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Hanycz SA, Noorani A, Hung PSP, Walker MR, Zhang AB, Latypov TH, Hodaie M. Hippocampus diffusivity abnormalities in classical trigeminal neuralgia. Pain Rep 2024; 9:e1159. [PMID: 38655236 PMCID: PMC11037743 DOI: 10.1097/pr9.0000000000001159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 02/16/2024] [Accepted: 02/24/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Patients with chronic pain frequently report cognitive symptoms that affect memory and attention, which are functions attributed to the hippocampus. Trigeminal neuralgia (TN) is a chronic neuropathic pain disorder characterized by paroxysmal attacks of unilateral orofacial pain. Given the stereotypical nature of TN pain and lack of negative symptoms including sensory loss, TN provides a unique model to investigate the hippocampal implications of chronic pain. Recent evidence demonstrated that TN is associated with macrostructural hippocampal abnormalities indicated by reduced subfield volumes; however, there is a paucity in our understanding of hippocampal microstructural abnormalities associated with TN. Objectives To explore diffusivity metrics within the hippocampus, along with its functional and structural subfields, in patients with TN. Methods To examine hippocampal microstructure, we utilized diffusion tensor imaging in 31 patients with TN and 21 controls. T1-weighted magnetic resonance images were segmented into hippocampal subfields and registered into diffusion-weighted imaging space. Fractional anisotropy (FA) and mean diffusivity were extracted for hippocampal subfields and longitudinal axis segmentations. Results Patients with TN demonstrated reduced FA in bilateral whole hippocampi and hippocampal body and contralateral subregions CA2/3 and CA4, indicating microstructural hippocampal abnormalities. Notably, patients with TN showed significant correlation between age and hippocampal FA, while controls did not exhibit this correlation. These effects were driven chiefly by female patients with TN. Conclusion This study demonstrates that TN is associated with microstructural hippocampal abnormalities, which may precede and potentially be temporally linked to volumetric hippocampal alterations demonstrated previously. These findings provide further evidence for the role of the hippocampus in chronic pain and suggest the potential for targeted interventions to mitigate cognitive symptoms in patients with chronic pain.
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Affiliation(s)
- Shaun Andrew Hanycz
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Brain, Imaging, and Behaviour—Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alborz Noorani
- Division of Brain, Imaging, and Behaviour—Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Shih-Ping Hung
- Division of Brain, Imaging, and Behaviour—Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Matthew R. Walker
- Division of Brain, Imaging, and Behaviour—Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Ashley B. Zhang
- MD Program, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Timur H. Latypov
- Division of Brain, Imaging, and Behaviour—Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mojgan Hodaie
- Division of Brain, Imaging, and Behaviour—Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Neurosurgery, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
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Adams MS, Mensink RP, Plat J, Joris PJ. Long-term effects of an egg-protein hydrolysate on cognitive performance and brain vascular function: a double-blind randomized controlled trial in adults with elevated subjective cognitive failures. Eur J Nutr 2024:10.1007/s00394-024-03394-y. [PMID: 38703228 DOI: 10.1007/s00394-024-03394-y] [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: 02/07/2024] [Accepted: 04/16/2024] [Indexed: 05/06/2024]
Abstract
PURPOSE Short-term intake of the egg-protein hydrolysate Newtricious (NWT)-03 improved executive function, but underlying mechanisms and long-term effects, including other cognitive domains, are unknown. METHODS A 36-week randomized controlled trial involving 44 overweight/obese individuals experiencing elevated Subjective Cognitive Failures (SCF; aged 60-75 years) assessed the impact of daily consumption of 5.7 g of NWT-03 or placebo powders on cognitive performance (psychomotor speed, executive function, memory) and Cerebral Blood Flow (CBF), a marker of brain vascular function. Cognitive performance was evaluated using a neurophysiological test battery (CANTAB) and CBF was measured using magnetic resonance imaging perfusion method Arterial Spin Labeling (ASL). Serum samples were collected to determine brain-derived neurotrophic factor (BDNF) concentrations. RESULTS Anthropometrics, and energy and nutrient intakes remained stable throughout the trial. NWT-03 was well tolerated, and compliance was excellent (median: 99%; range: 87-103%). No overall intervention effects were observed on cognitive performance or CBF, but post-hoc analyses revealed significant improvements on executive function in women, but not men. Specifically, a reduction of 74 ms in reaction latency on the multitasking task (95% CI: -134 to -15; p = 0.02), a reduction of 9 between errors (95%CI: -14 to -3; p < 0.001), and a reduction of 9 total errors (95%CI: -15 to -3; p < 0.001) on the spatial working memory task were found in women. No intervention effects were observed on serum BDNF concentrations (p = 0.31). CONCLUSION Long-term consumption of NWT-03 improved multitasking abilities and working memory in women with elevated SCF. Brain vascular function remained unaffected. Sex differences in executive function require additional clarification.
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Affiliation(s)
- Micah S Adams
- Department of Nutrition and Movement Sciences, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Ronald P Mensink
- Department of Nutrition and Movement Sciences, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Jogchum Plat
- Department of Nutrition and Movement Sciences, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Peter J Joris
- Department of Nutrition and Movement Sciences, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Universiteitssingel 50, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
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Smith L, López Sánchez GF, Shin JI, Kostev K, Underwood BR, Oh H, Soysal P, Veronese N, Schuch F, Tully MA, Koyanagi A. Food insecurity and subjective cognitive complaints among adults aged ≥ 65 years from low- and middle-income countries. Eur J Nutr 2023; 62:3217-3226. [PMID: 37550594 PMCID: PMC10611875 DOI: 10.1007/s00394-023-03226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/27/2023] [Indexed: 08/09/2023]
Abstract
PURPOSE To date, no study has investigated the association between food insecurity and subjective cognitive complaints (SCC). Thus, the aims of the present study were to examine this association among older adults in low- and middle-income countries (LMICs), and to identify the potential mediators in this association, given the importance of SCC in dementia risk among older people, and the projected particularly large increase in dementia in this setting. METHODS Cross-sectional, community-based, nationally representative data from the World Health Organization (WHO) Study on global AGEing and Adult Health (SAGE) collected between 2007 and 2010 were analyzed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable linear regression and mediation (Karlson-Holm-Breen method) analyses were conducted to assess associations. RESULTS Data on 14,585 individuals aged ≥ 65 years [mean (SD) age 72.6 (11.5) years; 55.0% females] were analyzed. Severe food insecurity (vs. no food insecurity) was associated with 9.16 (95% CI = 6.95-11.37) points higher mean SCC score. Sleep/energy (mediated% 37.9%; P < 0.001), perceived stress (37.2%; P = 0.001), and depression (13.7%; P = 0.008) partially explained the association between severe food insecurity and SCC. CONCLUSION Food insecurity was associated with SCC among older adults in LMICs. Future studies should assess whether addressing food insecurity among older adults in LMICs can improve cognitive health.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
- Severance Underwood Meta-research Center, Institute of Convergence Science, Yonsei University, Seoul, South Korea
| | | | - Benjamin R Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireland, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
- ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
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Pozzato I, Arora M, McBain C, Wijesuriya N, Tran Y, Middleton JW, Craig AR. Cognitive Failure in Adults with Spinal Cord Injury: A Valuable Adjunct Measure for Enhancing Cognitive Assessment and Rehabilitation Outcomes. Neurol Int 2023; 15:1371-1382. [PMID: 37987460 PMCID: PMC10660745 DOI: 10.3390/neurolint15040087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/28/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
Cognitive impairment is common in persons with spinal cord injury (SCI), impacting their daily functioning and rehabilitation. This study assesses the extent of self-reported cognitive failures in everyday life in persons with SCI and its relationships with objective neurocognitive measures and psychosocial factors, including depressive mood, anxiety, perceived control, and fatigue. The differences between forty-one adults with a chronic SCI and forty-one able-bodied controls were examined. The participants completed the Cognitive Failures Questionnaire (CFQ) to assess cognitive failure and neurocognitive tests assessing attention and executive functions, as well as a psychosocial assessment. The SCI group reported higher cognitive failure rates than the able-bodied group (31.7% versus 19%, p > 0.05). Objective neurocognitive tests did not significantly correlate with the CFQ scores in either group. However, the CFQ scores were positively associated with most psychosocial factors, even after controlling for covariates. The CFQ scores were significantly associated with depressive mood in persons with SCI. These findings highlight the importance of incorporating self-reported cognitive measures into neurocognitive assessments and rehabilitation planning for adults with SCI. Self-reports capture everyday cognitive challenges that objective tests may miss. Additionally, this study highlights the strong connections between cognitive failures and psychosocial issues, particularly mood disorders, emphasizing the need for comprehensive rehabilitation and psychosocial support post-SCI, addressing both cognitive and emotional wellbeing.
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Affiliation(s)
- Ilaria Pozzato
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia (J.W.M.); (A.R.C.)
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Mohit Arora
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia (J.W.M.); (A.R.C.)
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Candice McBain
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia (J.W.M.); (A.R.C.)
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | | | - Yvonne Tran
- Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW 2109, Australia;
| | - James W. Middleton
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia (J.W.M.); (A.R.C.)
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
| | - Ashley R. Craig
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia (J.W.M.); (A.R.C.)
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2065, Australia
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Rivas-Fernández MÁ, Lindín M, Zurrón M, Díaz F, Lojo-Seoane C, Pereiro AX, Galdo-Álvarez S. Neuroanatomical and neurocognitive changes associated with subjective cognitive decline. Front Med (Lausanne) 2023; 10:1094799. [PMID: 36817776 PMCID: PMC9932036 DOI: 10.3389/fmed.2023.1094799] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Subjective Cognitive Decline (SCD) can progress to mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia and thus may represent a preclinical stage of the AD continuum. However, evidence about structural changes observed in the brain during SCD remains inconsistent. Materials and methods This cross-sectional study aimed to evaluate, in subjects recruited from the CompAS project, neurocognitive and neurostructural differences between a group of forty-nine control subjects and forty-nine individuals who met the diagnostic criteria for SCD and exhibited high levels of subjective cognitive complaints (SCCs). Structural magnetic resonance imaging was used to compare neuroanatomical differences in brain volume and cortical thickness between both groups. Results Relative to the control group, the SCD group displayed structural changes involving frontal, parietal, and medial temporal lobe regions of critical importance in AD etiology and functionally related to several cognitive domains, including executive control, attention, memory, and language. Conclusion Despite the absence of clinical deficits, SCD may constitute a preclinical entity with a similar (although subtle) pattern of neuroanatomical changes to that observed in individuals with amnestic MCI or AD dementia.
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Affiliation(s)
- Miguel Ángel Rivas-Fernández
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain,Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Mónica Lindín
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain,Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Montserrat Zurrón
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain,Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Fernando Díaz
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain,Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Cristina Lojo-Seoane
- Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,Department of Developmental and Educational Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Arturo X. Pereiro
- Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,Department of Developmental and Educational Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Santiago Galdo-Álvarez
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain,Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,*Correspondence: Santiago Galdo-Álvarez,
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Smith L, Shin JI, Song TJ, Underwood BR, Jacob L, López Sánchez GF, Schuch F, Oh H, Veronese N, Soysal P, Butler L, Barnett Y, Koyanagi A. Association between depression and subjective cognitive complaints in 47 low- and middle-income countries. J Psychiatr Res 2022; 154:28-34. [PMID: 35926423 DOI: 10.1016/j.jpsychires.2022.07.021] [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: 02/12/2022] [Revised: 06/13/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
Abstract
People with depression and subjective cognitive complaints (SCC) may be at particularly high risk for developing dementia. However, to date, studies on depression and SCC are limited mainly to single high-income countries. Thus, the aim of the present study was to investigate the association between depression and SCC in adults from low- and middle-income countries (LMICs). Cross-sectional, community-based data were analyzed from the World Health Survey. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). ICD-10 Diagnostic Criteria for Research was used for the diagnosis of subsyndromal depression, brief depressive episode, and depressive episode. Multivariable linear regression was conducted to explore the associations. Data on 237,952 individuals aged ≥18 years [mean (SD) age 38.4 (16.0) years; females 50.8%] were analyzed. After adjustment for potential confounders (age, sex, education, anxiety), compared to no depressive disorder, subsyndromal depression (b-coefficient 7.91; 95%CI = 5.63-10.18), brief depressive episode (b-coefficient 10.37; 95%CI = 8.95-11.78), and depressive episode (b-coefficient 13.57; 95%CI = 12.33-14.81) were significantly associated with higher mean SCC scores. The association was similar in all age groups (i.e., 18-44, 45-64, and ≥65 years), and both males and females. All depression types assessed were associated with worse SCC among adults in 47 LMICs. Future longitudinal studies are needed to investigate whether older people with depression and SCC are at higher risk for dementia onset in LMICs.
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Affiliation(s)
- Lee Smith
- Cambridge, Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, 03372, South Korea
| | - Tae-Jin Song
- Department of Neurology, Ewha Womans University, South Korea
| | - Benjamin R Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust, The Gnodde Goldman Sachs Translational Neuroscience Unit, University of Cambridge, Cambridge, UK
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78000, Versailles, France
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, 90007, USA
| | - Nicola Veronese
- Department of Internal Medicine and Geriatrics, University of Palermo, 90133, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Bezmialem Vakif University, 34093, Istanbul, Turkey
| | - Laurie Butler
- Cambridge, Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Cambridge, Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Barcelona, Spain; ICREA, Pg, Lluis Companys 23, 08010, Barcelona, Spain
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Huang W, Zhu W, Chen H, Li F, Huang J, Zhou Y, Sun X, Lan Y. Longitudinal association between depressive symptoms and cognitive decline among middle-aged and elderly population. J Affect Disord 2022; 303:18-23. [PMID: 35108603 DOI: 10.1016/j.jad.2022.01.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 12/24/2021] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Depression is considered a risk factor for cognitive decline. The long-term impact of depressive symptoms on cognitive performance has not been established thus far. OBJECTIVES This study aimed to determine the longitudinal associations between depressive symptoms and cognitive performance among middle-aged and elderly population. METHODS We included 10,387 adults aged ≥45 years from the Health and Retirement Study (2004 to 2014) in this study. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CESD) scale. Participant's cognitive function was assessed via the telephone interview for cognitive status (TICS); the total cognitive score ranged from 0 to 35. We classified the participants into four clusters according to the quartile of the total cognitive score (TCS). We examined the change of depressive symptoms and cognitive performance by using the unconditional latent growth curve modeling (LGCM) method, and a parallel LGCM method was used to examine the longitudinal associations between depressive symptoms and cognitive performance among middle-aged and elderly adults in each cluster. RESULTS Participants with lower levels of cognitive performance were associated with a greater risk of high depressive symptoms. Results from unconditional LGCM showed a sustained decline in cognitive performance and an increasing trend in depressive symptoms per 2 years for each cluster of participants. The parallel LGCM indicated that baseline levels of depression showed a significant negative correlation with the cognitive performance at baseline (β [95% CI] of intercept(Dep) predicting intercept(TCS) were -0.33 [-0.41, -0.26], -0.03[-0.06, -0.00], -0.05 [-0.07, -0.02] and -0.64 [-0.70,-0.58], for clusters of Q1 to Q3 and the entire population, respectively). Further, a significant positive prospective association was observed between baseline levels of depression and changes in cognitive performance (intercept(Dep) predicting slope(TCS) were -0.05 [-0.08, -0.02], -0.09[-0.13, -0.05], -0.12 [-0.15, -0.08], -0.11 [-0.15, -0.06] and -0.04 [-0.06,-0.02] for clusters of Q1 to Q4 and the entire population, respectively). Moreover, for participants with the highest quartile of TCS, the rising trend of depressive symptoms accelerated the decline of cognitive performance during the follow-up period (Slope(Dep) predicting Slope(TCS): -0.44 [-0.86, -0.01]). CONCLUSION Our results suggest that depressive symptoms were associated with lower cognitive performance and larger subsequent decline during follow-up period. Adults with depression may require more medical attention, and early intervention is required to delay the development of cognitive impairment and dementia.
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Affiliation(s)
- Wentao Huang
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China.
| | - Wenjing Zhu
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Hongyan Chen
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Feng Li
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Jingxin Huang
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Ye Zhou
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Xibin Sun
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Yutao Lan
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China.
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Examining the Role of Aging Perceptions in Subjective Cognitive Decline. Alzheimer Dis Assoc Disord 2022; 36:288-294. [PMID: 35867952 PMCID: PMC9712147 DOI: 10.1097/wad.0000000000000518] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/18/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE While subjective cognitive decline (SCD) is gaining ground as a "preclinical" risk state for Alzheimer disease, its utility depends on our understanding of the factors linked to SCD. Rarely examined sociocultural factors including perceptions of aging may relate to the subjective experience of cognitive aging. Identifying such associations will help to refine the utility of SCD as an early marker of AD while setting the stage for addressing modifiable factors contributing to SCD. METHODS The study consisted of N=136 participants (68% female; 73% White; 22% Black race, age mean =74.72; education mean =16.01). Questionnaires assessed SCD, depressive symptoms, and age perceptions (essentialist aging beliefs, subjective age, age group identification, and explicit/implicit age stereotypes). Cognitive functioning was measured with a semantic interference and learning task. RESULTS SCD was correlated with essentialist aging beliefs, age identification, and depressive symptoms [ rrange =0.18 to 0.22, Prange =0.009 to 0.02, confidence interval (CI) range =0.00-0.39]. Essentialist aging beliefs were correlated with subjective age and age group identification ( rrange =0.22 to 0.42, Prange <0.001 to 0.003, CI range =0.08-0.57). Both age group identification and essentialism were correlated with depressive symptoms ( rrange =0.22, Prange =0.009 to 0.01, CI range =0.04-0.39). In the adjusted regression model including depressive symptoms, age perceptions, and SCD, only SCD was associated with cognition ( b =-0.31, P <0.001). CONCLUSION Although correlated with SCD, perceptions of aging do not explain the relationship between SCD and performance on a sensitive cognitive test among older adults.
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Poptsi E, Moraitou D, Tsardoulias E, Symeonidisd AL, Tsolaki M. Is the Discrimination of Subjective Cognitive Decline from Cognitively Healthy Adulthood and Mild Cognitive Impairment Possible? A Pilot Study Utilizing the R4Alz Battery. J Alzheimers Dis 2021; 77:715-732. [PMID: 32741834 DOI: 10.3233/jad-200562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The early diagnosis of neurocognitive disorders before the symptoms' onset is the ultimate goal of the scientific community. REMEDES for Alzheimer (R4Alz) is a battery, designed for assessing cognitive control abilities in people with minor and major neurocognitive disorders. OBJECTIVE To investigate whether the R4Alz battery's tasks differentiate subjective cognitive decline (SCD) from cognitively healthy adults (CHA) and mild cognitive impairment (MCI). METHODS The R4Alz battery was administered to 175 Greek adults, categorized in five groups a) healthy young adults (HYA; n = 42), b) healthy middle-aged adults (HMaA; n = 33), c) healthy older adults (HOA; n = 14), d) community-dwelling older adults with SCD (n = 34), and e) people with MCI (n = 52). RESULTS Between the seven R4Alz subtasks, four showcased the best results for differentiating HOA from SCD: the working memory updating (WMCUT-S3), the inhibition and switching subtask (ICT/RST-S1&S2), the failure sets (FS) of the ICT/RST-S1&S2, and the cognitive flexibility subtask (ICT/RST-S3). The total score of the four R4Alz subtasks (R4AlzTot4) leads to an excellent discrimination among SCD and healthy adulthood, and to fare discrimination among SCD and MCI. CONCLUSION The R4Alz battery is a novel approach regarding the neuropsychological assessment of people with SCD, since it can very well assist toward discriminating SCD from HOA. The R4Alz is able to measure decline of specific cognitive control abilities - namely of working memory updating, and complex executive functions - which seem to be the neuropsychological substrate of cognitive complaints in community dwelling adults of advancing age.
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Affiliation(s)
- Eleni Poptsi
- Laboratory of Psychology, Section of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), Macedonia, Hellas.,Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (LND, CIRI - AUTh) Macedonia, Hellas.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Macedonia, Hellas
| | - Despina Moraitou
- Laboratory of Psychology, Section of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), Macedonia, Hellas.,Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (LND, CIRI - AUTh) Macedonia, Hellas.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Macedonia, Hellas
| | - Emmanouil Tsardoulias
- School of Electrical and Computer Engineering, Faculty of Engineering, Aristotle University of Thessaloniki (AUTh), Macedonia, Hellas
| | - Andreas L Symeonidisd
- School of Electrical and Computer Engineering, Faculty of Engineering, Aristotle University of Thessaloniki (AUTh), Macedonia, Hellas
| | - Magda Tsolaki
- Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (LND, CIRI - AUTh) Macedonia, Hellas.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Macedonia, Hellas.,1st Department of Neurology, School of Medicine, Aristotle University of Thessaloniki (AUTh), Macedonia, Hellas
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10
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Jeong HT, Youn YC, Sung HH, Kim SY. Power Spectral Changes of Quantitative EEG in the Subjective Cognitive Decline: Comparison of Community Normal Control Groups. Neuropsychiatr Dis Treat 2021; 17:2783-2790. [PMID: 34465994 PMCID: PMC8403030 DOI: 10.2147/ndt.s320130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/06/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of this study is to compare and analyze the power spectral changes between subjective cognitive decline (SCD) subjects and normal controls (NC) while checking the preclinical stage of AD in the SCD subjects and to use the derived data for biomarker research that can diagnose early-stage AD in the future. METHODS We recruited 23 SCD patients and 23 normal control subjects and QEEG analysis including power spectral density (PSD) and source-level analysis were performed. An automated preprocessing procedure and statistical analysis were performed by iSync Brain® (iMediSync Inc., Republic of Korea) (https://isyncbrain.com/) using the international standard 10-20 system (19 electrodes). RESULTS Absolute PSD, there was no statistically significant difference in all of the EEG power measurements of the 19 channels. In the relative PSD analysis, the average delta band power of the SCD group was significantly higher in Fp2, F4, and F8 than NC. Alpha1 band power of the O1 channel was 22.56±16.05 for the SCD group and 33.19±19.05 for the NC (p-value <0.05). Source-level analysis did not show a statistically significant difference. CONCLUSION SCD subjects showed a partial increase of delta waves in the frontal lobe region and a partial decrease in alpha1, a fast wave in the occipital region, compared to the NC. SCD is considered one of the earliest clinical symptoms of AD and it is predicted to be related to minor nerve damage. We were able to observe the power spectral changes in SCD subjects in this cross-sectional study, a large number of subjects and longitudinal studies are needed to evaluate their predictability for future deterioration such as conversion to MCI.
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Affiliation(s)
- Ho Tae Jeong
- Department of Neurology, Chung-Ang University of College of Medicine, Seoul, Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University of College of Medicine, Seoul, Korea
| | - Hyun-Ho Sung
- Department of Clinical Laboratory Science, Dongnam Health University, Suwon, Korea
| | - Sang Yun Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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11
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Structural imaging outcomes in subjective cognitive decline: Community vs. clinical-based samples. Exp Gerontol 2020; 145:111216. [PMID: 33340685 DOI: 10.1016/j.exger.2020.111216] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 11/13/2020] [Accepted: 12/05/2020] [Indexed: 11/21/2022]
Abstract
Subjective cognitive decline (SCD) has been proposed as a preclinical stage of Alzheimer's disease (AD). Neuroimaging studies have suggested early AD-like structural brain alterations in SCD subjects compared to healthy controls. However, there is substantial heterogeneity in the results, which might depend on whether SCD samples were drawn from the community or from memory clinics. Here we reviewed brain atrophy, assessed through structural magnetic resonance imaging, separately for SCD-community and clinic-based samples. SCD-community samples show a more consistent pattern of atrophy, involving the hippocampus and temporal and parietal cortices. Similarly, in SCD-clinic samples the temporo-parietal cortex showed early vulnerability, however these studies reported a more heterogeneous atrophy pattern. Overall, these studies suggest both commonalities and differences in brain atrophy patterns between SCD clinical and community samples. In SCD-community, the temporal cortex is involved, while SCD-clinical exhibited a more complex pattern of atrophy, which may be related to a more heterogeneous sample reporting neuropsychiatric symptoms along with preclinical AD.
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12
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Wang Y, Yang Y, Wang T, Nie S, Yin H, Liu J. Correlation between White Matter Hyperintensities Related Gray Matter Volume and Cognition in Cerebral Small Vessel Disease. J Stroke Cerebrovasc Dis 2020; 29:105275. [DOI: 10.1016/j.jstrokecerebrovasdis.2020.105275] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/22/2020] [Indexed: 12/14/2022] Open
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13
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Subtle executive deficits are associated with higher brain amyloid burden and lower cortical volume in subjective cognitive decline: the FACEHBI cohort. Sci Rep 2020; 10:17721. [PMID: 33082443 PMCID: PMC7576802 DOI: 10.1038/s41598-020-74704-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 09/17/2020] [Indexed: 11/24/2022] Open
Abstract
To determine whether lower performance on executive function tests in subjective cognitive decline (SCD) individuals are associated with higher levels of brain amyloid beta (Aβ) deposition and regional volumetric reduction in areas of interest for Alzheimer’s disease (AD). 195 individuals with SCD from the FACEHBI study were assessed with a neuropsychological battery that included the following nine executive function tests: Trail Making Test A and B (TMTA, TMTB), the Rule Shift Cards subtest of BADS, the Automatic Inhibition subtest of the Syndrom Kurz Test (AI-SKT), Digit Span Backwards and Similarities from WAIS-III, and the letter, semantic, and verb fluency tests. All subjects underwent an 18F-Florbetaben positron emission tomography (FBB-PET) scan to measure global standard uptake value ratio (SUVR), and a magnetic resonance imaging (MRI). A multiple regression analysis, adjusted for age, was carried out to explore the association between global SUVR and performance on executive tests. Then, on those tests significantly associated with amyloid burden, a voxel-based morphometry (VBM) analysis was carried out to explore their correlates with grey matter volume. Multiple regression analysis revealed a statistically significant association between Aβ deposition and performance on one of the executive tests (the AI-SKT). Moreover, VBM analysis showed worse AI-SKT scores were related to lower volume in bilateral hippocampus and left inferior frontal regions. In conclusion, in SCD individuals, worse automatic inhibition ability has been found related to higher cerebral Aβ deposition and lower volume in the hippocampus and frontal regions. Thus, our results may contribute to the early detection of AD in individuals with SCD.
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14
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Rabin LA, Wang C, Mogle JA, Lipton RB, Derby CA, Katz MJ. An approach to classifying subjective cognitive decline in community-dwelling elders. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12103. [PMID: 33015309 PMCID: PMC7521594 DOI: 10.1002/dad2.12103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/06/2020] [Accepted: 08/12/2020] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Subjective cognitive decline (SCD) may be an early symptomatic manifestation of Alzheimer's disease, though published research largely neglects how to classify SCD in community-based studies. METHODS In neuropsychologically intact Einstein Aging Study participants (n = 1115; mean age = 78; 63% female; 30% non-White), we used Cox models to examine the association between self-perceived cognitive functioning at baseline (using three different approaches) and incident amnestic mild cognitive impairment (aMCI) with covariates of age, sex, education, race/ethnicity, general (objective) cognition, depressive symptoms, and four other SCD-related features. RESULTS After a median of 3 years, 198 participants developed aMCI. In models that included all the variables, self-perceived cognitive functioning was consistently associated with incident aMCI as were age, general cognition, and perceived control; apolipoprotein E (APOE) ε4 allele status was significant in one model. We set cut points that optimized the diagnostic accuracy of SCD at various time frames. DISCUSSION We provide an approach to SCD classification and discuss implications for cognitive aging studies.
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Affiliation(s)
- Laura A. Rabin
- Department of PsychologyBrooklyn CollegeCity University of New York (CUNY)BrooklynNew YorkUSA
- Department of PsychologyGraduate CenterCity University of New York (CUNY)New YorkNew YorkUSA
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Cuiling Wang
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Jacqueline A. Mogle
- Edna Bennett Pierce Prevention Research CenterThe Pennsylvania State University, University ParkPennsylvaniaUSA
| | - Richard B. Lipton
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Psychiatry and Behavioral MedicineAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Carol A. Derby
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Mindy J. Katz
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
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15
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Si T, Xing G, Han Y. Subjective Cognitive Decline and Related Cognitive Deficits. Front Neurol 2020; 11:247. [PMID: 32508729 PMCID: PMC7248257 DOI: 10.3389/fneur.2020.00247] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 03/13/2020] [Indexed: 12/21/2022] Open
Abstract
Since late stage dementia, including Alzheimer's disease (AD), cannot be reversed by any available drugs, there is increasing research interest in the preclinical stage of AD, i.e., subjective cognitive decline (SCD). SCD is characterized by self-perceptive cognitive decline but is difficult to detect using objective tests. At SCD stage, the cognitive deficits can be more easily reversed compared to that of mild cognitive impairment (MCI) and AD only if accurate diagnosis of SCD and early intervention can be developed. In this paper, we review the recent progress of SCD research including current assessment tools, biomarkers, neuroimaging, intervention and expected prognosis, and the potential relevance to traumatic brain injury (TBI)-induced cognitive deficits.
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Affiliation(s)
- Tong Si
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guoqiang Xing
- The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong Central Hospital, Nanchong, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
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16
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Shen S, Zeng X, Xu L, Chen L, Liu Z, Chu J, Yang Y, Wu X, Chen X. Association between motoric cognitive risk syndrome and frailty among older Chinese adults. BMC Geriatr 2020; 20:110. [PMID: 32192446 PMCID: PMC7081673 DOI: 10.1186/s12877-020-01511-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 03/10/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Motoric cognitive risk syndrome (MCR) is a newly proposed predementia syndrome incorporating subjective cognitive complaints and slow gait. Previous studies have reported that subjective cognitive complaints and slow gait are associated with frailty in cognitively unimpaired older adults, but little is known about the link between MCR and frailty in older adults. Therefore, the aim of the study was to explore the associations of MCR and its components with frailty in older Chinese adults. METHODS In an observational cross-sectional study, a total of 429 older adults aged 60 years and older were admitted to the geriatric department. According to MCR criteria, all participants were classified into 4 groups: 1) the MCR group; 2) the subjective cognitive complaints only group; 3) the slow gait only group; and 4) the healthy control group. Physical frailty was assessed by the Clinical Frailty Scale (CFS). Multivariate logistic regression analysis was used to examine the association between MCR and frailty in older adults. RESULTS The prevalence rates of subjective cognitive complaints, slow gait and MCR were 15.9, 10.0 and 4.0%, respectively. After adjusting for confounding variables, the logistic regression analysis showed that slow gait (odds ratio [OR]: 3.40, 95% confidence interval [CI]: 1.40-8.23, P = 0.007) and MCR (OR: 5.53, 95% CI: 1.46-20.89, P = 0.012) were independently associated with frailty, but subjective cognitive complaints were not. CONCLUSIONS MCR and slow gait were significantly associated with frailty in older Chinese adults. Further studies should prospectively determine the causal relationship between MCR and frailty.
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Affiliation(s)
- Shanshan Shen
- Department of Geriatric, Zhejiang Hospital, No. 12 Lingyin Road, Hangzhou, 310013, Zhejiang Province, China
| | - Xingkun Zeng
- Department of Geriatric, Zhejiang Hospital, No. 12 Lingyin Road, Hangzhou, 310013, Zhejiang Province, China
| | - Liyu Xu
- Department of Geriatric, Zhejiang Hospital, No. 12 Lingyin Road, Hangzhou, 310013, Zhejiang Province, China
| | - Lingyan Chen
- Department of Geriatric, Zhejiang Hospital, No. 12 Lingyin Road, Hangzhou, 310013, Zhejiang Province, China
| | - Zixia Liu
- Department of Geriatric, Zhejiang Hospital, No. 12 Lingyin Road, Hangzhou, 310013, Zhejiang Province, China
| | - Jiaojiao Chu
- Department of Geriatric, Zhejiang Hospital, No. 12 Lingyin Road, Hangzhou, 310013, Zhejiang Province, China
| | - Yinghong Yang
- Department of Geriatric, Zhejiang Hospital, No. 12 Lingyin Road, Hangzhou, 310013, Zhejiang Province, China
| | - Xiushao Wu
- Department of Geriatric, Zhejiang Hospital, No. 12 Lingyin Road, Hangzhou, 310013, Zhejiang Province, China
| | - Xujiao Chen
- Department of Geriatric, Zhejiang Hospital, No. 12 Lingyin Road, Hangzhou, 310013, Zhejiang Province, China.
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17
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Sutin AR, Aschwanden D, Stephan Y, Terracciano A. Five Factor Model Personality Traits and Subjective Cognitive Failures. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020; 155:109741. [PMID: 32863506 PMCID: PMC7451823 DOI: 10.1016/j.paid.2019.109741] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Momentary lapses in memory, perception, or action, known as cognitive failures, are relatively common. These lapses may reflect, in part, aspects of psychological functioning, such as personality traits. The present research addresses how Five Factor Model personality traits and facets are associated with cognitive failures, and whether these associations are accounted for by depressed affect. Participants (N=5,133; 50% female) who ranged in age from 18 to 91 completed an online survey that assessed their personality traits, cognitive failures, and depressed affect. Higher neuroticism was associated with more cognitive failures, whereas Conscientiousness and Agreeableness were associated with fewer failures, controlling for sociodemographic characteristics. Controlling for depressed affect reduced the associations in most cases by about 50%, but most relations were still apparent. Facet-level analyses provided a more detailed picture of how the traits are associated with cognitive failures. Subjective perceptions of lapses in cognition are associated with basic personality traits and may reflect, in part, processes related to those traits beyond depressed affect.
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18
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Margioti E, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Ntanasi E, Vlachos GS, Scarmeas N. Exploring the association between subjective cognitive decline and frailty: the Hellenic Longitudinal Investigation of Aging and Diet Study (HELIAD). Aging Ment Health 2020; 24:137-147. [PMID: 30621435 DOI: 10.1080/13607863.2018.1525604] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Subjective cognitive decline (SCD) refers to self-evaluations of impairment in cognitive functions in the absence of objective deficits. Frailty is a multidimensional syndrome that results in increased vulnerability. Both terms are associated with cognitive decline and increased incidence of dementia. The aim of this study was to explore potential associations between SCD and frailty in elderly individuals.Methods: In this cross-sectional study, we included 1454 participants aged 65 and older from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) study. Individuals with a diagnosis of dementia, mild cognitive impairment, severe anxiety or depression were excluded. SCD were assessed with eighteen questions categorized into cognitive domains. Frailty was assessed according to the Fried definition, the Frailty Index (FI) and the Tilburg Frailty Indicator (TFI). Logistic regression analysis was used to investigate the association.Results: Lower educational level, female sex and low socioeconomic status were found to be associated with frailty and more SCD complaints. Having two or more types of SCD complaints was significantly associated with frailty according to all frailty definitions. All types of SCD complaints were significantly associated with the FI and the TFI. In addition, SCD complaints concerning problems requiring mathematical reasoning had the strongest association with frailty.Conclusion: We found that SCD complaints may be a valid indicator of frailty in cognitively unimpaired older people. We believe that SCD may provide a crucial proactive assessment to detect frailty and to implement programs that will help maintain good health and quality of life during aging.
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Affiliation(s)
- Eleni Margioti
- Laboratory of Cognitive Neuroscience School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Mary-Helen Kosmidis
- Laboratory of Cognitive Neuroscience School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Diabetics, Harokopio University, Athens, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Eva Ntanasi
- Department of Nutrition and Diabetics, Harokopio University, Athens, Greece.,Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - George S Vlachos
- Eginition Hospital, Department of Social Medicine Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- Eginition Hospital, Department of Social Medicine Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
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19
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Sacuiu S, Eckerström M, Johansson L, Kern S, Sigström R, Xinxin G, Östling S, Skoog I. Increased Risk of Dementia in Subjective Cognitive Decline if CT Brain Changes are Present. J Alzheimers Dis 2019; 66:483-495. [PMID: 30320572 PMCID: PMC6218129 DOI: 10.3233/jad-180073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Subjective cognitive decline (SCD) has low predictive value for incident dementia. Objectives: We examined whether CT detectable brain changes add predictive value to SCD in a population sample with high scores on the Mini-Mental State Examination. Methods: Subjective reports of memory and executive function were gathered in a non-demented population sample ≥70 years (n = 921). CT-brain was performed at baseline (n = 626). Brain atrophy, infarcts, and white matter lesions (WMLs) were classified using visual ratings. Dementia incidence was evaluated periodically during 12 years. Results: The prevalence of SCD was 32.5% among individuals without dementia. During follow-up, 151 individuals (16.4%) developed dementia. The risk of dementia was increased in SCD, and increased further with WMLs and cortical atrophy present. However, the positive predictive values for incident dementia were low, 25% in SCD and 41% in SCD with WMLs and cortical atrophy. Conclusion: Our observations add clinical value to the use of SCD and CT to select relevant populations for interventions against dementia, but more stringent screening methods are necessary to reach individuals at risk.
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Affiliation(s)
- Simona Sacuiu
- Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Marie Eckerström
- Cognitive Medicine Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Lena Johansson
- Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Silke Kern
- Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Robert Sigström
- Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Guo Xinxin
- Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Svante Östling
- Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
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20
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Salis C, Murray L, Vonk JMJ. Systematic review of subjective memory measures to inform assessing memory limitations after stroke and stroke-related aphasia. Disabil Rehabil 2019; 43:1488-1506. [PMID: 31559870 DOI: 10.1080/09638288.2019.1668485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM Primary aims of this systematic review were to: (1) identify the range of subjective memory measures used in the stroke and stroke-related aphasia literature and (2) critically appraise their psychometric properties as well as (3) the methodological qualities of studies that included them, (4) investigate whether such measures provide an accurate reflection of memory impairments (i.e., in comparison to norms from age-matched, neurotypical participants), (5) document the representation of individuals with stroke-related aphasia, and (6) examine the extent to which subjective memory measures correlate with objective memory measures. METHODS Systematic review of the literature from 1970 to June 2019 using a comprehensive range of relevant search terms in EMBASE, Medline, PsychINFO, SCOPUS, and Web of Science. Eligibility criteria were for studies to include adults who had suffered of clinical stroke, to report a subjective memory measure that was completed by the stroke survivors, to be reported in a peer-reviewed journal, and to be published in English or Dutch. Quality appraisal was carried out for the included studies as well as the subjective memory measures they employed. RESULTS A total of 7,077 titles or abstracts were screened, with 41 studies included in the quantitative and qualitative synthesis. Twenty-six subjective memory measures were used in the included studies. The critical appraisal of their psychometric properties and the methodological quality of the included studies revealed significant shortcomings; for example, neurotypical participants were included in only 14 of the 41 studies. When statistical comparisons were made, different outcomes arose. Only eight studies statistically compared subjective with objective memory measures. CONCLUSIONS This literature domain currently provides an unclear picture as to how memory limitations affect participation in stroke and stroke-related aphasia.IMPLICATIONS FOR REHABILITATIONA broad range of subjective memory measures have been used to determine stroke survivors' perceptions of their everyday memory issues.Because of psychometric weaknesses such as inadequate reliability and cross-cultural validity among subjective memory measures, there remains a need to carefully review a given measure's properties to determine if it is appropriate for use with a given stroke survivor.Stroke survivors with aphasia have been infrequently included or inadequately described in studies of subjective memory measures, and thus how these individuals perceive their everyday memory abilities requires further investigation.Although the relationship between subjective and objective memory measures has been infrequently investigated by stroke researchers, both types of measures should be considered as they likely offer complementary rather than redundant information about stroke survivors' memory abilities.
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Affiliation(s)
- Christos Salis
- Speech and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Laura Murray
- Communication Sciences and Disorders, Western University, London, ON Canada
| | - Jet M J Vonk
- Department of Neurology, Columbia University, New York, NY, USA
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21
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Physical multimorbidity and subjective cognitive complaints among adults in the United Kingdom: a cross-sectional community-based study. Sci Rep 2019; 9:12417. [PMID: 31455875 PMCID: PMC6711967 DOI: 10.1038/s41598-019-48894-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 08/14/2019] [Indexed: 02/06/2023] Open
Abstract
Our goal was to examine the association between physical multimorbidity and subjective cognitive complaints (SCC) using UK nationally representative cross-sectional community-based data, and to quantify the extent to which a broad range of mainly psychological and behavioral factors explain this relationship. Data from the 2007 Adult Psychiatric Morbidity Survey were analyzed [N = 7399 adults, mean (SD) age 46.3 (18.6) years, 48.6% men]. Multimorbidity was defined as ≥2 physical diseases. SCC included two different cognitive constructs: subjective concentration and memory complaints. Multivariable logistic regression and mediation analyses were conducted. Multimorbidity was associated with higher prevalence of subjective concentration (30.7% vs. 17.3%) and memory complaints (42.8% vs. 22.9%) compared to no multimorbidity. In the regression model adjusted for sociodemographics, multimorbidity was associated with subjective concentration (OR = 2.58; 95% CI = 2.25–2.96) and memory complaints (OR = 2.34; 95% CI = 2.08–2.62). Sleep problems, stressful life events and any anxiety disorder explained 21–23%, 20–22% and 14–15% of the multimorbidity-SCC association, respectively. Multimorbidity and SCC are highly co-morbid. The utility of SCC screening in identifying individuals at high risk for future cognitive decline among individuals with multimorbidity should be assessed.
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Kuhn E, Moulinet I, Perrotin A, La Joie R, Landeau B, Tomadesso C, Bejanin A, Sherif S, De La Sayette V, Desgranges B, Vivien D, Poisnel G, Chételat G. Cross-sectional and longitudinal characterization of SCD patients recruited from the community versus from a memory clinic: subjective cognitive decline, psychoaffective factors, cognitive performances, and atrophy progression over time. ALZHEIMERS RESEARCH & THERAPY 2019; 11:61. [PMID: 31286994 PMCID: PMC6615169 DOI: 10.1186/s13195-019-0514-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/13/2019] [Indexed: 12/04/2022]
Abstract
Background Subjective cognitive decline (SCD) defines a heterogeneous population, part of which having Alzheimer’s disease (AD). We aimed at characterizing SCD populations according to whether or not they referred to a memory clinic, by assessing the factors associated with increased AD risk. Methods Seventy-eight cognitively unimpaired older adults from the IMAP+ study (Caen) were included, amongst which 28 healthy controls (HC) and 50 SCD recruited from the community (SCD-community; n = 23) or from a memory clinic (SCD-clinic; n = 27). Participants underwent cognitive, psychoaffective, structural MRI, FDG-PET, and amyloid-PET assessments. They were followed up over a mean period of 2.4 ± 0.8 years. The groups were compared in terms of baseline and follow-up levels of SCD (self- and informant-reported), cognition, subclinical anxiety and depression, and atrophy progression over time. We also investigated SCD substrates within each SCD group through the correlations between self-reported SCD and other psychometric and brain measures. Results Compared to HC, both SCD groups showed similar cognitive performances but higher informant-reported SCD and anxiety. Compared to SCD-community, SCD-clinic showed higher informant-reported SCD, depression score, and atrophy progression over time but similar brain amyloid load. A significant increase over time was found for depression in the SCD-community and for self-reported praxis-domestic activities SCD factor in the SCD-clinic. Higher self-reported SCD correlated with (i) lower grey matter volume and higher anxiety in SCD-community, (ii) greater informant-reported SCD in SCD-clinic, and (iii) lower glucose metabolism in both SCD groups. Conclusions Higher subclinical depression and informant-reported SCD specifically characterize the SCD group that refers to a memory clinic. The same group appears as a frailer population than SCD-community as they show greater atrophy progression over time. Yet, both the SCD groups were quite similar otherwise including for brain amyloid load and the SCD-community showed increased depression score over time. Altogether, our findings highlight the relevance of assessing psychoaffective factors and informant-reported SCD in SCD populations and point to both differences and similarities in SCD populations referring or not to a memory clinic. Electronic supplementary material The online version of this article (10.1186/s13195-019-0514-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elizabeth Kuhn
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Inès Moulinet
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Audrey Perrotin
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Brigitte Landeau
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Clémence Tomadesso
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France.,Normandie Univ, UNICAEN, PSL Recherche Universités, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, GIP Cyceron, 14000, Caen, France
| | - Alexandre Bejanin
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Siya Sherif
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Vincent De La Sayette
- Normandie Univ, UNICAEN, PSL Recherche Universités, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, GIP Cyceron, 14000, Caen, France.,CHU de Caen, Service de Neurologie, Caen, France
| | - Béatrice Desgranges
- Normandie Univ, UNICAEN, PSL Recherche Universités, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, GIP Cyceron, 14000, Caen, France
| | - Denis Vivien
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France.,Department of Clinical Research, Caen Normandy Hospital (CHU) de Caen, 14000, Caen, France
| | - Géraldine Poisnel
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Gaëlle Chételat
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France.
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Kletenik I, Alvarez E, Honce JM, Valdez B, Vollmer TL, Medina LD. Subjective cognitive concern in multiple sclerosis is associated with reduced thalamic and cortical gray matter volumes. Mult Scler J Exp Transl Clin 2019; 5:2055217319827618. [PMID: 30800417 PMCID: PMC6378429 DOI: 10.1177/2055217319827618] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 12/15/2022] Open
Abstract
Objective Brain atrophy has been correlated with objective cognitive dysfunction in multiple sclerosis but few studies have explored self-reported subjective cognitive concerns and their relationship to brain volume changes. This study explores the relationship between subjective cognitive concerns in multiple sclerosis and reduced brain volume in regions of interest implicated in cognitive dysfunction. Methods A total of 158 patients with multiple sclerosis completed the Quality of Life in Neurologic Disorders Measures (Neuro-QoL) short forms to assess subjective cognitive concerns and underwent brain magnetic resonance imaging. Regional brain volumes from regions of interest implicated in cognitive dysfunction were measured using NeuroQuant automated volumetric quantitation. Linear regression was used to analyze the relationship between subjective cognitive concerns and brain volume. Results Controlling for age, disease duration, gender, depression and fatigue, increased subjective cognitive concerns were associated with reduced thalamic volume (standardized β = 0.223, t150 =2.406, P = 0.017) and reduced cortical gray matter volume (standardized β = 0.240, t150 = 2.777, P = 0.006). Increased subjective cognitive concerns were not associated with any other regions of interest that were analyzed. Conclusions Subjective cognitive concern in MS is associated with reduced thalamic and cortical gray matter volumes, areas of the brain that have been implicated in objective cognitive impairment. These findings may lend neuroanatomical significance to subjective cognitive concerns and patient-reported outcomes as measured by Neuro-QoL.
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Affiliation(s)
- Isaiah Kletenik
- Department of Neurology, University of Colorado School of Medicine, USA
| | - Enrique Alvarez
- Department of Neurology, University of Colorado School of Medicine, USA.,Rocky Mountain MS Center, University of Colorado School of Medicine, USA
| | - Justin M Honce
- Department of Radiology, University of Colorado School of Medicine, USA
| | - Brooke Valdez
- Rocky Mountain MS Center, University of Colorado School of Medicine, USA
| | - Timothy L Vollmer
- Department of Neurology, University of Colorado School of Medicine, USA.,Rocky Mountain MS Center, University of Colorado School of Medicine, USA
| | - Luis D Medina
- Department of Psychology, University of Houston, USA.,IK and EA are co-first authors and contributed equally to the work
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25
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Kim JY, Jeon H, Kwon A, Jin MJ, Lee SH, Chung YC. Self-Awareness of Psychopathology and Brain Volume in Patients With First Episode Psychosis. Front Psychiatry 2019; 10:839. [PMID: 31803084 PMCID: PMC6873658 DOI: 10.3389/fpsyt.2019.00839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/22/2019] [Indexed: 01/06/2023] Open
Abstract
Memory impairment, excessive rumination, and increased interpersonal sensitivity are major characteristics of high psychosis risk or first episode psychosis (FEP). Herein, we investigated the relationship between brain volume and self-awareness of psychopathology in patients with FEP. All participants (FEP: 34 and HCs: 34) completed clinical assessments and the following self-reported psychopathology evaluations: prospective and retrospective memory questionnaire (PRMQ), ruminative response scale (RRS), and interpersonal sensitivity measure (IPSM). Structural magnetic resonance imaging was then conducted. The PRMQ, RRS, and IPSM scores were significantly higher in the FEP group than in the healthy controls (HCs). The volumes of the amygdala, hippocampus, and superior temporal gyrus (STG) were significantly lower in the FEP group than in the HCs. There was a significant group-dependent moderation effect between self-awareness of psychopathology (PRMQ, RRS, and IPSM scores) and right STG (rSTG) volume. In the FEP group, self-awareness of psychopathology was positively associated with rSTG volume, while in the HCs, this correlation was negative. Our results indicate that self-awareness of psychopathology impacts rSTG volume in the opposite direction between patients with FEP and HCs. In patients with FEP, awareness of impairment may induce increases in rSTG brain volume. However, HCs showed decreased rSTG volume when they were aware of impairment.
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Affiliation(s)
- Jeong-Youn Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea
| | - Hyeonjin Jeon
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea
| | - Aeran Kwon
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea
| | - Min Jin Jin
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea.,Department of Psychology, Chung-Ang University, Seoul, South Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea.,Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang, South Korea
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, South Korea
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Ruan Q, D'Onofrio G, Sancarlo D, Greco A, Lozupone M, Seripa D, Panza F, Yu Z. Emerging biomarkers and screening for cognitive frailty. Aging Clin Exp Res 2017; 29:1075-1086. [PMID: 28260159 DOI: 10.1007/s40520-017-0741-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/16/2017] [Indexed: 11/24/2022]
Abstract
Physical frailty and cognitive frailty are two important targets of secondary intervention in aging research to narrow the gap between life and health span. The objective of the present narrative review was to examine clinical and epidemiological studies investigating the recently proposed construct of cognitive frailty and its subtypes, with a focus on operational definitions, clinical criteria, and emerging biomarkers potentially useful for the screening of this novel entity. Both physical frailty and frailty indexes with a multidimensional nature were associated with late-life cognitive impairment/decline, incident dementia, Alzheimer's disease (AD), mild cognitive impairment, vascular dementia, non-AD dementias, and AD pathology proposing cognitive frailty as a clinical entity with cognitive impairment related to physical causes with a potential reversibility. The new clinical and research AD criteria established by the National Institute on Aging-Alzheimer's Association and the American Psychiatric Association could improve the differential diagnosis of cognitive impairment within the cognitive frailty construct. The emerging biomarkers of sarcopenia, physical frailty, and cognitive impairment will provide the basis to establish more reliable clinical and research criteria for cognitive frailty, using different operational definitions for frailty and cognitive impairment and useful clinical, biological, and imaging markers for this novel clinical construct.
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Affiliation(s)
- Qingwei Ruan
- Shanghai Key Laboratory of Clinical Geriatrics, Department of Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Institute of Geriatrics and Gerontology, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - Grazia D'Onofrio
- Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Daniele Sancarlo
- Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Antonio Greco
- Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Davide Seripa
- Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Francesco Panza
- Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
- Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.
| | - Zhuowei Yu
- Shanghai Key Laboratory of Clinical Geriatrics, Department of Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Institute of Geriatrics and Gerontology, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
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Subjective Cognitive Impairment, Depressive Symptoms, and Fatigue after a TIA or Transient Neurological Attack: A Prospective Study. Behav Neurol 2017; 2017:5181024. [PMID: 29348702 PMCID: PMC5733631 DOI: 10.1155/2017/5181024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 09/30/2017] [Accepted: 10/08/2017] [Indexed: 11/17/2022] Open
Abstract
Introduction Subjective cognitive impairment (SCI), depressive symptoms, and fatigue are common after stroke and are associated with reduced quality of life. We prospectively investigated their prevalence and course after a transient ischemic attack (TIA) or nonfocal transient neurological attack (TNA) and the association with diffusion-weighted imaging (DWI) lesions. Methods The Cognitive Failures Questionnaire, Hospital Anxiety and Depression Scale, and Subjective Fatigue subscale from the Checklist Individual Strength were used to assess subjective complaints shortly after TIA or TNA and six months later. With repeated measure analysis, the associations between DWI lesion presence or clinical diagnosis (TIA or TNA) and subjective complaints over time were determined. Results We included 103 patients (28 DWI positive). At baseline, SCI and fatigue were less severe in DWI positive than in DWI negative patients, whereas at follow-up, there were no differences. SCI (p = 0.02) and fatigue (p = 0.01) increased in severity only in DWI positive patients. There were no differences between TIA and TNA. Conclusions Subjective complaints are highly prevalent in TIA and TNA patients. The short-term prognosis is not different between DWI-positive and DWI negative patients, but SCI and fatigue increase in severity within six months after the event when an initial DWI lesion is present.
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Naharci MI, Cintosun U, Ozturk A, Oztin H, Turker T, Bozoglu E, Doruk H. Effect of anticholinergic burden on the development of dementia in older adults with subjective cognitive decline. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1358130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Mehmet Ilkin Naharci
- Gulhane Medical Faculty, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences, Kecioren, Turkey
| | - Umit Cintosun
- Gulhane Training and Research Hospital, Geriatrics Clinic, Kecioren, Turkey
| | - Ahmet Ozturk
- Gulhane Training and Research Hospital, Geriatrics Clinic, Kecioren, Turkey
| | - Hasan Oztin
- Gulhane Medical Faculty, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences, Kecioren, Turkey
| | - Turker Turker
- Gulhane Medical Faculty, Department of Public Health, University of Health Sciences, Kecioren, Ankara, Turkey
| | - Ergun Bozoglu
- Gulhane Medical Faculty, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences, Kecioren, Turkey
| | - Huseyin Doruk
- Gulhane Medical Faculty, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences, Kecioren, Turkey
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Ellison JM. Stage-Dependent Significance of Subjective Memory Complaints: Responding to the Worried Well … and to the Unworried Unwell. Am J Geriatr Psychiatry 2017; 25:617-619. [PMID: 28372895 DOI: 10.1016/j.jagp.2017.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 02/27/2017] [Indexed: 11/28/2022]
Affiliation(s)
- James M Ellison
- The Swank Foundation Endowed Chair in Memory Care and Geriatrics, Swank Memory Care Center, Wilmington, DE; Department of Psychiatry and Human Behavior, The Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.
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Vannini P, Amariglio R, Hanseeuw B, Johnson KA, McLaren DG, Chhatwal J, Pascual-Leone A, Rentz D, Sperling RA. Memory self-awareness in the preclinical and prodromal stages of Alzheimer's disease. Neuropsychologia 2017; 99:343-349. [PMID: 28385579 PMCID: PMC5473166 DOI: 10.1016/j.neuropsychologia.2017.04.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 03/03/2017] [Accepted: 04/01/2017] [Indexed: 10/19/2022]
Abstract
While loss of insight of cognitive deficits, anosognosia, is a common symptom in Alzheimer's disease dementia, there is a lack of consensus regarding the presence of altered awareness of memory function in the preclinical and prodromal stages of the disease. Paradoxically, very early in the Alzheimer's disease process, individuals may experience heightened awareness of memory changes before any objective cognitive deficits can be detected, here referred to as hypernosognosia. In contrast, awareness of memory dysfunction shown by individuals with mild cognitive impairment (MCI) is very variable, ranging from marked concern to severe lack of insight. This study aims at improving our mechanistic understanding of how alterations in memory self-awareness are related to pathological changes in clinically normal (CN) adults and MCI patients. 297 CN and MCI patients underwent PiB-PET (Positron Emission Tomography using Pittsburgh Compound B) in vivo amyloid imaging. Amyloid burden was estimated from Alzheimer's disease vulnerable regions, including the frontal, lateral parietal and lateral temporal, and retrosplenial cortex. Memory self-awareness was assessed using discrepancy scores between subjective and objective measures of memory function. A set of univariate analysis of variance were performed to assess the relationship between self-awareness of memory and amyloid pathology. Whereas CN individuals harboring amyloid pathology demonstrated hypernosognosia, MCI patients with increased amyloid pathology demonstrated anosognosia. In contrast, MCI patients with low amounts of amyloid were observed to have normal insight into their memory functions. Altered self-awareness of memory tracks with amyloid pathology. The findings of variability of awareness may have important implications for the reliability of self-report of dysfunction across the spectrum of preclinical and prodromal Alzheimer's disease.
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Affiliation(s)
- Patrizia Vannini
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Rebecca Amariglio
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Bernard Hanseeuw
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Department of Radiology, Division of Molecular Imaging and Nuclear Medicine, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Department of Neurology, Cliniques Universitaires Saint-Luc, Institute of Neurosciences, Université Catholique de Louvain, 10 Av. Hippocrate, 1200 Brussels, Belgium
| | - Keith A Johnson
- Department of Radiology, Division of Molecular Imaging and Nuclear Medicine, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA
| | - Donald G McLaren
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA; Biospective, Inc., Montreal, Canada
| | - Jasmeer Chhatwal
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation and Cognitive Neurology Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Dorene Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Reisa A Sperling
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02114, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Lauriola M, Esposito R, Delli Pizzi S, de Zambotti M, Londrillo F, Kramer JH, Rabinovici GD, Tartaro A. Sleep changes without medial temporal lobe or brain cortical changes in community-dwelling individuals with subjective cognitive decline. Alzheimers Dement 2016; 13:783-791. [PMID: 28034600 DOI: 10.1016/j.jalz.2016.11.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 11/08/2016] [Accepted: 11/16/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Subjective cognitive decline (SCD) is a risk factor for mild cognitive impairment (MCI) and Alzheimer's disease (AD). Although sleep has been shown to be altered in MCI and AD, little is known about sleep in SCD. METHODS Seventy cognitively normal community-dwelling participants were classified as SCD (32) or controls (38) using the Subjective Cognitive Decline Questionnaire. Sleep was assessed using actigraphy and diaries. FreeSurfer was used for performing medial temporal lobes (MTLs) and brain cortical parcellation of 3T magnetic resonance images. Multiple regression models were used to assess the presence of sleep, MTL, or regional cortical differences between groups. RESULTS Objective sleep was disrupted in SCD participants, which showed increased nighttime wakefulness and reduced sleep efficiency. No group differences emerged in subjective sleep or magnetic resonance imaging outcomes. DISCUSSION Objective sleep resulted disrupted in community-dwelling SCD, without any subjective sleep or cortical change. Sleep assessment/intervention in SCD might help prevent/delay AD onset.
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Affiliation(s)
- Mariella Lauriola
- Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA.
| | - Roberto Esposito
- Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Stefano Delli Pizzi
- Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | | | - Francesco Londrillo
- Azienda Sanitaria Locale di Pescara (ASL), Centro di Salute Mentale Pescara Nord, Pescara, Italy
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - Armando Tartaro
- Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
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Classifying anatomical subtypes of subjective memory impairment. Neurobiol Aging 2016; 48:53-60. [DOI: 10.1016/j.neurobiolaging.2016.08.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/18/2016] [Accepted: 08/10/2016] [Indexed: 11/22/2022]
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Perrotin A, La Joie R, de La Sayette V, Barré L, Mézenge F, Mutlu J, Guilloteau D, Egret S, Eustache F, Chételat G. Subjective cognitive decline in cognitively normal elders from the community or from a memory clinic: Differential affective and imaging correlates. Alzheimers Dement 2016; 13:550-560. [PMID: 27693187 DOI: 10.1016/j.jalz.2016.08.011] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 08/05/2016] [Accepted: 08/17/2016] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Subjective cognitive decline (SCD) could indicate preclinical Alzheimer's disease, but the existing literature is confounded by heterogeneous approaches to studying SCD. We assessed the differential cognitive, affective, and neuroimaging correlates of two aspects of SCD: reporting high cognitive difficulties on a self-rated questionnaire versus consulting at a memory clinic. METHODS We compared 28 patients from a memory clinic with isolated SCD, 35 community-recruited elders with similarly high levels of self-reported cognitive difficulties, and 35 community-recruited controls with low self-reported cognitive difficulties. RESULTS Increased anxiety and amyloid β deposition were observed in both groups with high self-reported difficulties, whereas subclinical depression and (hippocampal) atrophy were specifically associated with medical help seeking. Cognitive tests showed no group differences. DISCUSSION These results further validate the concept of SCD in both community- and clinic-based groups. Yet, recruitment methods influence associated biomarkers and affective symptomatology, highlighting the heterogeneous nature of SCD depending on study characteristics.
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Affiliation(s)
- Audrey Perrotin
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Renaud La Joie
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
| | - Vincent de La Sayette
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, Service de Neurologie, Caen, France
| | - Louisa Barré
- Université de Caen Normandie, UMR-S1077, Caen, France; CEA, DRF/I2BM, LDM-TEP Group, Caen, France; CNRS, UMR ISTCT 6301, LDM-TEP Group, Caen, France
| | - Florence Mézenge
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Justine Mutlu
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Denis Guilloteau
- INSERM U930, Université François Rabelais de Tours, CHRU de Tours, Tours, France
| | - Stéphanie Egret
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Francis Eustache
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Gaël Chételat
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
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van Uden IW, van der Holst HM, van Leijsen EM, Tuladhar AM, van Norden AG, de Laat KF, Claassen JA, van Dijk EJ, Kessels RP, Richard E, Tendolkar I, de Leeuw FE. Late-onset depressive symptoms increase the risk of dementia in small vessel disease. Neurology 2016; 87:1102-9. [DOI: 10.1212/wnl.0000000000003089] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 05/30/2016] [Indexed: 11/15/2022] Open
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Prospective memory in subjective cognitive decline: a preliminary study on the role of early cognitive marker in dementia. Alzheimer Dis Assoc Disord 2016; 29:229-35. [PMID: 25187222 DOI: 10.1097/wad.0000000000000060] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Accumulating evidence shows that subjective cognitive decline (SCD) without impairment on conventional neuropsychological tests may indicate increased risk for Alzheimer disease. Previous studies of mild cognitive impairment have demonstrated the potential role of prospective memory (PM) in the early detection of cognitive decline. We thus aimed to investigate the performance of people with SCD on PM tasks relative to their healthy controls (HCs). Forty-one participants with SCD and demographically matched HCs received regular cognitive testing as well as 2 single-trial naturalistic time-based and event-based PM tasks. Statistical analyses showed that the individuals with SCD performed worse on the time-based PM task, especially on the prospective component, when compared with their HCs. Our findings suggest that PM, especially the time-based one on the prospective component, may be an early cognitive marker of dementia. This implies an underlying difficulty among subjects with SCD in self-initiation that exacerbates their memory difficulties. Further investigation on a large scale is needed.
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Subcortical matter in the α-synucleinopathies spectrum: an MRI pilot study. J Neurol 2016; 263:1575-82. [DOI: 10.1007/s00415-016-8173-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 05/14/2016] [Accepted: 05/14/2016] [Indexed: 11/25/2022]
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Lucas HD, Monti JM, McAuley E, Watson PD, Kramer AF, Cohen NJ. Relational memory and self-efficacy measures reveal distinct profiles of subjective memory concerns in older adults. Neuropsychology 2016; 30:568-578. [PMID: 27054441 DOI: 10.1037/neu0000275] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Subjective memory concerns (SMCs) in healthy older adults are associated with future decline and can indicate preclinical dementia. However, SMCs may be multiply determined, and often correlate with affective or psychosocial variables rather than with performance on memory tests. Our objective was to identify sensitive and selective methods to disentangle the underlying causes of SMCs. METHOD Because preclinical dementia pathology targets the hippocampus, we hypothesized that performance on hippocampally dependent relational memory tests would correlate with SMCs. We thus administered a series of memory tasks with varying dependence on relational memory processing to 91 older adults, along with questionnaires assessing depression, anxiety, and memory self-efficacy. We used correlational, regression, and mediation analyses to compare the variance in SMCs accounted for by these measures. RESULTS Performance on the task most dependent on relational memory processing showed a stronger negative association with SMCs than did other memory performance metrics. SMCs were also negatively associated with memory self-efficacy. These 2 measures, along with age and education, accounted for 40% of the variance in SMCs. Self-efficacy and relational memory were uncorrelated and independent predictors of SMCs. Moreover, self-efficacy statistically mediated the relationship between SMCs and depression and anxiety, which can be detrimental to cognitive aging. CONCLUSIONS These data identify multiple mechanisms that can contribute to SMCs, and suggest that SMCs can both cause and be caused by age-related cognitive decline. Relational memory measures may be effective assays of objective memory difficulties, while assessing self-efficacy could identify detrimental affective responses to cognitive aging. (PsycINFO Database Record
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Affiliation(s)
- Heather D Lucas
- Beckman Institute, University of Illinois at Urbana-Champaign
| | - Jim M Monti
- Beckman Institute, University of Illinois at Urbana-Champaign
| | - Edward McAuley
- Beckman Institute, University of Illinois at Urbana-Champaign
| | | | - Arthur F Kramer
- Beckman Institute, University of Illinois at Urbana-Champaign
| | - Neal J Cohen
- Beckman Institute, University of Illinois at Urbana-Champaign
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Mendonça MD, Alves L, Bugalho P. From Subjective Cognitive Complaints to Dementia: Who is at Risk?: A Systematic Review. Am J Alzheimers Dis Other Demen 2016; 31:105-14. [PMID: 26142292 PMCID: PMC10852868 DOI: 10.1177/1533317515592331] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Subjective cognitive complaints (SCCs) are frequent in the elderly population. The majority of individuals with subjective complaints never progress to significant cognitive decline, but some of them have a higher risk of progression to objective cognitive impairment than persons with no cognitive concerns. We performed a systematic review of community-based studies that focused on the progression risk associated with SCC and on the complainers’ characteristics associated with progression. Seventeen studies were included. As a group, SCCs are associated with a significantly higher risk of progression to dementia. Worried complainers, persons who refer an impact of their complaints on activities of daily living, and those whose complaints are also noticed by an informant have the highest risk of progression. Taking into account the fluctuating course of SCC and their frequent reversion, care should be taken to not overvaluate them. Further studies are necessary to better define risk features.
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Affiliation(s)
- Marcelo D. Mendonça
- Neurology Department, Hospital Egas Moniz—Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboan, Lisbon, Portugal
| | - Luísa Alves
- Neurology Department, Hospital Egas Moniz—Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboan, Lisbon, Portugal
| | - Paulo Bugalho
- Neurology Department, Hospital Egas Moniz—Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboan, Lisbon, Portugal
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van Uden IW, van der Holst HM, Tuladhar AM, van Norden AG, de Laat KF, Rutten-Jacobs LC, Norris DG, Claassen JA, van Dijk EJ, Kessels RP, de Leeuw FE. White Matter and Hippocampal Volume Predict the Risk of Dementia in Patients with Cerebral Small Vessel Disease: The RUN DMC Study. J Alzheimers Dis 2015; 49:863-73. [DOI: 10.3233/jad-150573] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Ingeborg W.M. van Uden
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands
| | - Helena M. van der Holst
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands
| | - Anil M. Tuladhar
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands
| | | | | | - Loes C.A. Rutten-Jacobs
- University of Cambridge, Department of Clinical Neurosciences, Neurology Unit, Cambridge, UK
| | - David G. Norris
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany
| | - Jurgen A.H.R. Claassen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Department of Geriatrics, Nijmegen, The Netherlands
| | - Ewoud J. van Dijk
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands
| | - Roy P.C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Department of Medical Psychology, Nijmegen, The Netherlands
| | - Frank-Erik de Leeuw
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands
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Schaapsmeerders P, Tuladhar AM, Maaijwee NAM, Rutten-Jacobs LCA, Arntz RM, Schoonderwaldt HC, Dorresteijn LDA, van Dijk EJ, Kessels RPC, de Leeuw FE. Lower Ipsilateral Hippocampal Integrity after Ischemic Stroke in Young Adults: A Long-Term Follow-Up Study. PLoS One 2015; 10:e0139772. [PMID: 26462115 PMCID: PMC4603678 DOI: 10.1371/journal.pone.0139772] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/17/2015] [Indexed: 11/18/2022] Open
Abstract
Background and purpose Memory impairment after stroke is poorly understood as stroke rarely occurs in the hippocampus. Previous studies have observed smaller ipsilateral hippocampal volumes after stroke compared with controls. Possibly, these findings on macroscopic level are not the first occurrence of structural damage and are preceded by microscopic changes that may already be associated with a worse memory function. We therefore examined the relationship between hippocampal integrity, volume, and memory performance long after first-ever ischemic stroke in young adults. Methods We included all consecutive first-ever ischemic stroke patients, without hippocampal strokes or recurrent stroke/TIA, aged 18–50 years, admitted to our academic hospital between 1980 and 2010. One hundred and forty-six patients underwent T1 MPRAGE, DTI scanning and completed the Rey Auditory Verbal Learning Test and were compared with 84 stroke-free controls. After manual correction of hippocampal automatic segmentation, we calculated mean hippocampal fractional anisotropy (FA) and diffusivity (MD). Results On average 10 years after ischemic stroke, lesion volume was associated with lower ipsilateral hippocampal integrity (p<0.05), independent of hippocampal volume. In patients with a normal ipsilateral hippocampal volume (volume is less than or equal to 1.5 SD below the mean volume of controls) significant differences in ipsilateral hippocampal MD were observed (p<0.0001). However, patients with a normal hippocampal volume and high hippocampal MD did not show a worse memory performance compared with patients with a normal volume and low hippocampal MD (p>0.05). Conclusions Patients with average ipsilateral hippocampal volume could already have lower ipsilateral hippocampal integrity, although at present with no attendant worse memory performance compared with patients with high hippocampal integrity. Longitudinal studies are needed to investigate whether a low hippocampal integrity after stroke might lead to exacerbated memory decline with increasing age.
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Affiliation(s)
- Pauline Schaapsmeerders
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Anil M. Tuladhar
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Noortje A. M. Maaijwee
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | | | - Renate M. Arntz
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Hennie C. Schoonderwaldt
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | | | - Ewoud J. van Dijk
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience and Centre for Cognition, Radboud University Nijmegen, Nijmegen, the Netherlands
- Department of Medical Psychology, Radboud university medical centre, Nijmegen, the Netherlands
| | - Frank-Erik de Leeuw
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
- * E-mail:
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Wilbers J, Kappelle AC, Versteeg L, Tuladhar AM, Steens SCA, Meijer FJA, Boogerd W, Dorresteijn LD, Kaanders JH, Kessels RPC, van Dijk EJ. Cognitive function, depression, fatigue and quality of life among long-term survivors of head and neck cancer. Neurooncol Pract 2015; 2:144-150. [PMID: 31386076 DOI: 10.1093/nop/npv012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Indexed: 11/12/2022] Open
Abstract
Background Long-term cancer treatment complications become more prevalent as survival improves. Little is known about the psychological complications in long-term survivors of head and neck cancer (HNC). We investigated cognitive functioning and its relation with depression, fatigue, cognitive complaints, and brain lesions on MRI. Methods This study is part of a multicentre, prospective cohort study of 65 patients treated for HNC. A comprehensive neuropsychological assessment was combined with validated questionnaires on subjective memory complaints, depression, and fatigue after a median of 7 years follow-up. Results were compared with age- and education-adjusted normative data. Further, we evaluated cerebral white matter hyperintensities (WMH), brain volume, and infarctions on MRI. Results HNC patients had worse cognitive performance in two of the five assessed cognitive domains: episodic memory (z = -0.48, P = .003) and speed of information processing (z = -0.47, P < 0.001). Patients with fatigue performed worse than patients without fatigue on verbal fluency (mean difference in z-score 0.52, P = .02) and speed of information processing (0.49, P = .04). Patients with subjective memory complaints had a worse episodic memory performance (mean difference in z-score -0.96; P = .02). Patients with cerebral infarction(s) on MRI performed worse on fluency (mean difference in z-score 0.74, P = .005). A lower cognitive performance was not associated with depression, WMH or brain volume. Conclusion Long-term HNC survivors showed worse cognitive functioning 7 years after treatment. Cognitive function was associated with subjective complaints and fatigue, but not with depressive symptoms. Cerebral infarctions on MRI were correlated with cognitive function, whereas WMH, and brain volume were not.
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Affiliation(s)
- Joyce Wilbers
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
| | - Arnoud C Kappelle
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
| | - Laura Versteeg
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
| | - Anil M Tuladhar
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
| | - Stefan C A Steens
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
| | - Frederick J A Meijer
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
| | - Willem Boogerd
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
| | - Lucille D Dorresteijn
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
| | - Johannes H Kaanders
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
| | - Roy P C Kessels
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
| | - Ewoud J van Dijk
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.)
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Mollica MA, Navarra J, Fernández-Prieto I, Olives J, Tort A, Valech N, Coll-Padrós N, Molinuevo JL, Rami L. Subtle visuomotor difficulties in preclinical Alzheimer's disease. J Neuropsychol 2015; 11:56-73. [PMID: 26172318 DOI: 10.1111/jnp.12079] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/12/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Individuals with preclinical Alzheimer's disease (Pre-AD) present nonimpaired cognition, as measured by standard neuropsychological tests. However, detecting subtle difficulties in cognitive functions may be necessary for an early diagnosis and intervention. OBJECTIVES A new computer-based visuomotor coordination task (VMC) was developed to investigate the possible presence of early visuomotor difficulties in Pre-AD individuals. Associations between VMC task performance and AD biomarkers were studied. The influence of ApoE status on participants' performance was addressed, as well as the relationship between performance and subjective cognitive decline (SCD). METHODS Sixty-six cognitively normal (CN) elders (19 Pre-AD and 47 control participants [CTR]) and 15 patients with AD performed the VMC task, which consisted in executing visually guided goal-directed movements that required the coordination of the visual and motor systems. All participants underwent ApoE analysis and lumbar puncture. CN participants also completed an extensive standard neuropsychological battery. RESULTS Despite presenting normal cognition in standard tests, Pre-AD participants exhibited higher response times (RTs) to complete the VMC task than CTR (p < .01). Besides, patients with AD showed higher RTs than CTR (p < .001) and Pre-AD (p < .05), and more errors than CTR (p < .005). RTs in ApoE4 carriers were higher than that observed in ApoE4 noncarriers (p < .01). In CN individuals, RTs were related to amyloid β-protein 42 (AB42) biomarker (p < .01) and informant-rated SCD (p < .01). CONCLUSIONS The VMC task is able to discriminate Pre-AD from CTR individuals. Moreover, VMC results are associated with AB42 levels in CN individuals, suggesting that visuomotor dysfunction may be a sensitive marker of Pre-AD.
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Affiliation(s)
- Maria A Mollica
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Jordi Navarra
- Experimental Psychology and Brain Disorders Laboratory, Sant Joan de Deu Healthcare Park, Sant Joan de Deu Hospital, Barcelona, Spain
| | - Irune Fernández-Prieto
- Experimental Psychology and Brain Disorders Laboratory, Sant Joan de Deu Healthcare Park, Sant Joan de Deu Hospital, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.,Institute for Brain, Cognition and Behaviour (IR3C), Department of Basic Psychology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Jaume Olives
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Adrià Tort
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Natalia Valech
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Nina Coll-Padrós
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - José L Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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44
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Schaapsmeerders P, van Uden IWM, Tuladhar AM, Maaijwee NAM, van Dijk EJ, Rutten-Jacobs LCA, Arntz RM, Schoonderwaldt HC, Dorresteijn LDA, de Leeuw FE, Kessels RPC. Ipsilateral hippocampal atrophy is associated with long-term memory dysfunction after ischemic stroke in young adults. Hum Brain Mapp 2015; 36:2432-42. [PMID: 25757914 DOI: 10.1002/hbm.22782] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 01/16/2015] [Accepted: 02/24/2015] [Indexed: 11/06/2022] Open
Abstract
Memory impairment after stroke in young adults is poorly understood. In elderly stroke survivors memory impairments and the concomitant loss of hippocampal volume are usually explained by coexisting neurodegenerative disease (e.g., amyloid pathology) in interaction with stroke. However, neurodegenerative disease, such as amyloid pathology, is generally absent at young age. Accumulating evidence suggests that infarction itself may cause secondary neurodegeneration in remote areas. Therefore, we investigated the relation between long-term memory performance and hippocampal volume in young patients with first-ever ischemic stroke. We studied all consecutive first-ever ischemic stroke patients, aged 18-50 years, admitted to our academic hospital center between 1980 and 2010. Episodic memory of 173 patients was assessed using the Rey Auditory Verbal Learning Test and the Rey Complex Figure and compared with 87 stroke-free controls. Hippocampal volume was determined using FSL-FIRST, with manual correction. On average 10 years after stroke, patients had smaller ipsilateral hippocampal volumes compared with controls after left-hemispheric stroke (5.4%) and right-hemispheric stroke (7.7%), with most apparent memory dysfunctioning after left-hemispheric stroke. A larger hemispheric stroke was associated with a smaller ipsilateral hippocampal volume (b=-0.003, P<0.0001). Longer follow-up duration was associated with smaller ipsilateral hippocampal volume after left-hemispheric stroke (b=-0.028 ml, P=0.002) and right-hemispheric stroke (b=-0.015 ml, P=0.03). Our results suggest that infarction is associated with remote injury to the hippocampus, which may lower or expedite the threshold for cognitive impairment or even dementia later in life.
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Affiliation(s)
- Pauline Schaapsmeerders
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Inge W M van Uden
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Anil M Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Noortje A M Maaijwee
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ewoud J van Dijk
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Loes C A Rutten-Jacobs
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Renate M Arntz
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Hennie C Schoonderwaldt
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Centre for Neuroscience and Centre for Cognition, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands
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45
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Subjective memory impairment and cholinergic transmission: a TMS study. J Neural Transm (Vienna) 2014; 122:873-6. [DOI: 10.1007/s00702-014-1344-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 11/22/2014] [Indexed: 10/24/2022]
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46
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Mitchell AJ, Beaumont H, Ferguson D, Yadegarfar M, Stubbs B. Risk of dementia and mild cognitive impairment in older people with subjective memory complaints: meta-analysis. Acta Psychiatr Scand 2014; 130:439-51. [PMID: 25219393 DOI: 10.1111/acps.12336] [Citation(s) in RCA: 665] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To investigate whether people with subjective memory complaints (SMC) but no objective deficits are at increased risk of developing mild cognitive impairment (MCI) and dementia. METHOD Major electronic databases were searched till 03/2014, and a meta-analysis was conducted using inception cohort studies. RESULTS Across 28 studies, there were 29,723 unique individuals (14,714 with SMC and 15,009 without SMC) (mean 71.6 years) followed on average for 4.8 years through to dementia. The annual conversion rate (ACR) of SMC to dementia was 2.33% (95% CI = 1.93%-2.78%) a relative risk (RR) of 2.07 (95% CI = 1.76-2.44) compared with those without SMC (n = 15,009). From 11 studies the ACR of developing MCI was 6.67% (95% CI = 4.70-8.95%). In long-term studies over 4 years, 14.1% (9.67-19.1%) of people with SMC developed dementia and 26.6% (95% CI = 5.3-39.7) went on to develop MCI. The ACR from SMC to dementia and MCI were comparable in community and non-community settings. CONCLUSION Older people with SMC but no objective complaints are twice as likely to develop dementia as individuals without SMC. Approximately 2.3% and 6.6% of older people with SMC will progress to dementia and MCI per year.
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Affiliation(s)
- A J Mitchell
- Leicestershire Partnership Trust, Department of Cancer Studies and Molecular Medicine, Leicester Royal Infirmary, Leicester, UK
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47
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Samieri C, Proust-Lima C, M Glymour M, Okereke OI, Amariglio RE, Sperling RA, Rentz DM, Grodstein F. Subjective cognitive concerns, episodic memory, and the APOE ε4 allele. Alzheimers Dement 2014; 10:752-759.e1. [PMID: 25256133 DOI: 10.1016/j.jalz.2014.06.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 05/02/2014] [Accepted: 06/10/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Subjective cognitive concerns may represent a simple method to assess likelihood of memory decline among apolipoprotein E (APOE) ε4 carriers. METHODS We examined the relationship of self-reported subjective cognitive concerns, using seven specific cognitive concerns, with memory and memory decline over 6 years among APOE ε4 carriers and non-carriers from the Nurses' Health Study. RESULTS In both groups, increasing subjective cognitive concern score predicted worse baseline memory and faster rates of subsequent memory decline, after adjustment for age, education and depression. The relation with baseline memory appeared statistically stronger in APOE ε4 carriers (P-interaction = 0.03). For memory decline, mean differences in slopes of episodic memory (95% CI) for 4 to 7 versus no concern = -0.05 (-0.10, 0.01) standard units in APOE ε4 carriers, and -0.04 (-0.08, -0.01) standard units in non-carriers. CONCLUSIONS APOE ε4 carriers with self-assessed cognitive concerns appear to have worse memory, and possibly accelerated memory decline.
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Affiliation(s)
- Cécilia Samieri
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; INSERM, Centre INSERM U897-Epidémiologie-Biostatistiques, Bordeaux, France; Univ. Bordeaux, Centre INSERM U897-Epidémiologie-Biostatistiques, Bordeaux, France.
| | - Cécile Proust-Lima
- INSERM, Centre INSERM U897-Epidémiologie-Biostatistiques, Bordeaux, France; Univ. Bordeaux, Centre INSERM U897-Epidémiologie-Biostatistiques, Bordeaux, France
| | - Maria M Glymour
- Department of Social & Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA; Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Olivia I Okereke
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Dorene M Rentz
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Francine Grodstein
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
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48
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Kiuchi K, Kitamura S, Taoka T, Yasuno F, Tanimura M, Matsuoka K, Ikawa D, Toritsuka M, Hashimoto K, Makinodan M, Kosaka J, Morikawa M, Kichikawa K, Kishimoto T. Gray and white matter changes in subjective cognitive impairment, amnestic mild cognitive impairment and Alzheimer's disease: a voxel-based analysis study. PLoS One 2014; 9:e104007. [PMID: 25093415 PMCID: PMC4122459 DOI: 10.1371/journal.pone.0104007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 07/05/2014] [Indexed: 11/19/2022] Open
Abstract
Subjective cognitive impairment may be a very early at-risk period of the continuum of dementia. However, it is difficult to discriminate at-risk states from normal aging. Thus, detection of the early pathological changes in the subjective cognitive impairment period is needed. To elucidate these changes, we employed diffusion tensor imaging and volumetry analysis, and compared subjective cognitive impairment with normal, mild cognitive impairment and Alzheimer's disease. The subjects in this study were 39 Alzheimer's disease, 43 mild cognitive impairment, 28 subjective cognitive impairment and 41 normal controls. There were no statistically significant differences between the normal control and subjective cognitive impairment groups in all measures. Alzheimer's disease and mild cognitive impairment had the same extent of brain atrophy and diffusion changes. These results are consistent with the hypothetical model of the dynamic biomarkers of Alzheimer's disease.
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Affiliation(s)
- Kuniaki Kiuchi
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
- Medical Center for Dementia, Nara Medical University, Kashihara, Japan
- Sakai City Mental Health Center, Sakai, Japan
- * E-mail:
| | - Soichiro Kitamura
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
- Medical Center for Dementia, Nara Medical University, Kashihara, Japan
- Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan
| | - Toshiaki Taoka
- Department of Radiology, Nara Medical University, Kashihara, Japan
| | - Fumihiko Yasuno
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
- Medical Center for Dementia, Nara Medical University, Kashihara, Japan
| | | | - Kiwamu Matsuoka
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
- Medical Center for Dementia, Nara Medical University, Kashihara, Japan
| | - Daisuke Ikawa
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
| | | | | | - Manabu Makinodan
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
| | - Jun Kosaka
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
| | - Masayuki Morikawa
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
- Mie Prefectural Mental Care Center, Tsu, Japan
| | | | - Toshifumi Kishimoto
- Department of Psychiatry, Nara Medical University, Kashihara, Japan
- Medical Center for Dementia, Nara Medical University, Kashihara, Japan
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49
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van Rooij FG, Schaapsmeerders P, Maaijwee NAM, van Duijnhoven DAHJ, de Leeuw FE, Kessels RPC, van Dijk EJ. Persistent cognitive impairment after transient ischemic attack. Stroke 2014; 45:2270-4. [PMID: 25070959 DOI: 10.1161/strokeaha.114.005205] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whether permanent cognitive impairment occurs after TIA is unclear, as is its profile. METHODS Patients with TIA aged 45 to 65 years without prior stroke or dementia underwent comprehensive neuropsychological testing within 3 months. Z scores per cognitive domain were obtained, based on the mean of a control group within the same age range. Cognitive impairment was defined as a domain z score <-1.65. Patients underwent either computed tomography or MRI brain imaging. RESULTS One hundred seven patients with TIA (63% women, mean age, 56.6 years) were included and compared with 81 controls (56% women, mean age, 52.9 years). Patients performed worse on all cognitive domains except episodic memory. Working memory (25%), attention (22%), and information processing speed (16%) were most frequently impaired and more often than in the control group (age- and sex-adjusted odds ratios, respectively, 22.5 [95% confidence interval, 2.9-174.3], 6.8 [1.9-24.3], 7.1 [1.5-32.5]). More than 35% of patients with TIA had impairment of ≥1 cognitive domain. Presence of silent brain infarcts was related to worse executive functioning but did not explain the whole relationship between TIA and cognitive impairment. CONCLUSIONS More than a third of patients with TIA have impairment of ≥1 cognitive domain within 3 months after their TIA. The affected domains fit in the vascular cognitive impairment profile.
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Affiliation(s)
- Frank G van Rooij
- Departments of Neurology (F.G.v.R., P.S., N.A.M.M., F.-E.d.L., E.J.v.D.) and Medical Psychology (D.A.H.J.v.D., R.P.C.K.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands
| | - Pauline Schaapsmeerders
- Departments of Neurology (F.G.v.R., P.S., N.A.M.M., F.-E.d.L., E.J.v.D.) and Medical Psychology (D.A.H.J.v.D., R.P.C.K.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands
| | - Noortje A M Maaijwee
- Departments of Neurology (F.G.v.R., P.S., N.A.M.M., F.-E.d.L., E.J.v.D.) and Medical Psychology (D.A.H.J.v.D., R.P.C.K.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands
| | - Dirk A H J van Duijnhoven
- Departments of Neurology (F.G.v.R., P.S., N.A.M.M., F.-E.d.L., E.J.v.D.) and Medical Psychology (D.A.H.J.v.D., R.P.C.K.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands
| | - Frank-Erik de Leeuw
- Departments of Neurology (F.G.v.R., P.S., N.A.M.M., F.-E.d.L., E.J.v.D.) and Medical Psychology (D.A.H.J.v.D., R.P.C.K.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Departments of Neurology (F.G.v.R., P.S., N.A.M.M., F.-E.d.L., E.J.v.D.) and Medical Psychology (D.A.H.J.v.D., R.P.C.K.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands
| | - Ewoud J van Dijk
- Departments of Neurology (F.G.v.R., P.S., N.A.M.M., F.-E.d.L., E.J.v.D.) and Medical Psychology (D.A.H.J.v.D., R.P.C.K.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands.
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50
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Wilbers J, Kappelle AC, Kessels RP, Steens SC, Meijer FJ, Kaanders JH, Haast RA, Versteeg LE, Tuladhar AM, de Korte CL, Hansen HH, Hoebers FJ, Boogerd W, van Werkhoven ED, Nowee ME, Hart G, Bartelink H, Dorresteijn LD, van Dijk EJ. Long term cerebral and vascular complications after irradiation of the neck in head and neck cancer patients: a prospective cohort study: study rationale and protocol. BMC Neurol 2014; 14:132. [PMID: 24942263 PMCID: PMC4077148 DOI: 10.1186/1471-2377-14-132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 05/28/2014] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Successful treatment options for cancer result in more young long-term survivors prone for long-term complications. Carotid artery vasculopathy is a potential long-term complication after radiotherapy of the neck, resulting in cerebrovascular events and probably deficits in cognitive and motor functioning. Better insight into the underlying pathofysiology of radiotherapy induced carotid artery vasculopathy is needed for prognostic purposes and to develop preventive strategies. METHODS/DESIGN The current study is a prospective cohort study on the long-term cerebral and vascular complications after radiotherapy of the neck, in 103 patients treated for head and neck cancer, included in our study database between 2002 and 2008. Baseline protocol (before radiotherapy) included screening for cerebrovascular risk factors and intima media thickness measurement of carotid arteries by ultrasonography. Follow-up assessment more than 5 years after radiotherapy included screening of cerebrovascular risk factors, cerebrovascular events, neurological examination with gait and balance tests, extensive neuropsychological examination, self-report questionnaires, ultrasonography of the carotid arteries with measurement of intima media thickness and elastography, magnetic resonance imaging of the brain and magnetic resonance angiography of the carotid arteries. DISCUSSION The current study adds to the understanding of the causes and consequences of long-term cerebral and vascular changes after radiotherapy of the neck. These data will be helpful to develop a protocol for diagnostic and preventive strategies for long-term neurological complications in future head and neck cancer patients with anticipated radiotherapy treatment.
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Affiliation(s)
- Joyce Wilbers
- Department of Neurology, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behaviour Centre for Neuroscience, PO box 9101, 6500 HB Nijmegen, The Netherlands.
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