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Sweeney A, Passmore AP, Beverland D, McGuinness B, McAuley DF, Mawhinney T, Schott JM, Heslegrave A, Zetterberg H, Cunningham EL. Cerebrospinal Fluid Markers of Neurodegeneration Associated with Postoperative Delirium in an Older Elective Arthroplasty Population. Alzheimers Dement 2022. [DOI: 10.1002/alz.068131] [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: 12/24/2022]
Affiliation(s)
| | | | | | - Bernadette McGuinness
- Ageing Research Group, Centre for Public Health, Queen's University Belfast Belfast United Kingdom
| | | | | | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology London United Kingdom
| | | | - Henrik Zetterberg
- Department of Neurodegenerative Disease and UK Dementia Research Institute, UCL Institute of Neurology, Queen Square London United Kingdom
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Sweeney A, Passmore AP, Beverland D, McGuinness B, McAuley DF, Mawhinney T, O'Brien S, Schott JM, Heslegrave A, Zetterberg H, Cunningham EL. Plasma Markers of Neurodegeneration Associated with Postoperative Delirium in an Older Elective Arthroplasty Population. Alzheimers Dement 2022. [DOI: 10.1002/alz.068193] [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: 12/24/2022]
Affiliation(s)
| | | | | | - Bernadette McGuinness
- Ageing Research Group, Centre for Public Health, Queen's University Belfast Belfast United Kingdom
| | | | | | | | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology London United Kingdom
| | - Amanda Heslegrave
- UCL Queen Square Institute of Neurology London United Kingdom
- UK Dementia Research Institute at UCL London United Kingdom
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease and UK Dementia Research Institute, UCL Institute of Neurology, Queen Square London United Kingdom
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
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3
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Sweeney A, Passmore AP, Beverland D, McGuinness B, McAuley DF, Mawhinney T, O'Brien S, Schott JM, Heslegrave A, Zetterberg H, Cunningham EL. Preoperative Cerebrospinal Fluid and Plasma Markers of Inflammation and Neurodegeneration Predict Mortality Eight Years Later in an Observational Cohort Study of Postoperative delirium in an Older Elective Arthroplasty Populatio. Alzheimers Dement 2022. [DOI: 10.1002/alz.068179] [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: 12/24/2022]
Affiliation(s)
| | | | | | - Bernadette McGuinness
- Ageing Research Group, Centre for Public Health, Queen's University Belfast Belfast United Kingdom
| | | | | | | | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology London United Kingdom
| | | | - Henrik Zetterberg
- Department of Neurodegenerative Disease and UK Dementia Research Institute, UCL Institute of Neurology, Queen Square London United Kingdom
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
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Edison P, Femminella GD, Ritchie CW, Holmes C, Walker Z, Ridha BH, Raza S, Livingston NR, Nowell J, Busza G, Frangou E, Love S, Williams G, Lawrence RM, McFarlane B, Archer H, Coulthard E, Underwood B, Koranteng P, Karim S, Bannister C, Perneczky R, Prasanna A, Junaid K, McGuinness B, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Holscher C, Mansouri A, Chester‐Jones M, Holmes J, Williams SCR, Brooks DJ, Harrison JE, Tadros G, Passmore AP, Ballard C. Evaluation of liraglutide in the treatment of Alzheimer's disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.057848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Paul Edison
- Imperial College London London United Kingdom
| | | | - Craig W. Ritchie
- Centre for Dementia Prevention University of Edinburgh Edinburgh United Kingdom
| | - Clive Holmes
- University of Southampton Southampton United Kingdom
| | - Zuzana Walker
- Division of Psychiatry University College London London United Kingdom
| | - Basil H Ridha
- Dementia Research Centre, Institute of Neurology, University College London London United Kingdom
| | - Sanara Raza
- Imperial College London London United Kingdom
| | | | | | - Gail Busza
- Imperial College London London United Kingdom
| | | | | | | | - Robert M Lawrence
- South West London and St George's Mental Health NHS Trust London United Kingdom
| | - Brady McFarlane
- Southern Health NHS Foundation Trust Southampton United Kingdom
| | | | | | - Ben Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust Cambridge United Kingdom
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust Northampton United Kingdom
| | - Salman Karim
- Lancashire Care NHS Foundation Trust Preston United Kingdom
| | | | - Robert Perneczky
- Imperial College London London United Kingdom
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
- University Hospital LMU Munich Germany
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust Wolverhampton United Kingdom
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust Nottingham United Kingdom
| | - Bernadette McGuinness
- Ageing Research Group Centre for Public Health Queen's University Belfast Belfast United Kingdom
| | | | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust Derby United Kingdom
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust Bradford United Kingdom
| | - Naghma Malik
- North West Boroughs Partnership NHS Foundation Trust Warrington United Kingdom
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust Redruth United Kingdom
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust South Petherton United Kingdom
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust Shrewsbury United Kingdom
| | | | | | | | | | - Steven CR Williams
- Institute of Psychiatry Psychology and Neuroscience King's College London London United Kingdom
| | - David J Brooks
- Imperial College London London United Kingdom
- Newcastle University Newcastle United Kingdom
- Aarhus University Aarhus Denmark
| | - John E Harrison
- King's College ‐ Institute of Psychiatry Psychology & Neuroscience London United Kingdom
| | - George Tadros
- Heart of England NHS Foundation Trust Birmingham United Kingdom
| | | | - Clive Ballard
- University of Exeter Medical School Exeter United Kingdom
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McMichael AJ, Zafeiridi E, Ryan M, Cunningham EL, Passmore AP, McGuinness B. Anticholinergic drug use and risk of mortality for people with dementia in Northern Ireland. Aging Ment Health 2021; 25:1475-1482. [PMID: 33073601 DOI: 10.1080/13607863.2020.1830028] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Anticholinergic burden refers to the cumulative effect of medications which contain anticholinergic properties. We assessed how anticholinergic burden and different types of anticholinergic medications influence mortality rates among people with dementia in Northern Ireland. Our secondary aim was to determine what demographic characteristics predict the anticholinergic burden of people with dementia. METHODS Data were extracted from the Enhanced Prescribing database for 25,418 people who were prescribed at least one dementia management medication between 2010 and 2016. Information was also extracted on the number of times each available anticholinergic drug was prescribed between 2010 and 2016, allowing the calculation of an overall anticholinergic burden. Cox proportional hazard models were used to determine how anticholinergic burden influenced mortality whilst multilevel model regression determined what demographic characteristics influence overall anticholinergic burden. RESULTS Of the 25,418 people with dementia, only 15% (n = 3880) had no anticholinergic burden. Diazepam (42%) and risperidone (18%) were the two most commonly prescribed drugs. Unadjusted Cox proportional hazard models indicated that higher anticholinergic burden was associated with significantly higher mortality rates in comparison to people with dementia who had no anticholinergic burden (HR = 1.59: 95% CI = 1.07-2.36). In particular, urological (HR = 1.20: 95% CI = 1.05-1.38) and respiratory (HR = 1.17: 95% CI = 1.08-1.27) drugs significantly increased mortality rates. People with dementia living in areas with low levels of deprivation had significantly lower anticholinergic burden (HR=-.39: 95% CI=-.47:-30). CONCLUSIONS Reducing anticholinergic burden is essential for people with dementia. Further research should address the unfavourable prognosis of people living with dementia in highly deprived areas.
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Affiliation(s)
- A J McMichael
- Centre for Public Health, Institute for Clinical Sciences Block B, Queens University Belfast, Belfast, Northern Ireland
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6
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Cuperlovic-Culf M, Cunningham EL, Teimoorinia H, Surendra A, Pan X, Bennett SAL, Jung M, McGuiness B, Passmore AP, Beverland D, Green BD. Metabolomics and computational analysis of the role of monoamine oxidase activity in delirium and SARS-COV-2 infection. Sci Rep 2021; 11:10629. [PMID: 34017039 PMCID: PMC8138024 DOI: 10.1038/s41598-021-90243-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/05/2021] [Indexed: 02/03/2023] Open
Abstract
Delirium is an acute change in attention and cognition occurring in ~ 65% of severe SARS-CoV-2 cases. It is also common following surgery and an indicator of brain vulnerability and risk for the development of dementia. In this work we analyzed the underlying role of metabolism in delirium-susceptibility in the postoperative setting using metabolomic profiling of cerebrospinal fluid and blood taken from the same patients prior to planned orthopaedic surgery. Distance correlation analysis and Random Forest (RF) feature selection were used to determine changes in metabolic networks. We found significant concentration differences in several amino acids, acylcarnitines and polyamines linking delirium-prone patients to known factors in Alzheimer's disease such as monoamine oxidase B (MAOB) protein. Subsequent computational structural comparison between MAOB and angiotensin converting enzyme 2 as well as protein-protein docking analysis showed that there potentially is strong binding of SARS-CoV-2 spike protein to MAOB. The possibility that SARS-CoV-2 influences MAOB activity leading to the observed neurological and platelet-based complications of SARS-CoV-2 infection requires further investigation.
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Affiliation(s)
- Miroslava Cuperlovic-Culf
- Digital Technologies Research Centre, National Research Council of Canada, Ottawa, Canada.
- Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, K1H 8M5, Canada.
| | - Emma L Cunningham
- Centre for Public Health, Queen's University Belfast, Block B, Institute of Clinical Sciences, Royal Victoria Hospital Site, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland
| | - Hossen Teimoorinia
- NRC Herzberg Astronomy and Astrophysics, 5071 West Saanich Road, Victoria, BC, V9E 2E7, Canada
| | - Anuradha Surendra
- Digital Technologies Research Centre, National Research Council of Canada, Ottawa, Canada
| | - Xiaobei Pan
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, 8 Malone Road, Belfast, BT9 5BN, Northern Ireland
| | - Steffany A L Bennett
- Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, K1H 8M5, Canada
- Neural Regeneration Laboratory, Ottawa Institute of Systems Biology, Brain and Mind Research Institute, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Mijin Jung
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, 8 Malone Road, Belfast, BT9 5BN, Northern Ireland
| | - Bernadette McGuiness
- Centre for Public Health, Queen's University Belfast, Block B, Institute of Clinical Sciences, Royal Victoria Hospital Site, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland
| | - Anthony Peter Passmore
- Centre for Public Health, Queen's University Belfast, Block B, Institute of Clinical Sciences, Royal Victoria Hospital Site, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland
| | - David Beverland
- Outcomes Assessment Unit, Musgrave Park Hospital, Stockman's Lane, Belfast, BT9 7JB, Northern Ireland
| | - Brian D Green
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, 8 Malone Road, Belfast, BT9 5BN, Northern Ireland.
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7
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Femminella GD, Livingston NR, Raza S, van der Doef T, Frangou E, Love S, Busza G, Calsolaro V, Carver S, Holmes C, Ritchie CW, Lawrence RM, McFarlane B, Tadros G, Ridha BH, Bannister C, Walker Z, Archer H, Coulthard E, Underwood B, Prasanna A, Koranteng P, Karim S, Junaid K, McGuinness B, Passmore AP, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Tan T, Holscher C, Harrison J, Brooks DJ, Ballard C, Edison P. Does insulin resistance influence neurodegeneration in non-diabetic Alzheimer's subjects? Alzheimers Res Ther 2021; 13:47. [PMID: 33597002 PMCID: PMC7890851 DOI: 10.1186/s13195-021-00784-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 11/14/2020] [Accepted: 02/03/2021] [Indexed: 12/12/2022]
Abstract
Background Type 2 diabetes is a risk factor for Alzheimer’s disease (AD), and AD brain shows impaired insulin signalling. The role of peripheral insulin resistance on AD aetiopathogenesis in non-diabetic patients is still debated. Here we evaluated the influence of insulin resistance on brain glucose metabolism, grey matter volume and white matter lesions (WMLs) in non-diabetic AD subjects. Methods In total, 130 non-diabetic AD subjects underwent MRI and [18F]FDG PET scans with arterial cannula insertion for radioactivity measurement. T1 Volumetric and FLAIR sequences were acquired on a 3-T MRI scanner. These subjects also had measurement of glucose and insulin levels after a 4-h fast on the same day of the scan. Insulin resistance was calculated by the updated homeostatic model assessment (HOMA2). For [18F]FDG analysis, cerebral glucose metabolic rate (rCMRGlc) parametric images were generated using spectral analysis with arterial plasma input function. Results In this non-diabetic AD population, HOMA2 was negatively associated with hippocampal rCMRGlc, along with total grey matter volumes. No significant correlation was observed between HOMA2, hippocampal volume and WMLs. Conclusions In non-diabetic AD, peripheral insulin resistance is independently associated with reduced hippocampal glucose metabolism and with lower grey matter volume, suggesting that peripheral insulin resistance might influence AD pathology by its action on cerebral glucose metabolism and on neurodegeneration. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00784-w.
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Affiliation(s)
- Grazia Daniela Femminella
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Nicholas R Livingston
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Sanara Raza
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Thalia van der Doef
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | | | | | - Gail Busza
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Valeria Calsolaro
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Stefan Carver
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | | | | | - Robert M Lawrence
- South West London and St George's Mental Health NHS Trust, London, UK
| | | | - George Tadros
- Heart of England NHS Foundation Trust, Birmingham, UK
| | - Basil H Ridha
- Brighton and Sussex University Hospital Trust, Brighton, UK
| | | | - Zuzana Walker
- Mental Health Unit, St. Margaret's Hospital, Epping, Essex, UK
| | | | | | - Ben Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust, Wolverhampton, UK
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK
| | - Salman Karim
- Lancashire Care NHS Foundation Trust, Preston, UK
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | | | | | | | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Naghma Malik
- North West Boroughs Partnership NHS Foundation Trust, Warrington, UK
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust, Redruth, UK
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust, South Petherton, UK
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Shrewsbury, UK
| | - Tricia Tan
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK
| | - Christian Holscher
- Research and Experimental Center, Henan University of Chinese Medicine, Zhengzhou, China
| | - John Harrison
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | - Paul Edison
- Division of Neurology, Neurology Imaging Unit, Department of Brain Sciences, Imperial College London, 1st Floor B Block, Hammersmith Hospital Campus, Du Cane Road, London, W12 0NN, UK.
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8
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McGrattan A, Mcevoy CT, Woodside JV, Linden G, Passmore AP, Holmes C, Patterson C, Teeling J, McGuinness B. Adherence to a Mediterranean diet is associated with better cognitive performance many years later in the PRIME cohort. Alzheimers Dement 2020. [DOI: 10.1002/alz.045069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | | | | | - Gerry Linden
- Queen's University Belfast Belfast United Kingdom
| | | | - Clive Holmes
- University of Southampton Southampton United Kingdom
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9
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Femminella GD, van der Doef T, Carver S, Holmes C, Ritchie CW, Lawrence RM, McFarlane B, Tadros G, Ridha BH, Bannister C, Walker Z, Archer H, Coulthard E, Underwood B, Prasanna A, Koranteng P, Karim S, Junaid K, McGuinness B, Passmore AP, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Harrison JE, Ballard C, Brooks DJ, Edison P. Behavioural symptoms in Alzheimer’s disease are associated with white matter lesions (WML) volume and are independent of atrophy and hypometabolism. Alzheimers Dement 2020. [DOI: 10.1002/alz.045223] [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)
| | | | | | - Clive Holmes
- University of Southampton Southampton United Kingdom
| | - Craig W. Ritchie
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh United Kingdom
| | - Robert M Lawrence
- South West London and St George's Mental Health NHS Trust London United Kingdom
| | - Brady McFarlane
- Southern Health NHS Foundation Trust Southampton United Kingdom
| | - George Tadros
- Heart of England NHS Foundation Trust Birmingham United Kingdom
| | - Basil H Ridha
- Dementia Research Centre, Institute of Neurology University College London London United Kingdom
| | | | - Zuzana Walker
- Mental Health Unit, St. Margaret’s Hospital Epping United Kingdom
| | | | | | - Ben Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust Cambridge United Kingdom
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust Wolverhampton United Kingdom
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust Northampton United Kingdom
| | - Salman Karim
- Lancashire Care NHS Foundation Trust Preston United Kingdom
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust Nottingham United Kingdom
| | | | | | - Ramin Nilforooshan
- Surrey and Borders Partnership NHS Foundation Trust Chertsey United Kingdom
| | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust Derby United Kingdom
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust Bradford United Kingdom
| | - Naghma Malik
- North West Boroughs Partnership NHS Foundation Trust Warrington United Kingdom
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust, Redruth United Kingdom
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust South Petherton United Kingdom
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust Shrewsbury United Kingdom
| | - John E. Harrison
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Netherlands
| | - Clive Ballard
- University of Exeter Medical School Exeter United Kingdom
| | | | - Paul Edison
- Imperial College London London United Kingdom
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10
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Edison P, Raza S, Femminella GD, Blunt EG, Carver S, Livingston NR, Nowell J, Holmes C, Ritchie CW, Lawrence RM, McFarlane B, Tadros G, Ridha BH, Bannister C, Walker Z, Archer H, Coulthard E, Underwood B, Prasanna A, Koranteng P, Karim S, Junaid K, McGuinness B, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Harrison JE, Brooks DJ, Passmore AP, Ballard C. Relationship between spectral analysis, SUV and SUV Pons ratio as a measure of cerebral glucose metabolic rate in Alzheimer's disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.046068] [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)
- Paul Edison
- Imperial College London London United Kingdom
| | | | | | | | | | | | | | - Clive Holmes
- University of Southampton Southampton United Kingdom
| | - Craig W. Ritchie
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh United Kingdom
| | - Robert M Lawrence
- South West London and St George's Mental Health NHS Trust London United Kingdom
| | - Brady McFarlane
- Southern Health NHS Foundation Trust Southampton United Kingdom
| | - George Tadros
- Heart of England NHS Foundation Trust Birmingham United Kingdom
| | - Basil H Ridha
- Dementia Research Centre Institute of Neurology University College London London United Kingdom
| | | | - Zuzana Walker
- Mental Health Unit St. Margaret’s Hospital Epping United Kingdom
| | | | | | - Ben Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust Cambridge United Kingdom
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust Wolverhampton United Kingdom
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust Northampton United Kingdom
| | - Salman Karim
- Lancashire Care NHS Foundation Trust Preston United Kingdom
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust Nottingham United Kingdom
| | | | - Ramin Nilforooshan
- Surrey and Borders Partnership NHS Foundation Trust Chertsey United Kingdom
| | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust Derby United Kingdom
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust Bradford United Kingdom
| | - Naghma Malik
- North West Boroughs Partnership NHS Foundation Trust Warrington United Kingdom
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust Redruth United Kingdom
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust South Petherton United Kingdom
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust Shrewsbury United Kingdom
| | - John E Harrison
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | - Clive Ballard
- University of Exeter Medical School Exeter United Kingdom
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11
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Edison P, Femminella GD, Nowell J, Raza S, Livingston NR, Blunt EG, Carver S, Holmes C, Ritchie CW, Lawrence RM, McFarlane B, Tadros G, Ridha BH, Bannister C, Walker Z, Archer H, Coulthard E, Underwood B, Prasanna A, Koranteng P, Karim S, Junaid K, McGuinness B, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Harrison JE, Brooks DJ, Passmore AP, Ballard C. Assessing the relationship between cognitive dysfunction and brain atrophy in Alzheimer's disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.046004] [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: 11/11/2022]
Affiliation(s)
- Paul Edison
- Imperial College London London United Kingdom
| | | | | | | | | | | | | | - Clive Holmes
- University of Southampton Southampton United Kingdom
| | - Craig W Ritchie
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh United Kingdom
| | - Robert M Lawrence
- South West London and St George's Mental Health NHS Trust London United Kingdom
| | - Brady McFarlane
- Southern Health NHS Foundation Trust Southampton United Kingdom
| | - George Tadros
- Heart of England NHS Foundation Trust Birmingham United Kingdom
| | - Basil H Ridha
- Dementia Research Centre Institute of Neurology University College London London United Kingdom
| | | | - Zuzana Walker
- Mental Health Unit, St. Margaret’s Hospital Epping United Kingdom
| | | | | | - Ben Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust Cambridge United Kingdom
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust Wolverhampton United Kingdom
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust Northampton United Kingdom
| | - Salman Karim
- Lancashire Care NHS Foundation Trust Preston United Kingdom
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust Nottingham United Kingdom
| | | | - Ramin Nilforooshan
- Surrey and Borders Partnership NHS Foundation Trust Chertsey United Kingdom
| | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust Derby United Kingdom
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust Bradford United Kingdom
| | - Naghma Malik
- North West Boroughs Partnership NHS Foundation Trust Warrington United Kingdom
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust Redruth United Kingdom
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust South Petherton United Kingdom
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust Shrewsbury United Kingdom
| | - John E Harrison
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | - Clive Ballard
- University of Exeter Medical School Exeter United Kingdom
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12
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Edison P, Femminella GD, Livingston NR, Raza S, Nowell J, Carver S, Holmes C, Blunt EG, Lawrence RM, McFarlane B, Tadros G, Ritchie CW, Ridha BH, Bannister C, Walker Z, Archer H, Coulthard E, Underwood B, Prasanna A, Koranteng P, Karim S, Junaid K, McGuinness B, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Harrison JE, Brooks DJ, Passmore AP, Ballard C. Influence of cerebral glucose metabolic rate on cognitive function in Alzheimer's subjects. Alzheimers Dement 2020. [DOI: 10.1002/alz.045899] [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: 11/05/2022]
Affiliation(s)
- Paul Edison
- Imperial College London London United Kingdom
| | | | | | | | | | | | - Clive Holmes
- University of Southampton Southampton United Kingdom
| | | | - Robert M Lawrence
- South West London and St George's Mental Health NHS Trust London United Kingdom
| | - Brady McFarlane
- Southern Health NHS Foundation Trust Southampton United Kingdom
| | - George Tadros
- Heart of England NHS Foundation Trust Birmingham United Kingdom
| | - Craig W Ritchie
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh United Kingdom
| | - Basil H Ridha
- Dementia Research Centre Institute of Neurology University College London London United Kingdom
| | | | - Zuzana Walker
- Mental Health Unit St. Margaret’s Hospital Essex United Kingdom
| | | | | | - Ben Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust Cambridge United Kingdom
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust Wolverhampton United Kingdom
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust Northampton United Kingdom
| | - Salman Karim
- Lancashire Care NHS Foundation Trust Preston United Kingdom
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust Nottingham United Kingdom
| | | | - Ramin Nilforooshan
- Surrey and Borders Partnership NHS Foundation Trust Chertsey United Kingdom
| | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust Derby United Kingdom
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust Bradford United Kingdom
| | - Naghma Malik
- North West Boroughs Partnership NHS Foundation Trust Warrington United Kingdom
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust Redruth United Kingdom
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust, South Petherton United Kingdom
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust Shrewsbury United Kingdom
| | - John E Harrison
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | - Clive Ballard
- University of Exeter Medical School Exeter United Kingdom
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13
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Delgado LMR, Nolan H, Buick AR, Barbey F, Dyer J, McGuinness B, Passmore AP, Murphy B. Evaluation of adaption skills in older adults using behavioural and EEG repeated measurements during a visual oddball object detection task. Alzheimers Dement 2020. [DOI: 10.1002/alz.042575] [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: 11/09/2022]
Affiliation(s)
| | | | | | - Florentine Barbey
- BrainWaveBank Ltd. Dublin Ireland
- Trinity College Dublin Dublin Ireland
| | - John Dyer
- BrainWaveBank Ltd. Belfast United Kingdom
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14
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McMichael AJ, Zafeiridi E, Passmore AP, McGuinness B. The influence of antipsychotics and antidepressants on people with dementia in Northern Ireland: A retrospective analysis. Alzheimers Dement 2020. [DOI: 10.1002/alz.043020] [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: 11/11/2022]
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15
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Sweeney A, Devereux B, Ong C, McKinley J, Kearney S, Doherty K, Foy J, Murphy B, McGuinness B, Passmore AP. The identification of mild cognitive impairment in Parkinson’s disease using EEG and machine learning. Alzheimers Dement 2020. [DOI: 10.1002/alz.040432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Charlie Ong
- South Eastern Health & Social Care Trust Dundonald Belfast United Kingdom
| | - John McKinley
- Belfast Health & Social Care Trust Belfast United Kingdom
| | - Seamus Kearney
- Belfast Health & Social Care Trust Belfast United Kingdom
| | - Karen Doherty
- Belfast Health & Social Care Trust Belfast United Kingdom
| | - Julia Foy
- South Eastern Health & Social Care Trust Dundonald Belfast United Kingdom
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16
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O'Neill RA, Maxwell AP, Hogg RE, Passmore AP, Quinn N, Kee F, Young I, McKay G, McGuinness B. Variation in retinal microvascular parameters is associated with mild cognitive impairment and Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.040893] [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)
| | | | - Ruth E Hogg
- Queen's University Belfast Belfast United Kingdom
| | | | - Nicola Quinn
- Queen's University Belfast Belfast United Kingdom
| | - Frank Kee
- Queen's University Belfast Belfast United Kingdom
| | - Ian Young
- Queen's University Belfast Belfast United Kingdom
| | - Gareth McKay
- Queen's University Belfast Belfast United Kingdom
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17
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Femminella GD, Frangou E, Love SB, Busza G, Holmes C, Ritchie C, Lawrence R, McFarlane B, Tadros G, Ridha BH, Bannister C, Walker Z, Archer H, Coulthard E, Underwood BR, Prasanna A, Koranteng P, Karim S, Junaid K, McGuinness B, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Harrison J, Hölscher C, Brooks DJ, Passmore AP, Ballard C, Edison P. Correction to: Evaluating the effects of the novel GLP-1 analogue liraglutide in Alzheimer's disease: study protocol for a randomised controlled trial (ELAD study). Trials 2020; 21:660. [PMID: 32684162 PMCID: PMC7370449 DOI: 10.1186/s13063-020-04608-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
| | - Eleni Frangou
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sharon B Love
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Gail Busza
- Department of Medicine, Imperial College London, London, UK
| | - Clive Holmes
- Southern Health NHS Foundation Trust, Havant, UK
| | - Craig Ritchie
- Department of Medicine, Imperial College London, London, UK
| | | | | | - George Tadros
- Aston Medical school, Aston University, Birmingham, UK
| | - Basil H Ridha
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | | | - Zuzana Walker
- University College London and Essex Partnership University NHS Foundation Trust, Runwell, UK
| | | | | | - Ben R Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust, Peterborough, UK
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust, West Bromwich, UK
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK
| | - Salman Karim
- Lancashire Care NHS Foundation Trust, Preston, UK
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | | | | | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Naghma Malik
- 5 Boroughs Partnership NHS Foundation Trust, Warrington, UK
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust, Redruth, UK
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust, Bridgwater, UK
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Stafford, UK
| | - John Harrison
- Alzheimer Center VUmc Amsterdam, Amsterdam, the Netherlands.,Institute of Psychiatry, Psychology & Neuroscience King's College London, London, UK
| | - Christian Hölscher
- Research Department, Henan University of Chinese Medicine, Zhengzhou, China
| | - David J Brooks
- Department of Medicine, Imperial College London, London, UK.,Newcastle University, Newcastle upon Tyne, UK
| | | | - Clive Ballard
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Paul Edison
- Department of Medicine, Imperial College London, London, UK. .,School of Medicine, College of Biomedical and Life sciences, Cardiff University, Cardiff, CF14 4YS, UK.
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18
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Murphy B, Barbey F, Buick AR, Dyer J, Farina F, McGuinness B, Passmore AP, Whelan R. F3-03-03: REPLICATING LAB ELECTROPHYSIOLOGY WITH OLDER USERS IN THE HOME, USING GAMIFIED DRY EEG. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | - John Dyer
- BrainWaveBank; Belfast United Kingdom
| | | | | | | | - Robert Whelan
- Trinity College Institute of Neuroscience; Dublin Ireland
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19
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Femminella GD, Wang YT, van der Doef T, Frangou E, Love S, Calsolaro V, Carver S, Holmes C, Ritchie CW, Lawrence RM, McFarlane B, Tadros G, Ridha BH, Bannister C, Walker Z, Archer H, Coulthard E, Underwood B, Prasanna A, Koranteng P, Karim S, Junaid K, McGuinness B, Passmore AP, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Harrison J, Ballard C, Brooks DJ, Edison P. P3-328: DOES INSULIN RESISTANCE INFLUENCE WHITE MATTER LESIONS IN NON-DIABETIC AD SUBJECTS? Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3360] [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: 10/25/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Clive Holmes
- University of Southampton; Southampton United Kingdom
| | | | - Robert M. Lawrence
- South West London and St George's Mental Health NHS Trust; London United Kingdom
| | - Brady McFarlane
- Southern Health NHS Foundation Trust; Southampton United Kingdom
| | - George Tadros
- Heart of England NHS Foundation Trust; Birmingham United Kingdom
| | - Basil H. Ridha
- Brighton and Sussex University Hospital Trust; Brighton United Kingdom
| | | | - Zuzana Walker
- Mental Health Unit; St. Margaret's Hospital; Epping Essex United Kingdom
| | | | | | - Ben Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust; Cambridge United Kingdom
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust; Wolverhampton United Kingdom
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust; Northampton United Kingdom
| | - Salman Karim
- Lancashire Care NHS Foundation Trust; Preston United Kingdom
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust; Nottingham United Kingdom
| | | | | | - Ramin Nilforooshan
- Surrey and Borders Partnership NHS Foundation Trust; Chertsey United Kingdom
| | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust; Derby United Kingdom
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust; Bradford United Kingdom
| | - Naghma Malik
- North West Boroughs Partnership NHS Foundation Trust; Warrington United Kingdom
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust; Redruth United Kingdom
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust; South Petherton United Kingdom
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust; Shrewsbury United Kingdom
| | - John Harrison
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC; Vrije Universiteit Amsterdam; Amsterdam Netherlands
| | - Clive Ballard
- University of Exeter Medical School; Exeter United Kingdom
| | | | - Paul Edison
- Imperial College London; London United Kingdom
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20
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Femminella GD, Frangou E, Love SB, Busza G, Holmes C, Ritchie C, Lawrence R, McFarlane B, Tadros G, Ridha BH, Bannister C, Walker Z, Archer H, Coulthard E, Underwood BR, Prasanna A, Koranteng P, Karim S, Junaid K, McGuinness B, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Harrison J, Hölscher C, Brooks DJ, Passmore AP, Ballard C, Edison P. Evaluating the effects of the novel GLP-1 analogue liraglutide in Alzheimer's disease: study protocol for a randomised controlled trial (ELAD study). Trials 2019; 20:191. [PMID: 30944040 PMCID: PMC6448216 DOI: 10.1186/s13063-019-3259-x] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [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: 03/23/2018] [Accepted: 02/27/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Liraglutide is a glucagon-like peptide-1 (GLP-1) analogue currently approved for type 2 diabetes and obesity. Preclinical evidence in transgenic models of Alzheimer's disease suggests that liraglutide exerts neuroprotective effects by reducing amyloid oligomers, normalising synaptic plasticity and cerebral glucose uptake, and increasing the proliferation of neuronal progenitor cells. The primary objective of the study is to evaluate the change in cerebral glucose metabolic rate after 12 months of treatment with liraglutide in participants with Alzheimer's disease compared to those who are receiving placebo. METHODS/DESIGN ELAD is a 12-month, multi-centre, randomised, double-blind, placebo-controlled, phase IIb trial of liraglutide in participants with mild Alzheimer's dementia. A total of 206 participants will be randomised to receive either liraglutide or placebo as a daily injection for a year. The primary outcome will be the change in cerebral glucose metabolic rate in the cortical regions (hippocampus, medial temporal lobe, and posterior cingulate) from baseline to follow-up in the treatment group compared with the placebo group. The key secondary outcomes are the change from baseline to 12 months in z scores for clinical and cognitive measures (Alzheimer's Disease Assessment Scale-Cognitive Subscale and Executive domain scores of the Neuropsychological Test Battery, Clinical Dementia Rating Sum of Boxes, and Alzheimer's Disease Cooperative Study-Activities of Daily Living) and the incidence and severity of treatment-emergent adverse events or clinically important changes in safety assessments. Other secondary outcomes are 12-month change in magnetic resonance imaging volume, diffusion tensor imaging parameters, reduction in microglial activation in a subgroup of participants, reduction in tau formation and change in amyloid levels in a subgroup of participants measured by tau and amyloid imaging, and changes in composite scores using support machine vector analysis in the treatment group compared with the placebo group. DISCUSSION Alzheimer's disease is a leading cause of morbidity worldwide. As available treatments are only symptomatic, the search for disease-modifying therapies is a priority. If the ELAD trial is successful, liraglutide and GLP-1 analogues will represent an important class of compounds to be further evaluated in clinical trials for Alzheimer's treatment. TRIAL REGISTRATION ClinicalTrials.gov, NCT01843075 . Registration 30 April 2013.
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Affiliation(s)
| | - Eleni Frangou
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sharon B Love
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Gail Busza
- Department of Medicine, Imperial College London, London, UK
| | - Clive Holmes
- Southern Health NHS Foundation Trust, Havant, UK
| | - Craig Ritchie
- Department of Medicine, Imperial College London, London, UK
| | | | | | - George Tadros
- Aston Medical school, Aston University, Birmingham, UK
| | - Basil H Ridha
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | | | - Zuzana Walker
- University College London and Essex Partnership University NHS Foundation Trust, Runwell, UK
| | | | | | - Ben R Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust, Peterborough, UK
| | - Aparna Prasanna
- Black Country Partnership NHS Foundation Trust, West Bromwich, UK
| | - Paul Koranteng
- Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK
| | - Salman Karim
- Lancashire Care NHS Foundation Trust, Preston, UK
| | - Kehinde Junaid
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | | | | | | | | | - Simon Thacker
- Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Naghma Malik
- 5 Boroughs Partnership NHS Foundation Trust, Warrington, UK
| | - Vandana Mate
- Cornwall Partnership NHS Foundation Trust, Redruth, UK
| | - Lucy Knight
- Somerset Partnership NHS Foundation Trust, Bridgwater, UK
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Stafford, UK
| | - John Harrison
- Alzheimer Center VUmc Amsterdam, Amsterdam, the Netherlands.,Institute of Psychiatry, Psychology & Neuroscience King's College London, London, UK
| | | | - David J Brooks
- Department of Medicine, Imperial College London, London, UK.,Newcastle University, Newcastle upon Tyne, UK
| | | | - Clive Ballard
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Paul Edison
- Department of Medicine, Imperial College London, London, UK. .,School of Medicine, College of Biomedical and Life sciences, Cardiff University, Cardiff, CF14 4YS, UK.
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21
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Femminella GD, Fan Z, Frangou E, Love S, Calsolaro V, Holmes C, Ritchie CW, Lawrence RM, McFarlane B, Tadros G, Ridha BH, Bannister C, Walker Z, Archer H, Coulthard E, Underwood B, Prasanna A, Koranteng P, Karim S, Junaid K, McGuinness B, Passmore AP, Nilforooshan R, Macharouthu A, Donaldson A, Thacker S, Russell G, Malik N, Mate V, Knight L, Kshemendran S, Harrison J, Ballard C, Brooks DJ, Edison P. P3‐225: PERIPHERAL INSULIN RESISTANCE DOES NOT CORRELATE WITH CEREBRAL GLUCOSE METABOLIC RATE IN NON‐DIABETIC ALZHEIMER'S PATIENTS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1584] [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: 10/28/2022]
Affiliation(s)
| | - Zhen Fan
- Imperial College LondonLondonUnited Kingdom
| | | | | | | | - Clive Holmes
- University of SouthamptonSouthamptonUnited Kingdom
| | | | - Robert M. Lawrence
- South West London and St George's Mental Health National Health Service TrustLondonUnited Kingdom
| | - Brady McFarlane
- Southern Health, National Health Service Foundation TrustSouthamptonUnited Kingdom
| | - George Tadros
- Heart of England National Health Service Foundation TrustBirminghamUnited Kingdom
| | - Basil H. Ridha
- Dementia Research Centre, Institute of NeurologyUniversity College LondonLondonUnited Kingdom
| | | | - Zuzana Walker
- Mental Health UnitSt. Margaret's HospitalEppingEssexUnited Kingdom
| | - Hilary Archer
- North Bristol National Health Service TrustBristolUnited Kingdom
| | | | - Ben Underwood
- Cambridgeshire and Peterborough National Health Service Foundation TrustCambridgeUnited Kingdom
| | - Aparna Prasanna
- Black Country Partnership National Health Service Foundation TrustWolverhamptonUnited Kingdom
| | - Paul Koranteng
- Northamptonshire Healthcare National Health Service Foundation TrustNorthamptonUnited Kingdom
| | - Salman Karim
- Lancashire Care National Health Servuce Foundation TrustPrestonUnited Kingdom
| | - Kehinde Junaid
- Nottinghamshire Healthcare National Health Service Foundation TrustNottinghamUnited Kingdom
| | | | | | - Ramin Nilforooshan
- Surrey and Borders Partnership National Health Service Foundation TrustChertseyUnited Kingdom
| | | | | | - Simon Thacker
- Derbyshire Healthcare National Health Service Foundation TrustDerbyUnited Kingdom
| | - Gregor Russell
- Bradford District Care National Health Service Foundation TrustBradfordUnited Kingdom
| | - Naghma Malik
- North West Boroughs Partnership National Health Service Foundation TrustWarringtonUnited Kingdom
| | - Vandana Mate
- Cornwall Partnership National Health Service Foundation TrustRedruthUnited Kingdom
| | - Lucy Knight
- Somerset Partnership National Health Service Foundation TrustSouth PethertonUnited Kingdom
| | - Sajeev Kshemendran
- South Staffordshire and Shropshire Healthcare National Health Service Foundation TrustShrewsburyUnited Kingdom
| | - John Harrison
- Alzheimer CenterVU University Medical CenterAmsterdamNetherlands
| | - Clive Ballard
- University of Exeter Medical SchoolExeterUnited Kingdom
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22
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Murphy B, Buick AR, Dyer J, Nolan H, McGuinness B, Passmore AP. P4‐317: MEASURING COGNITIVE DECLINE WITH HOME‐BASED GAMIFIED MOBILE EEG. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.07.140] [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: 10/28/2022]
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23
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Kehoe PG, Blair PS, Howden B, Thomas DL, Malone IB, Horwood J, Clement C, Selman LE, Baber H, Lane A, Coulthard E, Passmore AP, Fox NC, Wilkinson IB, Ben-Shlomo Y. The Rationale and Design of the Reducing Pathology in Alzheimer's Disease through Angiotensin TaRgeting (RADAR) Trial. J Alzheimers Dis 2018; 61:803-814. [PMID: 29226862 DOI: 10.3233/jad-170101] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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] [Indexed: 01/18/2023]
Abstract
BACKGROUND Anti-hypertensives that modify the renin angiotensin system may reduce Alzheimer's disease (AD) pathology and reduce the rate of disease progression. OBJECTIVE To conduct a phase II, two arm, double-blind, placebo-controlled, randomized trial of losartan to test the efficacy of Reducing pathology in Alzheimer's Disease through Angiotensin TaRgeting (RADAR). METHODS Men and women aged at least 55 years with mild-to-moderate AD will be randomly allocated 100 mg encapsulated generic losartan or placebo once daily for 12 months after successful completion of a 2-week open-label phase and 2-week placebo washout to establish drug tolerability. 228 participants will provide at least 182 subjects with final assessments to provide 84% power to detect a 25% difference in atrophy rate (therapeutic benefit) change over 12 months at an alpha level of 0.05. We will use intention-to-treat analysis, estimating between-group differences in outcomes derived from appropriate (linear or logistic) multivariable regression models adjusting for minimization variables. RESULTS The primary outcome will be rate of whole brain atrophy as a surrogate measure of disease progression. Secondary outcomes will include changes to 1) white matter hyperintensity volume and cerebral blood flow; 2) performance on a standard series of assessments of memory, cognitive function, activities of daily living, and quality of life. Major assessments (for all outcomes) and relevant safety monitoring of blood pressure and bloods will be at baseline and 12 months. Additional cognitive assessment will also be conducted at 6 months along with safety blood pressure and blood monitoring. Monitoring of blood pressure, bloods, and self-reported side effects will occur during the open-label phase and during the majority of the post-randomization dispensing visits. CONCLUSION This study will identify whether losartan is efficacious in the treatment of AD and whether definitive Phase III trials are warranted.
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Affiliation(s)
- Patrick G Kehoe
- Dementia Research Group, Translational Health Sciences, Bristol Medical School, University of Bristol, Faculty of Health Sciences, Level 1 Learning and Research>, Southmead Hospital, Bristol, UK
| | - Peter S Blair
- Bristol Randomised Trials Collaboration (BRTC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Beth Howden
- Bristol Randomised Trials Collaboration (BRTC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - David L Thomas
- Leonard Wolfson Experimental Neurology Centre, UCL Institute of Neurology, Queen Square, London, UK
- Dementia Research Centre (DRC), Institute of Neurology, University College London, Queen Square, London, UK
| | - Ian B Malone
- Dementia Research Centre (DRC), Institute of Neurology, University College London, Queen Square, London, UK
| | - Jeremy Horwood
- Bristol Randomised Trials Collaboration (BRTC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Clare Clement
- Bristol Randomised Trials Collaboration (BRTC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lucy E Selman
- Bristol Randomised Trials Collaboration (BRTC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hannah Baber
- Bristol Randomised Trials Collaboration (BRTC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Athene Lane
- Bristol Randomised Trials Collaboration (BRTC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Elizabeth Coulthard
- ReMemBr Group, Translational Health Sciences, Bristol Medical School, University of Bristol, Faculty of Health Sciences, Brain Centre, Southmead Hospital, Bristol, UK
| | - Anthony Peter Passmore
- Institute of Clinical Sciences, Queens University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Nick C Fox
- Dementia Research Centre (DRC), Institute of Neurology, University College London, Queen Square, London, UK
| | - Ian B Wilkinson
- Division of Experimental Medicine and Immunotherapeutics, School of Clinical Medicine, University of Cambridge, and Clinical Trials Unit, Addenbrookes Hospital, Cambridge, UK
| | - Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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24
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Cunningham EL, McGuinness B, Beverland D, McAuley DF, O'Brien S, Mawhinney T, Toombs J, Zetterberg H, Schott JM, Lunn M, Passmore AP. [P1–348]: CSF Aβ42 CONCENTRATION INDEPENDENTLY PREDICTS POSTOPERATIVE DELIRIUM IN AN ELDERLY ELECTIVE ARTHROPLASTY POPULATION. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.364] [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: 10/18/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Henrik Zetterberg
- Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at University of GothenburgGothenburgSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at University of GothenburgGothenburgSweden
- University of GothenburgGothenburgSweden
- University College LondonLondonUnited Kingdom
| | - Jonathan M. Schott
- University College LondonLondonUnited Kingdom
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
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Pollock D, Cunningham E, McGuinness B, Passmore AP. Pisa syndrome due to donepezil: pharmacokinetic interactions to blame? Age Ageing 2017; 46:529-530. [PMID: 28104598 DOI: 10.1093/ageing/afw253] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/22/2016] [Indexed: 11/12/2022] Open
Abstract
We report a case of Pisa syndrome (PS) due to the acetylcholinesterase inhibitor donepezil which may have been precipitated by pharmacokinetic interactions with commonly used medications. PS is defined as a reversible lateral bending of the trunk with a tendency to lean to one side. This is a rare but very distressing complication with this commonly used medication which was not initially recognised, leading to increasing disability for the patient and significant carer stress. Cessation of donepezil and modulation of potential interacting medications resulted in complete resolution.
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Affiliation(s)
- David Pollock
- Elderly Care Unit, Belfast Health and Social Care trust, 51 Lisburn Road, Belfast BT9 7AB, UK
| | - Emma Cunningham
- Centre for Public Health, Institute of Clinical Sciences, Queens University Belfast, Block B, Grosvenor Road, Belfast BT12 6BJ, UK
| | - Bernadette McGuinness
- Centre for Public Health, Institute of Clinical Sciences, Queens University Belfast, Block B, Grosvenor Road, Belfast BT12 6BJ, UK
| | - Anthony Peter Passmore
- Centre for Public Health, Institute of Clinical Sciences, Queens University Belfast, Block B, Grosvenor Road, Belfast BT12 6BJ, UK
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Cunningham EL, Passmore AP, McAuley DF, Beverland D, O'Brien S, McGuinness B. P1‐242: Utility of Neuropsychological Tests in Predicting Post‐Operative Delirium Following Elective Primary Arthroplasty. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.991] [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: 10/20/2022]
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McGuinness B, Barrett SL, McIlvenna J, Passmore AP, Shorter GW. Predicting conversion to dementia in a memory clinic: A standard clinical approach compared with an empirically defined clustering method (latent profile analysis) for mild cognitive impairment subtyping. Alzheimers Dement (Amst) 2015; 1:447-54. [PMID: 27239523 PMCID: PMC4879478 DOI: 10.1016/j.dadm.2015.10.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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] [Indexed: 11/10/2022]
Abstract
Introduction Mild cognitive impairment (MCI) has clinical value in its ability to predict later dementia. A better understanding of cognitive profiles can further help delineate who is most at risk of conversion to dementia. We aimed to (1) examine to what extent the usual MCI subtyping using core criteria corresponds to empirically defined clusters of patients (latent profile analysis [LPA] of continuous neuropsychological data) and (2) compare the two methods of subtyping memory clinic participants in their prediction of conversion to dementia. Methods Memory clinic participants (MCI, n = 139) and age-matched controls (n = 98) were recruited. Participants had a full cognitive assessment, and results were grouped (1) according to traditional MCI subtypes and (2) using LPA. MCI participants were followed over approximately 2 years after their initial assessment to monitor for conversion to dementia. Results Groups were well matched for age and education. Controls performed significantly better than MCI participants on all cognitive measures. With the traditional analysis, most MCI participants were in the amnestic multidomain subgroup (46.8%) and this group was most at risk of conversion to dementia (63%). From the LPA, a three-profile solution fit the data best. Profile 3 was the largest group (40.3%), the most cognitively impaired, and most at risk of conversion to dementia (68% of the group). Discussion LPA provides a useful adjunct in delineating MCI participants most at risk of conversion to dementia and adds confidence to standard categories of clinical inference.
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Affiliation(s)
- Bernadette McGuinness
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Suzanne L Barrett
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - John McIlvenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Anthony Peter Passmore
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Gillian W Shorter
- National Institute for Mental Health Research, Australian National University, Canberra, ACT, Australia; All Ireland Hub for Trials Methodology Research, Ulster University, Londonderry, Northern Ireland
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Cunningham EL, McGuinness B, Herron B, Passmore AP. Dementia. Ulster Med J 2015; 84:79-87. [PMID: 26170481 PMCID: PMC4488926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/04/2015] [Indexed: 11/17/2022]
Abstract
Dementia is a clinical diagnosis requiring new functional dependence on the basis of progressive cognitive decline. It is estimated that 1.3% of the entire UK population, or 7.1% of those aged 65 or over, have dementia. Applying these to 2013 population estimates gives an estimated number of 19,765 people living with dementia in Northern Ireland. The clinical syndrome of dementia can be due to a variety of underlying pathophysiological processes. The most common of these is Alzheimer's disease (50-75%) followed by vascular dementia (20%), dementia with Lewy bodies (5%) and frontotemporal lobar dementia (5%). The clinical symptoms and pathophysiological processes of these diseases overlap significantly. Biomarkers to aid diagnosis and prognosis are emerging. Acetylcholinesterase inhibitors and memantine are the only medications currently licensed for the treatment of dementia. The nature of symptoms mean people with dementia are more dependent and vulnerable, both socially and in terms of physical and mental health, presenting evolving challenges to society and to our healthcare systems.
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Affiliation(s)
| | - B McGuinness
- Centre for Public Health, Queen's University Belfast ; Belfast Health and Social Care Trust
| | - B Herron
- Belfast Health and Social Care Trust
| | - A P Passmore
- Centre for Public Health, Queen's University Belfast ; Belfast Health and Social Care Trust
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Affiliation(s)
- E L Cunningham
- Centre for Public Health, Queen's University Belfast, Block B, Institute Clinical Sciences, Royal Victoria Hospital, Belfast, BT12 6BA
| | - A P Passmore
- Centre for Public Health, Queen's University Belfast, Block B, Institute Clinical Sciences, Royal Victoria Hospital, Belfast, BT12 6BA
| | - D F McAuley
- Centre for Public Health, Queen's University Belfast, Block B, Institute Clinical Sciences, Royal Victoria Hospital, Belfast, BT12 6BA
| | - B McGuinness
- Centre for Public Health, Queen's University Belfast, Block B, Institute Clinical Sciences, Royal Victoria Hospital, Belfast, BT12 6BA
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Graham SF, Chevallier OP, Elliott CT, Hölscher C, Johnston J, McGuinness B, Kehoe PG, Passmore AP, Green BD. Untargeted metabolomic analysis of human plasma indicates differentially affected polyamine and L-arginine metabolism in mild cognitive impairment subjects converting to Alzheimer's disease. PLoS One 2015; 10:e0119452. [PMID: 25803028 PMCID: PMC4372431 DOI: 10.1371/journal.pone.0119452] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/13/2015] [Indexed: 11/19/2022] Open
Abstract
This study combined high resolution mass spectrometry (HRMS), advanced chemometrics and pathway enrichment analysis to analyse the blood metabolome of patients attending the memory clinic: cases of mild cognitive impairment (MCI; n = 16), cases of MCI who upon subsequent follow-up developed Alzheimer's disease (MCI_AD; n = 19), and healthy age-matched controls (Ctrl; n = 37). Plasma was extracted in acetonitrile and applied to an Acquity UPLC HILIC (1.7μm x 2.1 x 100 mm) column coupled to a Xevo G2 QTof mass spectrometer using a previously optimised method. Data comprising 6751 spectral features were used to build an OPLS-DA statistical model capable of accurately distinguishing Ctrl, MCI and MCI_AD. The model accurately distinguished (R2 = 99.1%; Q2 = 97%) those MCI patients who later went on to develop AD. S-plots were used to shortlist ions of interest which were responsible for explaining the maximum amount of variation between patient groups. Metabolite database searching and pathway enrichment analysis indicated disturbances in 22 biochemical pathways, and excitingly it discovered two interlinked areas of metabolism (polyamine metabolism and L-Arginine metabolism) were differentially disrupted in this well-defined clinical cohort. The optimised untargeted HRMS methods described herein not only demonstrate that it is possible to distinguish these pathologies in human blood but also that MCI patients 'at risk' from AD could be predicted up to 2 years earlier than conventional clinical diagnosis. Blood-based metabolite profiling of plasma from memory clinic patients is a novel and feasible approach in improving MCI and AD diagnosis and, refining clinical trials through better patient stratification.
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Affiliation(s)
- Stewart F. Graham
- Advanced Asset Technology Centre, Institute for Global Food Security, Queen’s University Belfast, Stranmillis Road, Belfast, BT9 5AG, United Kingdom
- William Beaumont Research Institute, 3811 W. 13 Mile Road, Royal Oak, Michigan 48073, United States of America
- * E-mail:
| | - Olivier P. Chevallier
- Advanced Asset Technology Centre, Institute for Global Food Security, Queen’s University Belfast, Stranmillis Road, Belfast, BT9 5AG, United Kingdom
| | - Christopher T. Elliott
- Advanced Asset Technology Centre, Institute for Global Food Security, Queen’s University Belfast, Stranmillis Road, Belfast, BT9 5AG, United Kingdom
| | - Christian Hölscher
- Division of Biomedical Sciences and Life Sciences, Lancaster University, Lancaster, LA1 4YG, United Kingdom
| | - Janet Johnston
- Ageing Group, Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - Bernadette McGuinness
- Ageing Group, Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - Patrick G. Kehoe
- Dementia Research Group, Institute of Clinical Neurosciences, School of Clinical Sciences, University of Bristol, Frenchay Hospital, Bristol, BS16 1LE, United Kingdom
| | - Anthony Peter Passmore
- Ageing Group, Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - Brian D. Green
- Advanced Asset Technology Centre, Institute for Global Food Security, Queen’s University Belfast, Stranmillis Road, Belfast, BT9 5AG, United Kingdom
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Cunningham EL, Passmore AP, McAuley DF, McGuinness B. Reciting the months of the year backwards: what is a 'normal' score? Age Ageing 2015. [DOI: 10.1093/ageing/el_719] [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: 11/14/2022] Open
Affiliation(s)
| | - AP Passmore
- Clinical Research Fellow, Queen's University Belfast
| | - DF McAuley
- Clinical Research Fellow, Queen's University Belfast
| | - B McGuinness
- Clinical Research Fellow, Queen's University Belfast
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Abstract
BACKGROUND Reporting of cause of death in patients with Alzheimer's disease (AD) has changed over the past few decades but concerns persist over the accuracy of death certificate completion in this setting. OBJECTIVES To examine the causes of death in AD and examine how this compares with those affecting the normal population. METHODS Death certificates were obtained for 85 AD patients and 52 control subjects from a cohort of 396 participants. Underlying causes of death and other conditions mentioned on the death certificates of the AD patients were analysed and compared with the Northern Ireland population age-and-sex adjusted mortality rates and subsequently to the death certificates of control subjects. RESULTS AD and pneumonia were causes of significant excess mortality and the most common underlying causes of death in the AD patient group (23.53 and 17.65%, respectively). When compared with the control subjects, AD and gastrointestinal diseases were found to be more prevalent. AD was recorded on 63.5% of death certificates of AD subjects who died during follow-up. CONCLUSION The cause of death documented for AD patients may be affected by the physician's knowledge of the patient or reflects the approach to management of patients with end-stage dementia.
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Affiliation(s)
- S Todd
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen’s University of Belfast, Belfast BT7 9BL, UK.
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Affiliation(s)
- S Todd
- Ageing Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, The Queen's University of Belfast, Belfast, UK.
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McGuinness B, Carson R, Barrett SL, Craig D, Passmore AP. Apolipoprotein ɛ4 and neuropsychological performance in Alzheimer's disease and vascular dementia. Neurosci Lett 2010; 483:62-6. [DOI: 10.1016/j.neulet.2010.07.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Revised: 06/23/2010] [Accepted: 07/23/2010] [Indexed: 11/16/2022]
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Affiliation(s)
- Stephen Todd
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, The Queen's University of Belfast, UK.
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Abstract
OBJECTIVE To compare performance of patients with mild-moderate Alzheimer's disease (AD) and vascular dementia (VaD) on tests of executive functioning and working memory. METHODS Patients with AD (n = 76) and VaD (n = 46) were recruited from a memory clinic along with dementia free participants (n = 28). They underwent specific tests of working memory from the Cognitive Drug Research (CDR) battery and pen and paper tests of executive function including CLOX 1 & 2, EXIT25 and a test of verbal fluency (COWAT). All patients had a CT brain scan which was independently scored for white matter change/ischaemia. RESULTS The AD and VaD groups were significantly impaired on all measures of working memory and executive functioning compared to the disease free group. There were no significant differences between the AD and VaD groups on any measure. Z-scores confirmed the pattern of impairment in executive functioning and working memory was largely equivalent in both patient groups. Small to moderate correlations were seen between the MMSE and the neurocognitive scores in both patient groups and the pattern of correlations was also very similar in both patient groups. CONCLUSIONS This study demonstrates sizeable executive functioning and working memory impairments in patients with mild-moderate AD and VaD but no significant differences between the disease groups.
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Affiliation(s)
- B McGuinness
- Geriatric Medicine, Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Whitla Medical Building, Queen's University Belfast, Belfast, UK.
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McNaull BBA, Todd S, McGuinness B, Passmore AP. Inflammation and anti-inflammatory strategies for Alzheimer's disease--a mini-review. Gerontology 2009; 56:3-14. [PMID: 19752507 DOI: 10.1159/000237873] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 04/02/2009] [Indexed: 11/19/2022] Open
Abstract
Until recently, the central nervous system (CNS) has been thought to be an immune privileged organ. However, it is now understood that neuroinflammation is linked with the development of several CNS diseases including late-onset Alzheimer's disease (LOAD). The development of inflammation is a complex process involving a wide array of molecular interactions which in the CNS remains to be further characterized. The development of neuroinflammation may represent an important link between the early stages of LOAD and its pathological outcome. It is proposed that risks for LOAD, which include genetic, biological and environmental factors can each contribute to impairment of normal CNS regulation and function. The links between risk factors and the development of neuroinflammation are numerous and involve many complex interactions which contribute to vascular compromise, oxidative stress and ultimately neuroinflammation. Once this cascade of events is initiated, the process of neuroinflammation can become overactivated resulting in further cellular damage and loss of neuronal function. Additionally, neuroinflammation has been associated with the formation of amyloid plaques and neurofibrillary tangles, the pathological hallmarks of LOAD. Increased levels of inflammatory markers have been correlated with an advanced cognitive impairment. Based on this knowledge, new therapies aimed at limiting onset of neuroinflammation could arrest or even reverse the development of the disease.
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Liu WW, Todd S, Craig D, Passmore AP, Coulson DTR, Murphy S, Irvine GB, Johnston JA. Elevated platelet beta-secretase activity in mild cognitive impairment. Dement Geriatr Cogn Disord 2008; 24:464-8. [PMID: 17986817 DOI: 10.1159/000110739] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS We have recently reported that platelet activity of the rate-limiting enzyme for beta-amyloid peptide production is elevated in established Alzheimer's disease. Laboratory investigation of the very early stages of dementia provides an opportunity to investigate pathological mechanisms before advanced disease hinders interpretation. Mild cognitive impairment (MCI) exists prior to obvious dementia, and is associated with increased risk of conversion to overt disease. METHODS We developed and used a fluorimetric assay to quantify platelet membrane beta-secretase activity in 52 patients with MCI and 75 controls. RESULTS Platelet membrane beta-secretase activity was 24% higher in individuals with MCI compared to controls (p = 0.001, unpaired t test with Welch correction). CONCLUSION Elevated platelet beta-secretase activity in subjects with MCI is an area for further study in relation to the etiology and diagnosis of MCI.
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Affiliation(s)
- W W Liu
- Division of Psychiatry and Neuroscience, School of Medicine and Dentistry, Queen's University Belfast, Belfast, UK
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McGuinness B, Todd S, Passmore AP, Bullock R. Systematic review: Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. J Neurol Neurosurg Psychiatry 2008; 79:4-5. [PMID: 18079296 DOI: 10.1136/jnnp.2007.118505] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- B McGuinness
- Department of Geriatric Medicine, Queen's University Belfast, Whitla Medical Building, 97 Lisburn Road, Belfast BT9 5HP, UK.
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Carson R, Craig D, McGuinness B, Johnston JA, O'Neill FA, Passmore AP, Ritchie CW. Alpha7 nicotinic acetylcholine receptor gene and reduced risk of Alzheimer's disease. J Med Genet 2007; 45:244-8. [PMID: 18057084 DOI: 10.1136/jmg.2007.052704] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Sporadic Alzheimer's disease (AD) is a common disabling disease of complex aetiology for which there are limited therapeutic options. We sought to investigate the role of the alpha7 nicotinic acetylcholine receptor gene (CHRNA7) in influencing risk of AD in a large population. CHRNA7 is a strong candidate gene for AD for several reasons: (1) its expression is altered differentially in the AD brain; (2) it interacts directly with beta amyloid peptide (Abeta(42)); and (3) agonist activation induces several neuroprotective pathways. METHODS In this study we used a genetic haplotype approach to assess the contribution of common variation at the CHRNA7 locus to risk of AD. Fourteen single nucleotide polymorphisms (SNPs) were genotyped in 764 AD patients and 314 controls. RESULTS Three blocks of high linkage disequilibrium (LD) and low haplotype diversity were identified. The block 1 TCC haplotype was significantly associated with reduced odds of AD (p = 0.001) and was independent of apolipoprotein E (APOE) status. Individual SNPs were not associated with risk for AD. CONCLUSIONS We conclude that genetic variation in CHRNA7 influences susceptibility to AD. These results provide support for the development of alpha7nAChR agonists or modulators as potential drug treatments for AD. Further work is necessary to replicate the findings in other populations.
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Johnston JA, Liu WW, Coulson DTR, Todd S, Murphy S, Brennan S, Foy CJ, Craig D, Irvine GB, Passmore AP. Platelet beta-secretase activity is increased in Alzheimer's disease. Neurobiol Aging 2006; 29:661-8. [PMID: 17174011 DOI: 10.1016/j.neurobiolaging.2006.11.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Revised: 10/31/2006] [Accepted: 11/09/2006] [Indexed: 01/02/2023]
Abstract
beta-Secretase activity is the rate-limiting step in Abeta peptide production from amyloid precursor protein. Abeta is a major component of Alzheimer's disease (AD) cortical amyloid plaques. beta-Secretase activity is elevated in post mortem brain tissue in AD. The current study investigated whether beta-secretase activity was also elevated in peripheral blood platelets. We developed a novel fluorimetric beta-secretase activity assay to investigate platelets isolated from individuals with AD (n=86), and age-matched controls (n=115). Platelet membrane beta-secretase activity (expressed as initial rate) varied over fourfold between individuals, raising important questions about in vivo regulation of this proteolytic activity. Nonetheless, we identified a significant 17% increase in platelet membrane beta-secretase activity in individuals with AD compared to controls (p=0.0003, unpaired t-test). Platelet membrane beta-secretase activity did not correlate with mini-mental state examination (MMSE) score in the AD group (mean MMSE=17.7, range 1-23), indicating that the increase did not occur as a secondary result of the disease process, and may even have preceded symptom onset.
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Affiliation(s)
- J A Johnston
- Queen's University Belfast, School of Medicine and Dentistry, Whitla Medical Building, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom.
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Johnston JA, Liu WW, Todd SA, Coulson DTR, Murphy S, Irvine GB, Passmore AP. Expression and activity of beta-site amyloid precursor protein cleaving enzyme in Alzheimer's disease. Biochem Soc Trans 2006; 33:1096-100. [PMID: 16246054 DOI: 10.1042/bst20051096] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Several lines of evidence indicate that the Abeta peptide is involved at some level in the pathological process that results in the clinical symptoms of AD (Alzheimer's disease). The N-terminus of Abeta is generated by cleavage of the Met-Asp bond at position 671-672 of APP (amyloid precursor protein), catalysed by a proteolytic activity called beta-secretase. Two 'beta-secretase' proteases have been identified: BACE (beta-site APP-cleaving enzyme) and BACE2. The cause of sporadic AD is currently unknown, but some studies have reported elevated BACE/beta-secretase activity in brain regions affected by the disease. We have demonstrated that robust beta-secretase activity is also detectable in platelets that contain APP and release Abeta. This review considers the current evidence for alterations in beta-secretase activity, and/or alterations in BACE expression, in post-mortem brain tissue and platelets from individuals with AD.
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Affiliation(s)
- J A Johnston
- School of Biology and Biochemistry, The Queen's University of Belfast, Medical Biology Centre, Belfast BT9 7BL, Northern Ireland.
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Abstract
OBJECTIVES The origins of behavioural and psychological symptoms of dementia are still poorly understood. By focusing on piecemeal behaviours as opposed to more robust syndrome change valid biological correlates may be overlooked. Our understanding of BPSD via the identification of neuropsychiatric syndromes. METHODS We recruited 435 subjects from old age psychiatry and elderly care memory outpatient clinics fulfilling the criteria for diagnosis of probable Alzheimer's disease. Behavioural and psychological symptoms were assessed using the Neuropsychiatric Inventory. Principal components factor analysis was carried out on the composite scores of the 12 symptom domains to identify behavioural syndromes (factors). Results were confirmed by performing three different rotations: Varimax, Equamax and Quartimax. RESULTS Four factors were identified (which accounted for 57% of the variance): 'affect' factor-depression/dysphoria, anxiety, irritability/lability and agitation/aggression; 'physical behaviour' factor-apathy, aberrant motor behaviour, sleep disturbance and appetite/eating disturbance; 'psychosis' factor-delusions and hallucinations; 'hypomania' factor-disinhibition and elation/euphoria. These groups were unchanged when different methods of rotation were used. CONCLUSIONS We report novel observations that agitation/aggression/irritability cluster within a depressive symptom factor and apathy is found within a physical behaviour factor.
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Affiliation(s)
- A Mirakhur
- Department of Geriatric Medicine, Queen's University of Belfast, Belfast, Northern Ireland
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Abstract
The rising number of people with cognitive impairment is placing health care budgets under significant strain. Dementia related behavioural change is a major independent risk factor for admission to expensive institutional care, and aggressive symptoms in particular are poorly tolerated by carers and frequently precipitate the collapse of home coping strategies. Aggressive change may result from known genetic risk factors for Alzheimer's disease (AD) and therefore accompany conventional markers such as apolipoprotein E (ApoE). We tested this hypothesis in 400 moderately to severely affected AD patients who were phenotyped for the presence of aggressive or agitated behaviour during the month prior to interview using the Neuropsychiatric Inventory with Caregiver Distress. The proportion of subjects with aggression/agitation in the month prior to interview was 51.8%. A significantly higher frequency of the e4 allele was found in individuals recording aggression/agitation in the month prior to interview (chi2 = 6.69, df = 2, p = 0.03). The additional risk for aggression/agitation conferred by e4 was also noted when e4 genotypes were compared against non-e4 genotypes (chi2 = 5.45, df = 1, p = 0.02, OR = 1.60, confidence interval (CI) 1.06 to 2.43). These results indicate that advanced Alzheimer's disease patients are at greater risk of aggressive symptoms because of a genetic weakness in apolipoprotein E.
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Affiliation(s)
- D Craig
- Department of Geriatric Medicine, Queen's University of Belfast, Whitla Medical Building, 97 Lisburn Road, Belfast BT9 7BL, UK.
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Kalbe E, Kessler J, Calabrese P, Smith R, Passmore AP, Brand M, Bullock R. DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 2004; 19:136-43. [PMID: 14758579 DOI: 10.1002/gps.1042] [Citation(s) in RCA: 448] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To design a new, highly sensitive psychometric screening to identify patients with mild cognitive impairment (MCI) and patients with dementia in the early stages of the disease. METHODS Five tasks were included in the DemTect: a word list, a number transcoding task, a word fluency task, digit span reverse, and delayed recall of the word list. The normation was performed with 145 healthy control subjects (CG). Furthermore, 97 MCI patients and 121 patients with possible Alzheimer's disease (AD) were tested with the DemTect and the MMSE. Classification rates for both tests were analysed. RESULTS On the basis of the CG data, age-dependant transformation algorithms for the DemTect subtests were defined, and an education correction was provided for the total transformed score. The patient groups scored significantly below the CG in both the DemTect and the MMSE. Compared to the MMSE, classification rates of the DemTect were superior for both the MCI and the AD group, with high sensitivities of 80% and 100%, respectively. CONCLUSIONS The DemTect is short (8-10 minutes), easy to administer, and its transformed total score (maximum 18) is independent of age and education. The DemTect helps in deciding whether cognitive performance is adequate for age (13-18 points), or whether MCI (9-12 points) or dementia (8 points or below) should be suspected.
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Affiliation(s)
- E Kalbe
- Max-Planck-Institute for Neurological Research, Cologne, Germany.
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Abstract
The objective of this study was to assess the effectiveness and tolerability of galantamine in patients with mild-to-moderate Alzheimer's disease (AD) in everyday clinical practice. Patient selection was made on 36 sequential patients attending Belfast City Hospital Memory Clinic between December 2000 and June 2001. Patients were treated with galantamine for 6 months, starting from 4 mg twice daily increasing to 8 mg twice daily and then to 12 mg twice daily at 4-weekly intervals. Patients (25 females, 11 males), mean age 78 years (59-90), were diagnosed with probable AD and had a mini-mental state examination (MMSE) score of 10-26. Efficacy was assessed using the MMSE, neuropsychiatric inventory (NPI), neuropsychiatric inventory caregiver distress (NPI-D) scale and the Bristol activities of daily living (B-ADL) scale at baseline and after 3 and 6 months of treatment. Mean improvements were noted on all four measures of efficacy at 3 and 6 months; improvements were significant on the MMSE, NPI and NPI-D at 3 months and on the NPI-D at 6 months. Galantamine was overall well tolerated. The most common adverse events were gastrointestinal, particularly nausea. Four patients stopped treatment due to adverse events, and seven were stabilised on 8 mg twice daily as they were unable to tolerate the target dose. This naturalistic study confirms clinical trial data, which shows galantamine improves cognition and behavioural symptoms and is overall well tolerated.
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Affiliation(s)
- C E Patterson
- Department of Geriatric Medicine, Whitla Medical Building, Queen's University Belfast, Belfast, UK.
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48
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Hart DJ, Craig D, Compton SA, Critchlow S, Kerrigan BM, McIlroy SP, Passmore AP. A retrospective study of the behavioural and psychological symptoms of mid and late phase Alzheimer's disease. Int J Geriatr Psychiatry 2003; 18:1037-42. [PMID: 14618556 DOI: 10.1002/gps.1013] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AIM To document the behavioural and psychological symptoms in patients with a diagnosis of established Alzheimer's disease (AD) for at least 3 years. METHODS Patients with a > or =3 year history of AD (NINCDS/ADRDA) were recruited from old age psychiatrist and elderly care memory clinics. Information regarding duration of symptoms and non-cognitive symptomatology was obtained during interview with a carer or next-of-kin who had contact with the patient at least 3 times a week and for at least 3 years. MMSE, FAST and NPI including caregiver distress, were used to assess cognition, function and behavioural/psychological disturbance respectively. With each non-cognitive symptom the carer was asked to estimate its onset. RESULTS The mean age of patients was 77 years and duration of illness 87 months. Mean MMSE was 8/30 and FAST score 6d. Of the psychological symptoms occurring at any stage, depression (56%), delusions (55%) and anxiety (52%) were most common, with hallucinations, elation and disinhibition occurring less frequently. In general, behavioural changes were more common with apathy occurring in 88% of patients, motor behaviour in 70%, aggression in 66%, irritability and appetite changes in 60% and sleep disturbance in 54%. All symptoms except apathy became less common when the carer was asked if they were still present in the last month. Mean onset of psychological symptoms was 47 months. Mean onset of behavioural symptoms was 48 months. Behavioural disturbance seemed to cause more care-giver distress than psychological change. CONCLUSION The results show behavioural and psychological symptoms in AD are common and distressing for carers. They appear to require a consistent period of neurodegeneration in order to emerge.
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Affiliation(s)
- D J Hart
- Department of Geriatric Medicine, Queen's University, Belfast, UK
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49
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Wilkinson DG, Passmore AP, Bullock R, Hopker SW, Smith R, Potocnik FCV, Maud CM, Engelbrecht I, Hock C, Ieni JR, Bahra RS. A multinational, randomised, 12-week, comparative study of donepezil and rivastigmine in patients with mild to moderate Alzheimer's disease. Int J Clin Pract 2002; 56:441-6. [PMID: 12166542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
This 12-week, multinational study compared the tolerability and cognitive effects of donepezil (up to 10 mg once daily) and rivastigmine (up to 6 mg twice daily) in 111 patients with mild to moderate Alzheimer's disease. Both medications were administered open label according to recommended dosing regimens from the respective product labelling available during the conduct of the study. More patients in the donepezil group (89.3%) completed the study compared with the rivastigmine group (69.1%; p=0.009), and 10.7% of the donepezil group and 21.8% of the rivastigmine group discontinued due to adverse events (AEs); 87.5% of donepezil-treated patients and 47.3% of rivastigmine-treated patients remained on the maximum approved dose of each drug at the last study visit. Both groups showed comparable improvements on the ADAS-cog administered by raters blind to study medication at weeks 4 and 12. Thus, using the recommended dosing schedules, donepezil was better tolerated with fewer discontinuations due to AEs, and both agents improved cognition to a similar extent.
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Affiliation(s)
- D G Wilkinson
- Memory Assessment and Research Centre, Moorgreen Hospital, Southampton, UK
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50
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Abstract
Few markers distinguish between different dementia types. As dementia affects many body systems outside the central nervous system, we investigated gastrointestinal regulatory peptides as possible disease markers in Alzheimer's Disease (AD) and vascular dementia (VaD). Subjects with mild-to-moderate dementia were diagnosed as probable AD and VaD according to defined criteria. Gastrointestinal peptides were stimulated using a standardized meal test, administered after an overnight fast to 58 dementia patients (40 AD, 18 VaD) and 47 controls matched for age and sex. Blood samples were taken at designated time intervals, and basal and stimulated plasma concentrations of eleven peptides were determined by radio-immunoassay. Results were analysed using the Kruskal-Wallis one-way analysis of variance; the Mann-Whitney U test was used in post hoc analysis where appropriate. There were significant differences in somatostatin levels but in none of the other peptides. Basal somatostatin was significantly increased in VaD compared to controls (p<0.05), and AD (p<0.005). Maximum stimulated levels were significantly elevated in VaD compared to AD (p<0.01). Median basal and stimulated levels of somatostatin were increased in VaD compared to AD, but the overlap in individual values between the groups makes it unlikely to be useful in distinguishing the two types of dementia.
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Affiliation(s)
- C J Foy
- Department of Geriatric Medicine, Queens University of Belfast, UK
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