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O'Donnell JL, Soda AK, Jiang H, Norris SA, Maiti B, Karimi M, Campbell MC, Moerlein SM, Tu Z, Perlmutter JS. PET Quantification of [ 18F]VAT in Human Brain and Its Test-Retest Reproducibility and Age Dependence. J Nucl Med 2024:jnumed.123.266860. [PMID: 38604762 DOI: 10.2967/jnumed.123.266860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/13/2024] [Indexed: 04/13/2024] Open
Abstract
Molecular imaging of brain vesicular acetylcholine transporter provides a biomarker to explore cholinergic systems in humans. We aimed to characterize the distribution of, and optimize methods to quantify, the vesicular acetylcholine transporter-specific tracer (-)-(1-(8-(2-[18F]fluoroethoxy)-3-hydroxy-1,2,3,4-tetrahydronaphthalen-2-yl)-piperidin-4-yl)(4-fluorophenyl)methanone ([18F]VAT) in the brain using PET. Methods: Fifty-two healthy participants aged 21-97 y had brain PET with [18F]VAT. [3H]VAT autoradiography identified brain areas devoid of specific binding in cortical white matter. PET image-based white matter reference region size, model start time, and duration were optimized for calculations of Logan nondisplaceable binding potential (BPND). Ten participants had 2 scans to determine test-retest variability. Finally, we analyzed age-dependent differences in participants. Results: [18F]VAT was widely distributed in the brain, with high striatal, thalamic, amygdala, hippocampal, cerebellar vermis, and regionally specific uptake in the cerebral cortex. [3H]VAT autoradiography-specific binding and PET [18F]VAT uptake were low in white matter. [18F]VAT SUVs in the white matter reference region correlated with age, requiring stringent erosion parameters. Logan BPND estimates stabilized using at least 40 min of data starting 25 min after injection. Test-retest variability had excellent reproducibility and reliability in repeat BPND calculations for 10 participants (putamen, 6.8%; r > 0.93). We observed age-dependent decreases in the caudate and putamen (multiple comparisons corrected) and in numerous cortical regions. Finally, we provide power tables to indicate potential mean differences that can be detected between 2 groups of participants. Conclusion: These results validate a reference region for BPND calculations and demonstrate the viability, reproducibility, and utility of using the [18F]VAT tracer in humans to quantify cholinergic pathways.
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Affiliation(s)
- John L O'Donnell
- Neurology, Washington University in Saint Louis, St. Louis, Missouri;
| | - Anil Kumar Soda
- Radiology, Washington University in Saint Louis, St. Louis, Missouri
| | - Hao Jiang
- Radiology, Washington University in Saint Louis, St. Louis, Missouri
| | - Scott A Norris
- Neurology, Washington University in Saint Louis, St. Louis, Missouri
- Radiology, Washington University in Saint Louis, St. Louis, Missouri
| | - Baijayanta Maiti
- Neurology, Washington University in Saint Louis, St. Louis, Missouri
- Radiology, Washington University in Saint Louis, St. Louis, Missouri
| | - Morvarid Karimi
- Neurology, Washington University in Saint Louis, St. Louis, Missouri
- Radiology, Washington University in Saint Louis, St. Louis, Missouri
| | - Meghan C Campbell
- Neurology, Washington University in Saint Louis, St. Louis, Missouri
- Radiology, Washington University in Saint Louis, St. Louis, Missouri
| | - Stephen M Moerlein
- Radiology, Washington University in Saint Louis, St. Louis, Missouri
- Biochemistry and Molecular Biophysics, Washington University in Saint Louis, St. Louis, Missouri; and
| | - Zhude Tu
- Radiology, Washington University in Saint Louis, St. Louis, Missouri
| | - Joel S Perlmutter
- Neurology, Washington University in Saint Louis, St. Louis, Missouri
- Radiology, Washington University in Saint Louis, St. Louis, Missouri
- Neuroscience, Physical, and Occupational Therapy, Washington University in Saint Louis, St. Louis, Missouri
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van der Horn HJ, Vakhtin AA, Julio K, Nitschke S, Shaff N, Dodd AB, Erhardt E, Phillips JP, Pirio Richardson S, Deligtisch A, Stewart M, Suarez Cedeno G, Meles SK, Mayer AR, Ryman SG. Parkinson's disease cerebrovascular reactivity pattern: A feasibility study. J Cereb Blood Flow Metab 2024:271678X241241895. [PMID: 38578669 DOI: 10.1177/0271678x241241895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
A mounting body of research points to cerebrovascular dysfunction as a fundamental element in the pathophysiology of Parkinson's disease (PD). In the current feasibility study, blood-oxygen-level-dependent (BOLD) MRI was used to measure cerebrovascular reactivity (CVR) in response to hypercapnia in 26 PD patients and 16 healthy controls (HC), and aimed to find a multivariate pattern specific to PD. Whole-brain maps of CVR amplitude (i.e., magnitude of response to CO2) and latency (i.e., time to reach maximum amplitude) were computed, which were further analyzed using scaled sub-profile model principal component analysis (SSM-PCA) with leave-one-out cross-validation. A meaningful pattern based on CVR latency was identified, which was named the PD CVR pattern (PD-CVRP). This pattern was characterized by relatively increased latency in basal ganglia, sensorimotor cortex, supplementary motor area, thalamus and visual cortex, as well as decreased latency in the cerebral white matter, relative to HC. There were no significant associations with clinical measures, though sample size may have limited our ability to detect significant associations. In summary, the PD-CVRP highlights the importance of cerebrovascular dysfunction in PD, and may be a potential biomarker for future clinical research and practice.
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Affiliation(s)
- Harm Jan van der Horn
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Andrei A Vakhtin
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Kayla Julio
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Stephanie Nitschke
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Nicholas Shaff
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Andrew B Dodd
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Erik Erhardt
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA
| | - John P Phillips
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Sarah Pirio Richardson
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, USA
- New Mexico VA Health Care System, Albuquerque, NM, USA
| | - Amanda Deligtisch
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | - Melanie Stewart
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | - Gerson Suarez Cedeno
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | - Sanne K Meles
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Andrew R Mayer
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Sephira G Ryman
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, USA
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Ananth MR, Gardus JD, Huang C, Palekar N, Slifstein M, Zaborszky L, Parsey RV, Talmage DA, DeLorenzo C, Role LW. Loss of cholinergic input to the entorhinal cortex is an early indicator of cognitive impairment in natural aging of humans and mice. Res Sq 2024:rs.3.rs-3851086. [PMID: 38260541 PMCID: PMC10802688 DOI: 10.21203/rs.3.rs-3851086/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
In a series of translational experiments using fully quantitative positron emission tomography (PET) imaging with a new tracer specific for the vesicular acetylcholine transporter ([18F]VAT) in vivo in humans, and genetically targeted cholinergic markers in mice, we evaluated whether changes to the cholinergic system were an early feature of age-related cognitive decline. We found that deficits in cholinergic innervation of the entorhinal cortex (EC) and decline in performance on behavioral tasks engaging the EC are, strikingly, early features of the aging process. In human studies, we recruited older adult volunteers that were physically healthy and without prior clinical diagnosis of cognitive impairment. Using [18F]VAT PET imaging, we demonstrate that there is measurable loss of cholinergic inputs to the EC that can serve as an early signature of decline in EC cognitive performance. These deficits are specific to the cholinergic circuit between the medial septum and vertical limb of the diagonal band (MS/vDB; CH1/2) to the EC. Using diffusion imaging, we further demonstrate impaired structural connectivity in the tracts between the MS/vDB and EC in older adults with mild cognitive impairment. Experiments in mouse, designed to parallel and extend upon the human studies, used high resolution imaging to evaluate cholinergic terminal density and immediate early gene (IEG) activity of EC neurons in healthy aging mice and in mice with genetic susceptibility to accelerated accumulation amyloid beta plaques and hyperphosphorylated mouse tau. Across species and aging conditions, we find that the integrity of cholinergic projections to the EC directly correlates with the extent of EC activation and with performance on EC-related object recognition memory tasks. Silencing EC-projecting cholinergic neurons in young, healthy mice during the object-location memory task impairs object recognition performance, mimicking aging. Taken together we identify a role for acetylcholine in normal EC function and establish loss of cholinergic input to the EC as an early, conserved feature of age-related cognitive decline in both humans and rodents.
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Weinstein JJ, Moeller SJ, Perlman G, Gil R, Van Snellenberg JX, Wengler K, Meng J, Slifstein M, Abi-Dargham A. Imaging the Vesicular Acetylcholine Transporter in Schizophrenia: A Positron Emission Tomography Study Using [ 18F]-VAT. Biol Psychiatry 2024:S0006-3223(24)00062-3. [PMID: 38309322 DOI: 10.1016/j.biopsych.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/10/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Despite longstanding interest in the central cholinergic system in schizophrenia (SCZ), cholinergic imaging studies with patients have been limited to receptors. Here, we conducted a proof-of-concept positron emission tomography study using [18F]-VAT, a new radiotracer that targets the vesicular acetylcholine transporter as a proxy measure of acetylcholine transmission capacity, in patients with SCZ and explored relationships of vesicular acetylcholine transporter with clinical symptoms and cognition. METHODS A total of 18 adult patients with SCZ or schizoaffective disorder (the SCZ group) and 14 healthy control participants underwent a positron emission tomography scan with [18F]-VAT. Distribution volume (VT) for [18F]-VAT was derived for each region of interest, and group differences in VT were assessed with 2-sample t tests. Functional significance was explored through correlations between VT and scores on the Positive and Negative Syndrome Scale and a computerized neurocognitive battery (PennCNB). RESULTS No group differences in [18F]-VAT VT were observed. However, within the SCZ group, psychosis symptom severity was positively associated with VT in multiple regions of interest, with the strongest effects in the hippocampus, thalamus, midbrain, cerebellum, and cortex. In addition, in the SCZ group, working memory performance was negatively associated with VT in the substantia innominata and several cortical regions of interest including the dorsolateral prefrontal cortex. CONCLUSIONS In this initial study, the severity of 2 important features of SCZ-psychosis and working memory deficit-was strongly associated with [18F]-VAT VT in several cortical and subcortical regions. These correlations provide preliminary evidence of cholinergic activity involvement in SCZ and, if replicated in larger samples, could lead to a more complete mechanistic understanding of psychosis and cognitive deficits in SCZ and the development of therapeutic targets.
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Affiliation(s)
- Jodi J Weinstein
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, New York; Department of Psychiatry, Columbia University Vagelos School of Medicine and New York State Psychiatric Institute, New York, New York.
| | - Scott J Moeller
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, New York
| | - Greg Perlman
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, New York
| | - Roberto Gil
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, New York
| | - Jared X Van Snellenberg
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, New York; Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York; Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Kenneth Wengler
- Department of Psychiatry, Columbia University Vagelos School of Medicine and New York State Psychiatric Institute, New York, New York; Department of Radiology, Stony Brook University Renaissance School of Medicine, Stony Brook, New York
| | - Jiayan Meng
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, New York
| | - Mark Slifstein
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, New York
| | - Anissa Abi-Dargham
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, New York; Department of Psychiatry, Columbia University Vagelos School of Medicine and New York State Psychiatric Institute, New York, New York
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5
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German‐Castelan L, Shanks HRC, Gros R, Saito T, Saido TC, Saksida LM, Bussey TJ, Prado MAM, Schmitz TW, Prado VF. Sex-dependent cholinergic effects on amyloid pathology: A translational study. Alzheimers Dement 2024; 20:995-1012. [PMID: 37846816 PMCID: PMC10916951 DOI: 10.1002/alz.13481] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/05/2023] [Accepted: 08/17/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION About two-thirds of Alzheimer's Disease (AD) patients are women, who exhibit more severe pathology and cognitive decline than men. Whether biological sex causally modulates the relationship between cholinergic signaling and amyloid pathology remains unknown. METHODS We quantified amyloid beta (Aβ) in male and female App-mutant mice with either decreased or increased cholinergic tone and examined the impact of ovariectomy and estradiol replacement in this relationship. We also investigated longitudinal changes in basal forebrain (cholinergic function) and Aβ in elderly individuals. RESULTS We show a causal relationship between cholinergic tone and amyloid pathology in males and ovariectomized female mice, which is decoupled in ovary-intact and ovariectomized females receiving estradiol. In elderly humans, cholinergic loss exacerbates Aβ. DISCUSSION Our findings emphasize the importance of reflecting human menopause in mouse models. They also support a role for therapies targeting estradiol and cholinergic signaling to reduce Aβ. HIGHLIGHTS Cholinergic tone regulates amyloid beta (Aβ) pathology in males and ovariectomized female mice. Estradiol uncouples the relationship between cholinergic tone and Aβ. In elderly humans, cholinergic loss correlates with increased Aβ in both sexes.
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Affiliation(s)
- Liliana German‐Castelan
- Robarts Research InstituteSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Neuroscience programSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
| | - Hayley R. C. Shanks
- Neuroscience programSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
| | - Robert Gros
- Robarts Research InstituteSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Department of MedicineSchulich School of Medicine & DentistryUniversity of Western OntarioLondonOntarioCanada
- Department of Physiology and PharmacologySchulich School of Medicine & DentistryUniversity of Western OntarioLondonOntarioCanada
| | - Takashi Saito
- Department of Neurocognitive ScienceInstitute of Brain ScienceNagoya City University Graduate School of Medical SciencesNagoyaJapan
- Laboratory for Proteolytic NeuroscienceRIKEN Center for Brain ScienceWako, SaitamaJapan
| | - Takaomi C. Saido
- Laboratory for Proteolytic NeuroscienceRIKEN Center for Brain ScienceWako, SaitamaJapan
| | - Lisa M. Saksida
- Robarts Research InstituteSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Neuroscience programSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Department of Physiology and PharmacologySchulich School of Medicine & DentistryUniversity of Western OntarioLondonOntarioCanada
- Western Institute for NeuroscienceUniversity of Western OntarioLondonOntarioCanada
| | - Timothy J. Bussey
- Robarts Research InstituteSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Neuroscience programSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Department of Physiology and PharmacologySchulich School of Medicine & DentistryUniversity of Western OntarioLondonOntarioCanada
- Western Institute for NeuroscienceUniversity of Western OntarioLondonOntarioCanada
| | - Marco A. M. Prado
- Robarts Research InstituteSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Neuroscience programSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Department of Physiology and PharmacologySchulich School of Medicine & DentistryUniversity of Western OntarioLondonOntarioCanada
- Western Institute for NeuroscienceUniversity of Western OntarioLondonOntarioCanada
- Department of Anatomy and Cell BiologySchulich School of Medicine & DentistryUniversity of Western OntarioLondonOntarioCanada
| | - Taylor W. Schmitz
- Robarts Research InstituteSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Neuroscience programSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Western Institute for NeuroscienceUniversity of Western OntarioLondonOntarioCanada
- Lawson Health Research InstituteSt. Joseph's HospitalLondonOntarioCanada
| | - Vania F. Prado
- Robarts Research InstituteSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Neuroscience programSchulich School of Medicine and DentistryUniversity of Western OntarioLondonOntarioCanada
- Department of Physiology and PharmacologySchulich School of Medicine & DentistryUniversity of Western OntarioLondonOntarioCanada
- Western Institute for NeuroscienceUniversity of Western OntarioLondonOntarioCanada
- Department of Anatomy and Cell BiologySchulich School of Medicine & DentistryUniversity of Western OntarioLondonOntarioCanada
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Citro S, Lazzaro GD, Cimmino AT, Giuffrè GM, Marra C, Calabresi P. A multiple hits hypothesis for memory dysfunction in Parkinson disease. Nat Rev Neurol 2024; 20:50-61. [PMID: 38052985 DOI: 10.1038/s41582-023-00905-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/07/2023]
Abstract
Cognitive disorders are increasingly recognized in Parkinson disease (PD), even in early disease stages, and memory is one of the most affected cognitive domains. Classically, hippocampal cholinergic system dysfunction was associated with memory disorders, whereas nigrostriatal dopaminergic system impairment was considered responsible for executive deficits. Evidence from PD studies now supports involvement of the amygdala, which modulates emotional attribution to experiences. Here, we propose a tripartite model including the hippocampus, striatum and amygdala as key structures for cognitive disorders in PD. First, the anatomo-functional relationships of these structures are explored and experimental evidence supporting their role in cognitive dysfunction in PD is summarized. We then discuss the potential role of α-synuclein, a pathological hallmark of PD, in the tripartite memory system as a key mechanism in the pathogenesis of memory disorders in the disease.
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Affiliation(s)
- Salvatore Citro
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Di Lazzaro
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Angelo Tiziano Cimmino
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Guido Maria Giuffrè
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Camillo Marra
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Calabresi
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy.
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
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Wang CSM, Chen PS, Tsai TY, Hou NT, Tang CH, Chen PL, Huang YC, Cheng KS. Cognitive Effect of Transcranial Direct Current Stimulation on Left Dorsolateral Prefrontal Cortex in Mild Alzheimer's Disease: A Randomized, Double-Blind, Cross-Over Small-Scale Exploratory Study. J Alzheimers Dis 2024; 98:563-577. [PMID: 38427493 DOI: 10.3233/jad-240002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Background Transcranial direct current stimulation (tDCS) is considered a potential therapeutic instrument for Alzheimer's disease (AD) because it affects long-term synaptic plasticity through the processes of long-term potentiation and long-term depression, thereby improving cognitive ability. Nevertheless, the efficacy of tDCS in treating AD is still debated. Dorsal lateral prefrontal cortex is the main role in executive functions. Objective We investigate the cognitive effects of tDCS on AD patients. Methods Thirty mild AD patients aged 66-86 years (mean = 75.6) were included in a double-blind, randomized, sham-controlled crossover study. They were randomly assigned to receive 10 consecutive daily sessions of active tDCS (2 mA for 30 min) or a sham intervention and switched conditions 3 months later. The anodal and cathodal electrodes were placed on the left dorsal lateral prefrontal cortex and the right supraorbital area, respectively. Subjects underwent various neuropsychological assessments before and after the interventions. Results The results showed that tDCS significantly improved Cognitive Abilities Screening Instrument scores, especially on the items of "concentration and calculation", "orientation", "language ability", and "categorical verbal fluency". Mini-Mental State Examination and Wisconsin Card Sorting Test scores in all domains of "concept formation", "abstract thinking", "cognitive flexibility", and "accuracy" also improved significantly after tDCS. For the sham condition, no difference was found between the baseline scores and the after-intervention scores on any of the neuropsychological tests. Conclusion >: Using tDCS improves the cognition of AD patients. Further large size clinical trials are necessary to validate the data.
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Affiliation(s)
- Carol Sheei-Meei Wang
- Department of BioMedical Engineering, National Cheng Kung University, Tainan City, Taiwan
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan
- Department of Psychiatry, College of Medicines, National Cheng Kung University Hospital, National Cheng Kung University, Tainan City, Taiwan
| | - Po See Chen
- Department of Psychiatry, College of Medicines, National Cheng Kung University Hospital, National Cheng Kung University, Tainan City, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Tsung-Yu Tsai
- Department of Psychiatry, College of Medicines, National Cheng Kung University Hospital, National Cheng Kung University, Tainan City, Taiwan
| | - Nien-Tsen Hou
- Department of Neurology, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Chia-Hung Tang
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Pai-Lien Chen
- Biostatistics Department, Family Health International (FHI) 360, Durham, NC, USA
| | - Ying-Che Huang
- Department of Neurology, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Kuo-Sheng Cheng
- Department of BioMedical Engineering, National Cheng Kung University, Tainan City, Taiwan
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Saha DK, Bohsali A, Saha R, Hajjar I, Calhoun VD. A Multivariate Method for Estimating and comparing whole brain functional connectomes from fMRI and PET data. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083351 DOI: 10.1109/embc40787.2023.10340631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Positron emission tomography (PET) and magnetic resonance imaging (MRI) are two commonly used imaging techniques to visualize brain function. The use of inter-network covariation (a functional connectome) is a widely used approach to infer links among different brain networks. While whole brain resting fMRI connectomes are widely used, PET data has mostly been analyzed using a few regions of interest. There has been much less work estimating PET spatial networks and almost no work on their connectivity (covariation) in the context of a whole brain data-driven connectome, nor have there been direct comparisons between whole brain PET and fMRI connectomes. Here we present an approach to leverage spatially constrained ICA to compute an estimate of the PET connectome. Results reveal highly modularized connectome patterns that are complementary to that identified from resting fMRI. Similarly, we were able to identify comparable resting networks from a PiB PET scan that can be directly compared to networks in rest fMRI data and results reveal similar, but not identical, network spatial patterns, with the PET networks being slightly smoother and, in some cases, showing variations in subnodes. The resulting networks, decomposed into spatial maps and subject expressions (loading parameters) linked to resting fMRI provide a new way to evaluate the complementary information in PET and fMRI and open up new possibilities for biomarker development.Clinical Relevance-This study analyzes the whole-brain PET and fMRI connectomes, capturing the complementary information from both imaging modalities, thereby introducing a new scope for biomarker development.
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Ananth MR, Rajebhosale P, Kim R, Talmage DA, Role LW. Basal forebrain cholinergic signalling: development, connectivity and roles in cognition. Nat Rev Neurosci 2023; 24:233-251. [PMID: 36823458 PMCID: PMC10439770 DOI: 10.1038/s41583-023-00677-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 01/18/2023] [Indexed: 02/25/2023]
Abstract
Acetylcholine plays an essential role in fundamental aspects of cognition. Studies that have mapped the activity and functional connectivity of cholinergic neurons have shown that the axons of basal forebrain cholinergic neurons innervate the pallium with far more topographical and functional organization than was historically appreciated. Together with the results of studies using new probes that allow release of acetylcholine to be detected with high spatial and temporal resolution, these findings have implicated cholinergic networks in 'binding' diverse behaviours that contribute to cognition. Here, we review recent findings on the developmental origins, connectivity and function of cholinergic neurons, and explore the participation of cholinergic signalling in the encoding of cognition-related behaviours.
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Affiliation(s)
- Mala R Ananth
- Section on Circuits, Synapses, and Molecular Signalling, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
| | - Prithviraj Rajebhosale
- Section on Genetics of Neuronal Signalling, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Ronald Kim
- Section on Genetics of Neuronal Signalling, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - David A Talmage
- Section on Genetics of Neuronal Signalling, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Lorna W Role
- Section on Circuits, Synapses, and Molecular Signalling, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
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Russell J, Ingram SM, Teal LB, Lindsley CW, Jones CK. M 1/M 4-Preferring Muscarinic Cholinergic Receptor Agonist Xanomeline Reverses Wake and Arousal Deficits in Nonpathologically Aged Mice. ACS Chem Neurosci 2023; 14:435-457. [PMID: 36655909 PMCID: PMC9897218 DOI: 10.1021/acschemneuro.2c00592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/21/2022] [Indexed: 01/20/2023] Open
Abstract
Degeneration of the cholinergic basal forebrain is implicated in the development of cognitive deficits and sleep/wake architecture disturbances in mild cognitive impairment (MCI) and Alzheimer's disease (AD). Indirect-acting muscarinic cholinergic receptor agonists, such as acetylcholinesterase inhibitors (AChEIs), remain the only FDA-approved treatments for the cognitive impairments observed in AD that target the cholinergic system. Novel direct-acting muscarinic cholinergic receptor agonists also improve cognitive performance in young and aged preclinical species and are currently under clinical development for AD. However, little is known about the effects of direct-acting muscarinic cholinergic receptor agonists on disruptions of sleep/wake architecture and arousal observed in nonpathologically aged rodents, nonhuman primates, and clinical populations. The purpose of the present study was to provide the first assessment of the effects of the direct-acting M1/M4-preferring muscarinic cholinergic receptor agonist xanomeline on sleep/wake architecture and arousal in young and nonpathologically aged mice, in comparison with the AChEI donepezil, when dosed in either the active or inactive phase of the circadian cycle. Xanomeline produced a robust reversal of both wake fragmentation and disruptions in arousal when dosed in the active phase of nonpathologically aged mice. In contrast, donepezil had no effect on either age-related wake fragmentation or arousal deficits when dosed during the active phase. When dosed in the inactive phase, both xanomeline and donepezil produced increases in wake and arousal and decreases in nonrapid eye movement sleep quality and quantity in nonpathologically aged mice. Collectively, these novel findings suggest that direct-acting muscarinic cholinergic agonists such as xanomeline may provide enhanced wakefulness and arousal in nonpathological aging, MCI, and AD patient populations.
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Affiliation(s)
- Jason
K. Russell
- Department of Pharmacology,
Warren
Center for Neuroscience Drug Discovery, and Vanderbilt Institute of
Chemical Biology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Shalonda M. Ingram
- Department of Pharmacology,
Warren
Center for Neuroscience Drug Discovery, and Vanderbilt Institute of
Chemical Biology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Laura B. Teal
- Department of Pharmacology,
Warren
Center for Neuroscience Drug Discovery, and Vanderbilt Institute of
Chemical Biology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Craig W. Lindsley
- Department of Pharmacology,
Warren
Center for Neuroscience Drug Discovery, and Vanderbilt Institute of
Chemical Biology, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Carrie K. Jones
- Department of Pharmacology,
Warren
Center for Neuroscience Drug Discovery, and Vanderbilt Institute of
Chemical Biology, Vanderbilt University, Nashville, Tennessee 37232, United States
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11
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Daamen M, Scheef L, Li S, Grothe MJ, Gaertner FC, Buchert R, Buerger K, Dobisch L, Drzezga A, Essler M, Ewers M, Fliessbach K, Herrera Melendez AL, Hetzer S, Janowitz D, Kilimann I, Krause BJ, Lange C, Laske C, Munk MH, Peters O, Priller J, Ramirez A, Reimold M, Rominger A, Rostamzadeh A, Roeske S, Roy N, Scheffler K, Schneider A, Spottke A, Spruth EJ, Teipel SJ, Wagner M, Düzel E, Jessen F, Boecker H. Cortical Amyloid Burden Relates to Basal Forebrain Volume in Subjective Cognitive Decline. J Alzheimers Dis 2023; 95:1013-1028. [PMID: 37638433 DOI: 10.3233/jad-230141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Atrophy of cholinergic basal forebrain (BF) nuclei is a frequent finding in magnetic resonance imaging (MRI) volumetry studies that examined patients with prodromal or clinical Alzheimer's disease (AD), but less clear for individuals in earlier stages of the clinical AD continuum. OBJECTIVE To examine BF volume reductions in subjective cognitive decline (SCD) participants with AD pathologic changes. METHODS The present study compared MRI-based BF volume measurements in age- and sex-matched samples of N = 24 amyloid-positive and N = 24 amyloid-negative SCD individuals, based on binary visual ratings of Florbetaben positron emission tomography (PET) measurements. Additionally, we assessed associations of BF volume with cortical amyloid burden, based on semiquantitative Centiloid (CL) analyses. RESULTS Group differences approached significance for BF total volume (p = 0.061) and the Ch4 subregion (p = 0.059) only, showing the expected relative volume reductions for the amyloid-positive subgroup. There were also significant inverse correlations between BF volumes and CL values, which again were most robust for BF total volume and the Ch4 subregion. CONCLUSIONS The results are consistent with the hypothesis that amyloid-positive SCD individuals, which are considered to represent a transitional stage on the clinical AD continuum, already show incipient alterations of BF integrity. The negative association with a continuous measure of cortical amyloid burden also suggests that this may reflect an incremental process. Yet, further research is needed to evaluate whether BF changes already emerge at "grey zone" levels of amyloid accumulation, before amyloidosis is reliably detected by PET visual readings.
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Affiliation(s)
- Marcel Daamen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Lukas Scheef
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
- RheinAhrCampus, University of Applied Sciences Koblenz, Remagen, Germany
| | - Shumei Li
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | | | - Ralph Buchert
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilian University Munich, Munich, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Alexander Drzezga
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Forschungszentrum Jülich, Jülich, Germany
| | - Markus Essler
- Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany
| | - Michael Ewers
- Institute for Clinical Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Ana Lucia Herrera Melendez
- Institute of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stefan Hetzer
- Berlin Center of Advanced Neuroimaging, Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilian University Munich, Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Bernd Joachim Krause
- Department of Nuclear Medicine, Rostock University Medical Centre, Rostock, Germany
| | - Catharina Lange
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Matthias H Munk
- German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Oliver Peters
- Institute of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
- University of Edinburgh and UK Dementia Research Institute, Edinburgh, UK
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Department of Psychiatry and Psychotherapy, Division of Neurogenetics and Molecular Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Medical Faculty, Cologne, Germany
- Department of Psychiatry & Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
| | - Matthias Reimold
- Department of Nuclear Medicine and Clinical Molecular Imaging, Eberhard-Karls-University, Tübingen, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, Ludwig-Maximilian-University Munich, Munich, Germany
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ayda Rostamzadeh
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurodegenerative Disease and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Henning Boecker
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
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12
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Chang SR, Liu JG, Li H, Liu MX, Shi DD, Zhou LJ. Pharmaceutical and pharmacological studies of Shen Ma Yi Zhi granule for prevention of vascular dementia: A review. Front Neurosci 2022; 16:1044572. [PMID: 36507350 PMCID: PMC9731835 DOI: 10.3389/fnins.2022.1044572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background: With dementia significantly increasing hospitalization and disability rates, worldwide aging of the population presents major challenges to public health. The majority of cases of cognitive dysfunction among the elderly, however, are characterized by an identifiable, preventable and treatable vascular component. As such, increased study of preventative methods in the context of dementia is warranted. Traditional Chinese medicine compounds have been reported to be neuroprotective and improve cognitive function via a variety of mechanisms. Shen Ma Yi Zhi granule (SMYZG) is one such collection of compounds that has been proven clinically effective. Pharmacological mechanisms of action, pharmacokinetics and clinical applications of SMYZG have been previously studied using a variety of vascular dementia animal models. SMYZG activates and regulates four main signaling pathways relevant to vascular dementia including the AMPK/PPARα/PGC-1α/UCP2, Nrf2/HO-1, HIF-1/VEGF/Notch, and VEGF/Flk-1/p8 MAPK pathways. Furthermore, SMYZG influences anti-inflammatory and anti-oxidant stress responses, reverses demyelination of brain white matter and vascular endothelium, regulates pericyte function and normalizes mitochondrial metabolism. Neuroprotective effects of SMYZG, as well as those promoting regeneration of vascular endothelium, have also been reported in studies of rat models of vascular dementia. Future research concerning SMYG is warranted for development of vascular dementia preventative management strategies.
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Affiliation(s)
- Su-rui Chang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jian-gang Liu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China,*Correspondence: Jian-gang Liu,
| | - Hao Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Institute of Geriatrics of China Academy of Chinese Medical Sciences, Beijing, China,Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Hao Li,
| | - Mei-xia Liu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Institute of Geriatrics of China Academy of Chinese Medical Sciences, Beijing, China
| | - Dan-dan Shi
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Institute of Geriatrics of China Academy of Chinese Medical Sciences, Beijing, China
| | - Li-juan Zhou
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Institute of Geriatrics of China Academy of Chinese Medical Sciences, Beijing, China
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13
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Yingli B, Zunke G, Wei C, Shiyan W. Cerebral activity manipulation of low-frequency repetitive transcranial magnetic stimulation in post-stroke patients with cognitive impairment. Front Neurol 2022; 13:951209. [PMID: 36425802 PMCID: PMC9679635 DOI: 10.3389/fneur.2022.951209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/10/2022] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke cognitive impairment (PSCI). METHODS Thirty-six PSCI patients were randomly divided into treatment and control groups of equal size. Both groups were pre-treated with conventional cognitive rehabilitation training. Subsequently, the treatment group was exposed to 1 Hz low-frequency repetitive transcranial magnetic stimulations for 8 weeks, with 5 days per week. Meanwhile, the control group was treated with placebo stimulations. Patients were evaluated via the LOTCA scale assessments and changes in P300 latencies and amplitudes before and after 8 weeks of treatment. RESULTS Before treatment, there were no significant differences between the two groups in LOTCA scores, P300 latencies, and amplitudes (P > 0.05). After treatment, LOTCA scores for both groups improved (P < 0.05), and those of the treatment group were higher than those of the control (P < 0.05). For both groups, P300 latencies were not only shortened but also had greater amplitudes (P < 0.05), and those for the treatment group were significantly shorter and larger than those of the control (P < 0.05). CONCLUSION As a therapy, rTMS improved cognitive function in PSCI patients, possibly via regulation of neural electrical activity of the cerebral cortex.
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Affiliation(s)
- Bi Yingli
- Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Gong Zunke
- Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Chen Wei
- Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Wang Shiyan
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, China
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14
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Jeffers CD, Lawhn-Heath C, Butterfield RI, Hoffman JM, Scott PJH. SNMMI Clinical Trials Network Research Series for Technologists: Clinical Research Primer- Use of Imaging Agents in Therapeutic Drug Development and Approval. J Nucl Med Technol 2022; 50:jnmt.122.264372. [PMID: 35701219 DOI: 10.2967/jnmt.122.264372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/11/2022] [Indexed: 11/16/2022] Open
Abstract
The process of bringing a new drug to market is complex and has recently necessitated a new drug discovery paradigm for the pharmaceutical industry that is both more efficient and more economical. Key to this has been the increasing use of nuclear medicine and molecular imaging to support drug discovery efforts by answering critical questions on the pathway for development and approval of a new therapeutic drug. Some of these questions include: (i) Does the new drug reach its intended target in the body at sufficient levels to effectively treat or diagnose disease without unacceptable toxicity? (ii) How is the drug absorbed, metabolized, and excreted? (iii) What is the effective dose in humans? To conduct the appropriate imaging studies to answer such questions, pharmaceutical companies are increasingly partnering with molecular imaging departments. Nuclear medicine technologists are critical to this process as they perform scans to collect the qualitative and quantitative imaging data used to measure study endpoints. This article describes preclinical and clinical research trials and provides an overview of the different ways that radiopharmaceuticals are used to answer critical questions during therapeutic drug development.
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