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Chen J, Li T, Zhao B, Chen H, Yuan C, Garden GA, Wu G, Zhu H. The interaction effects of age, APOE and common environmental risk factors on human brain structure. Cereb Cortex 2024; 34:bhad472. [PMID: 38112569 PMCID: PMC10793588 DOI: 10.1093/cercor/bhad472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/09/2023] [Accepted: 11/06/2023] [Indexed: 12/21/2023] Open
Abstract
Mounting evidence suggests considerable diversity in brain aging trajectories, primarily arising from the complex interplay between age, genetic, and environmental risk factors, leading to distinct patterns of micro- and macro-cerebral aging. The underlying mechanisms of such effects still remain unclear. We conducted a comprehensive association analysis between cerebral structural measures and prevalent risk factors, using data from 36,969 UK Biobank subjects aged 44-81. Participants were assessed for brain volume, white matter diffusivity, Apolipoprotein E (APOE) genotypes, polygenic risk scores, lifestyles, and socioeconomic status. We examined genetic and environmental effects and their interactions with age and sex, and identified 726 signals, with education, alcohol, and smoking affecting most brain regions. Our analysis revealed negative age-APOE-ε4 and positive age-APOE-ε2 interaction effects, respectively, especially in females on the volume of amygdala, positive age-sex-APOE-ε4 interaction on the cerebellar volume, positive age-excessive-alcohol interaction effect on the mean diffusivity of the splenium of the corpus callosum, positive age-healthy-diet interaction effect on the paracentral volume, and negative APOE-ε4-moderate-alcohol interaction effects on the axial diffusivity of the superior fronto-occipital fasciculus. These findings highlight the need of considering age, sex, genetic, and environmental joint effects in elucidating normal or abnormal brain aging.
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Affiliation(s)
- Jie Chen
- Department of Biostatistics, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill NC 27514, United States
| | - Tengfei Li
- Department of Radiology, School of Medicine, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514, United States
- Biomedical Research Imaging Center, School of Medicine, University of North Carolina at Chapel Hill, 125 Mason Farm Road, Chapel Hill, NC 27599, United States
| | - Bingxin Zhao
- Department of Statistics and Data Science, The Wharton School, University of Pennsylvania, 265 South 37th Street, 3rd & 4th Floors, Philadelphia, PA 19104-1686, United States
| | - Hui Chen
- School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou 310058, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou 310058, China
- Department of Nutrition, Harvard T H Chan School of Public Health, 665 Huntington Avenue Boston, MA, 02115, United States
| | - Gwenn A Garden
- Department of Neurology, School of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive Chapel Hill, NC 27599-7025, United States
| | - Guorong Wu
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514, United States
- Departments of Statistics and Operations Research, University of North Carolina at Chapel Hill, 318 E Cameron Ave #3260, Chapel Hill, NC 27599, United States
- Departments of Computer Science, University of North Carolina at Chapel Hill, 201 South Columbia Street, Chapel Hill, NC 27599, United States
- UNC Neuroscience Center, University of North Carolina at Chapel Hill, 116 Manning Dr, Chapel Hill, NC 27599, United States
- Carolina Institute for Developmental Disabilities, 101 Renee Lynne Ct, Carrboro, NC 27510, United States
| | - Hongtu Zhu
- Department of Biostatistics, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill NC 27514, United States
- Biomedical Research Imaging Center, School of Medicine, University of North Carolina at Chapel Hill, 125 Mason Farm Road, Chapel Hill, NC 27599, United States
- Departments of Statistics and Operations Research, University of North Carolina at Chapel Hill, 318 E Cameron Ave #3260, Chapel Hill, NC 27599, United States
- Departments of Computer Science, University of North Carolina at Chapel Hill, 201 South Columbia Street, Chapel Hill, NC 27599, United States
- Departments of Genetics, University of North Carolina at Chapel Hill, 120 Mason Farm Road, Chapel Hill, NC 27514, United States
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2
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Grey-matter brain healthcare quotient and cognitive function: A large cohort study of an MRI brain screening system in Japan. Cortex 2021; 145:97-104. [PMID: 34695701 DOI: 10.1016/j.cortex.2021.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/24/2021] [Accepted: 09/14/2021] [Indexed: 11/22/2022]
Abstract
There is sometimes a divergence between brain atrophy and impairments in cognitive function. The present study aimed to assess the relationship between cognitive function and the grey-matter brain healthcare quotient (GM-BHQ), which represents brain volume as a deviation value. In addition, we aimed to investigate lifestyle factors that can help maintain cognitive function despite brain atrophy. A total of 1,757 adults included in a Japanese MRI brain screening cohort underwent MRI. We classified the participants into two age groups: under 65 years old (young adult/middle age group) and over 64 years old (elder group). The GM-BHQ was more strongly correlated with cognitive function in the young adult/middle age group than in the elder group (p < .01). Regression analysis revealed that years of education was associated with the maintenance of cognitive function despite brain atrophy (p < .05). In conclusion, our findings suggest that the relationship between brain volume and cognitive function becomes more obscure with age.
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3
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Duarte-Guterman P, Albert AY, Barha CK, Galea LAM. Sex influences the effects of APOE genotype and Alzheimer's diagnosis on neuropathology and memory. Psychoneuroendocrinology 2021; 129:105248. [PMID: 33962245 DOI: 10.1016/j.psyneuen.2021.105248] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/10/2021] [Accepted: 04/22/2021] [Indexed: 11/19/2022]
Abstract
Alzheimer's disease (AD) is characterized by severe cognitive decline and pathological changes in the brain (brain atrophy, hyperphosphorylation of tau, and deposition of amyloid-beta protein). Females have greater neuropathology (AD biomarkers and brain atrophy rates) and cognitive decline than males, however these effects can depend on diagnosis (amnestic mild cognitive impairment (aMCI) or AD) and APOE genotype (presence of ε4 alleles). Using the ADNI database (N = 630 females, N = 830 males), we analyzed the effect of sex, APOE genotype (non-carriers or carriers of APOEε4 alleles), and diagnosis (cognitively normal (CN), early aMCI (EMCI), late aMCI (LMCI), probable AD) on cognition (memory and executive function), hippocampal volume, and AD biomarkers (CSF levels of amyloid beta, tau, and ptau). Regardless of APOE genotype, memory scores were higher in CN, EMCI, and LMCI females compared to males but this sex difference was absent in probable AD, which may suggest a delay in the onset of cognitive decline or diagnosis and/or a faster trajectory of cognitive decline in females. We found that, regardless of diagnosis, CSF tau-pathology was disproportionately elevated in female carriers of APOEε4 alleles compared to males. In contrast, male carriers of APOEε4 alleles had reduced levels of CSF amyloid beta compared to females, irrespective of diagnosis. We also detected sex differences in hippocampal volume but the direction was dependent on the method of correction. Altogether results suggest that across diagnosis females show greater memory decline compared to males and APOE genotype affects AD neuropathology differently in males and females which may influence sex differences in incidence and progression of aMCI and AD.
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Affiliation(s)
- Paula Duarte-Guterman
- Djavad Mowafaghian Centre for Brain Health and Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Arianne Y Albert
- Women's Health Research Institute of British Columbia, Vancouver, BC, Canada
| | - Cindy K Barha
- Djavad Mowafaghian Centre for Brain Health and Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Liisa A M Galea
- Djavad Mowafaghian Centre for Brain Health and Department of Psychology, University of British Columbia, Vancouver, BC, Canada.
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Rossini F, Zauner H, Bergmann J, Kronbichler M, Spindler I, Golaszewski S, Trinka E, Staffen W. HMPAO-SPECT Can Discriminate between Patients with Subjective Cognitive Complaints with and without Cognitive Deficits and those with Mild Cognitive Impairment. Curr Alzheimer Res 2020; 16:843-851. [PMID: 31453786 DOI: 10.2174/1567205016666190827115138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 08/09/2019] [Accepted: 08/21/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Growing evidence suggests that pathological processes leading to Alzheimer's disease occurs gradually and begins to develop decades before the earliest clinical symptoms occur. The use of biomarkers has been proposed to detect evidence of preclinical Alzheimer's pathologic change in asymptomatic subjects. Subjective cognitive complaints (SCC) i.e. self-reported cognitive decline with normal cognition have been reported as an indicator of future cognitive decline, however, this condition is unspecific. OBJECTIVE In the present study we used the regional brain perfusion measured by HMPAO-SPECT as Biomarker of neurodegeneration to compare the regional brain perfusion of patient with subjective cognitive complaints with and without minimal cognitive dysfunction (SCC+ and SCC- respectively) in respect to patients with mild cognitive impairment (MCI). METHODS We retrospectively examined 736 Patients who referred to our Memory Clinic because of suspected cognitive dysfunction. After exclusion of patients with overt dementia, automated, quantitatively assessed relative cerebral blood flow of 10 forebrain regions (thalamus, parietotemporal, medial temporal, posterior temporal, posterior cingulate gyrus, each region left hemispheric and right hemispheric) and neuropsychological assessment of 64 SCC (32 SCC+; 32 SCC-) and 28 MCI subjects were analysed. RESULTS .The most relevant differences between groups in cognitive performance concerned verbal memory. Left hemispheric medial temporal region could significantly discriminate between all three groups, with a progressive decrease n perfusion from SCC towards MCI. Area under the curve of left medial temporal region showed a sensitivity of 0,61 and a specificity of 0,78 for discriminating MCI from SCC. CONCLUSION Automated analysis of HMPAO-SPECT data of MCI and SCC+ patients showed significant perfusion differences in medial temporal region and impaired verbal memory, both of which are known features of Alzheimer's disease. Perfusion patterns and verbal memory performance in SCC+ are more similar to MCI than SCC-. Thus, SPECT analysis could distinguish those subjects whose perfusion pattern resembles that of an MCI from those who do not. In our opinion, this could identify two populations with a different risk of progression to AD, with SCC+ subjects needing further diagnostic examination and repeated follow-up.
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Affiliation(s)
- F Rossini
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - H Zauner
- Rehabilitation Center of the Pensionsversicherungsanstalt, Großgmain, Austria
| | - J Bergmann
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria
| | - M Kronbichler
- Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
| | - I Spindler
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - S Golaszewski
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
| | - E Trinka
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
| | - W Staffen
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
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Lee J, Cho H, Jeon S, Kim HJ, Kim YJ, Lee J, Kim ST, Lee JM, Chin J, Lockhart SN, Lee AY, Na DL, Seo SW. Sex-Related Reserve Hypothesis in Alzheimer's Disease: Changes in Cortical Thickness with a Five-Year Longitudinal Follow-Up. J Alzheimers Dis 2019; 65:641-649. [PMID: 30056418 DOI: 10.3233/jad-180049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Sex effects on the progression of Alzheimer's disease (AD) have received less attention than other demographic factors, including onset age and education. OBJECTIVE The aim of this study was to investigate whether sex affected cortical thinning in the disease progression of AD. METHODS We prospectively recruited 36 patients with early-stage AD and 14 people with normal cognition. All subjects were assessed with magnetic resonance imaging at baseline, Year 1, Year 3, and Year 5. We performed cortical thickness analyses using surface-based morphometry on magnetic resonance imaging. RESULTS Women with AD showed more rapid cortical thinning in the left dorsolateral frontal cortex, left superior temporal gyrus, bilateral temporo-parietal association cortices, bilateral anterior cingulate gyri, bilateral medial frontal cortices, and bilateral occipital cortices over 5 years than men with AD, even though there was no difference in cortical thickness at baseline. In contrast, there were no regions of significantly more rapid atrophy in men with AD. CONCLUSIONS Our findings suggest that women deteriorate faster than men in the progression of AD.
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Affiliation(s)
- Juyoun Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.,Department of Neurology, Chungnam National University Hospital, Jung-gu, Daejeon, Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu, Seoul, Korea
| | - Seun Jeon
- Department of Biomedical Engineering, Hanyang University, Seongdong-gu, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Korea
| | - Jeongmin Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seongdong-gu, Seoul, Korea
| | - Juhee Chin
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea
| | - Samuel N Lockhart
- Department of Internal Medicine, Division of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ae Young Lee
- Department of Neurology, Chungnam National University Hospital, Jung-gu, Daejeon, Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea
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6
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Jung NY, Cho H, Kim YJ, Kim HJ, Lee JM, Park S, Kim ST, Kim EJ, Kim JS, Moon SH, Lee JH, Ewers M, Na DL, Seo SW. The impact of education on cortical thickness in amyloid-negative subcortical vascular dementia: cognitive reserve hypothesis. ALZHEIMERS RESEARCH & THERAPY 2018; 10:103. [PMID: 30261914 PMCID: PMC6161352 DOI: 10.1186/s13195-018-0432-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/17/2018] [Indexed: 01/22/2023]
Abstract
Background The protective effect of education has been well established in Alzheimer’s disease, whereas its role in patients with isolated cerebrovascular diseases remains unclear. We examined the correlation of education with cortical thickness and cerebral small vessel disease markers in patients with pure subcortical vascular mild cognitive impairment (svMCI) and patients with pure subcortical vascular dementia (SVaD). Methods We analyzed 45 patients with svMCI and 47 patients with SVaD with negative results on Pittsburgh compound B positron emission tomographic imaging who underwent structural brain magnetic resonance imaging. The main outcome was cortical thickness measured using surface-based morphometric analysis. We also assessed the volumes of white matter hyperintensities (WMH) and numbers of lacunes as other outcomes. To investigate the correlation of education with cortical thickness, WMH volume, and number of lacunes, multiple linear regression analyses were performed after controlling for covariates, including Mini Mental State Examination, in the svMCI and SVaD groups. Results In the SVaD group, higher education was correlated with more severe cortical thinning in the bilateral dorsolateral frontal, left medial frontal, and parahippocampal areas, whereas there was no correlation of education with cortical thickness in the svMCI group. There was no correlation between education and cerebral small vessel disease, including WMH and lacunes, in both patients with svMCI and patients with SVaD. Conclusions Our findings suggest that the compensatory effects of education on cortical thinning apply to patients with SVaD, which might be explained by the cognitive reserve hypothesis.
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Affiliation(s)
- Na-Yeon Jung
- Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea.,Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Jong Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Seongbeom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Busan, Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seung Hwan Moon
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. .,Neuroscience Center, Samsung Medical Center, Seoul, Korea.
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Cavedo E, Chiesa PA, Houot M, Ferretti MT, Grothe MJ, Teipel SJ, Lista S, Habert M, Potier M, Dubois B, Hampel H. Sex differences in functional and molecular neuroimaging biomarkers of Alzheimer's disease in cognitively normal older adults with subjective memory complaints. Alzheimers Dement 2018; 14:1204-1215. [DOI: 10.1016/j.jalz.2018.05.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/22/2018] [Accepted: 05/26/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Enrica Cavedo
- AXA Research Fund & Sorbonne University ChairParisFrance
- Sorbonne University, GRC n° 21Alzheimer Precision Medicine (APM)AP‐HPPitié‐Salpêtrière HospitalBoulevard de l'hôpitalParisFrance
- Brain & Spine Institute (ICM)INSERM U 1127CNRS UMR 7225ParisFrance
- Institute of Memory and Alzheimer's Disease (IM2A)Department of NeurologyPitié‐Salpêtrière HospitalAP‐HPParisFrance
- Laboratory of Alzheimer's Neuroimaging and EpidemiologyIRCCS Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Patrizia A. Chiesa
- AXA Research Fund & Sorbonne University ChairParisFrance
- Sorbonne University, GRC n° 21Alzheimer Precision Medicine (APM)AP‐HPPitié‐Salpêtrière HospitalBoulevard de l'hôpitalParisFrance
- Brain & Spine Institute (ICM)INSERM U 1127CNRS UMR 7225ParisFrance
- Institute of Memory and Alzheimer's Disease (IM2A)Department of NeurologyPitié‐Salpêtrière HospitalAP‐HPParisFrance
| | - Marion Houot
- Sorbonne University, GRC n° 21Alzheimer Precision Medicine (APM)AP‐HPPitié‐Salpêtrière HospitalBoulevard de l'hôpitalParisFrance
- Institute of Memory and Alzheimer's Disease (IM2A)Centre of Excellence of Neurodegenerative Disease (CoEN)ICMCIC NeurosciencesAPHP Department of NeurologyHopital Pitié‐SalpêtrièreUniversity Paris 6ParisFrance
| | - Maria Teresa Ferretti
- Institute for Regenerative Medicine University of ZurichSchlierenSwitzerland
- Neuroscience Center ZurichZurichSwitzerland
- Women's Brain ProjectSwitzerland
| | - Michel J. Grothe
- German Center for Neurodegenerative Diseases (DZNE) – Rostock/GreifswaldRostockGermany
- Department of Psychosomatic MedicineUniversity of RostockRostockGermany
| | - Stefan J. Teipel
- German Center for Neurodegenerative Diseases (DZNE) – Rostock/GreifswaldRostockGermany
- Department of Psychosomatic MedicineUniversity of RostockRostockGermany
| | - Simone Lista
- AXA Research Fund & Sorbonne University ChairParisFrance
- Sorbonne University, GRC n° 21Alzheimer Precision Medicine (APM)AP‐HPPitié‐Salpêtrière HospitalBoulevard de l'hôpitalParisFrance
- Brain & Spine Institute (ICM)INSERM U 1127CNRS UMR 7225ParisFrance
- Institute of Memory and Alzheimer's Disease (IM2A)Department of NeurologyPitié‐Salpêtrière HospitalAP‐HPParisFrance
| | - Marie‐Odile Habert
- Sorbonne UniversitésUPMC Univ Paris 06CNRSINSERMLaboratoire d'Imagerie BiomédicaleParisFrance
- Centre pour l'Acquisition et le Traitement des ImagesParisFrance
- AP‐HPHôpital Pitié‐SalpêtrièreDépartement de Médecine NucléaireParisFrance
| | - Marie‐Claude Potier
- ICM Institut du Cerveau et de la Moelle épinièreCNRS UMR7225INSERM U1127UPMCHôpital de la Pitié‐SalpêtrièreParisFrance
| | - Bruno Dubois
- Sorbonne University, GRC n° 21Alzheimer Precision Medicine (APM)AP‐HPPitié‐Salpêtrière HospitalBoulevard de l'hôpitalParisFrance
- Brain & Spine Institute (ICM)INSERM U 1127CNRS UMR 7225ParisFrance
- Institute of Memory and Alzheimer's Disease (IM2A)Department of NeurologyPitié‐Salpêtrière HospitalAP‐HPParisFrance
| | - Harald Hampel
- AXA Research Fund & Sorbonne University ChairParisFrance
- Sorbonne University, GRC n° 21Alzheimer Precision Medicine (APM)AP‐HPPitié‐Salpêtrière HospitalBoulevard de l'hôpitalParisFrance
- Brain & Spine Institute (ICM)INSERM U 1127CNRS UMR 7225ParisFrance
- Institute of Memory and Alzheimer's Disease (IM2A)Department of NeurologyPitié‐Salpêtrière HospitalAP‐HPParisFrance
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Boller B, Mellah S, Ducharme-Laliberté G, Belleville S. Relationships between years of education, regional grey matter volumes, and working memory-related brain activity in healthy older adults. Brain Imaging Behav 2018; 11:304-317. [PMID: 27734304 DOI: 10.1007/s11682-016-9621-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The aim of this study was to examine the relationships between educational attainment, regional grey matter volume, and functional working memory-related brain activation in older adults. The final sample included 32 healthy older adults with 8 to 22 years of education. Structural magnetic resonance imaging (MRI) was used to measure regional volume and functional MRI was used to measure activation associated with performing an n-back task. A positive correlation was found between years of education and cortical grey matter volume in the right medial and middle frontal gyri, in the middle and posterior cingulate gyri, and in the right inferior parietal lobule. The education by age interaction was significant for cortical grey matter volume in the left middle frontal gyrus and in the right medial cingulate gyrus. In this region, the volume loss related to age was larger in the low than high-education group. The education by age interaction was also significant for task-related activity in the left superior, middle and medial frontal gyri due to the fact that activation increased with age in those with higher education. No correlation was found between regions that are structurally related with education and those that are functionally related with education and age. The data suggest a protective effect of education on cortical volume. Furthermore, the brain regions involved in the working memory network are getting more activated with age in those with higher educational attainment.
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Affiliation(s)
- Benjamin Boller
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Psychology Department, Université de Montréal, Montréal, QC, Canada
| | - Samira Mellah
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Gabriel Ducharme-Laliberté
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Psychology Department, Université de Montréal, Montréal, QC, Canada
| | - Sylvie Belleville
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada. .,Psychology Department, Université de Montréal, Montréal, QC, Canada.
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9
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Suo C, Gates N, Fiatarone Singh M, Saigal N, Wilson GC, Meiklejohn J, Sachdev P, Brodaty H, Wen W, Singh N, Baune BT, Baker M, Foroughi N, Wang Y, Valenzuela MJ. Midlife managerial experience is linked to late life hippocampal morphology and function. Brain Imaging Behav 2017; 11:333-345. [PMID: 27848149 PMCID: PMC5408055 DOI: 10.1007/s11682-016-9649-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An active cognitive lifestyle has been suggested to have a protective role in the long-term maintenance of cognition. Amongst healthy older adults, more managerial or supervisory experiences in midlife are linked to a slower hippocampal atrophy rate in late life. Yet whether similar links exist in individuals with Mild Cognitive Impairment (MCI) is not known, nor whether these differences have any functional implications. 68 volunteers from the Sydney SMART Trial, diagnosed with non-amnestic MCI, were divided into high and low managerial experience (HME/LME) during their working life. All participants underwent neuropsychological testing, structural and resting-state functional MRI. Group comparisons were performed on hippocampal volume, morphology, hippocampal seed-based functional connectivity, memory and executive function and self-ratings of memory proficiency. HME was linked to better memory function (p = 0.024), mediated by larger hippocampal volume (p = 0.025). More specifically, deformation analysis found HME had relatively more volume in the CA1 sub-region of the hippocampus (p < 0.05). Paradoxically, this group rated their memory proficiency worse (p = 0.004), a result correlated with diminished functional connectivity between the right hippocampus and right prefrontal cortex (p < 0.001). Finally, hierarchical regression modelling substantiated this double dissociation.
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Affiliation(s)
- C Suo
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Science, Monash University, Clayton, Australia
| | - N Gates
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - M Fiatarone Singh
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences and Sydney Medical School, The University of Sydney, Lidcombe, Australia
- Hebrew SeniorLife, Boston, MA, USA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - N Saigal
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - G C Wilson
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - J Meiklejohn
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - P Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - H Brodaty
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - W Wen
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - N Singh
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - B T Baune
- Department of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - M Baker
- Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences and Sydney Medical School, The University of Sydney, Lidcombe, Australia
- School of Exercise Science, Australian Catholic University, Strathfield, NSW, Australia
| | - N Foroughi
- Clinical and Rehabilitation Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Y Wang
- Hebrew SeniorLife, Boston, MA, USA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
- Department of Medicine and the Diabetes Center, University of California, San Francisco, San Francisco, CA, USA
| | - Michael J Valenzuela
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
- Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia.
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
- Brain and Mind Centre, 100 Mallett St Camperdown, Sydney, NSW, 2050, Australia.
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Association of lifelong exposure to cognitive reserve-enhancing factors with dementia risk: A community-based cohort study. PLoS Med 2017; 14:e1002251. [PMID: 28291786 PMCID: PMC5349652 DOI: 10.1371/journal.pmed.1002251] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 02/02/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Variation in the clinical manifestation of dementia has been associated with differences in cognitive reserve, although less is known about the cumulative effects of exposure to cognitive reserve factors over the life course. We examined the association of cognitive reserve-related factors over the lifespan with the risk of dementia in a community-based cohort of older adults. METHODS AND FINDINGS Information on early-life education, socioeconomic status, work complexity at age 20, midlife occupation attainment, and late-life leisure activities was collected in a cohort of dementia-free community dwellers aged 75+ y residing in the Kungsholmen district of Stockholm, Sweden, in 1987-1989. The cohort was followed up to 9 y (until 1996) to detect incident dementia cases. To exclude preclinical phases of disease, participants who developed dementia at the first follow-up examination 3 y after the baseline were excluded (n = 602 after exclusions). Structural equation modelling was used to generate latent factors of cognitive reserve from three periods over the life course: early (before 20 y), adulthood (around 30-55 y), and late life (75 y and older). The correlation between early- and adult-life latent factors was strong (γ = 0.9), whereas early-late (γ = 0.27) and adult-late (γ = 0.16) latent factor correlations were weak. One hundred forty-eight participants developed dementia during follow-up, and 454 remained dementia-free. The relative risk (RR) of dementia was estimated using Cox models with life-course cognitive reserve-enhancing factors modelled separately and simultaneously to assess direct and indirect effects. The analysis was repeated among carriers and noncarriers of the apolipoprotein E (APOE) ε4 allele. A reduced risk of dementia was associated with early- (RR 0.57; 95% CI 0.36-0.90), adult- (RR 0.60; 95% CI 0.42-0.87), and late-life (RR 0.52; 95% CI 0.37-0.73) reserve-enhancing latent factors in separate multivariable Cox models. In a mutually adjusted model, which may have been imprecisely estimated because of strong correlation between early- and adult-life factors, the late-life factor preserved its association (RR 0.65; 95% CI 0.45-0.94), whereas the effect of midlife (RR 0.73; 95% CI 0.50-1.06) and early-life factors (RR 0.76; 95% CI 0.47-1.23) on the risk of dementia was attenuated. The risk declined progressively with cumulative exposure to reserve-enhancing latent factors, and having high scores on cognitive reserve-enhancing composite factors in all three periods over the life course was associated with the lowest risk of dementia (RR 0.40; 95% CI 0.20-0.81). Similar associations were detected among APOE ε4 allele carriers and noncarriers. Limitations include measurement error and nonresponse, with both biases likely favouring the null. Strong correlation between early- and adult-life latent factors may have led to a loss in precision when estimating mutually adjusted effects of all periods. CONCLUSIONS In this study, cumulative exposure to reserve-enhancing factors over the lifespan was associated with reduced risk of dementia in late life, even among individuals with genetic predisposition.
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Colangeli S, Boccia M, Verde P, Guariglia P, Bianchini F, Piccardi L. Cognitive Reserve in Healthy Aging and Alzheimer's Disease: A Meta-Analysis of fMRI Studies. Am J Alzheimers Dis Other Demen 2016; 31:443-9. [PMID: 27307143 PMCID: PMC10852844 DOI: 10.1177/1533317516653826] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Cognitive reserve (CR) has been defined as the ability to optimize or maximize performance through differential recruitment of brain networks. In the present study, we aimed at providing evidence for a consistent brain network underpinning CR in healthy and pathological aging. To pursue this aim, we performed a coordinate-based meta-analysis of 17 functional magnetic resonance imaging studies on CR proxies in healthy aging, Alzheimer's disease (AD), and mild cognitive impairment (MCI). We found that different brain areas were associated with CR proxies in healthy and pathological aging. A wide network of areas, including medial and lateral frontal areas, that is, anterior cingulate cortex and dorsolateral prefrontal cortex, as well as precuneus, was associated with proxies of CR in healthy elderly patients. The CR proxies in patients with AD and amnesic-MCI were associated with activation in the anterior cingulate cortex. These results were discussed hypothesizing the existence of possible compensatory mechanisms in healthy and pathological aging.
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Affiliation(s)
- Stefano Colangeli
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Maddalena Boccia
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy Neuropsychology Unit, IRCCS Fondazione Santa Lucia of Rome, Rome, Italy
| | - Paola Verde
- Italian Air Force Experimental Flight Center, Aerospace Medicine Department, Pratica di Mare, Rome, Italy
| | - Paola Guariglia
- Dipartimento Scienze dell'Uomo e della Società, Università degli Studi Kore Enna, Enna, Italy
| | - Filippo Bianchini
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Laura Piccardi
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia of Rome, Rome, Italy Department of Life, Health and Environmental Sciences, L'Aquila University, L'Aquila, Italy
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12
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Fengler S, Roeske S, Heber I, Reetz K, Schulz JB, Riedel O, Wittchen HU, Storch A, Linse K, Baudrexel S, Hilker R, Mollenhauer B, Witt K, Schmidt N, Balzer-Geldsetzer M, Dams J, Dodel R, Gräber S, Pilotto A, Petrelli A, Fünkele S, Kassubek J, Kalbe E. Verbal memory declines more in female patients with Parkinson's disease: the importance of gender-corrected normative data. Psychol Med 2016; 46:2275-2286. [PMID: 27193073 DOI: 10.1017/s0033291716000908] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Data on gender-specific profiles of cognitive functions in patients with Parkinson's disease (PD) are rare and inconsistent, and possible disease-confounding factors have been insufficiently considered. METHOD The LANDSCAPE study on cognition in PD enrolled 656 PD patients (267 without cognitive impairment, 66% male; 292 with mild cognitive impairment, 69% male; 97 with PD dementia, 69% male). Raw values and age-, education-, and gender-corrected Z scores of a neuropsychological test battery (CERAD-Plus) were compared between genders. Motor symptoms, disease duration, l-dopa equivalent daily dose, depression - and additionally age and education for the raw value analysis - were taken as covariates. RESULTS Raw-score analysis replicated results of previous studies in that female PD patients were superior in verbal memory (word list learning, p = 0.02; recall, p = 0.03), while men outperformed women in visuoconstruction (p = 0.002) and figural memory (p = 0.005). In contrast, gender-corrected Z scores showed that men were superior in verbal memory (word list learning, p = 0.02; recall, p = 0.02; recognition, p = 0.04), while no difference was found for visuospatial tests. This picture could be observed both in the overall analysis of PD patients as well as in a differentiated group analysis. CONCLUSIONS Normative data corrected for gender and other sociodemographic variables are relevant, since they may elucidate a markedly different cognitive profile compared to raw scores. Our study also suggests that verbal memory decline is stronger in women than in men with PD. Future studies are needed to replicate these findings, examine the progression of gender-specific cognitive decline in PD and define different underlying mechanisms of this dysfunction.
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Affiliation(s)
- S Fengler
- Department of Medical Psychology,University Hospital Cologne,Germany
| | - S Roeske
- Department of Neurology,University Hospital Bonn, and German Center for Neurodegenerative Diseases (DZNE),Bonn,Germany
| | - I Heber
- Department of Neurology,Medical Faculty,RWTH Aachen University,Germany
| | - K Reetz
- Department of Neurology,Medical Faculty,RWTH Aachen University,Germany
| | - J B Schulz
- Department of Neurology,Medical Faculty,RWTH Aachen University,Germany
| | - O Riedel
- Leibniz-Institute of Prevention Research and Epidemiology,Department of Clinical Epidemiology,Bremen,Germany
| | - H U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden,Germany
| | - A Storch
- Division of Neurodegenerative Diseases,Department of Neurology,Technische Universität Dresden,Germany
| | - K Linse
- Division of Neurodegenerative Diseases,Department of Neurology,Technische Universität Dresden,Germany
| | - S Baudrexel
- Department of Neurology,J.W. Goethe University,Frankfurt/Main,Germany
| | - R Hilker
- Department of Neurology,J.W. Goethe University,Frankfurt/Main,Germany
| | - B Mollenhauer
- Department of Neuropathology,University Medical Center Goettingen,Germany
| | - K Witt
- Department of Neurology,Christian Albrechts University,Kiel,Germany
| | - N Schmidt
- Department of Neurology,Christian Albrechts University,Kiel,Germany
| | | | - J Dams
- Department of Neurology,Philipps University Marburg,Germany
| | - R Dodel
- Department of Neurology,Philipps University Marburg,Germany
| | - S Gräber
- Department of Neurodegenerative Diseases,Hertie Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases (DZNE), University Tübingen, and German Center for Neurodegenerative Diseases, Tübingen,Germany
| | - A Pilotto
- Department of Neurodegenerative Diseases,Hertie Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases (DZNE), University Tübingen, and German Center for Neurodegenerative Diseases, Tübingen,Germany
| | - A Petrelli
- Institute of Gerontology & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Vechta,Germany
| | - S Fünkele
- Department of Neurology,University of Ulm,Germany
| | - J Kassubek
- Department of Neurology,University of Ulm,Germany
| | - E Kalbe
- Department of Medical Psychology,University Hospital Cologne,Germany
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Arenaza-Urquijo EM, Wirth M, Chételat G. Cognitive reserve and lifestyle: moving towards preclinical Alzheimer's disease. Front Aging Neurosci 2015; 7:134. [PMID: 26321944 PMCID: PMC4530312 DOI: 10.3389/fnagi.2015.00134] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 06/29/2015] [Indexed: 01/13/2023] Open
Abstract
The large majority of neuroimaging studies in Alzheimer’s disease (AD) patients have supported the idea that lifestyle factors may protect against the clinical manifestations of AD rather than influence AD neuropathological processes (the cognitive reserve hypothesis). This evidence argues in favor of the hypothesis that lifestyle factors act as moderators between AD pathology and cognition, i.e., through indirect compensatory mechanisms. In this review, we identify emerging evidence in cognitively normal older adults that relate lifestyle factors to established AD neuroimaging biomarkers. While some of these investigations are in agreement with the compensatory view of cognitive reserve, other studies have revealed new clues on the neural mechanisms underlying beneficial effects of lifestyle factors on the brain. Specifically, they provide novel evidence suggesting direct effects of lifestyle factors on AD neuropathological processes. We propose a tentative theoretical model where lifestyle factors may act via direct neuroprotective and/or indirect compensatory mechanisms. Importantly, we suggest that neuroprotective mechanisms may have a major role during early stages and compensatory mechanisms in later stages of the disease. In the absence of an effective treatment for AD and considering the potential of lifestyle factors in AD prevention, understanding the neural mechanisms underlying lifestyle effects on the brain seems crucial. We hope to provide an integrative view that may help to better understand the complex effects of lifestyle factors on AD neuropathological processes, starting from the preclinical stage.
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Affiliation(s)
- Eider M Arenaza-Urquijo
- INSERM, U1077 Caen, France ; Université de Caen Basse-Normandie, UMR-S1077 Caen, France ; Ecole Pratique des Hautes Etudes, UMR-S1077 Caen, France ; CHU de Caen, U1077 Caen, France
| | - Miranka Wirth
- INSERM, U1077 Caen, France ; Université de Caen Basse-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 Basse-Normandie, UMR-S1077 Caen, France ; Ecole Pratique des Hautes Etudes, UMR-S1077 Caen, France ; CHU de Caen, U1077 Caen, France
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14
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Pusswald G, Lehrner J, Hagmann M, Dal-Bianco P, Benke T, Marisa Loitfelder, Marksteiner J, Mosbacher J, Ransmayr G, Sanin G, Schmidt R. Gender-Specific Differences in Cognitive Profiles of Patients with Alzheimer’s Disease: Results of the Prospective Dementia Registry Austria (PRODEM-Austria). J Alzheimers Dis 2015; 46:631-7. [DOI: 10.3233/jad-150188] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Gisela Pusswald
- Department of Neurology, Medical University of Vienna, Austria
| | - Johann Lehrner
- Department of Neurology, Medical University of Vienna, Austria
| | - Michael Hagmann
- Department of Medical Statistics and Informatics, Medical University of Vienna, Austria
| | | | - Thomas Benke
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Marisa Loitfelder
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Austria
| | - Josef Marksteiner
- Department of Psychiatry and Psychotherapy, Regional Hospital Hall in Tirol, Austria
| | - Jochen Mosbacher
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Austria
| | | | - Guenter Sanin
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Reinhold Schmidt
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Austria
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15
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Bialystok E, Poarch G. Language Experience Changes Language and Cognitive Ability. ZEITSCHRIFT FUR ERZIEHUNGSWISSENSCHAFT : ZFE 2014; 17:433-446. [PMID: 25435805 PMCID: PMC4243303 DOI: 10.1007/s11618-014-0491-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The sustained use of two languages by bilinguals has been shown to induce broad changes in language and cognitive abilities across the lifespan. The largest changes are seen as advantages in executive control, a set of processes responsible for controlled attention, inhibition, and shifting. Moreover, there is evidence that these executive control advantages mitigate cognitive decline in older age and contribute to cognitive reserve. In this paper, we examine some of the evidence for these findings and explain their relation to bilingual language use. These effects are considered in terms of their implications for our understanding of cognitive and brain plasticity. Some implications for social policy are discussed.
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Affiliation(s)
- Ellen Bialystok
- Department of Psychology, York University, 4700 Keele Street, Toronto M3J 1P3, Ontario
| | - Gregory Poarch
- Department of English Linguistics, University of Tübingen, Wilhelmstraße 50, 72074 Tübingen, Deutschland
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16
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Rapp SR, Espeland MA, Manson JE, Resnick SM, Bryan NR, Smoller S, Coker LH, Phillips LS, Stefanick ML, Sarto GE. Educational attainment, MRI changes, and cognitive function in older postmenopausal women from the Women's Health Initiative Memory Study. Int J Psychiatry Med 2013; 46:121-43. [PMID: 24552037 PMCID: PMC4544866 DOI: 10.2190/pm.46.2.a] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The relationship between neuropathology and clinically manifested functional and cognitive deficits is complex. Clinical observations of individuals with greater neuropathology who function better than some individuals with less neuropathology are common and puzzling. Educational attainment, a proxy for "cognitive reserve," may help to explain this apparent contradiction. The objective of this study is to determine if educational attainment is correlated with cognitive decline, brain lesion volume, and total brain atrophy. One thousand three hundred ninety of the 7,479 community-dwelling women 65 years of age and older enrolled in the Women's Health Initiative Memory Study, two parallel randomized, placebo-controlled clinical trials comparing unopposed and opposed postmenopausal hormone therapy with placebo, were studied. Study participants received annual assessments of global cognitive function with the Modified Mini Mental State exam. One thousand sixty-three participants also received supplemental neurocognitive battery and neuroimaging studies. Magnetic resonance imaging was used to calculate total ischemic lesion and brain volumes. Incident cases of probable dementia and mild cognitive impairment were centrally adjudicated. After adjustment for total lesion and total brain volumes (atrophy), higher educational attainment predicted better cognitive performance (p < 0.001). Following conversion to dementia/MCI, higher education predicted steeper declines in cognitive function (p < 0.001). Thus, higher educational attainment was associated with a delay in diagnosis of dementia/MCI in the face of a growing neuropathological load.
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Affiliation(s)
- Stephen R. Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157,Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157
| | - Mark A. Espeland
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157
| | - JoAnn E. Manson
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215
| | - Susan M. Resnick
- Laboratory of Personality and Cognition, Intramural Research Program, National Institute on Aging, NIH, 5600 Nathan Shock Drive, Baltimore, MD 21224
| | - Nick R. Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104
| | - Sylvia Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461
| | - Laura H. Coker
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157
| | - Lawrence S. Phillips
- Division of Endocrinology, Emory University School of Medicine, Atlanta, GA 30322
| | - Marcia L. Stefanick
- Center for Disease Prevention Research, Stanford University, Palo Alto, California, 94304
| | - Gloria E. Sarto
- University of Wisconsin Center for Women’s Health Research, Madison, WI 53715
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17
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Noble KG, Grieve SM, Korgaonkar MS, Engelhardt LE, Griffith EY, Williams LM, Brickman AM. Hippocampal volume varies with educational attainment across the life-span. Front Hum Neurosci 2012; 6:307. [PMID: 23162453 PMCID: PMC3494123 DOI: 10.3389/fnhum.2012.00307] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 10/24/2012] [Indexed: 11/25/2022] Open
Abstract
Socioeconomic disparities—and particularly differences in educational attainment—are associated with remarkable differences in cognition and behavior across the life-span. Decreased educational attainment has been linked to increased exposure to life stressors, which in turn have been associated with structural differences in the hippocampus and the amygdala. However, the degree to which educational attainment is directly associated with anatomical differences in these structures remains unclear. Recent studies in children have found socioeconomic differences in regional brain volume in the hippocampus and amygdala across childhood and adolescence. Here we expand on this work, by investigating whether disparities in hippocampal and amygdala volume persist across the life-span. In a sample of 275 individuals from the BRAINnet Foundation database ranging in age from 17 to 87, we found that socioeconomic status (SES), as operationalized by years of educational attainment, moderates the effect of age on hippocampal volume. Specifically, hippocampal volume tended to markedly decrease with age among less educated individuals, whereas age-related reductions in hippocampal volume were less pronounced among more highly educated individuals. No such effects were found for amygdala volume. Possible mechanisms by which education may buffer age-related effects on hippocampal volume are discussed.
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Affiliation(s)
- Kimberly G Noble
- Department of Pediatrics, College of Physicians and Surgeons, Columbia University New York, NY, USA ; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University New York, NY, USA
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18
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Hu S, Coupé P, Pruessner JC, Collins DL. Nonlocal regularization for active appearance model: Application to medial temporal lobe segmentation. Hum Brain Mapp 2012; 35:377-95. [PMID: 22987811 DOI: 10.1002/hbm.22183] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 07/24/2012] [Accepted: 07/25/2012] [Indexed: 01/18/2023] Open
Abstract
The human medial temporal lobe (MTL) is an important part of the limbic system, and its substructures play key roles in learning, memory, and neurodegeneration. The MTL includes the hippocampus (HC), amygdala (AG), parahippocampal cortex (PHC), entorhinal cortex, and perirhinal cortex--structures that are complex in shape and have low between-structure intensity contrast, making them difficult to segment manually in magnetic resonance images. This article presents a new segmentation method that combines active appearance modeling and patch-based local refinement to automatically segment specific substructures of the MTL including HC, AG, PHC, and entorhinal/perirhinal cortex from MRI data. Appearance modeling, relying on eigen-decomposition to analyze statistical variations in image intensity and shape information in study population, is used to capture global shape characteristics of each structure of interest with a generative model. Patch-based local refinement, using nonlocal means to compare the image local intensity properties, is applied to locally refine the segmentation results along the structure borders to improve structure delimitation. In this manner, nonlocal regularization and global shape constraints could allow more accurate segmentations of structures. Validation experiments against manually defined labels demonstrate that this new segmentation method is computationally efficient, robust, and accurate. In a leave-one-out validation on 54 normal young adults, the method yielded a mean Dice κ of 0.87 for the HC, 0.81 for the AG, 0.73 for the anterior parts of the parahippocampal gyrus (entorhinal and perirhinal cortex), and 0.73 for the posterior parahippocampal gyrus.
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Affiliation(s)
- Shiyan Hu
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
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Robertson IH. A noradrenergic theory of cognitive reserve: implications for Alzheimer's disease. Neurobiol Aging 2012; 34:298-308. [PMID: 22743090 DOI: 10.1016/j.neurobiolaging.2012.05.019] [Citation(s) in RCA: 162] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 05/24/2012] [Accepted: 05/27/2012] [Indexed: 01/25/2023]
Abstract
The gap between symptoms and pathology in Alzheimer's disease has been explained by the hypothetical construct of "cognitive reserve"--a set of variables including education, intelligence, and mental stimulation which putatively allow the brain to adapt to-and hence mask--underlying pathologies by maintaining cognitive function despite underlying neural changes. This review proposes a hypothesis that a biological mechanism may mediate between these social/psychological processes on the one hand, and apparently reduced risk of Alzheimer's disease on the other, namely repeated activation of the noradrenergic system over a lifetime by the processes implicated in cognitive reserve. Noradrenaline's neuroprotective effects both in vivo and in vitro, and its key role in mediating the neuroprotective effects of environmental enrichment on the brain, make noradrenaline's key role in mediating cognitive reserve--by disease compensation, disease modification, or a combination of both--a viable hypothesis.
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Affiliation(s)
- Ian H Robertson
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College, Dublin, Ireland.
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Canu E, Frisoni GB, Agosta F, Pievani M, Bonetti M, Filippi M. Early and late onset Alzheimer's disease patients have distinct patterns of white matter damage. Neurobiol Aging 2012; 33:1023-33. [DOI: 10.1016/j.neurobiolaging.2010.09.021] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 07/29/2010] [Accepted: 09/20/2010] [Indexed: 12/22/2022]
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Craik FI, Rose NS. Training cognition: Parallels with physical fitness? JOURNAL OF APPLIED RESEARCH IN MEMORY AND COGNITION 2012. [DOI: 10.1016/j.jarmac.2011.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Ewers M, Frisoni GB, Teipel SJ, Grinberg LT, Amaro E, Heinsen H, Thompson PM, Hampel H. Staging Alzheimer's disease progression with multimodality neuroimaging. Prog Neurobiol 2011; 95:535-46. [PMID: 21718750 PMCID: PMC3223355 DOI: 10.1016/j.pneurobio.2011.06.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 06/09/2011] [Accepted: 06/14/2011] [Indexed: 01/15/2023]
Abstract
Rapid developments in medical neuroimaging have made it possible to reconstruct the trajectory of Alzheimer's disease (AD) as it spreads through the living brain. The current review focuses on the progressive signature of brain changes throughout the different stages of AD. We integrate recent findings on changes in cortical gray matter volume, white matter fiber tracts, neuropathological alterations, and brain metabolism assessed with molecular positron emission tomography (PET). Neurofibrillary tangles accumulate first in transentorhinal and cholinergic brain areas, and 4-D maps of cortical volume changes show early progressive temporo-parietal cortical thinning. Findings from diffusion tensor imaging (DTI) for assessment fiber tract integrity show cortical disconnection in corresponding brain networks. Importantly, the developmental trajectory of brain changes is not uniform and may be modulated by several factors such as onset of disease mechanisms, risk-associated and protective genes, converging comorbidity, and individual brain reserve. There is a general agreement between in vivo brain maps of cortical atrophy and amyloid pathology assessed through PET, reminiscent of post mortem histopathology studies that paved the way in the staging of AD. The association between in vivo and post mortem findings will clarify the temporal dynamics of pathophysiological alterations in the development of preclinical AD. This will be important in designing effective treatments that target specific underlying disease AD mechanisms.
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Affiliation(s)
- Michael Ewers
- Department of Radiology, University of California at San Francisco, San Francisco, USA.
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Sánchez JL, Torrellas C, Martín J, Barrera I. Study of sociodemographic variables linked to lifestyle and their possible influence on cognitive reserve. J Clin Exp Neuropsychol 2011; 33:874-91. [PMID: 21950513 DOI: 10.1080/13803395.2011.567976] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Cognitive reserve is an active mechanism based on the application of resources learned thanks to a good education, profession, or premorbid intelligence. The aim of this research is to study whether the inclusion of sociodemographic variables linked to lifestyle can discriminate individuals more effectively regarding their level of cognitive reserve. Results show the importance of educational, intellectual, and professional type variables, which can contribute to a deeper knowledge of this construct. In our view, a broad number of variables should be used to assess cognitive reserve effectively.
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Affiliation(s)
- Juan Luis Sánchez
- Department of Basic Psychology, Psychobiology and Methodology, University of Salamanca, Spain.
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Bartrés-Faz D, Arenaza-Urquijo EM. Structural and functional imaging correlates of cognitive and brain reserve hypotheses in healthy and pathological aging. Brain Topogr 2011; 24:340-57. [PMID: 21853422 DOI: 10.1007/s10548-011-0195-9] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 07/25/2011] [Indexed: 10/17/2022]
Abstract
In the field of ageing and dementia, brain- or cognitive reserve refers to the capacity of the brain to manage pathology or age-related changes thereby minimizing clinical manifestations. The brain reserve capacity (BRC) hypothesis argues that this capacity derives from an individual's unique neural profile (e.g., cell count, synaptic connections, brain volume, etc.). Complimentarily, the cognitive reserve (CR) hypothesis emphasizes inter-individual differences in the effective recruitment of neural networks and cognitive processes to compensate for age-related effects or pathology. Despite an abundance of research, there is scarce literature attempting to synthesize the BRC the CR models. In this paper, we will review important aging and dementia studies using structural and functional neuroimaging techniques to investigate and attempt to assimilate both reserve hypotheses. The possibility to conceptualize reserve as reflecting indexes of brain plasticity will be proposed and novel data suggesting an intimate and complex correspondence between active and passive components of reserve will be presented.
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Affiliation(s)
- David Bartrés-Faz
- Department of Psychiatry and Clinical Psychobiology, Faculty of Medicine, University of Barcelona, Casanova 143, Barcelona, Spain.
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25
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[Cognitive reserve and its relevance for the prevention and diagnosis of dementia]. DER NERVENARZT 2011; 82:325-30, 332-35. [PMID: 20938631 DOI: 10.1007/s00115-010-3165-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Progressive brain damage is undoubtedly the main cause of clinical symptoms of dementia in neurodegenerative disorders such as Alzheimer's disease. However, the association between brain damage and cognitive symptoms is not linear. Certain interindividual differences such as a good school education or a greater brain volume are associated with a higher resilience against brain damage that is usually referred to as cognitive reserve (CR). Individuals with high CR have a diminished risk for dementia and both active and passive concepts for this phenomenon are discussed. In the concept of passive CR, peculiarities of brain structure such as higher synapse or neuron counts are regarded as buffers against brain damage. Symptoms of dementia do not occur until a certain threshold of damage is passed. In addition to the passive concepts, active mechanisms are also discussed that are associated with the ability to maintain a certain level of cognitive performance in the face of progressive neurodegeneration for a longer period. In subjects with healthy cognitive function, these active mechanisms contribute to the adaptation of brain activity when task difficulty level is increased. Confronted with progressive neurodegeneration, these active mechanisms help to compensate for brain damage. Individuals with higher CR show more efficient activation for solving the same task, which helps them to preserve normal levels of cognitive performance for a longer period.
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Schweizer TA, Ware J, Fischer CE, Craik FIM, Bialystok E. Bilingualism as a contributor to cognitive reserve: evidence from brain atrophy in Alzheimer's disease. Cortex 2011; 48:991-6. [PMID: 21596373 DOI: 10.1016/j.cortex.2011.04.009] [Citation(s) in RCA: 156] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 12/08/2010] [Accepted: 04/12/2011] [Indexed: 12/21/2022]
Abstract
Much of the research on delaying the onset of symptoms of Alzheimer's disease (AD) has focused on pharmacotherapy, but environmental factors have also been acknowledged to play a significant role. Bilingualism may be one factor contributing to 'cognitive reserve' (CR) and therefore to a delay in symptom onset. If bilingualism is protective, then the brains of bilinguals should show greater atrophy in relevant areas, since their enhanced CR enables them to function at a higher level than would be predicted from their level of disease. We analyzed a number of linear measurements of brain atrophy from the computed tomography (CT) scans of monolingual and bilingual patients diagnosed with probable AD who were matched on level of cognitive performance and years of education. Bilingual patients with AD exhibited substantially greater amounts of brain atrophy than monolingual patients in areas traditionally used to distinguish AD patients from healthy controls, specifically, the radial width of the temporal horn and the temporal horn ratio. Other measures of brain atrophy were comparable for the two groups. Bilingualism appears to contribute to increased CR, thereby delaying the onset of AD and requiring the presence of greater amounts of neuropathology before the disease is manifest.
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Affiliation(s)
- Tom A Schweizer
- Keenan Research Centre of the Li Ka Shing Knowledge Institute at St. Michael's Hospital, Toronto, Canada.
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Sex differences in grey matter atrophy patterns among AD and aMCI patients: results from ADNI. Neuroimage 2011; 56:890-906. [PMID: 21356315 DOI: 10.1016/j.neuroimage.2011.02.060] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 02/14/2011] [Accepted: 02/20/2011] [Indexed: 11/21/2022] Open
Abstract
We used longitudinal magnetic resonance imaging (MRI) data to determine whether there are any gender differences in grey matter atrophy patterns over time in 197 individuals with probable Alzheimer's disease (AD) and 266 with amnestic mild cognitive impairment (aMCI), compared with 224 healthy controls participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI). While previous research has differentiated probable AD and aMCI groups from controls in brain atrophy, it is unclear whether and how sex plays a role in patterns of change over time. Using regional volumetric maps, we fit longitudinal models to the grey matter data collected at repeated occasions, seeking differences in patterns of volume change over time by sex and diagnostic group in a voxel-wise analysis. Additionally, using a region-of-interest approach, we fit longitudinal models to the global volumetric data of predetermined brain regions to determine whether this more conventional approach is sufficient for determining sex and group differences in atrophy. Our longitudinal analyses revealed that, of the various grey matter regions investigated, males and females in the AD group and the aMCI group showed different patterns of decline over time compared to controls in the bilateral precuneus, bilateral caudate nucleus, right entorhinal gyrus, bilateral thalamus, bilateral middle temporal gyrus, left insula, and right amygdala. As one of the first investigation to model more than two time points of structural MRI data over time, our findings add insight into how AD and aMCI males and females differ from controls and from each other over time.
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Perneczky R, Wagenpfeil S, Lunetta KL, Cupples LA, Green RC, DeCarli C, Farrer LA, Kurz A. Education attenuates the effect of medial temporal lobe atrophy on cognitive function in Alzheimer's disease: the MIRAGE study. J Alzheimers Dis 2010; 17:855-62. [PMID: 19542606 DOI: 10.3233/jad-2009-1117] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Functional imaging and neuropathological studies suggest that individuals with higher education have better cognitive performance at the same level of brain pathology than less educated subjects. No in vivo studies are available that directly test how education modifies the effect of structural pathology on cognition in Alzheimer's disease (AD). The present study therefore aimed to measure this effect using data from a large multi-center study. 270 patients with AD underwent cognitive testing using the Mini Mental State Examination (MMSE), apolipoprotein E (APOE) genotyping, and cerebral magnetic resonance imaging. A linear regression analysis was used to examine the relation of medial temporal lobe atrophy (MTA), as a proxy of AD pathology, to MMSE score, adjusting for age, gender, APOE, cerebrovascular disease, ethnicity, education, and disease duration. An interaction term for MTA and education was introduced to test the hypothesis that education modifies the effect of MTA on cognition. There was a significant inverse association between MTA and cognition. Most interestingly, the interaction term between education and MTA was significant suggesting that education modifies the relation of MTA to cognition. At any level of pathology, cognition remained higher for better educated individuals.
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Affiliation(s)
- Robert Perneczky
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany.
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Ho AJ, Raji CA, Becker JT, Lopez OL, Kuller LH, Hua X, Dinov ID, Stein JL, Rosano C, Toga AW, Thompson PM. The effects of physical activity, education, and body mass index on the aging brain. Hum Brain Mapp 2010; 32:1371-82. [PMID: 20715081 DOI: 10.1002/hbm.21113] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Revised: 04/21/2010] [Accepted: 05/25/2010] [Indexed: 01/13/2023] Open
Abstract
Normal human aging is accompanied by progressive brain tissue loss and cognitive decline; however, several factors are thought to influence brain aging. We applied tensor-based morphometry to high-resolution brain MRI scans to determine whether educational level or physical activity was associated with brain tissue volumes in the elderly, particularly in regions susceptible to age-related atrophy. We mapped the 3D profile of brain volume differences in 226 healthy elderly subjects (130F/96M; 77.9 ± 3.6 SD years) from the Cardiovascular Health Study-Cognition Study. Statistical maps revealed the 3D profile of brain regions whose volumes were associated with educational level and physical activity (based on leisure-time energy expenditure). After controlling for age, sex, and physical activity, higher educational levels were associated with ~2-3% greater tissue volumes, on average, in the temporal lobe gray matter. After controlling for age, sex, and education, greater physical activity was associated with ~2-2.5% greater average tissue volumes in the white matter of the corona radiata extending into the parietal-occipital junction. Body mass index (BMI) was highly correlated with both education and physical activity, so we examined BMI as a contributing factor by including physical activity, education, and BMI in the same model; only BMI effects remained significant. This is one of the largest MRI studies of factors influencing structural brain aging, and BMI may be a key factor explaining the observed relationship between education, physical activity, and brain structure. Independent contributions to brain structure could not be teased apart as all these factors were highly correlated with one another.
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Affiliation(s)
- April J Ho
- Department of Neurology, Laboratory of Neuro Imaging, UCLA School of Medicine, Los Angeles, California 90095-7332, USA
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Structural and functional patterns in healthy aging, mild cognitive impairment, and Alzheimer disease. Alzheimer Dis Assoc Disord 2010; 24:1-10. [PMID: 19571730 DOI: 10.1097/wad.0b013e3181aba730] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to analyze the combined contribution of magnetic resonance imaging and magnetoencephalography (MEG) to the diagnosis of mild cognitive impairment (MCI) and AD. To whole-head MEG recordings were obtained from three diagnosis groups: Alzheimer disease (AD), MCI, and control. Magnetic resonance imaging volumetric data of global brain, temporal lobe, and hippocampal volumes, were also obtained. Results indicated that a reduction of volume in the hippocampal structure allowed the discrimination between AD and MCI patients as compared with controls. The percentage of correct classification was 91.3% when AD versus controls was compared, and 83.3% when we compared MCI versus control. MEG data showed that AD patients exhibit higher theta and delta activity than MCI and controls. Such higher activity was significant in parietal, temporal, and occipital areas. Left parietal theta classified controls versus MCIs with 78.3% rate of correct classification. Right occipital theta and the left parietal delta allowed the discrimination of controls versus ADs, with 81.8% rate of correct classification. Left parietal theta discriminated between ADs and MCIs with 56.6% rate of correct classification. In addition, the combination of both techniques significantly improved the rate of correct classification, thus indicating that a multidisciplinary perspective of techniques may improve the diagnostic capabilities.
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31
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Chao LL, Mueller SG, Buckley ST, Peek K, Raptentsetseng S, Elman J, Yaffe K, Miller BL, Kramer JH, Madison C, Mungas D, Schuff N, Weiner MW. Evidence of neurodegeneration in brains of older adults who do not yet fulfill MCI criteria. Neurobiol Aging 2010; 31:368-77. [PMID: 18550226 PMCID: PMC2814904 DOI: 10.1016/j.neurobiolaging.2008.05.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Revised: 04/25/2008] [Accepted: 05/01/2008] [Indexed: 12/01/2022]
Abstract
We sought to determine whether there are structural and metabolic changes in the brains of older adults with cognitive complaints yet who do not meet MCI criteria (i.e., preMCI). We compared the volumes of regional lobar gray matter (GM) and medial temporal lobe structures, including the hippocampus, entorhinal cortex (ERC), fusiform and parahippocampal gyri, and metabolite ratios from the posterior cingulate in individuals who had a Clinical Demetia Rating (CDR) of 0.5, but who did not meet MCI criteria (preMCI, N=17), patients with mild cognitive impairment (MCI, N=13), and cognitively normal controls (N=18). Controls had more ERC, fusiform, and frontal gray matter volume than preMCI and MCI subjects and greater parahippocampal volume and more posterior cingulate N-acetylaspartate (NAA)/myoinosotil (mI) than MCI. There were no significant differences between MCI and preMCI subjects on any of these measures. These findings suggest there are neurodegenerative changes in the brains of older adults who have cognitive complaints severe enough to qualify for CDR=0.5 yet show no deficits on formal neuropsychological testing. The results further support the hypothesis that detection of individuals with very mild forms of Alzheimer's disease (AD) may be facilitated by use of the CDR, which emphasizes changes in cognition over time within individuals rather than comparison with group norms.
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Affiliation(s)
- L L Chao
- Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, San Francisco, CA 94121, USA.
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32
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Longitudinal Measurement of Ventricular Volume Gain in the Healthy Old. Brain Imaging Behav 2009. [DOI: 10.1007/s11682-009-9079-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schultz RR, de Castro CC, Bertolucci PHF. Memory with emotional content, brain amygdala and Alzheimer's disease. Acta Neurol Scand 2009; 120:101-10. [PMID: 19154540 DOI: 10.1111/j.1600-0404.2008.01132.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES A highly adaptive aspect of human memory is the enhancement of explicit, consciously accessible memory by emotional stimuli. We studied the performance of Alzheimer's disease (AD) patients and elderly controls using a memory battery with emotional content, and we correlated these results with the amygdala and hippocampus volume. METHODS Twenty controls and 20 early AD patients were subjected to the International Affective Picture System (IAPS) and to magnetic resonance imaging-based volumetric measurements of the medial temporal lobe structures. RESULTS The results show that excluding control group subjects with 5 or more years of schooling, both groups showed improvement with pleasant or unpleasant figures for the IAPS in an immediate free recall test. Likewise, in a delayed free recall test, both the controls and the AD group showed improvement for pleasant pictures, when education factor was not controlled. The AD group showed improvement in the immediate and delayed free recall test proportional to the medial temporal lobe structures, with no significant clinical correlation between affective valence and amygdala volume. CONCLUSION AD patients can correctly identify emotions, at least at this early stage, but this does not improve their memory performance.
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Affiliation(s)
- R R Schultz
- Behavior Neurology Section, University of Santo Amaro, São Paulo, SP, Brazil.
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Bosch B, Bartrés-Faz D, Rami L, Arenaza-Urquijo EM, Fernández-Espejo D, Junqué C, Solé-Padullés C, Sánchez-Valle R, Bargalló N, Falcón C, Molinuevo JL. Cognitive reserve modulates task-induced activations and deactivations in healthy elders, amnestic mild cognitive impairment and mild Alzheimer's disease. Cortex 2009; 46:451-61. [PMID: 19560134 DOI: 10.1016/j.cortex.2009.05.006] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Revised: 04/20/2009] [Accepted: 05/06/2009] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Cognitive reserve (CR) reflects the capacity of the brain to endure neuropathology in order to minimize clinical manifestations. Previous studies showed that CR modulates the patterns of brain activity in both healthy and clinical populations. In the present study we sought to determine whether reorganizations of functional brain resources linked to CR could already be observed in amnestic mild cognitive impairment (a-MCI) and mild Alzheimer's disease (AD) patients when performing a task corresponding to an unaffected cognitive domain. We further investigated if activity in regions showing task-induced deactivations, usually identified as pertaining to the default-mode network (DMN), was also influenced by CR. METHODS Fifteen healthy elders, 15 a-MCI and 15 AD patients underwent functional magnetic resonance imaging (fMRI) during a speech comprehension task. Differences in the regression of slopes between CR proxies and blood-oxygen-level dependent (BOLD) signals across clinical groups were investigated for activation and deactivation areas. Correlations between significant fMRI results and a language comprehension test were also computed. RESULTS Among a-MCI and AD we observed positive correlations between CR measures and BOLD signals in task-induced activation areas directly processing speech, as well as greater deactivations in regions of the DMN. These relationships were inverted in healthy elders. We found no evidence that these results were mediated by gray matter volumes. Increased activity in left frontal areas and decreased activity in the anterior cingulate were related to better language comprehension in clinical evaluations. CONCLUSIONS The present findings provide evidence that the neurofunctional reorganizations related to CR among a-MCI and AD patients can be seen even when considering a preserved cognitive domain, being independent of gray matter atrophy. Areas showing both task-induced activations and deactivations are modulated by CR in an opposite manner when considering healthy elders versus patients. Brain reorganizations facilitated by CR may reflect behavioral compensatory mechanisms.
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Affiliation(s)
- Beatriz Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Catalonia, Spain
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Pievani M, Rasser PE, Galluzzi S, Benussi L, Ghidoni R, Sabattoli F, Bonetti M, Binetti G, Thompson PM, Frisoni GB. Mapping the effect of APOE epsilon4 on gray matter loss in Alzheimer's disease in vivo. Neuroimage 2009; 45:1090-8. [PMID: 19349226 PMCID: PMC2739903 DOI: 10.1016/j.neuroimage.2009.01.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Revised: 12/12/2008] [Accepted: 01/07/2009] [Indexed: 11/17/2022] Open
Abstract
Previous studies suggest that in Alzheimer's disease (AD) the Apolipoprotein E (APOE) epsilon4 allele is associated with greater vulnerability of medial temporal lobe structures. However, less is known about its effect on the whole cortical mantle. Here we aimed to identify APOE-related patterns of cortical atrophy in AD using an advanced computational anatomy technique. We studied 15 AD patients carriers (epsilon4+, age: 72+/-10 SD years, MMSE: 20+/-3 SD) and 14 non-carriers (epsilon4-, age: 69+/-9, MMSE: 20+/-5) of the epsilon4 allele and compared them to 29 age-and-sex matched controls (age: 70+/-9, MMSE: 28+/-1). Each subject underwent a clinical evaluation, a neuropsychological battery, and high-resolution MRI. UCLA's cortical pattern matching technique was used to identify regions of local cortical atrophy. epsilon4+ and epsilon4- patients showed similar performance on neuropsychological tests (p>.05, t-test). Diffuse cortical atrophy was detected for both epsilon4+ (p=.0001, permutation test) and epsilon4- patients (p=.0001, permutation test) relative to controls, and overall gray matter loss was about 15% in each patients group. Differences in gray matter loss between carriers and non-carriers mapped to the temporal cortex and right occipital pole (20% greater loss in carriers) and to the posterior cingulate, left orbitofrontal and dorsal fronto-parietal cortex (5-15% greater loss in non-carriers). APOE effect in AD was not significant (p>.74, ANOVA), but a significant APOE by region (temporal vs fronto-parietal cortex) interaction was detected (p=.002, ANOVA), in both early and late-onset patients (p<.05, ANOVA). We conclude that the epsilon4 allele modulates disease phenotype in AD, being associated with a pattern of differential temporal and fronto-parietal vulnerability.
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Affiliation(s)
- M Pievani
- LENITEM Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS Centro San Giovanni di Dio - FBF, Brescia, Italy
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Seo SW, Im K, Lee JM, Kim ST, Ahn HJ, Go SM, Kim SH, Na DL. Effects of demographic factors on cortical thickness in Alzheimer's disease. Neurobiol Aging 2009; 32:200-9. [PMID: 19321233 DOI: 10.1016/j.neurobiolaging.2009.02.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Revised: 12/29/2008] [Accepted: 02/04/2009] [Indexed: 11/27/2022]
Abstract
The aim of this study was to investigate the effect of demographic factors (age of onset, sex and years of education) on the distribution of cortical thickness in a large sample of patients with Alzheimer's disease (AD). The study participants consisted of 193 AD patients and 142 controls with no cognitive impairment (NCI) that were measured with cortical thickness across the entire brain. The effects of demographic factors on cortical thickness were analyzed by applying linear regression after controlling confounding factors. Older individuals in NCI group showed more cortical thinning in frontal, temporal association cortices and insula than younger participants. Early onset AD was associated with cortical thinning in the parietal lobe, whereas late onset AD was associated with cortical thinning in the medial temporal region. The NCI group demonstrated sex-related differences in cortical thickness, although those differences were not present in the AD group. While the education effect was absent in NCI individuals, high levels of education in the AD group correlated with cortical thinning in the frontal and temporoparietal association cortices. Our results show that AD with earlier onset and higher education had suffered more pronounced cortical atrophy in specific parts of the brain than their counterparts, which may be related to cognitive reserve theory.
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Affiliation(s)
- Sang Won Seo
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 ILwon-dong Kangnam-ku, Seoul 135-710, Republic of Korea
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Staffen W, Bergmann J, Schönauer U, Zauner H, Kronbichler M, Golaszewski S, Ladurner G. Cerebral perfusion (HMPAO-SPECT) in patients with depression with cognitive impairment versus those with mild cognitive impairment and dementia of Alzheimer's type: a semiquantitative and automated evaluation. Eur J Nucl Med Mol Imaging 2009; 36:801-10. [PMID: 19137294 DOI: 10.1007/s00259-008-1028-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Accepted: 11/21/2008] [Indexed: 02/07/2023]
Abstract
PURPOSE Comparative evaluation of regional brain perfusion measured by HMPAO-SPECT of patients with mild cognitive impairment (MCI), dementia of Alzheimer's type (DAT) and depression with cognitive impairment (DCI). METHODS A total of 736 patients were investigated because of suspected cognitive dysfunction. After exclusion of patients with other forms of dementia than DAT or relevant accompanying disorders, SPECT data from 149 MCI, 131 DAT and 127 DCI patients, and 123 controls without any cognitive impairment, were analysed. Relative cerebral blood flow of 34 anatomical regions was assessed with automated analysis software (BRASS). RESULTS Calculation of global forebrain perfusion discriminated demented from nondemented patients. Compared to controls DCI patients showed hypoperfusion of the thalamus, lentiform nucleus and medial temporal cortex. MCI patients differed significantly from controls concerning perfusion in both hemispheric temporal and parietal areas, and in the (right hemispheric) posterior part of the cingulate gyrus. MCI and DCI patients differed in the parietal, temporal superior and right hemispheric cingulate gyrus posterior cortices. Global forebrain and regional perfusion was more extensively reduced in DAT patients and discriminated them from controls, and MCI and DCI patients. Frontal perfusion disturbance was only present in DAT patients. CONCLUSION Automated analysis of HMPAO-SPECT data from MCI patients showed significant perfusion deficits in regions also involved in DAT patients, but ROC analysis demonstrated only moderate sensitivity and specificity for differentiating DAT patients from controls and DCI patients. Frontal hypoperfusion seems to correspond with conversion from MCI to DAT. Finally, the results in DCI patients again raise the question of depression as an early symptom of neurodegeneration.
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Affiliation(s)
- W Staffen
- Christian-Doppler-Clinic, Department of Neurology, Paracelsus Medical University, Salzburg, Austria.
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Möller T, Born C, Reiser M, Möller HJ, Hampel H, Teipel S. Alzheimer-Krankheit und vaskuläre Demenz. DER NERVENARZT 2008; 80:54-61. [DOI: 10.1007/s00115-008-2556-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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40
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Solé-Padullés C, Bartrés-Faz D, Junqué C, Vendrell P, Rami L, Clemente IC, Bosch B, Villar A, Bargalló N, Jurado MA, Barrios M, Molinuevo JL. Brain structure and function related to cognitive reserve variables in normal aging, mild cognitive impairment and Alzheimer's disease. Neurobiol Aging 2007; 30:1114-24. [PMID: 18053618 DOI: 10.1016/j.neurobiolaging.2007.10.008] [Citation(s) in RCA: 250] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Revised: 10/07/2007] [Accepted: 10/13/2007] [Indexed: 10/22/2022]
Abstract
Cognitive reserve (CR) is the brain's capacity to cope with cerebral damage to minimize clinical manifestations. The 'passive model' considers head or brain measures as anatomical substrates of CR, whereas the 'active model' emphasizes the use of brain networks effectively. Sixteen healthy subjects, 12 amnestic mild cognitive impairment (MCI) and 16 cases with mild Alzheimer's disease (AD) were included to investigate the relationships between proxies of CR and cerebral measures considered in the 'passive' and 'active' models. CR proxies were inferred premorbid IQ (WAIS Vocabulary test), 'education-occupation', a questionnaire of intellectual and social activities and a composite CR measure. MRI-derived whole-brain volumes and brain activity by functional MRI during a visual encoding task were obtained. Among healthy elders, higher CR was related to larger brains and reduced activity during cognitive processing, suggesting more effective use of cerebral networks. In contrast, higher CR was associated with reduced brain volumes in MCI and AD and increased brain function in the latter, indicating more advanced neuropathology but that active compensatory mechanisms are still at work in higher CR patients. The right superior temporal gyrus (BA 22) and the left superior parietal lobe (BA 7) showed greatest significant differences in direction of slope with CR and activation between controls and AD cases. Finally, a regression analysis revealed that fMRI patterns were more closely related to CR proxies than brain volumes. Overall, inverse relationships for healthy and pathological aging groups emerged between brain structure and function and CR variables.
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Affiliation(s)
- Cristina Solé-Padullés
- Departament de Psiquiatria i Psicobiologia Clínica, Universitat de Barcelona, Barcelona, Spain
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Apostolova LG, Steiner CA, Akopyan GG, Dutton RA, Hayashi KM, Toga AW, Cummings JL, Thompson PM. Three-dimensional gray matter atrophy mapping in mild cognitive impairment and mild Alzheimer disease. ACTA ACUST UNITED AC 2007; 64:1489-95. [PMID: 17923632 DOI: 10.1001/archneur.64.10.1489] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Alzheimer disease (AD) is the most common form of dementia worldwide. Mild cognitive impairment (MCI) is the recent terminology for patients with cognitive deficiencies in the absence of functional decline. Most patients with MCI harbor the pathologic changes of AD and demonstrate transition to dementia at a rate of 10% to 15% per year. Patients with AD and MCI experience progressive brain atrophy. OBJECTIVE To analyze the structural magnetic resonance imaging data for 24 patients with amnestic MCI and 25 patients with mild AD using an advanced 3-dimensional cortical mapping technique. DESIGN Cross-sectional cohort design. Patients/ METHODS We analyzed the structural magnetic resonance imaging data of 24 amnestic MCI (mean MMSE, 28.1; SD, 1.7) and 25 mild AD patients (all MMSE scores, >18; mean MMSE, 23.7; SD, 2.9) using an advanced 3-dimensional cortical mapping technique. RESULTS We observed significantly greater cortical atrophy in patients with mild AD. The entorhinal cortex, right more than left lateral temporal cortex, right parietal cortex, and bilateral precuneus showed 15% more atrophy and the remainder of the cortex primarily exhibited 10% to 15% more atrophy in patients with mild AD than in patients with amnestic MCI. CONCLUSION There are striking cortical differences between mild AD and the immediately preceding cognitive state of amnestic MCI. Cortical areas affected earlier in the disease process are more severely affected than those that are affected late. Our method may prove to be a reliable in vivo disease-tracking technique that can also be used for evaluating disease-modifying therapies in the future.
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Affiliation(s)
- Liana G Apostolova
- Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, 10911 Westwood Blvd, Second Floor, Los Angeles, CA 90095, USA.
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Ain KB, Lee C, Williams KD. Phase II trial of thalidomide for therapy of radioiodine-unresponsive and rapidly progressive thyroid carcinomas. Thyroid 2007; 17:663-70. [PMID: 17696837 DOI: 10.1089/thy.2006.0289] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There are no known effective therapies for distantly metastatic, rapidly progressive thyroid carcinomas unresponsive to radioiodine. OBJECTIVE Since thyroid carcinomas are hypervascular and thalidomide is antiangiogenic, we assessed thalidomide's tumoristatic effects and toxicity in a phase II trial. DESIGN Thirty-six patients with follicular, papillary, insular, or medullary thyroid carcinomas and distant, radioiodine-unresponsive metastases (volumes increasing >or= 30% per year before entry) were accrued between July 2001 and December 2002. Daily thalidomide started at 200 mg, increasing over 6 weeks to 800 mg or maximum tolerated dose. Toxicities and responses were assessed at 8-week intervals with tumor volume assessments. MAIN OUTCOMES Twenty-eight of 36 patients were evaluable, 5 with partial responses (PR: 18%; 95% confidence interval [95% CI]: 6-37%) and 9 patients with stable disease (SD: 32%; 95% CI: 12-42%) for overall 50% response (95% CI: 31-69%). Median PR duration was 4 months (range: 2-6 months), and SD duration was 6 months (range: 2-14 months). Median survival was 23.5 months for responders (PR + SD) and 11 months for nonresponders. Most frequent toxicity was fatigue (69% grade 1-2, 8% grade 3-4). Four patients had grade 3-4 infections (without neutropenia), one had pericardial effusion, and one had pulmonary embolus. CONCLUSIONS Thalidomide confers therapeutic benefit in subsets of thyroid cancer patients with rapidly progressive, distantly metastatic disease.
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Affiliation(s)
- Kenneth B Ain
- Thyroid Cancer Research Laboratory, Veterans Affairs Medical Center, Lexington, Kentucky, USA.
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Shinno H, Inagaki T, Miyaoka T, Okazaki S, Kawamukai T, Utani E, Inami Y, Horiguchi J. A decrease in N-acetylaspartate and an increase in myoinositol in the anterior cingulate gyrus are associated with behavioral and psychological symptoms in Alzheimer's disease. J Neurol Sci 2007; 260:132-8. [PMID: 17540407 DOI: 10.1016/j.jns.2007.04.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2006] [Revised: 04/16/2007] [Accepted: 04/17/2007] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE The cognitive decline in Alzheimer's disease (AD) patients has been reported to involve alterations in the medial temporal lobe and the posterior cingulate gyrus. On the other hand, the neurochemical pathologies of the behavioral and psychological symptoms of dementia (BPSD) have not been sufficiently discussed. The aim of this study was to clarify the pathologies of BPSD in AD patients. METHODS Thirty patients with probable AD were included and underwent the following assessments: Mini Mental State Examination (MMSE), Clock Drawing Test (CDT), Story Recall Test (SRT), Behavioral pathology in Alzheimer's disease (BEHAVE-AD) and proton MRS ((1)H-MRS). None of them had been medicated for BPSD. RESULTS The MRS study revealed that MMSE, CDT, and SRT scores were positively related to N-acetyl-aspartate (NAA)/creatine(Cr) and negatively related to myoinositol (mI)/Cr in the posterior cingulate gyrus, but not in the anterior cingulate gyrus. On the other hand, the scores obtained in two categories of BEHAVE-AD (delusional thought/ activity disturbances) were negatively related with NAA/Cr and positively related with mI/Cr in the anterior cingulate gyrus, but not in the posterior cingulate gyrus. CONCLUSION We conclude that BPSD and the decline in cognitive function in AD might have separate pathologies.
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Affiliation(s)
- Hideto Shinno
- Department of Psychiatry, Shimane University Faculty of Medicine, Izumo, Japan.
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Anderson VC, Litvack ZN, Kaye JA. Magnetic resonance approaches to brain aging and Alzheimer disease-associated neuropathology. Top Magn Reson Imaging 2007; 16:439-52. [PMID: 17088693 DOI: 10.1097/01.rmr.0000245458.05654.d0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The noninvasive, nonradioactive, quantitative nature of magnetic resonance techniques has propelled them to the forefront of neuroscience and neuropsychiatric research. In particular, recent advances have confirmed their enormous potential in patients with Alzheimer disease (AD). Structural and functional magnetic resonance (MR) imaging have demonstrated significant correlation with clinical outcomes and underlying pathology and are used increasingly in the AD clinic. This review will highlight the role of high-resolution structural MR imaging and functional magnetic resonance imaging in the identification of atrophic and hemodynamic changes in AD and their potential as diagnostic biomarkers and surrogates of therapeutic response. Advanced MR techniques based on diffusion, perfusion, and neurochemical abnormalities in the aging brain will be presented briefly. These newer techniques continue to expand our understanding of neuropathology in the aging brain and are likely to play an important clinical role in the future.
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Affiliation(s)
- Valerie C Anderson
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR 97239, USA.
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Christensen H, Anstey KJ, Parslow RA, Maller J, Mackinnon A, Sachdev P. The brain reserve hypothesis, brain atrophy and aging. Gerontology 2006; 53:82-95. [PMID: 17057394 DOI: 10.1159/000096482] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2005] [Accepted: 09/01/2006] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Researchers have used the concept of brain reserve to explain the dissociation between pathological brain damage and cognitive and functional performance. A variety of brain reserve hypotheses exist, and different empirical strategies have been employed to investigate these variants. OBJECTIVE The study investigates (i) the relationship between measures of brain burden (atrophy, white matter hyperintensities (WMH)) and measures of reserve (education, creativity, and intelligence); (ii) the relationship between cognitive decline and reserve; (iii) whether measures of reserve mediate the effect of atrophy on estimated cognitive change, and (iv) the association between brain risk factors, education and atrophy. METHODS A cross-sectional study of a sample of 446 individuals 60-64 years of age who underwent MRI scans as part of a large epidemiological study. Measures were taken of education, intelligence, creativity, cognitive speed, brain volume, WMH, estimated cognitive decline from earlier in life and brain atrophy. RESULTS No association was found between estimated cognitive decline and brain burden (atrophy, WMH). Risk factors for brain insult were not associated with greater brain atrophy in the less well educated. Neither education, nor any other measure including intelligence or creativity, provided a buffer for cognitive decline in individuals with high levels of brain atrophy. CONCLUSION Little support was found for the brain reserve hypothesis.
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Affiliation(s)
- Helen Christensen
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia.
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Scarmeas N, Albert SM, Manly JJ, Stern Y. Education and rates of cognitive decline in incident Alzheimer's disease. J Neurol Neurosurg Psychiatry 2006; 77:308-16. [PMID: 16484637 PMCID: PMC2077720 DOI: 10.1136/jnnp.2005.072306] [Citation(s) in RCA: 219] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Some (but not all) epidemiological studies have noted faster rates of progression in high education patients with Alzheimer's disease (AD), which has been attributed to harbouring/tolerating a higher pathological burden at the time of clinical dementia for subjects with higher education. We wanted to assess the relationship between education and rates of decline in AD. METHODS During the course of a community based multiethnic prospective cohort study of individuals aged > or = 65 years living in New York, 312 patients were diagnosed with incident AD and were followed overall for 5.6 (up to 13.3) years. The subjects received an average of 3.7 (up to 9) neuropsychological assessments consisting of 12 individual tests. With the aid of a normative sample, a standardised composite cognitive score as well as individual cognitive domain scores were calculated. Generalised estimating equation models were used to examine the association between education and rates of cognitive decline. RESULTS Composite cognitive performance declined by 9% of a standard deviation per year. Rates of decline before and after AD incidence were similar. For each additional year of education there was 0.3% standard deviation lower composite cognitive performance for each year of follow up. The association between higher education and faster decline was noted primarily in the executive speed (0.6%) and memory (0.5%) cognitive domains and was present over and above age, gender, ethnicity, differential baseline cognitive performance, depression, and vascular comorbidity. CONCLUSIONS We conclude that higher education AD patients experience faster cognitive decline.
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Affiliation(s)
- N Scarmeas
- Cognitive Neuroscience Division, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, 622 West 168th Street, PH 19th Floor, New York, NY 10032, USA.
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Maestú F, García-Segura J, Ortiz T, Montoya J, Fernández A, Gil-Gregorio P, Campo P, Fernández S, Viaño J, Portera A. Evidence of biochemical and biomagnetic interactions in Alzheimer's disease: an MEG and MR spectroscopy study. Dement Geriatr Cogn Disord 2005; 20:145-52. [PMID: 16020943 DOI: 10.1159/000087062] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Several neuroimaging studies have shown reliable differences between Alzheimer's disease (AD) patients and age-matched controls. However, few studies have demonstrated the interactions between neuroimaging methods for the diagnoses of AD. OBJECTIVE In this study, we try to elucidate the complementary nature of magnetoencephalography (MEG) and magnetic resonance spectroscopy (MRS) examinations in the assessmentof AD. METHODS Ten patients fulfilling the NINCDS-ADRDA criteria of probable AD, and 10 elderly individuals with no history of neurological or psychiatric illness serving as age-matched controls participated in the study. All patients and controls received an MRS, MEG and neuropsychological assessment. MEG data were obtained in the context of a working memory task, previously utilized in a similar sample of patients. RESULTS The AD group showed a reduced number of activity sources over left temporoparietal areas during the late portion of the evoked magnetic field (between 400-800 ms), as well as a bilateral temporoparietal increase in creatine and myoinositol concentrations, and in the myoinositol/N-acetyl-aspartate ratio. The combination of the variables 'number of dipoles during the late portion of the evoked magnetic field' and 'myoinositol/N-acetyl-aspartate ratio' accounted for 65% of the variance of the Mini Mental State Examination scores. CONCLUSIONS These results highlight the importance of assessing the complex brain pathology underlying AD by utilizing multiple brain examination modalities in a coordinate approach.
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Affiliation(s)
- F Maestú
- Centro de Magnetoencefalografía, Facultad de Biología, Universidad Complutense, Madrid, España.
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Fernández A, García-Segura JM, Ortiz T, Montoya J, Maestú F, Gil-Gregorio P, Campo P, Viaño J. Proton magnetic resonance spectroscopy and magnetoencephalographic estimation of delta dipole density: a combination of techniques that may contribute to the diagnosis of Alzheimer's disease. Dement Geriatr Cogn Disord 2005; 20:169-77. [PMID: 16020946 DOI: 10.1159/000087094] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2005] [Indexed: 11/19/2022] Open
Abstract
Whole-head magnetoencephalographic recordings were obtained from 10 patients with Alzheimer's disease (AD) and 10 healthy controls in a resting position. Spectroscopic examinations were performed by means of a 1.5-tesla whole-body scanner in the temporoparietal regions of both hemispheres. The relationship between (1)H-MRS-based and magnetoencephalography (MEG)-based measures and their conjoined capability to improve the diagnosis of AD were investigated in this study. Logistic regression analyses were performed. Three separated logistic models were calculated for (1)H-MRS-based metabolites, low-frequency magnetic activity, and the combination of both measures. A combined myoinositol/N-acetyl aspartate (mI/NAA)-delta dipole density (DD) model predicted the diagnosis with 90% sensitivity and 100% specificity. Additionally, the combination of temporoparietal mI/NAA and delta DD values explained the variability of individuals' cognitive status. The results support the notion that a multidisciplinary approach may improve the understanding and diagnosis of AD.
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Affiliation(s)
- Alberto Fernández
- Centro de Magnetoencefalografía Dr. Pérez-Modrego, Universidad Complutense de Madrid, Madrid, Spain
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Mosconi L. Brain glucose metabolism in the early and specific diagnosis of Alzheimer's disease. FDG-PET studies in MCI and AD. Eur J Nucl Med Mol Imaging 2005; 32:486-510. [PMID: 15747152 DOI: 10.1007/s00259-005-1762-7] [Citation(s) in RCA: 597] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The demographics of aging suggest a great need for the early diagnosis of dementia and the development of preventive strategies. Neuropathology and structural MRI studies have pointed to the medial temporal lobe (MTL) as the brain region earliest affected in Alzheimer's disease (AD). MRI findings provide strong evidence that in mild cognitive impairments (MCI), AD-related volume losses can be reproducibly detected in the hippocampus, the entorhinal cortex (EC) and, to a lesser extent, the parahippocampal gyrus; they also indicate that lateral temporal lobe changes are becoming increasingly useful in predicting the transition to dementia. Fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) imaging has revealed glucose metabolic reductions in the parieto-temporal, frontal and posterior cingulate cortices to be the hallmark of AD. Overall, the pattern of cortical metabolic changes has been useful for the prediction of future AD as well as in distinguishing AD from other neurodegenerative diseases. FDG-PET on average achieves 90% sensitivity in identifying AD, although specificity in differentiating AD from other dementias is lower. Moreover, recent MRI-guided FDG-PET studies have shown that MTL hypometabolism is the most specific and sensitive measure for the identification of MCI, while the utility of cortical deficits is controversial. This review highlights cross-sectional, prediction and longitudinal FDG-PET studies and attempts to put into perspective the value of FDG-PET in diagnosing AD-like changes, particularly at an early stage, and in providing diagnostic specificity. The examination of MTL structures, which has so far been exclusive to MRI protocols, is then examined as a possible strategy to improve diagnostic specificity. All told, there is considerable promise that early and specific diagnosis is feasible through a combination of imaging modalities.
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Affiliation(s)
- Lisa Mosconi
- Department of Clinical Pathophysiology, University of Florence, Italy.
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Bokde ALW, Teipel SJ, Schwarz R, Leinsinger G, Buerger K, Moeller T, Möller HJ, Hampel H. Reliable manual segmentation of the frontal, parietal, temporal, and occipital lobes on magnetic resonance images of healthy subjects. ACTA ACUST UNITED AC 2005; 14:135-45. [PMID: 15795167 DOI: 10.1016/j.brainresprot.2004.10.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2004] [Revised: 10/20/2004] [Accepted: 10/22/2004] [Indexed: 11/22/2022]
Abstract
BACKGROUND It is a challenge to reliably measure the lobar volumes from magnetic resonance imaging (MRI) data. OBJECTIVE Description of a landmark-based method for volumetric segmentation of the brain into the four cerebral lobes from MR images. METHOD The segmentation method relies on a combination of anatomical landmarks and geometrical definitions. The first step, described previously, is a segmentation of the four lobes on the surface of the brain. The internal borders between the lobes are defined on the axial slices of the brain. The intra- and inter- rater reliability was determined from the MRI scans of a group of 10 healthy control subjects measured by 2 independent raters. RESULTS The intra-rater relative error (and intra-class correlation coefficient) of the lobar volume measures ranged from 0.81% to 3.85% (from 0.97 to 0.99). The inter-rater relative error (and intra-class correlation coefficient) ranged from 0.55% to 3.09% (from 0.94 to 0.99). CONCLUSION This technique has been shown to have high intra- and inter-rater reliability. The current method provides a method to obtain volumetric estimates of the 4 cerebral lobes.
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Affiliation(s)
- Arun L W Bokde
- Dementia and Neuro-imaging Research Section, Alzheimer's Memorial Center and Geriatric Psychiatry Branch, Department of Psychiatry, Ludwig-Maximilian University, Nussbaumstr. 7, Station D2, 80336 Munich, Germany
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