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Huang P, Lin L, Zhang J, Cheng Y, Pan X. Efficacy analysis of three brain stimulation techniques for Alzheimer's disease: a meta-analysis of repeated transcranial magnetic stimulation, transcranial direct current stimulation, and deep brain stimulation. Expert Rev Neurother 2024; 24:117-127. [PMID: 38088070 DOI: 10.1080/14737175.2023.2293225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION This systematic review and meta-analysis study investigates the efficacy of repeated transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS) using neuropsychological assessments as a potential treatment option for Alzheimer's disease (AD). METHODS PubMed, Embase, and the Cochrane Library were searched for studies on rTMS, tDCS, and DBS for the treatment of patients with AD between April 1970 and October 2022. The mini-Mental State Examination (MMSE) and AD Assessment Scale - Cognitive Subscale (ADAS-Cog) were adopted as the efficacy index. RESULTS The analysis yielded 17 eligible studies. rTMS greatly improved the cognition of patients with AD (immediate post-treatment WMD of MMSE score: 2.06, p < 0.00001; short-term follow-up WMD of MMSE score: 2.12, p = 0.006; WMD of ADAS-Cog score in single-arm studies: -4.97, p = 0.001). DBS did not reverse the progression of cognitive decline (WMD of ADAS-Cog score in single-arm studies: 7.40, p < 0.00001). Furthermore, tDCS demonstrated no significant efficacy in improving cognition in random clinical trials or single-arm studies. CONCLUSION rTMS is a promising non-medicinal alternative for cognitive improvement inpatients with AD.
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Affiliation(s)
- Peilin Huang
- Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, fuzhou, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Lin Lin
- Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, fuzhou, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Jiejun Zhang
- Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, fuzhou, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
- Center for Geriatrics, Hainan General Hospital, Hainan, China
| | - Yingzhe Cheng
- Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, fuzhou, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Xiaodong Pan
- Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, fuzhou, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
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Doss DJ, Johnson GW, Narasimhan S, Shless JS, Jiang JW, González HFJ, Paulo DL, Lucas A, Davis KA, Chang C, Morgan VL, Constantinidis C, Dawant BM, Englot DJ. Deep Learning Segmentation of the Nucleus Basalis of Meynert on 3T MRI. AJNR Am J Neuroradiol 2023; 44:1020-1025. [PMID: 37562826 PMCID: PMC10494939 DOI: 10.3174/ajnr.a7950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/25/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND AND PURPOSE The nucleus basalis of Meynert is a key subcortical structure that is important in arousal and cognition and has been explored as a deep brain stimulation target but is difficult to study due to its small size, variability among patients, and lack of contrast on 3T MR imaging. Thus, our goal was to establish and evaluate a deep learning network for automatic, accurate, and patient-specific segmentations with 3T MR imaging. MATERIALS AND METHODS Patient-specific segmentations can be produced manually; however, the nucleus basalis of Meynert is difficult to accurately segment on 3T MR imaging, with 7T being preferred. Thus, paired 3T and 7T MR imaging data sets of 21 healthy subjects were obtained. A test data set of 6 subjects was completely withheld. The nucleus was expertly segmented on 7T, providing accurate labels for the paired 3T MR imaging. An external data set of 14 patients with temporal lobe epilepsy was used to test the model on brains with neurologic disorders. A 3D-Unet convolutional neural network was constructed, and a 5-fold cross-validation was performed. RESULTS The novel segmentation model demonstrated significantly improved Dice coefficients over the standard probabilistic atlas for both healthy subjects (mean, 0.68 [SD, 0.10] versus 0.45 [SD, 0.11], P = .002, t test) and patients (0.64 [SD, 0.10] versus 0.37 [SD, 0.22], P < .001). Additionally, the model demonstrated significantly decreased centroid distance in patients (1.18 [SD, 0.43] mm, 3.09 [SD, 2.56] mm, P = .007). CONCLUSIONS We developed the first model, to our knowledge, for automatic and accurate patient-specific segmentation of the nucleus basalis of Meynert. This model may enable further study into the nucleus, impacting new treatments such as deep brain stimulation.
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Affiliation(s)
- D J Doss
- From the Department of Biomedical Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang., V.L.M., C. Constantinidis, D.J.E.), Vanderbilt University, Nashville, Tennessee
- Institute of Imaging Science (D.J.D., G.W.J., S.N., J.S.S., J.W.J., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Nashville, Tennessee
| | - G W Johnson
- From the Department of Biomedical Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang., V.L.M., C. Constantinidis, D.J.E.), Vanderbilt University, Nashville, Tennessee
- Institute of Imaging Science (D.J.D., G.W.J., S.N., J.S.S., J.W.J., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Nashville, Tennessee
| | - S Narasimhan
- From the Department of Biomedical Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang., V.L.M., C. Constantinidis, D.J.E.), Vanderbilt University, Nashville, Tennessee
- Institute of Imaging Science (D.J.D., G.W.J., S.N., J.S.S., J.W.J., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Nashville, Tennessee
- Department of Neurological Surgery (S.N., J.S.S., J.W.J., D.L.P., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - J S Shless
- Institute of Imaging Science (D.J.D., G.W.J., S.N., J.S.S., J.W.J., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Department of Neurological Surgery (S.N., J.S.S., J.W.J., D.L.P., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - J W Jiang
- Institute of Imaging Science (D.J.D., G.W.J., S.N., J.S.S., J.W.J., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Department of Neurological Surgery (S.N., J.S.S., J.W.J., D.L.P., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - H F J González
- From the Department of Biomedical Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang., V.L.M., C. Constantinidis, D.J.E.), Vanderbilt University, Nashville, Tennessee
- Institute of Imaging Science (D.J.D., G.W.J., S.N., J.S.S., J.W.J., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Nashville, Tennessee
| | - D L Paulo
- Department of Neurological Surgery (S.N., J.S.S., J.W.J., D.L.P., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - A Lucas
- Department of Bioengineering (A.L.), University of Pennsylvania, Philadelphia, Pennsylvania
| | - K A Davis
- Department of Neuroscience (K.A.D.), University of Pennsylvania, Philadelphia, Pennsylvania
- Center for Neuroengineering and Therapeutics (K.A.D.), University of Pennsylvania, Philadelphia, Pennsylvania
- Neurology (K.A.D.), University of Pennsylvania, Philadelphia, Pennsylvania
| | - C Chang
- From the Department of Biomedical Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang., V.L.M., C. Constantinidis, D.J.E.), Vanderbilt University, Nashville, Tennessee
- Institute of Imaging Science (D.J.D., G.W.J., S.N., J.S.S., J.W.J., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Nashville, Tennessee
- Department of Electrical and Computer Engineering (C. Chang, B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Department of Computer Science (C. Chang), Vanderbilt University, Nashville, Tennessee
| | - V L Morgan
- From the Department of Biomedical Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang., V.L.M., C. Constantinidis, D.J.E.), Vanderbilt University, Nashville, Tennessee
- Institute of Imaging Science (D.J.D., G.W.J., S.N., J.S.S., J.W.J., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Nashville, Tennessee
- Department of Neurological Surgery (S.N., J.S.S., J.W.J., D.L.P., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Neurology (V.L.M.), Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Radiological Sciences (V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - C Constantinidis
- From the Department of Biomedical Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang., V.L.M., C. Constantinidis, D.J.E.), Vanderbilt University, Nashville, Tennessee
- Department of Ophthalmology and Visual Sciences (C. Constantinidis), Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Neuroscience (C. Constantinidis), Vanderbilt University, Nashville, Tennessee
| | - B M Dawant
- Institute of Imaging Science (D.J.D., G.W.J., S.N., J.S.S., J.W.J., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Nashville, Tennessee
- Department of Electrical and Computer Engineering (C. Chang, B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
| | - D J Englot
- From the Department of Biomedical Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang., V.L.M., C. Constantinidis, D.J.E.), Vanderbilt University, Nashville, Tennessee
- Institute of Imaging Science (D.J.D., G.W.J., S.N., J.S.S., J.W.J., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Vanderbilt Institute for Surgery and Engineering (D.J.D., G.W.J., S.N., H.F.J.G., C. Chang, V.L.M., B.M.D., D.J.E.), Nashville, Tennessee
- Department of Neurological Surgery (S.N., J.S.S., J.W.J., D.L.P., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Electrical and Computer Engineering (C. Chang, B.M.D., D.J.E.), Vanderbilt University, Nashville, Tennessee
- Department of Radiological Sciences (V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, Tennessee
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Ehrenberg AJ, Kelberman MA, Liu KY, Dahl MJ, Weinshenker D, Falgàs N, Dutt S, Mather M, Ludwig M, Betts MJ, Winer JR, Teipel S, Weigand AJ, Eschenko O, Hämmerer D, Leiman M, Counts SE, Shine JM, Robertson IH, Levey AI, Lancini E, Son G, Schneider C, Egroo MV, Liguori C, Wang Q, Vazey EM, Rodriguez-Porcel F, Haag L, Bondi MW, Vanneste S, Freeze WM, Yi YJ, Maldinov M, Gatchel J, Satpati A, Babiloni C, Kremen WS, Howard R, Jacobs HIL, Grinberg LT. Priorities for research on neuromodulatory subcortical systems in Alzheimer's disease: Position paper from the NSS PIA of ISTAART. Alzheimers Dement 2023; 19:2182-2196. [PMID: 36642985 PMCID: PMC10182252 DOI: 10.1002/alz.12937] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 01/17/2023]
Abstract
The neuromodulatory subcortical system (NSS) nuclei are critical hubs for survival, hedonic tone, and homeostasis. Tau-associated NSS degeneration occurs early in Alzheimer's disease (AD) pathogenesis, long before the emergence of pathognomonic memory dysfunction and cortical lesions. Accumulating evidence supports the role of NSS dysfunction and degeneration in the behavioral and neuropsychiatric manifestations featured early in AD. Experimental studies even suggest that AD-associated NSS degeneration drives brain neuroinflammatory status and contributes to disease progression, including the exacerbation of cortical lesions. Given the important pathophysiologic and etiologic roles that involve the NSS in early AD stages, there is an urgent need to expand our understanding of the mechanisms underlying NSS vulnerability and more precisely detail the clinical progression of NSS changes in AD. Here, the NSS Professional Interest Area of the International Society to Advance Alzheimer's Research and Treatment highlights knowledge gaps about NSS within AD and provides recommendations for priorities specific to clinical research, biomarker development, modeling, and intervention. HIGHLIGHTS: Neuromodulatory nuclei degenerate in early Alzheimer's disease pathological stages. Alzheimer's pathophysiology is exacerbated by neuromodulatory nuclei degeneration. Neuromodulatory nuclei degeneration drives neuropsychiatric symptoms in dementia. Biomarkers of neuromodulatory integrity would be value-creating for dementia care. Neuromodulatory nuclei present strategic prospects for disease-modifying therapies.
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Affiliation(s)
- Alexander J Ehrenberg
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, California, USA
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, California, USA
| | - Michael A Kelberman
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kathy Y Liu
- Division of Psychiatry, University College London, London, UK
| | - Martin J Dahl
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - David Weinshenker
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Global Brain Health Institute, University of California, San Francisco, San Francisco, California, USA
| | - Shubir Dutt
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Mara Mather
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA
| | - Mareike Ludwig
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, University of Magdeburg, Magdeburg, Germany
| | - Matthew J Betts
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, University of Magdeburg, Magdeburg, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Magdeburg, Germany
| | - Joseph R Winer
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Stefan Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock/Greifswald, Rostock, Germany
- Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany
| | - Alexandra J Weigand
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Oxana Eschenko
- Department of Computational Neuroscience, Max Planck Institute for Biological Cybernetics, Tuebingen, Germany
| | - Dorothea Hämmerer
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Magdeburg, Germany
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Marina Leiman
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Magdeburg, Germany
| | - Scott E Counts
- Department of Translational Neuroscience, Michigan State University, Grand Rapids, Michigan, USA
- Department of Family Medicine, Michigan State University, Grand Rapids, Michigan, USA
- Michigan Alzheimer's Disease Research Center, Ann Arbor, Michigan, USA
| | - James M Shine
- Brain and Mind Center, The University of Sydney, Sydney, Australia
| | - Ian H Robertson
- Global Brain Health Institute, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Allan I Levey
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, Georgia, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
- Goizueta Institute, Emory University, Atlanta, Georgia, USA
| | - Elisa Lancini
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Magdeburg, Germany
| | - Gowoon Son
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Christoph Schneider
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Maxime Van Egroo
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Faculty of Health, Medicine, and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Qin Wang
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Agusta University, Agusta, Georgia, USA
| | - Elena M Vazey
- Department of Biology, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | | | - Lena Haag
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Magdeburg, Germany
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
- Psychology Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Sven Vanneste
- Global Brain Health Institute, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- School of Psychology, Trinity College Dublin, Dublin, Ireland
- Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Whitney M Freeze
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Neuropsychology and Psychiatry, Maastricht University, Maastricht, the Netherlands
| | - Yeo-Jin Yi
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Magdeburg, Germany
| | - Mihovil Maldinov
- Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Jennifer Gatchel
- Division of Geriatric Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Abhijit Satpati
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "V. Erspamer,", Sapienza University of Rome, Rome, Italy
- Hospital San Raffaele Cassino, Cassino, Italy
| | - William S Kremen
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, California, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK
| | - Heidi I L Jacobs
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Faculty of Health, Medicine, and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands
| | - Lea T Grinberg
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
- Global Brain Health Institute, University of California, San Francisco, San Francisco, California, USA
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
- Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil
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