status and rates of volumetric declines in fusiform (β = −0.117, SE = 0.049, p = 0.019). PiB+ males had steeper rates of volumetric declines in phg (β = −0.051, SE = 0.013, p < 0.001) and erc (β = −0.029, SE = 0.012, p = 0.014) than PiB- males, while there was no difference in rates of volumetric change between PiB+ and PiB- females. Conclusions Amyloidosis is a marker of entorhinal and parahippocampal volume loss. Amyloid positivity is a predictor of volume loss in brain regions affected by early AD pathology in men, but not women. Amyloid positivity is related to volume loss in regions of early AD pathology. Sex modified the association of amyloid positivity and brain volumetric changes. Amyloid-positive males were vulnerable to volume loss in regions of early AD. Females with and without amyloid positivity had similar volume changes.
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Affiliation(s)
- Nicole M Armstrong
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Chiung-Wei Huang
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Owen A Williams
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Jimit Doshi
- Section of Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Guray Erus
- Section of Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Christos Davatzikos
- Section of Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Dean F Wong
- Section of High Resolution Brain PET, Departments of Neurology, Psychiatry, Neuroscience, and Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Luigi Ferrucci
- Translational Gerontology Branch, Longitudinal Studies Section, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institutes of Health, National Institute on Aging, Baltimore, MD, United States of America.
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26
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Haque ME, Gabr RE, Hasan KM, George S, Arevalo OD, Zha A, Alderman S, Jeevarajan J, Mas MF, Zhang X, Satani N, Friedman ER, Sitton CW, Savitz S. Ongoing Secondary Degeneration of the Limbic System in Patients With Ischemic Stroke: A Longitudinal MRI Study. Front Neurol 2019; 10:154. [PMID: 30890995 PMCID: PMC6411642 DOI: 10.3389/fneur.2019.00154] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/06/2019] [Indexed: 01/08/2023] Open
Abstract
Purpose: Ongoing post-stroke structural degeneration and neuronal loss preceding neuropsychological symptoms such as cognitive decline and depression are poorly understood. Various substructures of the limbic system have been linked to cognitive impairment. In this longitudinal study, we investigated the post-stroke macro- and micro-structural integrity of the limbic system using structural and diffusion tensor magnetic resonance imaging. Materials and Methods: Nineteen ischemic stroke patients (11 men, 8 women, average age 53.4 ± 12.3, range 18–75 years), with lesions remote from the limbic system, were serially imaged three times over 1 year. Structural and diffusion-tensor images (DTI) were obtained on a 3.0 T MRI system. The cortical thickness, subcortical volume, mean diffusivity (MD), and fractional anisotropy (FA) were measured in eight different regions of the limbic system. The National Institutes of Health Stroke Scale (NIHSS) was used for clinical assessment. A mixed model for multiple factors was used for statistical analysis, and p-values <0.05 was considered significant. Results: All patients demonstrated improved NIHSS values over time. The ipsilesional subcortical volumes of the thalamus, hippocampus, and amygdala significantly decreased (p < 0.05) and MD significantly increased (p < 0.05). The ipsilesional cortical thickness of the entorhinal and perirhinal cortices was significantly smaller than the contralesional hemisphere at 12 months (p < 0.05). The cortical thickness of the cingulate gyrus at 12 months was significantly decreased at the caudal and isthmus regions as compared to the 1 month assessment (p < 0.05). The cingulum fibers had elevated MD at the ipsilesional caudal-anterior and posterior regions compared to the corresponding contralesional regions. Conclusion: Despite the decreasing NIHSS scores, we found ongoing unilateral neuronal loss/secondary degeneration in the limbic system, irrespective of the lesion location. These results suggest a possible anatomical basis for post stroke psychiatric complications.
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Affiliation(s)
- Muhammad E Haque
- Institute for Stroke and Cerebrovascular Diseases, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Refaat E Gabr
- Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Khader M Hasan
- Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Sarah George
- Institute for Stroke and Cerebrovascular Diseases, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Octavio D Arevalo
- Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Alicia Zha
- Institute for Stroke and Cerebrovascular Diseases, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Susan Alderman
- Institute for Stroke and Cerebrovascular Diseases, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jerome Jeevarajan
- Institute for Stroke and Cerebrovascular Diseases, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Manual F Mas
- TIRR Memorial Hermann Rehabilitation and Research, Houston, TX, United States
| | - Xu Zhang
- Biostatistics/Epidemiology/Research Design Component, Center for Clinical and Translational Sciences, McGovern Medical School at University of Texas Health Science Center at Houston (UTHealth), Houston, TX, United States
| | - Nikunj Satani
- Institute for Stroke and Cerebrovascular Diseases, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Elliott R Friedman
- Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Clark W Sitton
- Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Sean Savitz
- Institute for Stroke and Cerebrovascular Diseases, University of Texas Health Science Center at Houston, Houston, TX, United States
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27
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Li F, Takechi H, Saito R, Ayaki T, Kokuryu A, Kuzuya A, Takahashi R. A comparative study: visual rating scores and the voxel-based specific regional analysis system for Alzheimer's disease on magnetic resonance imaging among subjects with Alzheimer's disease, mild cognitive impairment, and normal cognition. Psychogeriatrics 2019; 19:95-104. [PMID: 30276926 DOI: 10.1111/psyg.12370] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/13/2018] [Accepted: 07/31/2018] [Indexed: 11/30/2022]
Abstract
AIM Hippocampal atrophy shown on magnetic resonance imaging can differentiate Alzheimer's disease (AD) patients from subjects with normal cognition (NC). Simplified automated methods that use volumetric analysis, such as as the voxel-based specific regional analysis system for AD, have become widely used in Japan. However, the diagnostic value of the voxel-based specific regional analysis system compared with visual rating scores for clinical diagnosis is unclear. METHODS Study participants consisted of 37 AD patients, 29 mild cognitive impairment (MCI) patients, and 21 NC subjects. All participants underwent neuropsychological testing and magnetic resonance imaging. The imaging was scored visually for regional brain atrophy by two raters based on a newly developed visual rating score. The voxel-based specific regional analysis system for AD scores were calculated with the analysis system's advanced software. We analyzed whether these scores aid in discriminating among AD, MCI, and NC. RESULTS The AD group had significantly different visual rating scores, regional analysis scores, and all neuropsychological test scores than the NC group. The AD group had significantly different visual rating scores than the MCI group, and a significant difference was observed between the MCI and NC groups on regional analysis scores. Both the visual rating and regional analysis scores showed equivalent correlations with the neuropsychological test scores. CONCLUSIONS Both the visual rating and regional analysis scores are clinically useful tools for differentiating among AD, MCI, and NC.
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Affiliation(s)
- Fangzhou Li
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hajime Takechi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, Toyoake, Japan
| | - Ryuji Saito
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takashi Ayaki
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Atsuko Kokuryu
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akira Kuzuya
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Bin Zahid A, Balser D, Thomas R, Mahan MY, Hubbard ME, Samadani U. Increase in brain atrophy after subdural hematoma to rates greater than associated with dementia. J Neurosurg 2018; 129:1579-1587. [DOI: 10.3171/2017.8.jns17477] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 08/21/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVEChronic subdural hematoma (cSDH) is a highly morbid condition associated with brain atrophy in the elderly. It has a reported 30% 1-year mortality rate. Approximately half of afflicted individuals report either no or relatively unremarkable trauma preceding their diagnosis, raising the possibility that cSDH is a manifestation of degenerative or inflammatory disease rather than trauma. The purpose of this study was to compare the rates of cerebral atrophy before and after cSDH to determine whether it is more likely that cSDH causes atrophy or that atrophy causes cSDH. The authors also compared atrophy rates in patients with cSDH to the rates in patients with and without dementia.METHODSThe authors developed algorithmic segmentation analysis software to measure whole-brain, CSF, and intracranial space volumes. They then identified military veterans who had undergone at least 4 brain CT scans over a period of 10 years. Within this database, the authors identified 146 patients with 962 head CT scans who had received diagnoses of either cSDH, dementia, or no known dementia condition. Volumetric analyses of brains in 45 patients with dementia (dementia group) and 73 patients without dementia (nondementia group), in whom 262 and 519 head CT scans were obtained, respectively, were compared with 11 patients in whom 81 CT scans were obtained a mean of 4.21 years before a cSDH diagnosis and 17 patients in whom 100 scans were obtained a mean of 4.24 years after SDH. Longitudinal measures were then related to disease status and the time since first scan by using hierarchical models, and atrophy rates between the groups were compared.RESULTSHead CT scans from patients were obtained for an average time period of 4.21 years (SD 1.69) starting at a mean patient age of 74 years. Absolute brain volume loss for the 17 patients in the post-SDH group (13 were treated surgically) was significantly greater, at 16.32 ml/year, compared with 6.61 ml/year in patients with dementia, 5.33 ml/year in patients without dementia, and 3.57 ml/year in pre-SDH patients. The atrophy rate for these individuals prior to enrollment in the study was 2.32 ml/year (p = 0.001). In terms of brain volume normalized to cranial cavity size, the post-SDH group had an atrophy rate of 0.7801%/year, compared with 0.4467%/year in patients with dementia, 0.3474%/year in patients without dementia, and 0.2135%/year in the pre-SDH group.CONCLUSIONSPrior to development of a cSDH, the atrophy rates in patients who ultimately develop cSDH are similar to those of patients without dementia. After development of a cSDH, the atrophy rates increase to more than twice those of patients with dementia. Chronic subdural hematoma is thus associated with a significant increase in brain atrophy rate. These findings suggest the neurotoxic consequences of cSDH and may have implications for better understanding of the pathophysiology of cerebral atrophy and dementia.
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Affiliation(s)
- Abdullah Bin Zahid
- 1Department of Surgery, Minneapolis VA Health Care System
- 2Department of Neurosurgery, University of Minnesota; and
- 3Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
| | - David Balser
- 1Department of Surgery, Minneapolis VA Health Care System
- 2Department of Neurosurgery, University of Minnesota; and
- 3Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Rebekah Thomas
- 3Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Margaret Y. Mahan
- 2Department of Neurosurgery, University of Minnesota; and
- 3Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Molly E. Hubbard
- 1Department of Surgery, Minneapolis VA Health Care System
- 2Department of Neurosurgery, University of Minnesota; and
- 3Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Uzma Samadani
- 1Department of Surgery, Minneapolis VA Health Care System
- 2Department of Neurosurgery, University of Minnesota; and
- 3Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
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Wachinger C, Nho K, Saykin AJ, Reuter M, Rieckmann A. A Longitudinal Imaging Genetics Study of Neuroanatomical Asymmetry in Alzheimer's Disease. Biol Psychiatry 2018; 84:522-530. [PMID: 29885764 PMCID: PMC6123250 DOI: 10.1016/j.biopsych.2018.04.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Contralateral brain structures represent a unique, within-patient reference element for disease, and asymmetries can provide a personalized measure of the accumulation of past disease processes. Neuroanatomical shape asymmetries have recently been associated with the progression of Alzheimer's disease (AD), but the biological basis of asymmetric brain changes in AD remains unknown. METHODS We investigated genetic influences on brain asymmetry by identifying associations between magnetic resonance imaging-derived measures of asymmetry and candidate single nucleotide polymorphisms (SNPs) that have previously been identified in genome-wide association studies for AD diagnosis and for brain subcortical volumes. For analyzing longitudinal neuroimaging data (1241 individuals, 6395 scans), we used a mixed effects model with interaction between genotype and diagnosis. RESULTS Significant associations between asymmetry of the amygdala, hippocampus, and putamen and SNPs in the genes BIN1, CD2AP, ZCWPW1, ABCA7, TNKS, and DLG2 were found. CONCLUSIONS The associations between SNPs in the genes TNKS and DLG2 and AD-related increases in shape asymmetry are of particular interest; these SNPs have previously been associated with subcortical volumes of amygdala and putamen but have not yet been associated with AD pathology. For AD candidate SNPs, we extend previous work to show that their effects on subcortical brain structures are asymmetric. This provides novel evidence about the biological underpinnings of brain asymmetry as a disease marker.
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Affiliation(s)
- Christian Wachinger
- Laboratory for Artificial Intelligence in Medical Imaging, Klinik für Kinder- und Jugendpsychiatrie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, München, Germany.
| | - Kwangsik Nho
- Center for Neuroimaging and Indiana Alzheimer Disease Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Andrew J Saykin
- Center for Neuroimaging and Indiana Alzheimer Disease Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Martin Reuter
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts; Deutsches Zentrum für Neurodegenerative Erkrankungen, Bonn, Germany
| | - Anna Rieckmann
- Umeå Center for Functional Brain Imaging, Department of Radiation Sciences, Umeå University, Umeå, Sweden
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Liu J, Li M, Lan W, Wu FX, Pan Y, Wang J. Classification of Alzheimer's Disease Using Whole Brain Hierarchical Network. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2018; 15:624-632. [PMID: 28114031 DOI: 10.1109/tcbb.2016.2635144] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Regions of interest (ROIs) based classification has been widely investigated for analysis of brain magnetic resonance imaging (MRI) images to assist the diagnosis of Alzheimer's disease (AD) including its early warning and developing stages, e.g., mild cognitive impairment (MCI) including MCI converted to AD (MCIc) and MCI not converted to AD (MCInc). Since an ROI representation of brain structures is obtained either by pre-definition or by adaptive parcellation, the corresponding ROI in different brains can be measured. However, due to noise and small sample size of MRI images, representations generated from single or multiple ROIs may not be sufficient to reveal the underlying anatomical differences between the groups of disease-affected patients and health controls (HC). In this paper, we employ a whole brain hierarchical network (WBHN) to represent each subject. The whole brain of each subject is divided into 90, 54, 14, and 1 regions based on Automated Anatomical Labeling (AAL) atlas. The connectivity between each pair of regions is computed in terms of Pearson's correlation coefficient and used as classification feature. Then, to reduce the dimensionality of features, we select the features with higher scores. Finally, we use multiple kernel boosting (MKBoost) algorithm to perform the classification. Our proposed method is evaluated on MRI images of 710 subjects (200 AD, 120 MCIc, 160 MCInc, and 230 HC) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. The experimental results show that our proposed method achieves an accuracy of 94.65 percent and an area under the receiver operating characteristic (ROC) curve (AUC) of 0.954 for AD/HC classification, an accuracy of 89.63 percent and an AUC of 0.907 for AD/MCI classification, an accuracy of 85.79 percent and an AUC of 0.826 for MCI/HC classification, and an accuracy of 72.08 percent and an AUC of 0.716 for MCIc/MCInc classification, respectively. Our results demonstrate that our proposed method is efficient and promising for clinical applications for the diagnosis of AD via MRI images.
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Opfer R, Ostwaldt AC, Sormani MP, Gocke C, Walker-Egger C, Manogaran P, De Stefano N, Schippling S. Estimates of age-dependent cutoffs for pathological brain volume loss using SIENA/FSL-a longitudinal brain volumetry study in healthy adults. Neurobiol Aging 2017; 65:1-6. [PMID: 29407463 DOI: 10.1016/j.neurobiolaging.2017.12.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/19/2017] [Accepted: 12/21/2017] [Indexed: 01/01/2023]
Abstract
Brain volume loss (BVL) has gained increasing interest for monitoring tissue damage in neurodegenerative diseases including multiple sclerosis (MS). In this longitudinal study, 117 healthy participants (age range 37.3-82.6 years) received at least 2 magnetic resonance imaging examinations. BVL (in %) was determined with the Structural Image Evaluation using Normalisation of Atrophy/FMRIB Software Library and annualized. Mean BVL per year was 0.15%, 0.30%, 0.46%, and 0.61% at ages 45, 55, 65, and 75 years, respectively. The corresponding BVL per year values of the age-dependent 95th percentiles were 0.52%, 0.77%, 1.05% and 1.45%. Pathological BVL can be assumed if an individual BVL per year exceeds these thresholds for a given age. The mean BVL per year determined in this longitudinal study was consistent with results from a cross-sectional study that was published recently. The cut-off for a pathological BVL per year at the age of 45 years (0.52%) was consistent with the cut-off suggested previously to distinguish between physiological and pathological BVL in MS patients. Different cut-off values, however, need to be considered when interpreting BVL assessed in cohorts of higher ages.
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Affiliation(s)
- Roland Opfer
- Neuroimmunology and Multiple Sclerosis Research, Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Jung diagnostics GmbH, Hamburg, Germany.
| | | | - Maria Pia Sormani
- Biostatistics Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Carola Gocke
- Medical Prevention Center Hamburg (MPCH), Hamburg, Germany
| | - Christine Walker-Egger
- Neuroimmunology and Multiple Sclerosis Research, Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Praveena Manogaran
- Neuroimmunology and Multiple Sclerosis Research, Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Department of Information Technology and Electrical Engineering, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Sven Schippling
- Neuroimmunology and Multiple Sclerosis Research, Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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d'Oleire Uquillas F, Jacobs HIL, Hanseeuw B, Marshall GA, Properzi M, Schultz AP, LaPoint MR, Johnson KA, Sperling RA, Vannini P. Interactive versus additive relationships between regional cortical thinning and amyloid burden in predicting clinical decline in mild AD and MCI individuals. NEUROIMAGE-CLINICAL 2017; 17:388-396. [PMID: 29159051 PMCID: PMC5683806 DOI: 10.1016/j.nicl.2017.10.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/09/2017] [Accepted: 10/28/2017] [Indexed: 11/13/2022]
Abstract
The biological mechanisms that link Beta-amyloid (Aβ) plaque deposition, neurodegeneration, and clinical decline in Alzheimer's disease (AD) dementia, have not been completely elucidated. Here we studied whether amyloid accumulation and neurodegeneration, independently or interactively, predict clinical decline over time in a group of memory impaired older individuals [diagnosed with either amnestic mild cognitive impairment (MCI), or mild AD dementia]. We found that baseline Aβ-associated cortical thinning across clusters encompassing lateral and medial temporal and parietal cortices was related to higher baseline Clinical Dementia Rating Sum-of-Boxes (CDR-SB). Baseline Aβ-associated cortical thinning also predicted CDR-SB over time. Notably, the association between CDR-SB change and cortical thickness values from the right lateral temporo-parietal cortex and right precuneus was driven by individuals with high Aβ burden. In contrast, the association between cortical thickness in the medial temporal lobe (MTL) and clinical decline was similar for individuals with high or low Aβ burden. Furthermore, amyloid pathology was a stronger predictor for clinical decline than MTL thickness. While this study validates previous findings relating AD biomarkers of neurodegeneration to clinical impairment, here we show that regions outside the MTL may be more vulnerable and specific to AD dementia. Additionally, excluding mild AD individuals revealed that these relationships remained, suggesting that lower cortical thickness values in specific regions, vulnerable to amyloid pathology, predict clinical decline already at the prodromal stage. Aβ burden is associated with cortical thinning in a pattern consistent with AD. Interaction between Aβ and neocortical thinning predicts clinical decline. MTL thickness predicts clinical decline regardless of Aβ burden. Amyloid pathology is a stronger predictor for clinical decline than MTL thickness.
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Affiliation(s)
| | - Heidi I L Jacobs
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Bernard Hanseeuw
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Department of Neurology, Saint-Luc University Hospital, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Gad A Marshall
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Molly R LaPoint
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Patrizia Vannini
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Liu J, Wang J, Hu B, Wu FX, Pan Y. Alzheimer’s Disease Classification Based on Individual Hierarchical Networks Constructed With 3-D Texture Features. IEEE Trans Nanobioscience 2017; 16:428-437. [DOI: 10.1109/tnb.2017.2707139] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Falahati F, Ferreira D, Muehlboeck JS, Eriksdotter M, Simmons A, Wahlund LO, Westman E. Monitoring disease progression in mild cognitive impairment: Associations between atrophy patterns, cognition, APOE and amyloid. NEUROIMAGE-CLINICAL 2017; 16:418-428. [PMID: 28879083 PMCID: PMC5573795 DOI: 10.1016/j.nicl.2017.08.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 08/03/2017] [Accepted: 08/12/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND A disease severity index (SI) for Alzheimer's disease (AD) has been proposed that summarizes MRI-derived structural measures into a single score using multivariate data analysis. OBJECTIVES To longitudinally evaluate the use of the SI to monitor disease progression and predict future progression to AD in mild cognitive impairment (MCI). Further, to investigate the association between longitudinal change in the SI and cognitive impairment, Apolipoprotein E (APOE) genotype as well as the levels of cerebrospinal fluid amyloid-beta 1-42 (Aβ) peptide. METHODS The dataset included 195 AD, 145 MCI and 228 control subjects with annual follow-up for three years, where 70 MCI subjects progressed to AD (MCI-p). For each subject the SI was generated at baseline and follow-ups using 55 regional cortical thickness and subcortical volumes measures that extracted by the FreeSurfer longitudinal stream. RESULTS MCI-p subjects had a faster increase of the SI over time (p < 0.001). A higher SI at baseline in MCI-p was related to progression to AD at earlier follow-ups (p < 0.001) and worse cognitive impairment (p < 0.001). AD-like MCI patients with the APOE ε4 allele and abnormal Aβ levels had a faster increase of the SI, independently (p = 0.003 and p = 0.004). CONCLUSIONS Longitudinal changes in the SI reflect structural brain changes and can identify MCI patients at risk of progression to AD. Disease-related brain structural changes are influenced independently by APOE genotype and amyloid pathology. The SI has the potential to be used as a sensitive tool to predict future dementia, monitor disease progression as well as an outcome measure for clinical trials.
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Affiliation(s)
- Farshad Falahati
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - J-Sebastian Muehlboeck
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Andrew Simmons
- Division of Clinical Geriatrics, 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.,NIHR Biomedical Research Centre for Mental Health, London, UK.,NIHR Biomedical Research Unit for Dementia, London, UK
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, 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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Zhao T, Sheng C, Bi Q, Niu W, Shu N, Han Y. Age-related differences in the topological efficiency of the brain structural connectome in amnestic mild cognitive impairment. Neurobiol Aging 2017; 59:144-155. [PMID: 28882420 DOI: 10.1016/j.neurobiolaging.2017.08.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/01/2017] [Accepted: 08/02/2017] [Indexed: 01/07/2023]
Abstract
Amnestic mild cognitive impairment (aMCI) is accompanied by the accelerated cognitive decline and rapid brain degeneration with aging. However, the age-related alterations of the topological organization of the brain connectome in aMCI patients remained largely unknown. In this study, we constructed the brain structural connectome in 51 aMCI patients and 51 healthy controls by diffusion magnetic resonance imaging and deterministic tractography. The different age-related alteration patterns of the global and regional network metrics between aMCI patients and healthy controls were assessed by a linear regression model. Compared with healthy controls, significantly decreased global and local network efficiency in aMCI patients were found. When correlating network efficiency with age, we observed a significant decline in network efficiency with aging in the aMCI patients, while not in the healthy controls. The age-related decreases of nodal efficiency in aMCI patients were mainly distributed in the key regions of the default-mode network, such as precuneus, anterior cingulate gyrus, and parahippocampal gyrus. In addition, age-related decreases in the connection strength of the edges between peripheral nodes were observed in aMCI patients. Moreover, the decreased regional efficiency of the parahippocampal gyrus was correlated with impaired memory performances in patients. The present study suggests an age-related disruption of the topological organization of the brain structural connectome in aMCI patients, which may provide evidence for different neural mechanisms underlying aging in aMCI and may serve as a potential imaging marker for the early diagnosis of Alzheimer's disease.
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Affiliation(s)
- Tengda Zhao
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, P. R. China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, P. R. China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, P. R. China
| | - Can Sheng
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, P. R. China; Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P. R. China
| | - Qiuhui Bi
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, P. R. China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, P. R. China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, P. R. China
| | - Weili Niu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, P. R. China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, P. R. China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, P. R. China
| | - Ni Shu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, P. R. China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, P. R. China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, P. R. China.
| | - Ying Han
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, P. R. China; Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P. R. China; National Clinical Research Center for Geriatric Disorders, Beijing, P. R. China; PKU Care Rehabilitation Hospital, Beijing, P. R. China.
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Yu WC, Chou MY, Peng LN, Lin YT, Liang CK, Chen LK. Synergistic effects of cognitive impairment on physical disability in all-cause mortality among men aged 80 years and over: Results from longitudinal older veterans study. PLoS One 2017; 12:e0181741. [PMID: 28746360 PMCID: PMC5528830 DOI: 10.1371/journal.pone.0181741] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 07/06/2017] [Indexed: 12/30/2022] Open
Abstract
Objective We evaluated effects of the interrelationship between physical disability and cognitive impairment on long-term mortality of men aged 80 years and older living in a retirement community in Taiwan. Methods This prospective cohort study enrolled older men aged 80 and older living in a Veterans Care Home. Those with confirmed diagnosis of dementia were excluded. All participants received comprehensive geriatric assessment, including sociodemographic data, Charlson’s Comorbidity Index (CCI), geriatric syndromes, activities of daily living (ADL) using the Barthel index and cognitive function using the Mini-Mental State Examination (MMSE). Subjects were categorized into normal cognitive function, mild cognitive deterioration, and moderate-to-severe cognitive impairment and were further stratified by physical disability status. Kaplan-Meier log-rank test was used for survival analysis. After adjusting for sociodemographic characteristics and geriatric syndromes, Cox proportional hazards model was constructed to examine associations between cognitive function, disability and increased mortality risk. Results Among 305 male subjects aged 85.1 ± 4.1 years, 89 subjects died during follow-up (mean follow-up: 1.87 ± 0.90 years). Kaplan-Meier unadjusted analysis showed reduced survival probability associated with moderate-to-severe cognitive status and physical disability. Mortality risk increased significantly only for physically disabled subjects with simultaneous mild cognitive deterioration (adjusted HR 1.951, 95% CI 1.036–3.673, p = 0.038) or moderate-to-severe cognitive impairment (aHR 2.722, 95% CI 1.430–5.181, p = 0.002) after adjusting for age, BMI, education levels, smoking status, polypharmacy, visual and hearing impairment, urinary incontinence, fall history, depressive symptoms and CCI. Mortality risk was not increased among physically independent subjects with or without cognitive impairment, and physically disabled subjects with intact cognition. Conclusions Physical disability is a major risk factor for all-cause mortality among men aged 80 years and older, and risk increased synergistically when cognitive impairment was present. Cognitive impairment alone without physical disability did not increase mortality risk in this population.
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Affiliation(s)
- Wan-Chen Yu
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ming-Yueh Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
- Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- * E-mail: (CKL); (LKC)
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- * E-mail: (CKL); (LKC)
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Accelerated Brain Atrophy on Serial Computed Tomography: Potential Marker of the Progression of Alzheimer Disease. J Comput Assist Tomogr 2017; 40:827-32. [PMID: 27224227 DOI: 10.1097/rct.0000000000000435] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aim of this study was to validate computed tomography (CT)-based longitudinal markers of the progression of Alzheimer disease (AD). MATERIALS AND METHODS We retrospectively studied 33 AD patients and 39 nondemented patients with other neurological illnesses (non-AD) having 4 to 12 CT examinations of the head, with over a mean (SD) of 3.9 (1.7) years. At each time point, we applied an automatic software to measure whole brain, cerebrospinal fluid, and intracranial space volumes. Longitudinal measures were then related to disease status and time since the first scan using hierarchical models. RESULTS Absolute brain volume loss accelerated for non-AD patients by 0.86 mL/y (95% confidence interval [CI], 0.64-1.08 mL/y) and 1.5× faster, that is, 1.32 mL/y (95% CI, 1.09-1.56 mL/y) for AD patients (P = 0.006). In terms of brain volume normalized to intracranial space, the acceleration in atrophy rate for non-AD patients was 0.0578%/y (95% CI, 0.0389%/y to 0.0767%/y), again 1.5× faster, that is, 0.0919%/y (95% CI, 0.0716%/y to 0.1122%/y) for AD patients (P = 0.017). This translates to an increase in atrophy rate from 0.5% to 1.4% in AD versus to 1.1% in non-AD group after 10 years. CONCLUSIONS Brain volumetry on CT reliably detected accelerated volume loss in AD and significantly lower acceleration factor in age-matched non-AD patients, leading to the possibility of its use to monitor the progression of cognitive decline and dementia.
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Yang C, Sun X, Tao W, Li X, Zhang J, Jia J, Chen K, Zhang Z. Multistage Grading of Amnestic Mild Cognitive Impairment: The Associated Brain Gray Matter Volume and Cognitive Behavior Characterization. Front Aging Neurosci 2017; 8:332. [PMID: 28119601 PMCID: PMC5222841 DOI: 10.3389/fnagi.2016.00332] [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: 03/03/2016] [Accepted: 12/22/2016] [Indexed: 01/19/2023] Open
Abstract
Background and Purpose: It is well known that there is a wide range of different pathological stages related to Alzheimer's disease (AD) among patients with amnestic mild cognitive impairment (aMCI). Further refinement of the stages based on neuropsychological and neuroimaging methods is important for earlier disease detection, as well as for the development and evaluation of disease-modifying interventions. Materials and Methods: In this cross-sectional study, 125 aMCI patients were classified into declined progressively three stages of mild, moderate and severe, utilizing the extreme groups approach (EGA) based on their memory function. Fifty-two patients, in addition to 24 cognitively normal subjects, were included in further structural MRI analyses. Characteristics of cognitive functions and brain structures across these newly defined stages were explored through general linear models. Results: Almost all the non-memory cognitive functions showed progressive decline as memory function deteriorated. In addition, medial structures including the right hippocampus, right lingual and left fusiform gyrus, presented with greater gray matter (GM) atrophy during the later stages of aMCI (corrected p < 0.05). Correlations were found between GM volume of the lingual gyrus and processing speed (r = 0.419, p = 0.003) and between the fusiform gyrus and general cognitive function (r = 0.281, p = 0.046). Moreover, both cognitive function and GM volume presented non-linear trajectories over stages of aMCI. Conclusion: Our study characterized the cognitive profiles along with the degree of episodic memory impairment, and these three stages of aMCI showed non-linear progressive decline in cognitive functions and GM volumes.
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Affiliation(s)
- Caishui Yang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China
| | - Xuan Sun
- Department of Geriatric Neurology, Chinese PLA General Hospital Beijing, China
| | - Wuhai Tao
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China
| | - Junying Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China
| | - Jianjun Jia
- Department of Geriatric Neurology, Chinese PLA General Hospital Beijing, China
| | - Kewei Chen
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China; Banner Alzheimer's InstitutePhoenix, AZ, USA
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal UniversityBeijing, China
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40
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Wachinger C, Salat DH, Weiner M, Reuter M. Whole-brain analysis reveals increased neuroanatomical asymmetries in dementia for hippocampus and amygdala. Brain 2016; 139:3253-3266. [PMID: 27913407 DOI: 10.1093/brain/aww243] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 08/05/2016] [Accepted: 08/12/2016] [Indexed: 01/18/2023] Open
Abstract
Structural magnetic resonance imaging data are frequently analysed to reveal morphological changes of the human brain in dementia. Most contemporary imaging biomarkers are scalar values, such as the volume of a structure, and may miss the localized morphological variation of early presymptomatic disease progression. Neuroanatomical shape descriptors, however, can represent complex geometric information of individual anatomical regions and may demonstrate increased sensitivity in association studies. Yet, they remain largely unexplored. In this article, we introduce a novel technique to study shape asymmetries of neuroanatomical structures across subcortical and cortical brain regions. We demonstrate that neurodegeneration of subcortical structures in Alzheimer's disease is not symmetric. The hippocampus shows a significant increase in asymmetry longitudinally and both hippocampus and amygdala show a significantly higher asymmetry cross-sectionally concurrent with disease severity above and beyond an ageing effect. Our results further suggest that the asymmetry in these structures is undirectional and that primarily the anterior hippocampus becomes asymmetric. Based on longitudinal asymmetry measures we subsequently study the progression from mild cognitive impairment to dementia, demonstrating that shape asymmetry in hippocampus, amygdala, caudate and cortex is predictive of disease onset. The same analyses on scalar volume measurements did not produce any significant results, indicating that shape asymmetries, potentially induced by morphometric changes in subnuclei, rather than size asymmetries are associated with disease progression and can yield a powerful imaging biomarker for the early presymptomatic classification and prediction of Alzheimer's disease. Because literature has focused on contralateral volume differences, subcortical disease lateralization may have been overlooked thus far.
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Affiliation(s)
- Christian Wachinger
- 1 A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA .,2 Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,3 Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - David H Salat
- 1 A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA.,4 Department of Radiology, Harvard Medical School, Boston MA, USA
| | - Michael Weiner
- 5 University of California, San Francisco, San Francisco VA Medical Center, San Francisco CA, 94121 USA
| | - Martin Reuter
- 1 A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA .,3 Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Cambridge, MA, USA.,4 Department of Radiology, Harvard Medical School, Boston MA, USA
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Villemagne VL, Chételat G. Neuroimaging biomarkers in Alzheimer's disease and other dementias. Ageing Res Rev 2016; 30:4-16. [PMID: 26827785 DOI: 10.1016/j.arr.2016.01.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 12/16/2022]
Abstract
In vivo imaging of β-amyloid (Aβ) has transformed the assessment of Aβ pathology and its changes over time, extending our insight into Aβ deposition in the brain by providing highly accurate, reliable, and reproducible quantitative statements of regional or global Aβ burden in the brain. This knowledge is essential for therapeutic trial recruitment and for the evaluation of anti-Aβ treatments. Although cross sectional evaluation of Aβ burden does not strongly correlate with cognitive impairment, it does correlate with cognitive (especially memory) decline and with a higher risk for conversion to AD in the aging population and MCI subjects. This suggests that Aβ deposition is a protracted pathological process starting well before the onset of symptoms. Longitudinal observations, coupled with different disease-specific biomarkers to assess potential downstream effects of Aβ are required to confirm this hypothesis and further elucidate the role of Aβ deposition in the course of Alzheimer's disease.
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Affiliation(s)
- Victor L Villemagne
- Department of Molecular Imaging & Therapy, Centre for PET, Austin Health, Victoria 3084, Australia; Department of Medicine, University of Melbourne, Austin Health, Victoria 3084, Australia; The Florey Institute of Neuroscience and Mental Health, Victoria 3052, Australia; Institut National de la Santé et de la Recherche Médicale (Inserm), Unité, 1077 Caen, France.
| | - Gaël Chételat
- The Florey Institute of Neuroscience and Mental Health, Victoria 3052, Australia; Institut National de la Santé et de la Recherche Médicale (Inserm), Unité, 1077 Caen, France; Université de Caen Basse-Normandie, Unité Mixte de Recherche (UMR), S1077 Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, 14000 Caen, France; Unité 1077, Centre Hospitalier Universitaire de Caen, 14000 Caen, France
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42
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Löwe LC, Gaser C, Franke K. The Effect of the APOE Genotype on Individual BrainAGE in Normal Aging, Mild Cognitive Impairment, and Alzheimer's Disease. PLoS One 2016; 11:e0157514. [PMID: 27410431 PMCID: PMC4943637 DOI: 10.1371/journal.pone.0157514] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 05/30/2016] [Indexed: 01/28/2023] Open
Abstract
In our aging society, diseases in the elderly come more and more into focus. An important issue in research is Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD) with their causes, diagnosis, treatment, and disease prediction. We applied the Brain Age Gap Estimation (BrainAGE) method to examine the impact of the Apolipoprotein E (APOE) genotype on structural brain aging, utilizing longitudinal magnetic resonance image (MRI) data of 405 subjects from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. We tested for differences in neuroanatomical aging between carrier and non-carrier of APOE ε4 within the diagnostic groups and for longitudinal changes in individual brain aging during about three years follow-up. We further examined whether a combination of BrainAGE and APOE status could improve prediction accuracy of conversion to AD in MCI patients. The influence of the APOE status on conversion from MCI to AD was analyzed within all allelic subgroups as well as for ε4 carriers and non-carriers. The BrainAGE scores differed significantly between normal controls, stable MCI (sMCI) and progressive MCI (pMCI) as well as AD patients. Differences in BrainAGE changing rates over time were observed for APOE ε4 carrier status as well as in the pMCI and AD groups. At baseline and during follow-up, BrainAGE scores correlated significantly with neuropsychological test scores in APOE ε4 carriers and non-carriers, especially in pMCI and AD patients. Prediction of conversion was most accurate using the BrainAGE score as compared to neuropsychological test scores, even when the patient’s APOE status was unknown. For assessing the individual risk of coming down with AD as well as predicting conversion from MCI to AD, the BrainAGE method proves to be a useful and accurate tool even if the information of the patient’s APOE status is missing.
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Affiliation(s)
| | - Christian Gaser
- Structural Brain Mapping Group, Department of Neurology, University Hospital Jena, Jena, Germany
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - Katja Franke
- Structural Brain Mapping Group, Department of Neurology, University Hospital Jena, Jena, Germany
- * E-mail:
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43
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Kincses ZT, Király A, Veréb D, Vécsei L. Structural Magnetic Resonance Imaging Markers of Alzheimer's Disease and Its Retranslation to Rodent Models. J Alzheimers Dis 2016; 47:277-90. [PMID: 26401552 DOI: 10.3233/jad-143195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The importance of imaging biomarkers has been acknowledged in the diagnosis and in the follow-up of Alzheimer's disease (AD), one of the major causes of dementia. Next to the molecular biomarkers and PET imaging investigations, structural MRI approaches provide important information about the disease progression and about the pathomechanism. Furthermore,a growing body of literature retranslates these imaging biomarkers to various rodent models of the disease. The goal of this review is to provide an overview of the macro- and microstructural imaging biomarkers of AD, concentrating on atrophy measures and diffusion MRI alterations. A survey is also given of the imaging approaches used in rodent models of dementias that can promote drug development.
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Affiliation(s)
- Zsigmond Tamas Kincses
- Department of Neurology, University of Szeged, Szeged, Hungary.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - András Király
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - Dániel Veréb
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, University of Szeged, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
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44
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Rapid eye movement sleep disruption and sleep fragmentation are associated with increased orexin-A cerebrospinal-fluid levels in mild cognitive impairment due to Alzheimer's disease. Neurobiol Aging 2016; 40:120-126. [DOI: 10.1016/j.neurobiolaging.2016.01.007] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 01/11/2016] [Accepted: 01/13/2016] [Indexed: 01/30/2023]
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45
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Serra L, Cercignani M, Mastropasqua C, Torso M, Spanò B, Makovac E, Viola V, Giulietti G, Marra C, Caltagirone C, Bozzali M. Longitudinal Changes in Functional Brain Connectivity Predicts Conversion to Alzheimer’s Disease. J Alzheimers Dis 2016; 51:377-89. [DOI: 10.3233/jad-150961] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Laura Serra
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Mara Cercignani
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
- Brighton & Sussex Medical School, CISC, University of Sussex, Brighton, Falmer East Sussex, UK
| | | | - Mario Torso
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Barbara Spanò
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Elena Makovac
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Vanda Viola
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Camillo Marra
- Institute of Neurology, Catholic University, Rome, Italy
| | - Carlo Caltagirone
- Department of Neuroscience, University of Rome ‘Tor Vergata’, Rome, Italy
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Marco Bozzali
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
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46
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Bonifacio G, Zamboni G. Brain imaging in dementia. Postgrad Med J 2016; 92:333-40. [PMID: 26933232 DOI: 10.1136/postgradmedj-2015-133759] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 02/04/2016] [Indexed: 12/16/2022]
Abstract
The introduction of MRI and positron emission tomography (PET) brain imaging has contributed significantly to the understanding of different dementia syndromes. Over the past 20 years these imaging techniques have been increasingly used for clinical characterisation and differential diagnosis, and to provide insight into the effects on functional capacity of the brain, patterns of spatial distribution of different dementia syndromes and their natural history and evolution over time. Brain imaging is also increasingly used in clinical trials, as part of inclusion criteria and/or as a surrogate outcome measure. Here we review all the relatively specific findings that can be identified with different MRI and PET techniques in each of the most frequent dementing disorders.
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Affiliation(s)
- Guendalina Bonifacio
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Giovanna Zamboni
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Italy
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47
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Andrews KA, Frost C, Modat M, Cardoso MJ, Rowe CC, Villemagne V, Fox NC, Ourselin S, Schott JM, Rowe CC, Villemagne V, Fox NC, Ourselin S, Schott JM. Acceleration of hippocampal atrophy rates in asymptomatic amyloidosis. Neurobiol Aging 2016; 39:99-107. [PMID: 26923406 DOI: 10.1016/j.neurobiolaging.2015.10.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 09/09/2015] [Accepted: 10/14/2015] [Indexed: 11/24/2022]
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Novak G, Fox N, Clegg S, Nielsen C, Einstein S, Lu Y, Tudor IC, Gregg K, Di J, Collins P, Wyman BT, Yuen E, Grundman M, Brashear HR, Liu E. Changes in Brain Volume with Bapineuzumab in Mild to Moderate Alzheimer’s Disease. J Alzheimers Dis 2015; 49:1123-34. [DOI: 10.3233/jad-150448] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Gerald Novak
- Janssen Research and Development, Titusville, NJ, USA
| | - Nick Fox
- Dementia Research Centre, University College London Institute of Neurology, London, UK
| | - Shona Clegg
- Dementia Research Centre, University College London Institute of Neurology, London, UK
| | - Casper Nielsen
- Dementia Research Centre, University College London Institute of Neurology, London, UK
| | | | - Yuan Lu
- Jazz Pharmaceuticals, Palo Alto, CA, USA
| | | | - Keith Gregg
- Janssen Alzheimer Immunotherapy, South San Francisco, CA, USA
| | - Jianing Di
- Janssen Research and Development, San Diego, CA, USA
| | | | | | - Eric Yuen
- Janssen Alzheimer Immunotherapy, South San Francisco, CA, USA
| | | | | | - Enchi Liu
- Janssen Research and Development, San Diego, CA, USA
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49
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Tellechea P, Pujol N, Esteve-Belloch P, Echeveste B, García-Eulate MR, Arbizu J, Riverol M. Early- and late-onset Alzheimer disease: Are they the same entity? Neurologia 2015; 33:244-253. [PMID: 26546285 DOI: 10.1016/j.nrl.2015.08.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/06/2015] [Accepted: 08/14/2015] [Indexed: 11/29/2022] Open
Abstract
Early-onset Alzheimer disease (EOAD), which presents in patients younger than 65 years, has frequently been described as having different features from those of late-onset Alzheimer disease (LOAD). This review analyses the most recent studies comparing the clinical presentation and neuropsychological, neuropathological, genetic, and neuroimaging findings of both types in order to determine whether EOAD and LOAD are different entities or distinct forms of the same entity. We observed consistent differences between clinical findings in EOAD and in LOAD. Fundamentally, the onset of EOAD is more likely to be marked by atypical symptoms, and cognitive assessments point to poorer executive and visuospatial functioning and praxis with less marked memory impairment. Alzheimer-type features will be more dense and widespread in neuropathology studies, with structural and functional neuroimaging showing greater and more diffuse atrophy extending to neocortical areas (especially the precuneus). In conclusion, available evidence suggests that EOAD and LOAD are 2 different forms of a single entity. LOAD is likely to be influenced by ageing-related processes.
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Affiliation(s)
- P Tellechea
- Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - N Pujol
- Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - P Esteve-Belloch
- Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - B Echeveste
- Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - M R García-Eulate
- Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - J Arbizu
- Departamento de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - M Riverol
- Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
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50
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Tobin WO, Popescu BF, Lowe V, Pirko I, Parisi JE, Kantarci K, Fields JA, Bruns MB, Boeve BF, Lucchinetti CF. Multiple sclerosis masquerading as Alzheimer-type dementia: Clinical, radiological and pathological findings. Mult Scler 2015; 22:698-704. [PMID: 26447065 DOI: 10.1177/1352458515604382] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/22/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES We report a comprehensive clinical, radiological, neuropsychometric and pathological evaluation of a woman with a clinical diagnosis of AD dementia (ADem), but whose autopsy demonstrated widespread demyelination, without Alzheimer disease (AD) pathology. METHODS AND RESULTS Initial neuropsychometric evaluation suggested amnestic mild cognitive impairment (aMCI). Serial magnetic resonance images (MRI) images demonstrated the rate of increase in her ventricular volume was comparable to that of 46 subjects with aMCI who progressed to ADem, without accumulating white matter disease. Myelin immunohistochemistry at autopsy demonstrated extensive cortical subpial demyelination. Subpial lesions involved the upper cortical layers, and often extended through the entire width of the cortex. CONCLUSIONS Multiple sclerosis (MS) can cause severe cortical dysfunction and mimic ADem. Cortical demyelination is not well detected by standard imaging modalities and may not be detected on autopsy without myelin immunohistochemistry.
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Affiliation(s)
- W O Tobin
- Division of Neurology, Mayo Clinic, USA
| | - B F Popescu
- Department Anatomy and Cell Biology, University of Saskatchewan, Canada
| | - V Lowe
- Division of Radiology, Mayo Clinic, USA
| | - I Pirko
- Division of Neurology, Mayo Clinic, USA
| | - J E Parisi
- Division of Anatomical Pathology, Mayo Clinic, USA
| | | | - J A Fields
- Division of Psychology, Mayo Clinic, USA
| | - M B Bruns
- Division of Neurology, Mayo Clinic, USA
| | - B F Boeve
- Division of Neurology, Mayo Clinic, USA
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