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Quaranta D, Caraglia N, L'Abbate F, Giuffrè GM, Guglielmi V, Iacobucci GM, Rossini PM, Calabresi P, Marra C. Neuropsychological predictors of conversion from mild cognitive impairment to dementia at different timepoints. Brain Behav 2023; 13:e3098. [PMID: 37550896 PMCID: PMC10498086 DOI: 10.1002/brb3.3098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION Impairment of episodic memory is largely considered the main cognitive marker of prodromic Alzheimer's disease (AD). Nevertheless, the neuropathological process in AD starts several years before and, apart from biomarkers well defined in the Amyloid (A), Tauopathy (T), Neurodegeneration (N) framework, early clinical and neuropsychological markers able to detect mild cognitive impairment (MCI) due to AD before the appearance of memory disorders are lacking in clinical practice. Investigations on semantic memory have shown promising results in providing an earlier marker of dementia in MCI patients. METHODS A total of 253 MCI subjects were followed up every 6 months for 6 years-186 converted to dementia and 67 remained stable at the sixth year of follow-up. Twenty-seven patients progressed in the first 2 years (fast converters), 107 in the third to fourth year (intermediate converters), and 51 after the fourth year of follow-up (slow converters). RESULTS Stable MCI subjects performed better than fast decliners in Mini-Mental State Examination (MMSE), several long-term memory scores, and category verbal fluency test (CFT); stable and intermediate converters differ only in MMSE and CFT tests; and stable and slow converters differ only in MMSE and phonological/semantic discrepancy score. CONCLUSION Early impairment of semantic memory could predict the evolution to AD before the onset of episodic memory disorders, and the discrepancy between phonological and semantic verbal fluency could be able to detect this impairment in advance in respect of simple CFT tests. The assessment of different aspects of semantic memory and its degradation could represent an early cognitive marker to intercept MCI due to AD in clinical practice.
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Affiliation(s)
- Davide Quaranta
- Neurology UnitFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
| | - Naike Caraglia
- Neurology UnitFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
| | - Federica L'Abbate
- Neurology UnitFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
| | | | - Valeria Guglielmi
- Neurology UnitFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
| | | | - Paolo Maria Rossini
- Brain Connectivity Laboratory, Department of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
| | - Paolo Calabresi
- Neurology UnitFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
- Department of NeuroscienceCatholic University of Sacred HeartRomeItaly
| | - Camillo Marra
- Department of NeuroscienceCatholic University of Sacred HeartRomeItaly
- Memory ClinicFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
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Piccininni C, Quaranta D, Gainotti G, Lacidogna G, Guglielmi V, Giovannini S, Marra C. The Destiny of Multiple Domain Amnesic Mild Cognitive Impairment: Effect of Alternative Neuropsychological Definitions and Their Adjunctive Role in Respect of Memory Impairment. Arch Clin Neuropsychol 2021; 36:702-710. [PMID: 33313637 DOI: 10.1093/arclin/acaa094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 05/19/2020] [Accepted: 09/28/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Mild cognitive impairment is the main risk factor of dementia. Previous evidence has claimed that subjects with memory disturbances associated with impairment of other cognitive domains (multiple domain amnesic MCI) are at the highest risk of developing dementia. To date, a shared definition of amnesic MCI multiple domain (aMCI-MD) is still lacking. METHOD 163 subjects with aMCI were enrolled and followed-up for 2 years. They underwent a baseline comprehensive neuropsychological battery. The cut-off point for each test was set at 1, 1.5, and 2 SD below the mean obtained in normative studies; aMCI-MD was defined as the occurrence of abnormal scores on at least one, two, or three tests not assessing memory. The Episodic Memory Score (EMS), that measures the severity of memory impairment, was determined. Logistic regressionand Cox's proportional hazard risk models were carried out. The adjunctive effect of the definitions of aMCI-MD on the severity of memory impairment was assessed. RESULTS Fifty-four subjects progressed to dementia. Only restrictive definitions of aMCI-MD (at least three tests below 1.5 SD; at least two tests below 2 SD) predicted conversion to dementia in both logistic regression and survival analysis. None of the conditions showed a significant adjunctive effect on the EMS. CONCLUSIONS The predictive effect of impairment in tests assessing cognitive domains other than memory depends on its psychometric definition. The use of a restrictive definition would be of some usefulness, but the adjunctive effect of such a definition on an integrated analysis of memory impairment may be questionable.
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Affiliation(s)
- Chiara Piccininni
- Departement of Neuroscience, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Davide Quaranta
- Institute of Neurology, IRCCS Policlinico Universitario "A. Gemelli", Roma, Italy
| | - Guido Gainotti
- Institute of Neurology, IRCCS Policlinico Universitario "A. Gemelli", Roma, Italy
| | - Giordano Lacidogna
- Institute of Neurology, IRCCS Policlinico Universitario "A. Gemelli", Roma, Italy
| | - Valeria Guglielmi
- Departement of Neuroscience, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Silvia Giovannini
- Institute of Geriatrics, IRCCS Policlinico Universitario "A. Gemelli", Roma, Italy
| | - Camillo Marra
- Departement of Neuroscience, Università Cattolica del Sacro Cuore, Roma, Italy.,Institute of Neurology, IRCCS Policlinico Universitario "A. Gemelli", Roma, Italy
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Miraglia F, Vecchio F, Marra C, Quaranta D, Alù F, Peroni B, Granata G, Judica E, Cotelli M, Rossini PM. Small World Index in Default Mode Network Predicts Progression from Mild Cognitive Impairment to Dementia. Int J Neural Syst 2020; 30:2050004. [DOI: 10.1142/s0129065720500045] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Aim of this study was to explore the EEG functional connectivity in amnesic mild cognitive impairments (MCI) subjects with multidomain impairment in order to characterize the Default Mode Network (DMN) in converted MCI (cMCI), which converted to Alzheimer’s disease (AD), compared to stable MCI (sMCI) subjects. A total of 59 MCI subjects were recruited and divided -after appropriate follow-up- into cMCI or sMCI. They were further divided in MCI with linguistic domain (LD) impairment and in MCI with executive domain (ED) impairment. Small World (SW) index was measured as index of balance between integration and segregation brain processes. SW, computed restricting to nodes of DMN regions for all frequency bands, evaluated how they differ between MCI subgroups assessed through clinical and neuropsychological four-years follow-up. In addition, SW evaluated how this pattern differs between MCI with LD and MCI with ED. Results showed that SW index significantly decreased in gamma band in cMCI compared to sMCI. In cMCI with LD impairment, the SW index significantly decreased in delta band, while in cMCI with ED impairment the SW index decreased in delta and gamma bands and increased in alpha1 band. We propose that the DMN functional alterations in cognitive impairment could reflect an abnormal flow of brain information processing during resting state possibly associated to a status of pre-dementia.
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Affiliation(s)
- Francesca Miraglia
- Brain Connectivity Laboratory, IRCCS San Raffaele Pisana, Rome, Italy
- Via Val Cannuta, 247, 00166 Rome, Italy
| | - Fabrizio Vecchio
- Brain Connectivity Laboratory, IRCCS San Raffaele Pisana, Rome, Italy
| | - Camillo Marra
- Memory Clinic, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
| | - Davide Quaranta
- Memory Clinic, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
| | - Francesca Alù
- Brain Connectivity Laboratory, IRCCS San Raffaele Pisana, Rome, Italy
| | - Benedetta Peroni
- Institute of Neurology, Area of Neuroscience, Catholic University of The Sacred Heart, Rome, Italy
| | - Giuseppe Granata
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elda Judica
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milano, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Eguchi Y, Noda Y, Nakajima S, Tsugawa S, Kida H, Plitman E, Graff‐Guerrero A, Chakravarty MM, Takayama M, Arai Y, Matsuda H, Mimura M, Niimura H. Subiculum volumes associated with memory function in the oldest‐old individuals aged 95 years and older. Geriatr Gerontol Int 2019; 19:347-351. [DOI: 10.1111/ggi.13614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/13/2018] [Accepted: 12/31/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Yoko Eguchi
- Department of NeuropsychiatryKeio University School of Medicine Tokyo Japan
- Department of Nuclear MedicineSaitama Medical University International Medical Center Saitama Japan
| | - Yoshihiro Noda
- Department of NeuropsychiatryKeio University School of Medicine Tokyo Japan
| | - Shinichiro Nakajima
- Department of NeuropsychiatryKeio University School of Medicine Tokyo Japan
- Department of Psychiatry, Multimodal Imaging Group, Center for Addiction and Mental HealthUniversity of Toronto Toronto Canada
| | - Sakiko Tsugawa
- Department of NeuropsychiatryKeio University School of Medicine Tokyo Japan
| | - Hisashi Kida
- Department of NeuropsychiatryKeio University School of Medicine Tokyo Japan
| | - Eric Plitman
- Department of Psychiatry, Multimodal Imaging Group, Center for Addiction and Mental HealthUniversity of Toronto Toronto Canada
| | - Ariel Graff‐Guerrero
- Department of Psychiatry, Multimodal Imaging Group, Center for Addiction and Mental HealthUniversity of Toronto Toronto Canada
| | - Mallar M Chakravarty
- Cerebral Imaging CenterDouglas Mental Health University Institute Montreal Canada
- Departments of Psychiatry and Biological and Biomedical EngineeringMcGill University Montreal Canada
| | - Midori Takayama
- Faculty of Science and TechnologyKeio University Tokyo Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical ResearchKeio University School of Medicine Tokyo Japan
| | - Hiroshi Matsuda
- Department of Nuclear MedicineSaitama Medical University International Medical Center Saitama Japan
- Integrative Brain Imaging CenterNational Center of Neurology and Psychiatry Tokyo Japan
| | - Masaru Mimura
- Department of NeuropsychiatryKeio University School of Medicine Tokyo Japan
| | - Hidehito Niimura
- Department of NeuropsychiatryKeio University School of Medicine Tokyo Japan
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Venneri A, Jahn-Carta C, de Marco M, Quaranta D, Marra C. Diagnostic and prognostic role of semantic processing in preclinical Alzheimer's disease. Biomark Med 2018; 12:637-651. [PMID: 29896968 DOI: 10.2217/bmm-2017-0324] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Relatively spared during most of the timeline of normal aging, semantic memory shows a subtle yet measurable decline even during the pre-clinical stage of Alzheimer's disease. This decline is thought to reflect early neurofibrillary changes and impairment is detectable using tests of language relying on lexical-semantic abilities. A promising approach is the characterization of semantic parameters such as typicality and age of acquisition of words, and propositional density from verbal output. Seminal research like the Nun Study or the analysis of the linguistic decline of famous writers and politicians later diagnosed with Alzheimer's disease supports the early diagnostic value of semantic processing and semantic memory. Moreover, measures of these skills may play an important role for the prognosis of patients with mild cognitive impairment.
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Affiliation(s)
- Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | | | - Matteo de Marco
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Davide Quaranta
- Neurology Unit, Fondazione Policlinico Universitario 'A Gemelli', Rome, Italy
| | - Camillo Marra
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome; Memory Clinic, Fondazione Policlinico Universitario 'A Gemelli', Rome, Italy
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Lahr J, Minkova L, Tabrizi SJ, Stout JC, Klöppel S, Scheller E. Working Memory-Related Effective Connectivity in Huntington's Disease Patients. Front Neurol 2018; 9:370. [PMID: 29915555 PMCID: PMC5994408 DOI: 10.3389/fneur.2018.00370] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/07/2018] [Indexed: 11/30/2022] Open
Abstract
Huntington’s disease (HD) is a genetically caused neurodegenerative disorder characterized by heterogeneous motor, psychiatric, and cognitive symptoms. Although motor symptoms may be the most prominent presentation, cognitive symptoms such as memory deficits and executive dysfunction typically co-occur. We used functional magnetic resonance imaging (fMRI) and task fMRI-based dynamic causal modeling (DCM) to evaluate HD-related changes in the neural network underlying working memory (WM). Sixty-four pre-symptomatic HD mutation carriers (preHD), 20 patients with early manifest HD symptoms (earlyHD), and 83 healthy control subjects performed an n-back fMRI task with two levels of WM load. Effective connectivity was assessed in five predefined regions of interest, comprising bilateral inferior parietal cortex, left anterior cingulate cortex, and bilateral dorsolateral prefrontal cortex. HD mutation carriers performed less accurately and more slowly at high WM load compared with the control group. While between-group comparisons of brain activation did not reveal differential recruitment of the cortical WM network in mutation carriers, comparisons of brain connectivity as identified with DCM revealed a number of group differences across the whole WM network. Most strikingly, we observed decreasing connectivity from several regions toward right dorsolateral prefrontal cortex (rDLPFC) in preHD and even more so in earlyHD. The deterioration in rDLPFC connectivity complements results from previous studies and might mirror beginning cortical neural decline at premanifest and early manifest stages of HD. We were able to characterize effective connectivity in a WM network of HD mutation carriers yielding further insight into patterns of cognitive decline and accompanying neural deterioration.
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Affiliation(s)
- Jacob Lahr
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Freiburg Brain Imaging Center, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - Lora Minkova
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Freiburg Brain Imaging Center, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - Sarah J Tabrizi
- Department of Neurodegenerative Disease, Institute of Neurology, University College London, London, United Kingdom
| | - Julie C Stout
- School of Psychological Sciences, Institute of Clinical and Cognitive Neuroscience, Monash University, Melbourne, VIC, Australia
| | - Stefan Klöppel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Freiburg Brain Imaging Center, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Center for Geriatric Medicine and Gerontology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Elisa Scheller
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Freiburg Brain Imaging Center, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany
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Quaranta D, Caprara A, Piccininni C, Vita MG, Gainotti G, Marra C. Standardization, Clinical Validation, and Typicality Norms of a New Test Assessing Semantic Verbal Fluency. Arch Clin Neuropsychol 2016; 31:434-45. [PMID: 27353431 DOI: 10.1093/arclin/acw034] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Semantic verbal fluency (SVF) tests are widely used in clinical neuropsychology. We propose the standardization and clinical validation of a new SVF test based on the production of names of birds and articles of furniture (Birds and Articles of Furniture test-BAF). METHODS A sample of 268 subjects aged 40 years or more underwent the test. The clinical validation was conducted on subjects affected by amnesic Mild Cognitive Impairment (aMCI; N = 106), mild (N = 178), and moderate (N = 114) Alzheimer's disease (AD). RESULTS The BAF total score was influenced by both age and education, whereas the single scores obtained on BAF were also influenced by gender. The percentage of subjects with pathological score on BAF increased from aMCI (19%) to mild (45.5%) and moderate (71.1%) AD, and receiver operating characteristic curves analysis showed that the BAF may be highly reliable in distinguishing aMCI and AD patients from healthy subjects. We also provide typicality norms for birds and articles of furniture that could be useful in the assessment of qualitative features of words produced in semantic fluency tests. CONCLUSIONS The BAF test could be a valid and reliable tool in both clinical practice and research on subjects affected by cognitive impairment.
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Affiliation(s)
- Davide Quaranta
- Research Center for Neuropsychology, Institute of Neurology, Catholic University, Rome, Italy
| | - Alessia Caprara
- Research Center for Neuropsychology, Institute of Neurology, Catholic University, Rome, Italy
| | - Chiara Piccininni
- Research Center for Neuropsychology, Institute of Neurology, Catholic University, Rome, Italy
| | - Maria G Vita
- Research Center for Neuropsychology, Institute of Neurology, Catholic University, Rome, Italy
| | - Guido Gainotti
- Research Center for Neuropsychology, Institute of Neurology, Catholic University, Rome, Italy
| | - Camillo Marra
- Research Center for Neuropsychology, Institute of Neurology, Catholic University, Rome, Italy
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Minkova L, Scheller E, Peter J, Abdulkadir A, Kaller CP, Roos RA, Durr A, Leavitt BR, Tabrizi SJ, Klöppel S. Detection of Motor Changes in Huntington's Disease Using Dynamic Causal Modeling. Front Hum Neurosci 2015; 9:634. [PMID: 26635585 PMCID: PMC4658414 DOI: 10.3389/fnhum.2015.00634] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/06/2015] [Indexed: 11/17/2022] Open
Abstract
Deficits in motor functioning are one of the hallmarks of Huntington's disease (HD), a genetically caused neurodegenerative disorder. We applied functional magnetic resonance imaging (fMRI) and dynamic causal modeling (DCM) to assess changes that occur with disease progression in the neural circuitry of key areas associated with executive and cognitive aspects of motor control. Seventy-seven healthy controls, 62 pre-symptomatic HD gene carriers (preHD), and 16 patients with manifest HD symptoms (earlyHD) performed a motor finger-tapping fMRI task with systematically varying speed and complexity. DCM was used to assess the causal interactions among seven pre-defined regions of interest, comprising primary motor cortex, supplementary motor area (SMA), dorsal premotor cortex, and superior parietal cortex. To capture heterogeneity among HD gene carriers, DCM parameters were entered into a hierarchical cluster analysis using Ward's method and squared Euclidian distance as a measure of similarity. After applying Bonferroni correction for the number of tests, DCM analysis revealed a group difference that was not present in the conventional fMRI analysis. We found an inhibitory effect of complexity on the connection from parietal to premotor areas in preHD, which became excitatory in earlyHD and correlated with putamen atrophy. While speed of finger movements did not modulate the connection from caudal to pre-SMA in controls and preHD, this connection became strongly negative in earlyHD. This second effect did not survive correction for multiple comparisons. Hierarchical clustering separated the gene mutation carriers into three clusters that also differed significantly between these two connections and thereby confirmed their relevance. DCM proved useful in identifying group differences that would have remained undetected by standard analyses and may aid in the investigation of between-subject heterogeneity.
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Affiliation(s)
- Lora Minkova
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany ; Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany ; Laboratory for Biological and Personality Psychology, Department of Psychology, University of Freiburg Freiburg, Germany
| | - Elisa Scheller
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany ; Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany
| | - Jessica Peter
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany ; Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany
| | - Ahmed Abdulkadir
- Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany ; Department of Computer Science, University of Freiburg Freiburg, Germany
| | - Christoph P Kaller
- Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany ; Department of Neurology, University Medical Center Freiburg Freiburg, Germany ; BrainLinks-BrainTools Cluster of Excellence, University of Freiburg Freiburg, Germany
| | - Raymund A Roos
- Department of Neurology, Leiden University Medical Centre Leiden, Netherlands
| | - Alexandra Durr
- Department of Genetics and Cytogenetics, Pitié-Salpêtrière University Hospital Paris, France
| | - Blair R Leavitt
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia Vancouver, Canada
| | - Sarah J Tabrizi
- Department of Neurodegenerative Disease, Institute of Neurology, University College London London, UK
| | - Stefan Klöppel
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany ; Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany ; Department of Neurology, University Medical Center Freiburg Freiburg, Germany
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