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Birdsill AC, Koscik RL, Cody KA, Jonaitis EM, Cadman RV, Erickson CM, Chin NA, Przybelski RJ, Carlsson CM, Asthana S, Christian BT, Eisenmenger LB, Betthauser TJ, Johnson SC. Trajectory of clinical symptoms in relation to amyloid chronicity. Alzheimers Dement (Amst) 2022; 14:e12360. [PMID: 36187195 PMCID: PMC9489232 DOI: 10.1002/dad2.12360] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/27/2022] [Accepted: 08/29/2022] [Indexed: 01/25/2023]
Abstract
Introduction While it is generally appreciated that amyloid precedes symptomatic Alzheimer's disease (AD) by decades, a greater understanding of this timeline may increase prognostic accuracy, planning, and care of persons who are on the AD continuum. Methods We examined trajectories of Clinical Dementia Rating-Sum of Boxes (CDR-SB) relative to estimated years of amyloid positivity (A+) in n = 123 participants who were all A+ based on [C-11]Pittsburgh compound B positron emission tomography. Results The average amyloid chronicity at CDR-SB of 2.5 was 20.1 years. The average trajectory of CDR-SB accelerated after 10 years of elevated amyloid and varied greatly between 10 and 30 years. Exploratory analyses suggested that older age and higher volume of white matter hyperintensities shortened the interval between amyloid onset and cognitive impairment. Discussion The recontextualization of amyloid burden into the time domain will facilitate studies of disease progression, the influence of co-pathology, and factors that hasten or slow cognitive impairment.
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Affiliation(s)
- Alex C. Birdsill
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA
| | - Rebecca L. Koscik
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Karly A. Cody
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Robert V. Cadman
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Claire M. Erickson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Robert J. Przybelski
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Bradley T. Christian
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Waisman Laboratory for Brain Imaging and BehaviorUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Department of Medical PhysicsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Laura B. Eisenmenger
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of RadiologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Tobey J. Betthauser
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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Cody KA, Koscik RL, Erickson CM, Birdsill AC, Berman SE, Chin NA, Clark LR, Christian BT, Betthauser TJ, Johnson SC. Associations between lifestyle risk, β‐amyloid, tau, and cognition in late mid‐life. Alzheimers Dement 2020. [DOI: 10.1002/alz.046562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Karly Alex Cody
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Rebecca L. Koscik
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Claire M Erickson
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Alex C Birdsill
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Sara E Berman
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Nathaniel A. Chin
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Lindsay R Clark
- University of Wisconsin School of Medicine and Public Health Madison WI USA
- VA Geriatric Research Education and Clinical Center (GRECC) William S. Middleton Memorial Veterans Hospital Madison WI USA
| | | | - Tobey J Betthauser
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Sterling C Johnson
- University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison WI USA
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Birdsill AC, Koscik RL, Cody KA, Betthauser TJ, Erickson CM, Chin NA, Christian BT, Carlsson CM, Asthana S, Johnson SC. Trajectory of clinical symptoms accelerates after 10 years of amyloid. Alzheimers Dement 2020. [DOI: 10.1002/alz.046459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Alex C. Birdsill
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Rebecca L. Koscik
- The Wisconsin Alzheimer's Institute University of Wisconsin Madison WI USA
| | - Karly Alex Cody
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | - Claire M. Erickson
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Nathaniel A. Chin
- Division of Geriatrics and Gerontology University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | | | | | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research Center Madison WI USA
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Koscik RL, Jonaitis EM, Betthauser TJ, Hermann BP, Clark LR, Mueller KD, Du L, Birdsill AC, Chin NA, Christian BT, Johnson SC. PET differences between cognitively unimpaired stable and declining subtypes: Multiple approaches show higher amyloid and tau among those with sub‐clinical cognitive decline. Alzheimers Dement 2020. [DOI: 10.1002/alz.046316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Rebecca L. Koscik
- The Wisconsin Alzheimer's Institute University of Wisconsin Madison WI USA
| | - Erin M. Jonaitis
- The Wisconsin Alzheimer's Institute University of Wisconsin Madison WI USA
| | | | - Bruce P. Hermann
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital Madison WI USA
| | - Lindsay R. Clark
- The Wisconsin Alzheimer's Institute University of Wisconsin Madison WI USA
| | | | - Lianlian Du
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Alex C. Birdsill
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Nathaniel A. Chin
- Division of Geriatrics and Gerontology University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | | | - Sterling C. Johnson
- Alzheimer's Disease Research Center University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
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Foret JT, Dekhtyar M, Birdsill AC, Tanaka H, Haley AP. Metabolic syndrome components moderate the association between executive function and functional connectivity in the default mode network. Brain Imaging Behav 2020; 15:2139-2148. [PMID: 33179757 DOI: 10.1007/s11682-020-00409-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2020] [Indexed: 01/21/2023]
Abstract
Middle aged individuals with Metabolic Syndrome are at high risk for cognitive decline. Dyssynchrony in the resting state Default Mode Network is one early indicator of brain vulnerability. We set out to explore the relationship between default mode resting state functional connectivity and cognitive performance in both memory and executive domains at midlife in the presence of Metabolic Syndrome components. Seed-based Correlation Analyses were performed between the seed voxel in the posterior cingulate cortex and the medial prefrontal cortex on 200 participants (ages 40-61). Executive domain scores were significantly predicted by the interaction between number of Metabolic Syndrome components and resting state connectivity in the Default Mode Network (p = .004) such that connectivity was negatively related to executive function at higher numbers of Metabolic Syndrome components. Results were not significant for memory. Our findings indicate that clusters of cardiovascular disease risk factors alter functional relationships in the brain and highlights the need to continue exploring how compensatory techniques might operate to support cognitive performance at midlife.
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Affiliation(s)
- Janelle T Foret
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton, Stop A8000, Austin, TX, 78712, USA
| | - Maria Dekhtyar
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton, Stop A8000, Austin, TX, 78712, USA
| | - Alex C Birdsill
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Andreana P Haley
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton, Stop A8000, Austin, TX, 78712, USA. .,Biomedical Imaging Center, The University of Texas at Austin, Austin, TX, USA.
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Abstract
Metabolic syndrome (MetS) adversely affects the vasculature and cerebral white matter (CWM) integrity. Arterial stiffening has been associated with diminished CWM integrity. Physical activity (PA) can ameliorate components of MetS and subsequently affect arterial stiffening and CWM integrity. Our aim was to determine the role of PA on mitigating the adverse influence of MetS on arterial stiffness and CWM integrity. In a cross-sectional study design, sixty-six middle-aged adults (40-62 years) composed of 18 sedentary MetS (Sed MetS), 21 physically active MetS (Active MetS), and 27 healthy individuals absent of MetS risk factors were studied. Carotid artery stiffness was assessed via simultaneous ultrasound and tonometry. CWM integrity was measured using diffusion tensor imaging (DTI) through metrics of fractional anisotropy (FA) and mean diffusivity (MD). Carotid β-stiffness index in Active MetS was lower than Sed MetS but was not different from Healthy controls (6.6 ± 1.5, 7.7 ± 2.1, and 5.6 ± 1.6 au, p = 0.001). CWM integrity was significantly greater in Active MetS subjects compared to Sed MetS subjects but statistically equal to Healthy controls in the anterior limb of the internal capsule, and splenium of the corpus callosum, uncinate fasciculus, and superior corona radiata (all p < 0.05). Middle-aged individuals with MetS who habitually perform PA demonstrated lower arterial stiffness and more favorable CWM integrity than their sedentary peers, indicating that PA may be effective in mitigating the adverse effects of MetS on the vasculature and brain at midlife.
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Affiliation(s)
- Evan P Pasha
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, D3700, Austin, TX, 78712, USA.
| | - Alex C Birdsill
- Department of Psychology, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Andreana P Haley
- Department of Psychology, The University of Texas at Austin, Austin, TX, 78712, USA
- Imaging Research Center, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Hirofumi Tanaka
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, D3700, Austin, TX, 78712, USA
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Abstract
Sex differences in cerebral white matter (WM) aging have been debated extensively over the past 2 decades without unequivocal resolution. We aimed to determine if the effects of age and arterial stiffness on WM microstructure differ between sexes. Artery elasticity via carotid artery compliance (CAC) and WM diffusion metrics via diffusion tensor image-derived fractional anisotropy (FA) and mean diffusivity (MD) were measured in 155 (87 females) middle-aged (40-62 years) adults. Males demonstrated poorer water diffusion metrics in WM than women in the corpus callosum body, cingulum, and cingulum (hippocampal). Age and CAC had greater effects on WM water diffusion in males than females in midlife independent of education and cardiovascular risk factors. Sex-moderated age (cingulum FA, cingulum [hippocampal] MD, and uncinate MD, all p < 0.05) and CAC (cingulum FA, p < 0.05) related reductions in regional WM diffusion metrics. CAC mediated age-related associations in regional WM diffusion metrics (cingulum FA, cingulum MD, superior corona radiata MD, and uncinate MD, all p < 0.05) in males but not in females. Age and CAC were associated with WM diffusion metrics independent of cardiovascular risk factors. These associations appear to be stronger in males than in females.
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Affiliation(s)
- Evan P Pasha
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education.
| | - Alex C Birdsill
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Hirofumi Tanaka
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education
| | - Andreana P Haley
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA; Imaging Research Center, The University of Texas at Austin, Austin, TX, USA
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Pasha EP, Birdsill AC, Oleson S, Haley AP, Tanaka H. Impacts of Metabolic Syndrome Scores on Cerebrovascular Conductance Are Mediated by Arterial Stiffening. Am J Hypertens 2017; 31:72-79. [PMID: 28992237 PMCID: PMC5861594 DOI: 10.1093/ajh/hpx132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 05/17/2017] [Revised: 06/24/2017] [Accepted: 07/19/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Individuals with metabolic syndrome (MetS) exhibit reduced cerebral blood flow. The mechanisms of this reduction remain unknown but arterial stiffening has been implicated as a contributor. We determined if MetS was associated with reduced cerebral blood flow at midlife, and if so, whether arterial stiffness was responsible for mediating their relation. METHODS Middle-aged (40-60 years) community dwelling adults (n = 83) were studied. MetS score was calculated for each subject. Middle cerebral artery hemodynamics was measured using transcranial Doppler ultrasound. Indices of aortic, systemic, and carotid artery stiffness were derived. RESULTS Subjects had subclinical MetS pathology (MetS score = 19.8 ± 10.4) that was inversely associated with cerebrovascular conductance (CVC: r = -0.261, P = 0.02). Carotid-femoral pulse wave velocity (cfPWV) (r = -0.188, P = 0.09), brachial-ankle pulse wave velocity (baPWV) (r = -0.161, P = 0.15), and carotid artery distensibility (r = -0.10, P = 0.37) abrogated the direct association of MetS score and CVC, demonstrating full mediation. Nonparametric bootstrapping further indicated significant indirect effects of cfPWV, baPWV, and carotid artery distensibility, fully mediating reductions of CVC exerted from sublcinical MetS. Carotid artery distensibility demonstrated the greatest effect on CVC (B = -0.0019, SE = 0.0012, -0.0050 to -0.0002 95% confidence interval). CONCLUSIONS Arterial stiffness, particularly the stiffness of the carotid artery, mediated reductions in CVC related to MetS.
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Affiliation(s)
- Evan P Pasha
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, USA
| | - Alex C Birdsill
- Department of Psychology, The University of Texas at Austin, USA
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, USA
| | - Andreana P Haley
- Department of Psychology, The University of Texas at Austin, USA
- Imaging Research Center, The University of Texas at Austin, USA
| | - Hirofumi Tanaka
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, USA
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9
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Kaur S, Birdsill AC, Steward K, Pasha E, Kruzliak P, Tanaka H, Haley AP. Higher visceral fat is associated with lower cerebral N-acetyl-aspartate ratios in middle-aged adults. Metab Brain Dis 2017; 32:727-733. [PMID: 28144886 PMCID: PMC6802935 DOI: 10.1007/s11011-017-9961-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 01/24/2017] [Indexed: 01/01/2023]
Abstract
Excessive adipose tissue, particularly with a central distribution, consists of visceral fat, which is metabolically active and could impinge upon central nervous system functioning. The aim of the current study was to examine levels of visceral adiposity in relation to key cerebral metabolite ratios localized in the occipitoparietal grey matter. Seventy-three adults, aged between 40 and 60 years, underwent structural magnetic resonance imaging and single voxel 1H Magnetic Resonance Spectroscopy (1H MRS). Visceral fat was assessed using Dual Energy X Ray Absorptiometry (DXA). Individuals with higher visceral fat mass and volume had significantly lower ratios of N-acetyl-aspartate to total creatine (phosphocreatine + creatine, PCr + Cr) (NAA/PCr + Cr) (β = -0.29, p = 0.03, β = -0.28, p = 0.04). They also had significantly higher ratios of myo-inositol to total creatine (mI/PCr + Cr ) (β = 0.36, p = 0.01, β = 0.36, p = 0.01). Visceral fat mass and volume were not significantly related to ratios of glutamate to total creatine (Glu/PCr + Cr). While future studies are necessary, these results indicate central adiposity is associated with metabolic changes that could impinge upon the central nervous system in middle age.
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Affiliation(s)
- Sonya Kaur
- Department of Psychology, The University of Texas at Austin, 108 East Dean Keeton, Stop A8000, Austin, TX, 78712, USA
| | - Alex C Birdsill
- Department of Psychology, The University of Texas at Austin, 108 East Dean Keeton, Stop A8000, Austin, TX, 78712, USA
| | - Kayla Steward
- Department of Psychology, The University of Texas at Austin, 108 East Dean Keeton, Stop A8000, Austin, TX, 78712, USA
| | - Evan Pasha
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Peter Kruzliak
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Andreana P Haley
- Department of Psychology, The University of Texas at Austin, 108 East Dean Keeton, Stop A8000, Austin, TX, 78712, USA.
- Imaging Research Center, The University of Texas at Austin, Austin, TX, USA.
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Pasha EP, Birdsill AC, Oleson S, Haley AP, Tanaka H. Habitual Physical Activity Mitigates the Adverse Effects of Metabolic Syndrome on Arterial Stiffness and Cerebral White Matter Integrity. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000519208.67715.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Fischer BL, Bacher R, Bendlin BB, Birdsill AC, Ly M, Hoscheidt SM, Chappell RJ, Mahoney JE, Gleason CE. An Examination of Brain Abnormalities and Mobility in Individuals with Mild Cognitive Impairment and Alzheimer's Disease. Front Aging Neurosci 2017; 9:86. [PMID: 28424612 PMCID: PMC5380746 DOI: 10.3389/fnagi.2017.00086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 03/20/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Mobility changes are concerning for elderly patients with cognitive decline. Given frail older individuals' vulnerability to injury, it is critical to identify contributors to limited mobility. Objective: To examine whether structural brain abnormalities, including reduced gray matter volume and white matter hyperintensities, would be associated with limited mobility among individuals with cognitive impairment, and to determine whether cognitive impairment would mediate this relationship. Methods: Thirty-four elderly individuals with mild cognitive impairment (MCI) and Alzheimer's disease underwent neuropsychological evaluation, mobility assessment, and structural brain neuroimaging. Linear regression was conducted with predictors including gray matter volume in six regions of interest (ROI) and white matter hyperintensity (WMH) burden, with mobility measures as outcomes. Results: Lower gray matter volume in caudate nucleus was associated with slower speed on a functional mobility task. Higher cerebellar volume was also associated with slower functional mobility. White matter hyperintensity burden was not significantly associated with mobility. Conclusion: Our findings provide evidence for associations between subcortical gray matter volume and speed on a functional mobility task among cognitively impaired individuals.
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Affiliation(s)
- Barbara L Fischer
- Geriatric Research, Education, and Clinical Center, William S. Middleton Memorial Veterans HospitalMadison, WI, USA
| | - Rhonda Bacher
- Department of Statistics, University of Wisconsin-MadisonMadison, WI, USA
| | - Barbara B Bendlin
- School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, USA.,Wisconsin Alzheimer's Disease Research CenterMadison, WI, USA
| | - Alex C Birdsill
- School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, USA
| | - Martina Ly
- School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, USA
| | - Siobhan M Hoscheidt
- School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, USA.,Wisconsin Alzheimer's Disease Research CenterMadison, WI, USA
| | - Richard J Chappell
- Department of Statistics, University of Wisconsin-MadisonMadison, WI, USA.,Wisconsin Alzheimer's Disease Research CenterMadison, WI, USA.,Departments of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, USA
| | - Jane E Mahoney
- Division of Geriatrics, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, USA
| | - Carey E Gleason
- Geriatric Research, Education, and Clinical Center, William S. Middleton Memorial Veterans HospitalMadison, WI, USA.,School of Medicine and Public Health, University of Wisconsin-MadisonMadison, WI, USA.,Wisconsin Alzheimer's Disease Research CenterMadison, WI, USA
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Calvert HG, Birdsill AC, Oleson S, Kaur S, Castelli DM, Haley AP. Effects of Moderately Intense Acute Exercise on Cognitive Performance and Cerebral Metabolism. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000486296.48205.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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13
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Pasha EP, Birdsill AC, Parker P, Elmenshaway A, Tanaka H, Haley AP. Visceral Adiposity Predicts Subclinical White Matter Hyperintensities in Middle-Aged Adults. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000486282.41474.0a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Willette AA, Bendlin BB, Starks EJ, Birdsill AC, Johnson SC, Christian BT, Okonkwo OC, La Rue A, Hermann BP, Koscik RL, Jonaitis EM, Sager MA, Asthana S. Association of Insulin Resistance With Cerebral Glucose Uptake in Late Middle-Aged Adults at Risk for Alzheimer Disease. JAMA Neurol 2015. [PMID: 26214150 DOI: 10.1001/jamaneurol.2015.0613] [Citation(s) in RCA: 242] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE Converging evidence suggests that Alzheimer disease (AD) involves insulin signaling impairment. Patients with AD and individuals at risk for AD show reduced glucose metabolism, as indexed by fludeoxyglucose F 18-labeled positron emission tomography (FDG-PET). OBJECTIVES To determine whether insulin resistance predicts AD-like global and regional glucose metabolism deficits in late middle-aged participants at risk for AD and to examine whether insulin resistance-predicted variation in regional glucose metabolism is associated with worse cognitive performance. DESIGN, SETTING, AND PARTICIPANTS This population-based, cross-sectional study included 150 cognitively normal, late middle-aged (mean [SD] age, 60.7 [5.8] years) adults from the Wisconsin Registry for Alzheimer's Prevention (WRAP) study, a general community sample enriched for AD parental history. Participants underwent cognitive testing, fasting blood draw, and FDG-PET at baseline. We used the homeostatic model assessment of peripheral insulin resistance (HOMA-IR). Regression analysis tested the statistical effect of HOMA-IR on global glucose metabolism. We used a voxelwise analysis to determine whether HOMA-IR predicted regional glucose metabolism. Finally, predicted variation in regional glucose metabolism was regressed against cognitive factors. Covariates included age, sex, body mass index, apolipoprotein E ε4 genotype, AD parental history status, and a reference region used to normalize regional uptake. MAIN OUTCOMES AND MEASURES Regional glucose uptake determined using FDG-PET and neuropsychological factors. RESULTS Higher HOMA-IR was associated with lower global glucose metabolism (β = -0.29; P < .01) and lower regional glucose metabolism across large portions of the frontal, lateral parietal, lateral temporal, and medial temporal lobes (P < .05, familywise error corrected). The association was especially robust in the left medial temporal lobe (R2 = 0.178). Lower glucose metabolism in the left medial temporal lobe predicted by HOMA-IR was significantly related to worse performance on the immediate memory (β = 0.317; t148 = 4.08; P < .001) and delayed memory (β = 0.305; t148 = 3.895; P < .001) factor scores. CONCLUSIONS AND RELEVANCE Our results show that insulin resistance, a prevalent and increasingly common condition in developed countries, is associated with significantly lower regional cerebral glucose metabolism, which in turn may predict worse memory performance. Midlife may be a critical period for initiating treatments to lower peripheral insulin resistance to maintain neural metabolism and cognitive function.
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Affiliation(s)
- Auriel A Willette
- Department of Food Science and Human Nutrition, Iowa State University, Ames2Neuroscience Interdepartmental Program, Iowa State University, Ames
| | - Barbara B Bendlin
- Clinical Science Center, Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison4Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison
| | - Erika J Starks
- Clinical Science Center, Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison
| | - Alex C Birdsill
- Clinical Science Center, Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison
| | - Sterling C Johnson
- Clinical Science Center, Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison4Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison5Geriatric
| | - Bradley T Christian
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison
| | - Ozioma C Okonkwo
- Clinical Science Center, Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison4Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison
| | - Asenath La Rue
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison
| | - Bruce P Hermann
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison
| | - Rebecca L Koscik
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison
| | - Erin M Jonaitis
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison
| | - Mark A Sager
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison
| | - Sanjay Asthana
- Clinical Science Center, Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison5Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisco
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Beach TG, Adler CH, Sue LI, Serrano G, Shill HA, Walker DG, Lue L, Roher AE, Dugger BN, Maarouf C, Birdsill AC, Intorcia A, Saxon-Labelle M, Pullen J, Scroggins A, Filon J, Scott S, Hoffman B, Garcia A, Caviness JN, Hentz JG, Driver-Dunckley E, Jacobson SA, Davis KJ, Belden CM, Long KE, Malek-Ahmadi M, Powell JJ, Gale LD, Nicholson LR, Caselli RJ, Woodruff BK, Rapscak SZ, Ahern GL, Shi J, Burke AD, Reiman EM, Sabbagh MN. Arizona Study of Aging and Neurodegenerative Disorders and Brain and Body Donation Program. Neuropathology 2015; 35:354-89. [PMID: 25619230 DOI: 10.1111/neup.12189] [Citation(s) in RCA: 278] [Impact Index Per Article: 30.9] [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: 09/25/2014] [Accepted: 11/11/2014] [Indexed: 12/13/2022]
Abstract
The Brain and Body Donation Program (BBDP) at Banner Sun Health Research Institute (http://www.brainandbodydonationprogram.org) started in 1987 with brain-only donations and currently has banked more than 1600 brains. More than 430 whole-body donations have been received since this service was commenced in 2005. The collective academic output of the BBDP is now described as the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND). Most BBDP subjects are enrolled as cognitively normal volunteers residing in the retirement communities of metropolitan Phoenix, Arizona. Specific recruitment efforts are also directed at subjects with Alzheimer's disease, Parkinson's disease and cancer. The median age at death is 82. Subjects receive standardized general medical, neurological, neuropsychological and movement disorders assessments during life and more than 90% receive full pathological examinations by medically licensed pathologists after death. The Program has been funded through a combination of internal, federal and state of Arizona grants as well as user fees and pharmaceutical industry collaborations. Subsets of the Program are utilized by the US National Institute on Aging Arizona Alzheimer's Disease Core Center and the US National Institute of Neurological Disorders and Stroke National Brain and Tissue Resource for Parkinson's Disease and Related Disorders. Substantial funding has also been received from the Michael J. Fox Foundation for Parkinson's Research. The Program has made rapid autopsy a priority, with a 3.0-hour median post-mortem interval for the entire collection. The median RNA Integrity Number (RIN) for frozen brain and body tissue is 8.9 and 7.4, respectively. More than 2500 tissue requests have been served and currently about 200 are served annually. These requests have been made by more than 400 investigators located in 32 US states and 15 countries. Tissue from the BBDP has contributed to more than 350 publications and more than 200 grant-funded projects.
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Affiliation(s)
- Thomas G Beach
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Lucia I Sue
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Geidy Serrano
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Holly A Shill
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - LihFen Lue
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Alex E Roher
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Chera Maarouf
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Alex C Birdsill
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | - Joel Pullen
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Jessica Filon
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Sarah Scott
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Angelica Garcia
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | | | | | - Kathryn J Davis
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Kathy E Long
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | - Lisa D Gale
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | | | | | | | - Jiong Shi
- Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Anna D Burke
- Banner Alzheimer Institute, Phoenix, Arizona, USA
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16
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Willette AA, Johnson SC, Birdsill AC, Sager MA, Christian B, Baker LD, Craft S, Oh J, Statz E, Hermann BP, Jonaitis EM, Koscik RL, La Rue A, Asthana S, Bendlin BB. Insulin resistance predicts brain amyloid deposition in late middle-aged adults. Alzheimers Dement 2014; 11:504-510.e1. [PMID: 25043908 DOI: 10.1016/j.jalz.2014.03.011] [Citation(s) in RCA: 178] [Impact Index Per Article: 17.8] [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: 01/07/2014] [Accepted: 03/06/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Insulin resistance (IR) increases Alzheimer's disease (AD) risk. IR is related to greater amyloid burden post-mortem and increased deposition within areas affected by early AD. No studies have examined if IR is associated with an in vivo index of amyloid in the human brain in late middle-aged participants at risk for AD. METHODS Asymptomatic, late middle-aged adults (N = 186) from the Wisconsin Registry for Alzheimer's Prevention underwent [C-11]Pittsburgh compound B (PiB) positron emission tomography. The cross-sectional design tested the interaction between insulin resistance and glycemic status on PiB distribution volume ratio in three regions of interest (frontal, parietal, and temporal). RESULTS In participants with normoglycemia but not hyperglycemia, higher insulin resistance corresponded to higher PiB uptake in frontal and temporal areas, reflecting increased amyloid deposition. CONCLUSIONS This is the first human study to demonstrate that insulin resistance may contribute to amyloid deposition in brain regions affected by AD.
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Affiliation(s)
- Auriel A Willette
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Laboratory of Neurosciences, National Institute on Aging, Baltimore, MD, USA
| | - Sterling C Johnson
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Institute, Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Alex C Birdsill
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Mark A Sager
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Bradley Christian
- Department of Medical Physics, Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Laura D Baker
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Suzanne Craft
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jennifer Oh
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Eric Statz
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Bruce P Hermann
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Erin M Jonaitis
- Wisconsin Alzheimer's Institute, Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Rebecca L Koscik
- Wisconsin Alzheimer's Institute, Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Asenath La Rue
- Wisconsin Alzheimer's Institute, Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sanjay Asthana
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Barbara B Bendlin
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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17
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Adluru N, Destiche DJ, Lu SYF, Doran ST, Birdsill AC, Melah KE, Okonkwo OC, Alexander AL, Dowling NM, Johnson SC, Sager MA, Bendlin BB. White matter microstructure in late middle-age: Effects of apolipoprotein E4 and parental family history of Alzheimer's disease. Neuroimage Clin 2014; 4:730-42. [PMID: 24936424 PMCID: PMC4053649 DOI: 10.1016/j.nicl.2014.04.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 04/16/2014] [Accepted: 04/17/2014] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Little is still known about the effects of risk factors for Alzheimer's disease (AD) on white matter microstructure in cognitively healthy adults. The purpose of this cross-sectional study was to assess the effect of two well-known risk factors for AD, parental family history and APOE4 genotype. METHODS This study included 343 participants from the Wisconsin Registry for Alzheimer's Prevention, who underwent diffusion tensor imaging (DTI). A region of interest analysis was performed on fractional anisotropy maps, in addition to mean, radial, and axial diffusivity maps, aligned to a common template space using a diffeomorphic, tensor-based registration method. The analysis focused on brain regions known to be affected in AD including the corpus callosum, superior longitudinal fasciculus, fornix, cingulum, and uncinate fasciculus. Analyses assessed the impact of APOE4, parental family history of AD, age, and sex on white matter microstructure in late middle-aged participants (aged 47-76 years). RESULTS Both APOE4 and parental family history were associated with microstructural white matter differences. Participants with parental family history of AD had higher FA in the genu of the corpus callosum and the superior longitudinal fasciculus. We observed an interaction between family history and APOE4, where participants who were family history positive but APOE4 negative had lower axial diffusivity in the uncinate fasciculus, and participants who were both family history positive and APOE4 positive had higher axial diffusivity in this region. We also observed an interaction between APOE4 and age, whereby older participants (=65 years of age) who were APOE4 carriers, had higher MD in the superior longitudinal fasciculus and in the portion of the cingulum bundle running adjacent to the cingulate cortex, compared to non-carriers. Older participants who were APOE4 carriers also showed higher radial diffusivity in the genu compared to non-carriers. Across all participants, age had an effect on FA, MD, and axial and radial diffusivities. Sex differences were observed in FA and radial diffusivity. CONCLUSION APOE4 genotype, parental family history of AD, age, and sex are all associated with microstructural white matter differences in late middle-aged adults. In participants at risk for AD, alterations in diffusion characteristics-both expected and unexpected-may represent cellular changes occurring at the earliest disease stages, but further work is needed. Higher mean, radial, and axial diffusivities were observed in participants who are more likely to be experiencing later stage preclinical pathology, including participants who were both older and carried APOE4, or who were positive for both APOE4 and parental family history of AD.
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Affiliation(s)
- Nagesh Adluru
- Waisman Laboratory for Brain Imaging and Behavior, Madison, WI, USA
| | | | | | - Samuel T Doran
- Waisman Laboratory for Brain Imaging and Behavior, Madison, WI, USA
| | - Alex C Birdsill
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Department of Medicine, 600 Highland Avenue, Madison, WI 53792, USA
| | - Kelsey E Melah
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Department of Medicine, 600 Highland Avenue, Madison, WI 53792, USA
| | - Ozioma C Okonkwo
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Department of Medicine, 600 Highland Avenue, Madison, WI 53792, USA
| | - Andrew L Alexander
- Waisman Laboratory for Brain Imaging and Behavior, Madison, WI, USA ; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI 53705, USA ; University of Wisconsin School of Medicine and Public Health, Department of Psychiatry, 6001 Research Park Blvd, Madison, WI 53719, USA
| | - N Maritza Dowling
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Department of Medicine, 600 Highland Avenue, Madison, WI 53792, USA ; Department of Biostatistics and Medical Informatics, 600 Highland Avenue, Madison, WI 53792, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Department of Medicine, 600 Highland Avenue, Madison, WI 53792, USA ; Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran's Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA ; Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, 7818 Big Sky Drive, Madison, WI 53719, USA
| | - Mark A Sager
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Department of Medicine, 600 Highland Avenue, Madison, WI 53792, USA ; Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran's Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA ; Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, 7818 Big Sky Drive, Madison, WI 53719, USA
| | - Barbara B Bendlin
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Department of Medicine, 600 Highland Avenue, Madison, WI 53792, USA
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18
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Birdsill AC, Carlsson CM, Willette AA, Okonkwo OC, Johnson SC, Xu G, Oh JM, Gallagher CL, Koscik RL, Jonaitis EM, Hermann BP, LaRue A, Rowley HA, Asthana S, Sager MA, Bendlin BB. Low cerebral blood flow is associated with lower memory function in metabolic syndrome. Obesity (Silver Spring) 2013; 21:1313-20. [PMID: 23687103 PMCID: PMC3742665 DOI: 10.1002/oby.20170] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 11/04/2012] [Indexed: 01/03/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS)--a cluster of cardiovascular risk factors--is linked with cognitive decline and dementia. However, the brain changes underlying this link are presently unknown. In this study, we tested the relationship between MetS, cerebral blood flow (CBF), white matter hyperintensity burden, and gray matter (GM) volume in cognitively healthy late middle-aged adults. Additionally, the extent to which MetS was associated with cognitive performance was assessed. DESIGN AND METHODS Late middle-aged adults from the Wisconsin Registry for Alzheimer's Prevention (N = 69, mean age = 60.4 years) underwent a fasting blood draw, arterial spin labeling perfusion MRI, T1-weighted MRI, T2FLAIR MRI, and neuropsychological testing. MetS was defined as abnormalities on three or more factors, including abdominal obesity, triglycerides, HDL-cholesterol, blood pressure, and fasting glucose. RESULTS Mean GM CBF was 15% lower in MetS compared to controls. Voxel-wise image analysis indicated that the MetS group had lower CBF across a large portion of the cortical surface, with the exception of medial and inferior parts of the occipital and temporal lobes. The MetS group also had lower immediate memory function; a mediation analysis indicated this relationship was partially mediated by CBF. Among the MetS factors, abdominal obesity and elevated triglycerides were most strongly associated with lower CBF. CONCLUSIONS The results underscore the importance of reducing the number of cardiovascular risk factors for maintaining CBF and cognition in an aging population.
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Affiliation(s)
- Alex C Birdsill
- Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran’s Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Cynthia M Carlsson
- Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran’s Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | | | - Ozioma C Okonkwo
- Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran’s Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Sterling C Johnson
- Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran’s Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Guofan Xu
- Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran’s Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Jennifer M Oh
- Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran’s Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Catherine L Gallagher
- National Institute on Aging, Baltimore MD, USA
- William S. Middleton Memorial V. A. Hospital, Madison, Wisconsin, U.S.A
- Department of Neurology, University of Wisconsin, Madison, WI, USA
| | - Rebecca L Koscik
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Erin M Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Bruce P Hermann
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Asenath LaRue
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Howard A Rowley
- Wisconsin Alzheimer’s Disease Research Center, Department of Medicine, University of Wisconsin, Madison, WI, USA
- University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI, USA
| | - Sanjay Asthana
- Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran’s Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Mark A Sager
- Wisconsin Alzheimer’s Disease Research Center, Department of Medicine, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Barbara B Bendlin
- Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran’s Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, Department of Medicine, University of Wisconsin, Madison, WI, USA
- Corresponding Author: Barbara Bendlin, PhD, Assistant Professor, University of Wisconsin, School of Medicine and Public Health, J5/1M Clinical Science Center, MC 2420, 600 Highland Avenue, Madison, WI 53792, Phone: (608) 265-2483, Fax: (608) 265-3091,
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19
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Willette AA, Xu G, Johnson SC, Birdsill AC, Jonaitis EM, Sager MA, Hermann BP, La Rue A, Asthana S, Bendlin BB. Insulin resistance, brain atrophy, and cognitive performance in late middle-aged adults. Diabetes Care 2013; 36:443-9. [PMID: 23069842 PMCID: PMC3554303 DOI: 10.2337/dc12-0922] [Citation(s) in RCA: 159] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Insulin resistance dysregulates glucose uptake and other functions in brain areas affected by Alzheimer disease. Insulin resistance may play a role in Alzheimer disease etiopathogenesis. This longitudinal study examined whether insulin resistance among late middle-aged, cognitively healthy individuals was associated with 1) less gray matter in Alzheimer disease-sensitive brain regions and 2) worse cognitive performance. RESEARCH DESIGN AND METHODS Homeostasis model assessment of insulin resistance, gray matter volume, and the Rey Auditory Verbal Learning Test (RAVLT) were acquired in 372 participants at baseline and a consecutive subset of 121 individuals ~4 years later. Voxel-based morphometry and tensor-based morphometry were used, respectively, to test the association of insulin resistance with baseline brain volume and progressive gray matter atrophy. RESULTS Higher insulin resistance predicted less gray matter at baseline and 4 years later in medial temporal lobe, prefrontal cortices, precuneus, and other parietal gyri. A region-of-interest analysis, independent of the voxel-wise analyses, confirmed that higher insulin resistance was related to medial temporal lobe atrophy. Atrophy itself corresponded to cognitive deficits in the RAVLT. Temporal lobe atrophy that was predicted by higher insulin resistance significantly mediated worse RAVLT encoding performance. CONCLUSIONS These results suggest that insulin resistance in an asymptomatic, late middle-aged cohort is associated with progressive atrophy in regions affected by early Alzheimer disease. Insulin resistance may also affect the ability to encode episodic information by negatively influencing gray matter volume in medial temporal lobe.
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Affiliation(s)
- Auriel A Willette
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
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20
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Okonkwo OC, Xu G, Oh JM, Dowling NM, Carlsson CM, Gallagher CL, Birdsill AC, Palotti M, Wharton W, Hermann BP, LaRue A, Bendlin BB, Rowley HA, Asthana S, Sager MA, Johnson SC. Cerebral blood flow is diminished in asymptomatic middle-aged adults with maternal history of Alzheimer's disease. ACTA ACUST UNITED AC 2012; 24:978-88. [PMID: 23236200 DOI: 10.1093/cercor/bhs381] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cerebral blood flow (CBF) provides an indication of the metabolic status of the cortex and may have utility in elucidating preclinical brain changes in persons at risk for Alzheimer's disease (AD) and related diseases. In this study, we investigated CBF in 327 well-characterized adults including patients with AD (n = 28), patients with amnestic mild cognitive impairment (aMCI, n = 23), older cognitively normal (OCN, n = 24) adults, and asymptomatic middle-aged adults (n = 252) with and without a family history (FH) of AD. Compared with the asymptomatic cohort, AD patients displayed significant hypoperfusion in the precuneus, posterior cingulate, lateral parietal cortex, and the hippocampal region. Patients with aMCI exhibited a similar but less marked pattern of hypoperfusion. Perfusion deficits within the OCN adults were primarily localized to the inferior parietal lobules. Asymptomatic participants with a maternal FH of AD showed hypoperfusion in hippocampal and parietofrontal regions compared with those without a FH of AD or those with only a paternal FH of AD. These observations persisted when gray matter volume was included as a voxel-wise covariate. Our findings suggest that having a mother with AD might confer a particular risk for AD-related cerebral hypoperfusion in midlife. In addition, they provide further support for the potential utility of arterial spin labeling for the measurement of AD-related neurometabolic dysfunction, particularly in situations where [18F]fluorodeoxyglucose imaging is infeasible or clinically contraindicated.
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Affiliation(s)
- Ozioma C Okonkwo
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
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21
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Bendlin BB, Carlsson CM, Johnson SC, Zetterberg H, Blennow K, Willette AA, Okonkwo OC, Sodhi A, Ries ML, Birdsill AC, Alexander AL, Rowley HA, Puglielli L, Asthana S, Sager MA. CSF T-Tau/Aβ42 predicts white matter microstructure in healthy adults at risk for Alzheimer's disease. PLoS One 2012; 7:e37720. [PMID: 22701578 PMCID: PMC3368882 DOI: 10.1371/journal.pone.0037720] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 04/23/2012] [Indexed: 11/19/2022] Open
Abstract
Cerebrospinal fluid (CSF) biomarkers T-Tau and Aβ(42) are linked with Alzheimer's disease (AD), yet little is known about the relationship between CSF biomarkers and structural brain alteration in healthy adults. In this study we examined the extent to which AD biomarkers measured in CSF predict brain microstructure indexed by diffusion tensor imaging (DTI) and volume indexed by T1-weighted imaging. Forty-three middle-aged adults with parental family history of AD received baseline lumbar puncture and MRI approximately 3.5 years later. Voxel-wise image analysis methods were used to test whether baseline CSF Aβ(42), total tau (T-Tau), phosphorylated tau (P-Tau) and neurofilament light protein predicted brain microstructure as indexed by DTI and gray matter volume indexed by T1-weighted imaging. T-Tau and T-Tau/Aβ(42) were widely correlated with indices of brain microstructure (mean, axial, and radial diffusivity), notably in white matter regions adjacent to gray matter structures affected in the earliest stages of AD. None of the CSF biomarkers were related to gray matter volume. Elevated P-Tau and P-Tau/Aβ(42) levels were associated with lower recognition performance on the Rey Auditory Verbal Learning Test. Overall, the results suggest that CSF biomarkers are related to brain microstructure in healthy adults with elevated risk of developing AD. Furthermore, the results clearly suggest that early pathological changes in AD can be detected with DTI and occur not only in cortex, but also in white matter.
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Affiliation(s)
- Barbara B Bendlin
- Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veteran's Hospital, Madison, Wisconsin, United States of America.
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22
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Walther K, Birdsill AC, Glisky EL, Ryan L. Structural brain differences and cognitive functioning related to body mass index in older females. Hum Brain Mapp 2010; 31:1052-64. [PMID: 19998366 DOI: 10.1002/hbm.20916] [Citation(s) in RCA: 213] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Little is known about the effect of obesity on brain structures and cognition in healthy older adults. This study examined the association between body mass index (BMI), regional volume differences in gray and white matter measured by magnetic resonance imaging (MRI), and cognitive functioning in older females. Participants included 95 community-dwelling older females (ages 52-92 years) who underwent extensive neuropsychological testing and high-resolution MRI scanning. Optimized voxel-based morphometry techniques were employed to determine the correlation between BMI and regional gray and white matter volumes. Volumes of significant regions were then correlated with cognitive functioning. Higher BMI was associated with decreased gray matter volumes in the left orbitofrontal, right inferior frontal, and right precentral gyri, a right posterior region including the parahippocampal, fusiform, and lingual gyri, and right cerebellar regions, as well as increased volumes of white matter in the frontal, temporal, and parietal lobes, even when hypertension was considered. Compared to normal weight women, obese women performed poorer on tests of executive functioning. Smaller gray matter volume in the left orbitofrontal region was associated with lower executive functioning. Additionally, despite the lack of significant group differences in memory and visuomotor speed, gray and white matter volumes predicted performance on these measures. The results provide additional evidence for a negative link between increased body fat and brain functioning in older females.
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Affiliation(s)
- Katrin Walther
- Department of Psychology, University of Arizona, Tucson, Arizona 85721-0068, USA
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Birdsill AC, Walker DG, Lue L, Sue LI, Beach TG. Postmortem interval effect on RNA and gene expression in human brain tissue. Cell Tissue Bank 2010; 12:311-8. [PMID: 20703815 DOI: 10.1007/s10561-010-9210-8] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Accepted: 07/22/2010] [Indexed: 11/29/2022]
Abstract
Banked tissue is essential to the study of neurological disease but using postmortem tissue introduces a number of possible confounds. Foremost amongst these are factors relating to variation in postmortem interval (PMI). Currently there are conflicting reports on how PMI affects overall RNA integrity, and very few reports of how gene expression is affected by PMI. We analyzed total RNA extracted from frozen cerebellar cortex from 79 deceased human subjects enrolled in the Banner Sun Health Research Institute Brain and Body Donation Program. The PMI, which ranged from 1.5 to 45 h, correlated with overall RNA quality measures including RNA Integrity Number (RIN) (r = -0.34, P = 0.002) and RNA quantitative yield (r = -0.25, P = 0.02). Additionally, we determined the expression of 89 genes using a PCR-based gene expression array (RT(2) Profiler™ PCR Array: Human Alzheimer's Disease; SABiosciences™, Frederick, MD). A greater proportion of genes had decreased rather than increased expression with increasing PMI (65/89 vs. 20/89; P < 0.0001). Of these, transcripts from the genes ADAM9, LPL, PRKCG, and SERPINA3 had significantly decreased expression with increasing PMI (P < 0.01). No individual gene transcripts had significantly increased expression with increasing PMI. In conclusion, it is apparent that RNA degrades progressively with increasing PMI and that measurement of gene expression in brain tissue with longer PMI may give artificially low values. For tissue derived from autopsy, a short PMI optimizes its utility for molecular research.
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Affiliation(s)
- Alex C Birdsill
- Civin Laboratory for Neuropathology, Brain and Body Donation Program, Banner Sun Health Research Institute, 10515 West Santa Fe Drive, Sun City, AZ 85351, USA
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Walther K, Birdsill AC, Glisky EL, Ryan L. Relationship between Body Mass Index, Regional Brain Volume, and Gender in Healthy Older Adults - a Voxel Based Morphometry Study. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71577-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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