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Royse SK, Snitz BE, Hill AV, Reese AC, Roush RE, Kamboh MI, Bertolet M, Saeed A, Lopresti BJ, Villemagne VL, Lopez OL, Reis SE, Becker JT, Cohen AD. Apolipoprotein E and Alzheimer's disease pathology in African American older adults. Neurobiol Aging 2024; 139:11-19. [PMID: 38582070 DOI: 10.1016/j.neurobiolaging.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/07/2024] [Accepted: 03/22/2024] [Indexed: 04/08/2024]
Abstract
The apolipoprotein-E4 (APOE*4) and apolipoprotein-E2 (APOE*2) alleles are more common in African American versus non-Hispanic white populations, but relationships of both alleles with Alzheimer's disease (AD) pathology among African American individuals are unclear. We measured APOE allele and β-amyloid (Aβ) and tau using blood samples and positron emission tomography (PET) images, respectively. Individual regression models tested associations of each APOE allele with Aβ or tau PET overall, stratified by racialized group, and with a racialized group interaction. We included 358 older adults (42% African American) with Aβ PET, 134 (29% African American) of whom had tau PET. APOE*4 was associated with higher Aβ in non-Hispanic white (P < 0.0001), but not African American (P = 0.64) participants; racialized group modified the association between APOE*4 and Aβ (P < 0.0001). There were no other racialized group differences. These results suggest that the association of APOE*4 and Aβ differs between African American and non-Hispanic white populations. Other drivers of AD pathology in African American populations should be identified as potential therapeutic targets.
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Affiliation(s)
- Sarah K Royse
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA; University of Pittsburgh Department of Radiology, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
| | - Beth E Snitz
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - Ashley V Hill
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA
| | - Alexandria C Reese
- University of Pittsburgh Department of Radiology, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Rebecca E Roush
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - M Ilyas Kamboh
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA; University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Human Genetics, 130 De Soto Street, Pittsburgh, PA 15213, USA
| | - Marnie Bertolet
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA; University of Pittsburgh Department of Biostatistics, 130 De Soto Street, Pittsburgh, PA 15213, USA
| | - Anum Saeed
- University of Pittsburgh Heart and Vascular Institute, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Brian J Lopresti
- University of Pittsburgh Department of Radiology, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Victor L Villemagne
- University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Oscar L Lopez
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Steven E Reis
- University of Pittsburgh Heart and Vascular Institute, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - James T Becker
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Psychology, 210 South Bouquet Street, Pittsburgh, PA 15260, USA
| | - Ann D Cohen
- University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
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Royse SK, Snitz BE, Hengenius JB, Huppert TJ, Roush RE, Ehrenkranz RE, Wilson JD, Bertolet M, Reese AC, Cisneros G, Potopenko K, Becker JT, Cohen AD, Shaaban CE. Unhealthy white matter connectivity, cognition, and racialization in older adults. Alzheimers Dement 2024; 20:1483-1496. [PMID: 37828730 PMCID: PMC10947965 DOI: 10.1002/alz.13494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION White matter hyperintensities (WMH) may promote clinical Alzheimer's disease (AD) disparities between Black American (BA) and non-Hispanic White (nHW) populations. Using a novel measurement, unhealthy white matter connectivity (UWMC), we interrogated racialized group differences in associations between WMH in AD pathology-affected regions and cognition. METHODS UWMC is the proportion of white matter fibers that pass through WMH for every pair of brain regions. Individual regression models tested associations of UWMC in beta-amyloid (Aβ) or tau pathology-affected regions with cognition overall, stratified by racialized group, and with a racialized group interaction. RESULTS In 201 older adults ranging from cognitively unimpaired to AD, BA participants exhibited greater UWMC and worse cognition than nHW participants. UWMC was negatively associated with cognition in 17 and 5 Aβ- and tau-affected regions, respectively. Racialization did not modify these relationships. DISCUSSION Differential UWMC burden, not differential UWMC-and-cognition associations, may drive clinical AD disparities between racialized groups. HIGHLIGHTS Unhealthy white matter connectivity (UWMC) in Alzheimer's disease (AD) pathology-affected brain regions is associated with cognition. Relationships between UWMC and cognition are similar between Black American (BA) and non-Hispanic White (nHW) individuals. More UWMC may partially drive higher clinical AD burden in BA versus nHW populations. UWMC risk factors, particularly social and environmental, should be identified.
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Affiliation(s)
- Sarah K. Royse
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Beth E. Snitz
- Department of NeurologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - James B. Hengenius
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Theodore J. Huppert
- Department of Electrical EngineeringUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Rebecca E. Roush
- Department of NeurologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - James D. Wilson
- Department of Mathematics and StatisticsUniversity of San FranciscoSan FranciscoCaliforniaUSA
| | - Marnie Bertolet
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of BiostatisticsUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Geraldine Cisneros
- Department of PsychologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Katey Potopenko
- Department of PsychologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - James T. Becker
- Department of NeurologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of BiostatisticsUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Ann D. Cohen
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
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Rajabli F, Benchek P, Tosto G, Kushch N, Sha J, Bazemore K, Zhu C, Lee WP, Haut J, Hamilton-Nelson KL, Wheeler NR, Zhao Y, Farrell JJ, Grunin MA, Leung YY, Kuksa PP, Li D, Lucio da Fonseca E, Mez JB, Palmer EL, Pillai J, Sherva RM, Song YE, Zhang X, Iqbal T, Pathak O, Valladares O, Kuzma AB, Abner E, Adams PM, Aguirre A, Albert MS, Albin RL, Allen M, Alvarez L, Apostolova LG, Arnold SE, Asthana S, Atwood CS, Ayres G, Baldwin CT, Barber RC, Barnes LL, Barral S, Beach TG, Becker JT, Beecham GW, Beekly D, Benitez BA, Bennett D, Bertelson J, Bird TD, Blacker D, Boeve BF, Bowen JD, Boxer A, Brewer J, Burke JR, Burns JM, Buxbaum JD, Cairns NJ, Cantwell LB, Cao C, Carlson CS, Carlsson CM, Carney RM, Carrasquillo MM, Chasse S, Chesselet MF, Chin NA, Chui HC, Chung J, Craft S, Crane PK, Cribbs DH, Crocco EA, Cruchaga C, Cuccaro ML, Cullum M, Darby E, Davis B, De Jager PL, DeCarli C, DeToledo J, Dick M, Dickson DW, Dombroski BA, Doody RS, Duara R, Ertekin-Taner NI, Evans DA, Faber KM, Fairchild TJ, Fallon KB, Fardo DW, Farlow MR, Fernandez-Hernandez V, Ferris S, Foroud TM, Frosch MP, Fulton-Howard B, Galasko DR, Gamboa A, Gearing M, Geschwind DH, Ghetti B, Gilbert JR, Goate AM, Grabowski TJ, Graff-Radford NR, Green RC, Growdon JH, Hakonarson H, Hall J, Hamilton RL, Harari O, Hardy J, Harrell LE, Head E, Henderson VW, Hernandez M, Hohman T, Honig LS, Huebinger RM, Huentelman MJ, Hulette CM, Hyman BT, Hynan LS, Ibanez L, Jarvik GP, Jayadev S, Jin LW, Johnson K, Johnson L, Kamboh MI, Karydas AM, Katz MJ, Kauwe JS, Kaye JA, Keene CD, Khaleeq A, Kim R, Knebl J, Kowall NW, Kramer JH, Kukull WA, LaFerla FM, Lah JJ, Larson EB, Lerner A, Leverenz JB, Levey AI, Lieberman AP, Lipton RB, Logue M, Lopez OL, Lunetta KL, Lyketsos CG, Mains D, Margaret FE, Marson DC, Martin ERR, Martiniuk F, Mash DC, Masliah E, Massman P, Masurkar A, McCormick WC, McCurry SM, McDavid AN, McDonough S, McKee AC, Mesulam M, Miller BL, Miller CA, Miller JW, Montine TJ, Monuki ES, Morris JC, Mukherjee S, Myers AJ, Nguyen T, O'Bryant S, Olichney JM, Ory M, Palmer R, Parisi JE, Paulson HL, Pavlik V, Paydarfar D, Perez V, Peskind E, Petersen RC, Pierce A, Polk M, Poon WW, Potter H, Qu L, Quiceno M, Quinn JF, Raj A, Raskind M, Reiman EM, Reisberg B, Reisch JS, Ringman JM, Roberson ED, Rodriguear M, Rogaeva E, Rosen HJ, Rosenberg RN, Royall DR, Sager MA, Sano M, Saykin AJ, Schneider JA, Schneider LS, Seeley WW, Slifer SH, Small S, Smith AG, Smith JP, Sonnen JA, Spina S, St George-Hyslop P, Stern RA, Stevens AB, Strittmatter SM, Sultzer D, Swerdlow RH, Tanzi RE, Tilson JL, Trojanowski JQ, Troncoso JC, Tsuang DW, Van Deerlin VM, van Eldik LJ, Vance JM, Vardarajan BN, Vassar R, Vinters HV, Vonsattel JP, Weintraub S, Welsh-Bohmer KA, Whitehead PL, Wijsman EM, Wilhelmsen KC, Williams B, Williamson J, Wilms H, Wingo TS, Wisniewski T, Woltjer RL, Woon M, Wright CB, Wu CK, Younkin SG, Yu CE, Yu L, Zhu X, Kunkle BW, Bush WS, Wang LS, Farrer LA, Haines JL, Mayeux R, Pericak-Vance MA, Schellenberg GD, Jun GR, Reitz C, Naj AC. Multi-ancestry genome-wide meta-analysis of 56,241 individuals identifies LRRC4C, LHX5-AS1 and nominates ancestry-specific loci PTPRK , GRB14 , and KIAA0825 as novel risk loci for Alzheimer's disease: the Alzheimer's Disease Genetics Consortium. medRxiv 2023:2023.07.06.23292311. [PMID: 37461624 PMCID: PMC10350126 DOI: 10.1101/2023.07.06.23292311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Limited ancestral diversity has impaired our ability to detect risk variants more prevalent in non-European ancestry groups in genome-wide association studies (GWAS). We constructed and analyzed a multi-ancestry GWAS dataset in the Alzheimer's Disease (AD) Genetics Consortium (ADGC) to test for novel shared and ancestry-specific AD susceptibility loci and evaluate underlying genetic architecture in 37,382 non-Hispanic White (NHW), 6,728 African American, 8,899 Hispanic (HIS), and 3,232 East Asian individuals, performing within-ancestry fixed-effects meta-analysis followed by a cross-ancestry random-effects meta-analysis. We identified 13 loci with cross-ancestry associations including known loci at/near CR1 , BIN1 , TREM2 , CD2AP , PTK2B , CLU , SHARPIN , MS4A6A , PICALM , ABCA7 , APOE and two novel loci not previously reported at 11p12 ( LRRC4C ) and 12q24.13 ( LHX5-AS1 ). Reflecting the power of diverse ancestry in GWAS, we observed the SHARPIN locus using 7.1% the sample size of the original discovering single-ancestry GWAS (n=788,989). We additionally identified three GWS ancestry-specific loci at/near ( PTPRK ( P =2.4×10 -8 ) and GRB14 ( P =1.7×10 -8 ) in HIS), and KIAA0825 ( P =2.9×10 -8 in NHW). Pathway analysis implicated multiple amyloid regulation pathways (strongest with P adjusted =1.6×10 -4 ) and the classical complement pathway ( P adjusted =1.3×10 -3 ). Genes at/near our novel loci have known roles in neuronal development ( LRRC4C, LHX5-AS1 , and PTPRK ) and insulin receptor activity regulation ( GRB14 ). These findings provide compelling support for using traditionally-underrepresented populations for gene discovery, even with smaller sample sizes.
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Zhou TD, Zhang Z, Balachandrasekaran A, Raji CA, Becker JT, Kuller LH, Ge Y, Lopez OL, Dai W, Gach HM. Prospective Longitudinal Perfusion in Probable Alzheimer's Disease Correlated with Atrophy in Temporal Lobe. Aging Dis 2023:AD.2023.0430. [PMID: 37196135 DOI: 10.14336/ad.2023.0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/30/2023] [Indexed: 05/19/2023] Open
Abstract
Reduced cerebral blood flow (CBF) in the temporoparietal region and gray matter volumes (GMVs) in the temporal lobe were previously reported in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, the temporal relationship between reductions in CBF and GMVs requires further investigation. This study sought to determine if reduced CBF is associated with reduced GMVs, or vice versa. Data came from 148 volunteers of the Cardiovascular Health Study Cognition Study (CHS-CS), including 58 normal controls (NC), 50 MCI, and 40 AD who had perfusion and structural MRIs during 2002-2003 (Time 2). Sixty-three of the 148 volunteers had follow-up perfusion and structural MRIs (Time 3). Forty out of the 63 volunteers received prior structural MRIs during 1997-1999 (Time 1). The relationships between GMVs and subsequent CBF changes, and between CBF and subsequent GMV changes were investigated. At Time 2, we observed smaller GMVs (p<0.05) in the temporal pole region in AD compared to NC and MCI. We also found associations between: (1) temporal pole GMVs at Time 2 and subsequent declines in CBF in this region (p=0.0014) and in the temporoparietal region (p=0.0032); (2) hippocampal GMVs at Time 2 and subsequent declines in CBF in the temporoparietal region (p=0.012); and (3) temporal pole CBF at Time 2 and subsequent changes in GMV in this region (p = 0.011). Therefore, hypoperfusion in the temporal pole may be an early event driving its atrophy. Perfusion declines in the temporoparietal and temporal pole follow atrophy in this temporal pole region.
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Affiliation(s)
- Tony D Zhou
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Zongpai Zhang
- Computer Science, State University of New York at Binghamton, Binghamton, NY 13902, USA
| | | | - Cyrus A Raji
- Departments of Radiology and Neurology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - James T Becker
- Departments of Psychiatry, Psychology, and Neurology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Yulin Ge
- Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Oscar L Lopez
- Departments of Neurology and Psychiatry, University of Pittsburgh, PA 15260, USA
| | - Weiying Dai
- Computer Science, State University of New York at Binghamton, Binghamton, NY 13902, USA
| | - H Michael Gach
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO 63110, USA
- Departments of Radiology and Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63110, USA
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Sudre G, Bagić AI, Becker JT, Ford JP. An Emerging Screening Method for Interrogating Human Brain Function: Tutorial. JMIR Form Res 2023; 7:e37269. [PMID: 37103988 PMCID: PMC10176126 DOI: 10.2196/37269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/28/2023] Open
Abstract
Cognitive decline can be observed due to a myriad of causes. Clinicians would benefit from a noninvasive quantitative tool to screen and monitor brain function based on direct measures of neural features. In this study, we used neuroimaging data from magnetoencephalography (with a whole-head Elekta Neuromag 306 sensor system) to derive a set of features that strongly correlate with brain function. We propose that simple signal characteristics related to peak variability, timing, and abundance can be used by clinicians as a screening tool to investigate cognitive function in at-risk individuals. Using a minimalistic set of features, we were able to perfectly distinguish between participants with normative and nonnormative brain function, and we were also able to successfully predict participants' Mini-Mental Test score (r=0.99; P<.001; mean absolute error=0.413). This set of features can be easily visualized in an analog fashion, providing clinicians with several graded measurements (in comparison to a single binary diagnostic tool) that can be used for screening and monitoring cognitive decline.
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Affiliation(s)
| | - Anto I Bagić
- University of Pittsburgh Comprehensive Epilepsy Center, Department of Neurology, Pittsburgh, PA, United States
| | - James T Becker
- Departments of Psychiatry, Neurology, and Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - John P Ford
- Brain FIT Imaging, LLC, Unadilla, NY, United States
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Wang Z, Wang Z, Lyu L, Cheng Y, Seaberg EC, Molsberry SA, Ragin A, Becker JT. Dynamic impairment classification through arrayed comparisons. Stat Med 2023; 42:52-67. [PMID: 36318895 PMCID: PMC9798442 DOI: 10.1002/sim.9601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 08/17/2022] [Accepted: 10/19/2022] [Indexed: 12/24/2022]
Abstract
The multivariate normative comparison (MNC) method has been used for identifying cognitive impairment. When participants' cognitive brain domains are evaluated regularly, the longitudinal MNC (LMNC) has been introduced to correct for the intercorrelation among repeated assessments of multiple cognitive domains in the same participant. However, it may not be practical to wait until the end of study for diagnosis. For example, in participants of the Multicenter AIDS Cohort Study (MACS), cognitive functioning has been evaluated repeatedly for more than 35 years. Therefore, it is optimal to identify cognitive impairment at each assessment, while the family-wise error rate (FWER) is controlled with unknown number of assessments in future. In this work, we propose to use the difference of consecutive LMNC test statistics to construct independent tests. Frequency modeling can help predict how many assessments each participant will have, so Bonferroni-type correction can be easily adapted. A chi-squared test is used under the assumption of multivariate normality, and permutation test is proposed where this assumption is violated. We showed through simulation and the MACS data that our method controlled FWER below a predetermined level.
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Affiliation(s)
- Zheng Wang
- Department of Statistics, University of Pittsburgh, PA, USA
| | - Zi Wang
- Department of Statistics, University of Pittsburgh, PA, USA
| | - Lingyun Lyu
- Department of Biostatistics, University of Pittsburgh, PA, USA
| | - Yu Cheng
- Department of Statistics, University of Pittsburgh, PA, USA
- Department of Biostatistics, University of Pittsburgh, PA, USA
| | - Eric C. Seaberg
- Department of Epidemiology, Johns Hopkins University, MD, USA
| | | | - Ann Ragin
- Department of Radiology, Northwestern University, IL, USA
| | - James T. Becker
- Departments of Psychiatry, Neurology, and Psychology, University of Pittsburgh, PA, USA
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Bruña R, López-Sanz D, Maestú F, Cohen AD, Bagic A, Huppert T, Kim T, Roush RE, Snitz B, Becker JT. MEG Oscillatory Slowing in Cognitive Impairment is Associated with the Presence of Subjective Cognitive Decline. Clin EEG Neurosci 2023; 54:73-81. [PMID: 35188831 PMCID: PMC9392809 DOI: 10.1177/15500594221072708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The mechanisms behind Alzheimer's disease are not yet fully described, and changes in the electrophysiology of patients across the continuum of the disease could help to understand them. In this work, we study the power spectral distribution of a set of 129 individuals from the Connectomics of Brian Aging and Dementia project.From this sample, we acquired task-free data, with eyes closed, and estimated the power spectral distribution in source space. We compared the spectral profiles of three groups of individuals: 70 healthy controls, 27 patients with amnestic MCI, and 32 individuals showing cognitive impairment without subjective complaints (IWOC).The results showed a slowing of the brain activity in the aMCI patients, when compared to both the healthy controls and the IWOC individuals. These differences appeared both as a decrease in power for high frequency oscillations and an increase in power in alpha oscillations. The slowing of the spectrum was significant mainly in parietal and medial frontal areas.We were able to validate the slowing of the brain activity in individuals with aMCI, appearing in our sample in areas related to the default mode network. However, this pattern did not appear in the IWOC individuals, suggesting that their condition is not part of the AD continuum. This work raises interesting questions about this group of individuals, and the underlying brain mechanisms behind their cognitive impairment.
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Affiliation(s)
- Ricardo Bruña
- Electrical Engineering, Universidad de La Laguna, La Laguna, Tenerife, Spain
- Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Madrid, Spain
| | - David López-Sanz
- Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Madrid, Spain
- Psicobiología y Metodología en Ciencias del Comportamiento, Universidad Complutense de Madrid, Madrid, Madrid, Spain
| | - Fernando Maestú
- Experimental Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Madrid, Spain
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Madrid, Spain
| | - Ann D. Cohen
- Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anto Bagic
- Neurology, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
| | - Ted Huppert
- Electrical Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tae Kim
- Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rebecca E. Roush
- Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Betz Snitz
- Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James T. Becker
- Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Anderson AM, Bhondoekhan F, Curanovic D, Connelly MA, Otvos JD, Post WS, Michos ED, Stosor V, Levine A, Seaberg E, Weinstein AM, Becker JT. Higher Soluble CD163 in Blood Is Associated With Significant Depression Symptoms in Men With HIV. J Acquir Immune Defic Syndr 2022; 91:325-333. [PMID: 35969468 PMCID: PMC9588493 DOI: 10.1097/qai.0000000000003063] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/31/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND People with HIV (PWH) are more likely to experience depression, a highly morbid disease. More evidence is needed to better understand mechanisms of depression in PWH. We evaluated a panel of blood biomarkers in relation to depression symptoms in the Multicenter AIDS Cohort Study (MACS). SETTING Four sites in the United States. METHODS A cross-sectional analysis was performed within the MACS, a prospective study of cisgender men with and without HIV. Depression was assessed with the Center for Epidemiological Studies-Depression Scale, and six blood biomarkers were measured: GlycA, high sensitivity C-reactive protein (CRP), interleukin-6, CCL2, soluble CD14 (sCD14), and soluble CD163 (sCD163). Using univariable and multivariable logistic regression, the biomarkers and other factors were evaluated in relation to significant depression symptoms (SDS) by Center for Epidemiological Studies-Depression score ≥16. RESULTS 784 men were analyzed; most of whom (63%) were PWH. PWH were more likely to have SDS (32% vs. 21%). In univariable analysis, higher GlycA, CRP, and sCD163 concentrations were associated with SDS. In multivariable analysis, however, only higher sCD163 concentration was associated with SDS (odds ratio = 2.30, 95% CI = 1.11 to 4.76). This relationship was driven by the PWH group (odds ratio = 2.72, 95% CI = 1.12 to 6.58) and remained significant when controlling for antidepressant use. Lack of college education was also associated with SDS. CONCLUSIONS Higher sCD163, a marker of macrophage activation, was significantly associated with significant depression symptoms in the MACS. Further research on this biomarker and macrophage activation in general is warranted to better understand and treat depression in PWH.
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Affiliation(s)
- Albert M Anderson
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Druid Hills, GA
| | - Fiona Bhondoekhan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | | | | | - Wendy S Post
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Valentina Stosor
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Andrew Levine
- Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA; and
| | - Eric Seaberg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Andrea M Weinstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Duan W, Sehrawat P, Zhou TD, Becker JT, Lopez OL, Gach HM, Dai W. Pattern of Altered Magnetization Transfer Rate in Alzheimer's Disease. J Alzheimers Dis 2022; 88:693-705. [PMID: 35694929 DOI: 10.3233/jad-220335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Biomarkers for Alzheimer's disease (AD) are crucial for early diagnosis and treatment monitoring once disease modifying therapies become available. OBJECTIVE This study aims to quantify the forward magnetization transfer rate (kfor) map from brain tissue water to macromolecular protons and use it to identify the brain regions with abnormal kfor in AD and AD progression. METHODS From the Cardiovascular Health Study (CHS) cognition study, magnetization transfer imaging (MTI) was acquired at baseline from 63 participants, including 20 normal controls (NC), 18 with mild cognitive impairment (MCI), and 25 AD subjects. Of those, 53 participants completed a follow-up MRI scan and were divided into four groups: 15 stable NC, 12 NC-to-MCI, 12 stable MCI, and 14 MCI/AD-to-AD subjects. kfor maps were compared across NC, MCI, and AD groups at baseline for the cross-sectional study and across four longitudinal groups for the longitudinal study. RESULTS We found a lower kfor in the frontal gray matter (GM), parietal GM, frontal corona radiata (CR) white matter (WM) tracts, frontal and parietal superior longitudinal fasciculus (SLF) WM tracts in AD relative to both NC and MCI. Further, we observed progressive decreases of kfor in the frontal GM, parietal GM, frontal and parietal CR WM tracts, and parietal SLF WM tracts in stable MCI. In the parietal GM, parietal CR WM tracts, and parietal SLF WM tracts, we found trend differences between MCI/AD-to-AD and stable NC. CONCLUSION Forward magnetization transfer rate is a promising biomarker for AD diagnosis and progression.
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Affiliation(s)
- Wenna Duan
- Department of Computer Science, State of New Yorkat Binghamton, Binghamton, NY, USA
| | - Parshant Sehrawat
- Department of Computer Science, State of New Yorkat Binghamton, Binghamton, NY, USA
| | - Tony D Zhou
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, Washington University, Saint Louis, MO, USA
| | - James T Becker
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychiatry and Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Oscar L Lopez
- Department of Psychiatry and Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - H Michael Gach
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, Washington University, Saint Louis, MO, USA
| | - Weiying Dai
- Department of Computer Science, State of New Yorkat Binghamton, Binghamton, NY, USA
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10
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Dorris JL, DiCicco H, Becker JT, Rodakowski J. Developing a digital music program for older adults with changing cognition: A program development report. Music Med 2022; 14:97-101. [PMID: 35967736 PMCID: PMC9371460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This program development report describes the adaptation of a music program for older adults with memory loss from in-person to a digital format. The objective was to develop a music program that was both engaging for the older adults, acceptable for the music instructor, and clearly defined for future research and implementation. This report describes the content of the music program and the systematic process of its development.
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Affiliation(s)
- Jennie L Dorris
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences. University of Pittsburgh. Bridgeside Point I 100 Technology Drive, Suite 350 Pittsburgh, PA 15219
| | - Heather DiCicco
- BriTE Wellness, Inc., 201 South Highland Ave, Suite 101. Pittsburgh, PA 15206
| | - James T Becker
- Psychiatry, Neurology, and Psychology at the University of Pittsburgh. BriTE Wellness, Inc., 201 South Highland Ave, Suite 101. Pittsburgh, PA 15206
| | - Juleen Rodakowski
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences. University of Pittsburgh. Bridgeside Point I 100 Technology Drive, Suite 350 Pittsburgh, PA 15219
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11
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Kim T, Aizenstein HJ, Snitz BE, Cheng Y, Chang YF, Roush RE, Huppert TJ, Cohen A, Doman J, Becker JT. Tract Specific White Matter Lesion Load Affects White Matter Microstructure and Their Relationships With Functional Connectivity and Cognitive Decline. Front Aging Neurosci 2022; 13:760663. [PMID: 35185514 PMCID: PMC8848259 DOI: 10.3389/fnagi.2021.760663] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/27/2021] [Indexed: 11/24/2022] Open
Abstract
White matter hyperintensities (WMHs) are associated with cognitive decline. Assessing the effect of WMH on WM microstructural changes and its relationships with structural and functional connectivity to multiple cognitive domains are helpful to better understand the pathophysiological processes of cognitive impairment. 65 participants (49 normal and 16 MCI subjects, age: 67.4 ± 8.3 years, 44 females) were studied at 3T. The WMHs and fifty fiber tracts were automatically segmented from the T1/T2-weighted images and diffusion-weighted images, respectively. Tract-profiles of WMH were compared with those of apparent fiber density (AFD). The relationship between AFD and tract connectivity (TC) was assessed. Functional connectivity (FC) between tract ends obtained from resting-state functional MRI was examined in relation to TC. Tract-specific relationships of WMH, TC and FC with a multi-domain neuropsychological test battery and Montreal Cognitive Assessment (MoCA) were also separately assessed by lasso linear regression. Indirect pathways of TC and FC between WMH and multiple cognitive measures were tested using the mediation analysis. Higher WMH loads in WM tracts were locally matched with the reduced AFD, which was related to decrease in TC. However, no direct relationship was found between TC and FC. Tract-specific changes on WMH, TC and FC for each cognitive performance may explain that macro- and microstructural and functional changes are associated differently with each cognitive domain in a fiber specific manner. In these identified tracts, the differences between normal and MCI for WMH and TC were increased, and the relationships of WMH, TC and FC with cognitive outcomes were more significant, compared to the results from all tracts. Indirect pathways of two-step (TC-FC) between WMH and all cognitive domains were significant (p < 0.0083 with Bonferroni correction), while the separated indirect pathways through TC and through FC were different depending on cognitive domain. Deterioration in specific cognitive domains may be affected by alterations in a set of different tracts that are differently associated with macrostructural, microstructural, and function changes. Thus, assessments of WMH and its associated changes on specific tracts help for better understanding of the interrelationships of multiple changes in cognitive impairment.
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Affiliation(s)
- Tae Kim
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- *Correspondence: Tae Kim,
| | - Howard J. Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Beth E. Snitz
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yu Cheng
- Departments of Statistics and Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yue-Fang Chang
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Rebecca E. Roush
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Theodore J. Huppert
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Deparement of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Annie Cohen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jack Doman
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - James T. Becker
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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12
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Qu Y, Weinstein A, Wang Z, Cheng Y, Kingsley L, Levine A, Martin E, Munro C, Ragin AB, Rubin LH, Sacktor NW, Seaberg EC, Becker JT. Legacy effect on neuropsychological function in HIV-infected men on combination antiretroviral therapy. AIDS 2022; 36:19-27. [PMID: 34524146 PMCID: PMC8665003 DOI: 10.1097/qad.0000000000003071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To determine whether combination antiretroviral therapy (cART) initiation alters the trajectory of cognitive performance in HIV+ men, and whether cognition prior to cART predicts postcART function. DESIGN Longitudinal cohort study. Multicenter AIDS Cohort Study. METHODS From an initial set of 3701 men with complete neuropsychological data, men with HIV infection were initially matched with men without infection on cognitive status, race, age, and timeline (T0 defined as cART initiation). Propensity score matching was then used to match pairs on depressive symptoms at T0, education, T0 cognitive scores, and recruitment cohort. There were 506 matched pairs of infected and uninfected men in the final analysis. Mixed effect models were constructed to analyze the trajectories of cognitive functions and to test the effect of cART and HIV on cognitive functions over time. RESULTS Performance in each cognitive domain did not change following the initiation of cART among HIV-infected men with prior impairment and was comparable to the performance of their matched uninfected men. However, among the infected men who were unimpaired prior to cART, motor function declined significantly faster than it did for uninfected controls. CONCLUSIONS Cognitive dysfunction is persistent in HIV-infected men and cART does not alter the trajectory of cognitive decline in men who were impaired prior to effective therapy. This suggests that current cognitive impairment in HIV+ men results from a legacy effect, and from factors other than the HIV itself. Furthermore, motor skills may be uniquely vulnerable to the virus, cART, or age-related co-morbidities.
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Affiliation(s)
- Yang Qu
- Department of Statistics, University of Pittsburgh
| | | | - Zheng Wang
- Department of Biostatistics, University of Pittsburgh
| | - Yu Cheng
- Department of Statistics, University of Pittsburgh
- Department of Biostatistics, University of Pittsburgh
| | - Lawrence Kingsley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh
| | - Andrew Levine
- Department of Neurology, David Geffen School of Medicine, UCLA
| | - Eileen Martin
- Department of Psychiatry, Rush University School of Medicine
| | - Cynthia Munro
- Department of Psychiatry, The Johns Hopkins University School of Medicine
| | - Ann B. Ragin
- Department of Radiology, Northwestern University
| | - Leah H. Rubin
- Department of Psychiatry, The Johns Hopkins University School of Medicine
- Department of Neurology, The Johns Hopkins University School of Medicine
- Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University
| | - Ned W. Sacktor
- Department of Neurology, The Johns Hopkins University School of Medicine
| | - Eric C. Seaberg
- Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University
| | - James T. Becker
- Department of Psychiatry, University of Pittsburgh
- Department of Neurology, University of Pittsburgh
- Department of Psychology University of Pittsburgh
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13
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Anderson AM, Bhondoekhan F, Curanovic D, Connelly MA, Otvos JD, Post WS, Michos ED, Lahiri C, Wolinsky S, Levine A, Seaberg EC, Rubin LH, Vance DE, Becker JT. GlycA is associated with neuropsychological impairment in men with HIV. AIDS 2022; 36:156-159. [PMID: 34873097 PMCID: PMC8667277 DOI: 10.1097/qad.0000000000003094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Albert M Anderson
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia
| | | | - Dusica Curanovic
- Laboratory Corporation of America Holdings (Labcorp), Morrisville, North Carolina
| | - Margery A Connelly
- Laboratory Corporation of America Holdings (Labcorp), Morrisville, North Carolina
| | - James D Otvos
- Laboratory Corporation of America Holdings (Labcorp), Morrisville, North Carolina
| | - Wendy S Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Erin D Michos
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Cecile Lahiri
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia
| | | | - Andrew Levine
- David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California
| | | | | | - David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama
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14
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Bruña R, Maestú F, López-Sanz D, Bagic A, Cohen AD, Chang YF, Cheng Y, Doman J, Huppert T, Kim T, Roush RE, Snitz BE, Becker JT. Sex Differences in Magnetoencephalography-Identified Functional Connectivity in the Human Connectome Project Connectomics of Brain Aging and Dementia Cohort. Brain Connect 2021; 12:561-570. [PMID: 34726478 PMCID: PMC9419974 DOI: 10.1089/brain.2021.0059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: The human brain shows modest traits of sexual dimorphism, with the female brain, on average, 10% smaller than the male brain. These differences do not imply a lowered cognitive performance, but suggest a more optimal brain organization in women. Here we evaluate the patterns of functional connectivity (FC) in women and men from the Connectomics of Brain Aging and Dementia sample. Methods: We used phase locking values to calculate FC from the magnetoencephalography time series in a sample of 138 old adults (87 females and 51 males). We compared the FC patterns between sexes, with the intention of detecting regions with different levels of connectivity. Results: We found a frontal cluster, involving anterior cingulate and the medial frontal lobe, where women showed higher FC values than men. Involved connections included the following: (1) medial parietal areas, such as posterior cingulate cortices and precunei; (2) right insula; and (3) medium cingulate and paracingulate cortices. Moreover, these differences persisted when considering only cognitively intact individuals, but not when considering only cognitively impaired individuals. Discussion: Increased anteroposterior FC has been identified as a biomarker for increased risk of developing cognitive impairment or dementia. In our study, cognitively intact women showed higher levels of FC than their male counterparts. This result suggests that neurodegenerative processes could be taking place in these women, but the changes are undetected by current diagnosis tools. FC, as measured here, might be valuable for early identification of this neurodegeneration.
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Affiliation(s)
- Ricardo Bruña
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain.,Department of Experimental Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Madrid, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Fernando Maestú
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain.,Department of Experimental Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Madrid, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - David López-Sanz
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain.,Department of Psychobiology, Universidad Complutense de Madrid, Madrid, Spain
| | - Anto Bagic
- Department of Psychiatry, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Statistics, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ann D Cohen
- Department of Neurosurgery, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yue-Fang Chang
- Department of Neurosurgery, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yu Cheng
- Department of Statistics, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Biostatistics, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jack Doman
- Department of Neurosurgery, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ted Huppert
- Department of Electrical Engineering, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tae Kim
- Department of Radiology, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rebecca E Roush
- Department of Psychiatry, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Beth E Snitz
- Department of Psychiatry, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James T Becker
- Department of Psychiatry, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Neurology, and The University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Psychology, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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15
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Cohen AD, Bruña R, Chang YF, Cheng Y, Doman J, Huppert T, Kim T, Maestu F, Roush RE, Snitz BE, Becker JT. Connectomics in Brain Aging and Dementia - The Background and Design of a Study of a Connectome Related to Human Disease. Front Aging Neurosci 2021; 13:669490. [PMID: 34690734 PMCID: PMC8530182 DOI: 10.3389/fnagi.2021.669490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/18/2021] [Accepted: 09/06/2021] [Indexed: 11/20/2022] Open
Abstract
The natural history of Alzheimer’s Disease (AD) includes significant alterations in the human connectome, and this disconnection results in the dementia of AD. The organizing principle of our research project is the idea that the expression of cognitive dysfunction in the elderly is the result of two independent processes — the neuropathology associated with AD, and second the neuropathological changes of cerebrovascular disease. Synaptic loss, senile plaques, and neurofibrillary tangles are the functional and diagnostic hallmarks of AD, but it is the structural changes as a consequence of vascular disease that reduce brain reserve and compensation, resulting in an earlier expression of the clinical dementia syndrome. This work is being completed under the auspices of the Human Connectome Project (HCP). We have achieved an equal representation of Black individuals (vs. White individuals) and enrolled 60% Women. Each of the participants contributes demographic, behavioral and laboratory data. We acquire data relative to vascular risk, and the participants also undergo in vivo amyloid imaging, and magnetoencephalography (MEG). All of the data are publicly available under the HCP guidelines using the Connectome Coordinating Facility and the NIMH Data Archive. Locally, we use these data to address specific questions related to structure, function, AD, aging and vascular disease in multi-modality studies leveraging the differential advantages of magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), MEG, and in vivo beta amyloid imaging.
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Affiliation(s)
- Ann D Cohen
- Department of Psychiatry, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Ricardo Bruña
- Department of Experimental Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Madrid, Spain
| | - Yue-Fang Chang
- Department of Neurosurgery, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Yu Cheng
- Department of Statistics, The University of Pittsburgh, Pittsburgh, PA, United States.,Department of Biostatistics, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Jack Doman
- Department of Psychiatry, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Ted Huppert
- Department of Electrical Engineering, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Tae Kim
- Department of Radiology, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Fernando Maestu
- Department of Experimental Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Madrid, Spain
| | - Rebecca E Roush
- Department of Neurology, The University of Pittsburgh, Pittsburgh, PA, United States
| | - Beth E Snitz
- Department of Neurology, The University of Pittsburgh, Pittsburgh, PA, United States
| | - James T Becker
- Department of Psychiatry, The University of Pittsburgh, Pittsburgh, PA, United States.,Department of Neurology, The University of Pittsburgh, Pittsburgh, PA, United States.,Department of Psychology, The University of Pittsburgh, Pittsburgh, PA, United States
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16
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O’Connor EE, Zeffiro TA, Lopez OL, Becker JT. Differential Effects of AIDS and Chronic Human Immunodeficiency Virus Infection on Gray Matter Volume. Clin Infect Dis 2021; 73:e2303-e2310. [PMID: 33053187 PMCID: PMC8492157 DOI: 10.1093/cid/ciaa1552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Age, human immunodeficiency virus (HIV) infection, illicit drug use, and central nervous system (CNS) opportunistic infections can affect brain structure, with the striatum being particularly sensitive to HIV effects. Nevertheless, the impact of non-CNS AIDS-defining illness (ADI) on brain structure has been less investigated. We examined ADI and HIV effects on brain volume. METHODS In a cross-sectional study, including 95 virally suppressed seropositive and 84 demographically matched, seronegative participants, we examined serostatus and ADI effects. Cortical and subcortical gray matter volume (GMV) regions of interest were estimated with computational neuroanatomy techniques applied to high-resolution, T1-weighted magnetic resonance imaging data. Linear regression was used to model HIV serostatus and ADI effects on global and regional GMV, adjusting for age, sex, CD4 nadir, drug use, and total intracranial volume. RESULTS While HIV serostatus was associated with lower striatal volume (B = -.59 [95% confidence interval {CI}, -1.08 to -.10]), co-occurring ADI was independently associated with lower striatal volume (B = -.73 [95% CI, -1.36 to -.09]). ADI was also associated with lower global (B = -19.35 [95% CI, -32.42 to -6.29]) and regional GMV. CONCLUSIONS While HIV infection is associated with a localized effect on striatal structure, having a prior ADI is a strong predictor of smaller global and regional GMV. The lack of interaction between HIV serostatus or ADI with age suggests that chronic HIV infection and ADI have independent effects on brain structure, without associated accelerated lower volume with age. ADI history should be incorporated into statistical adjustments in HIV neuroimaging analysis. These findings also lend support to current HIV treatment guidelines urging prompt antiretroviral therapy initiation after HIV diagnosis.
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Affiliation(s)
- Erin E O’Connor
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Thomas A Zeffiro
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - James T Becker
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Psychology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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17
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Vance DE, Becker JT. Using HIV neuropsychological classification methods to predict employment status. AIDS 2021; 35:1859-1861. [PMID: 34397484 PMCID: PMC8371715 DOI: 10.1097/qad.0000000000002946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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18
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Duan W, Sehrawat P, Balachandrasekaran A, Bhumkar AB, Boraste PB, Becker JT, Kuller LH, Lopez OL, Gach HM, Dai W. Cerebral Blood Flow Is Associated with Diagnostic Class and Cognitive Decline in Alzheimer's Disease. J Alzheimers Dis 2021; 76:1103-1120. [PMID: 32597803 DOI: 10.3233/jad-200034] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Reliable cerebral blood flow (CBF) biomarkers using a noninvasive imaging technique are sought to facilitate early diagnosis and intervention in early Alzheimer's disease (AD). OBJECTIVE We aim to identify brain regions in which CBF values are affected and related to cognitive decline in early AD using a large cohort. METHODS Perfusion MRIs using continuous arterial spin labeling were acquired at 1.5 T in 58 normal controls (NC), 50 mild cognitive impairments (MCI), and 40 AD subjects from the Cardiovascular Health Study Cognition Study. Regional absolute CBF and normalized CBF (nCBF) values, without and with correction of partial volume effects, were compared across three groups. Association between regional CBF values and Modified Mini-Mental State Examination (3MSE) were investigated by multiple linear regression analyses adjusted for cardiovascular risk factors. RESULTS After correcting for partial volume effects and cardiovascular risk factors, ADs exhibited decreased nCBF with the strongest reduction in the bilateral posterior cingulate & precuneus region (p < 0.001) compared to NCs, and the strongest reduction in the bilateral superior medial frontal region (p < 0.001) compared to MCIs. MCIs exhibited the strongest nCBF decrease in the left hippocampus and nCBF increase in the right inferior frontal and insular region. The 3MSE scores within the symptomatic subjects were significantly associated with nCBF in the bilateral posterior and middle cingulate and parietal (p < 0.001), bilateral superior medial frontal (p < 0.001), bilateral temporoparietal (p < 0.02), and right hippocampus (p = 0.02) regions. CONCLUSION Noninvasive perfusion MRI can detect functional changes across diagnostic class and serve as a staging biomarker of cognitive status.
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Affiliation(s)
- Wenna Duan
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Parshant Sehrawat
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | | | - Ashish B Bhumkar
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Paresh B Boraste
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - James T Becker
- Departments of Psychiatry, Psychology, and Neurology, University of Pittsburgh, PA, USA
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Oscar L Lopez
- Departments of Neurology and Psychiatry, University of Pittsburgh, PA, USA
| | - H Michael Gach
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, Washington University, Saint Louis, MO, USA
| | - Weiying Dai
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
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19
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Duan W, Zhou GD, Balachandrasekaran A, Bhumkar AB, Boraste PB, Becker JT, Kuller LH, Lopez OL, Gach HM, Dai W. Cerebral Blood Flow Predicts Conversion of Mild Cognitive Impairment into Alzheimer's Disease and Cognitive Decline: An Arterial Spin Labeling Follow-up Study. J Alzheimers Dis 2021; 82:293-305. [PMID: 34024834 DOI: 10.3233/jad-210199] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND This is the first longitudinal study to assess regional cerebral blood flow (rCBF) changes during the progression from normal control (NC) through mild cognitive impairment (MCI) and Alzheimer's disease (AD). OBJECTIVE We aim to determine if perfusion MRI biomarkers, derived from our prior cross-sectional study, can predict the onset and cognitive decline of AD. METHODS Perfusion MRIs using arterial spin labeling (ASL) were acquired in 15 stable-NC, 14 NC-to-MCI, 16 stable-MCI, and 18 MCI/AD-to-AD participants from the Cardiovascular Health Study (CHS) cognition study. Group comparisons, predictions of AD conversion and time to conversion, and Modified Mini-Mental State Examination (3MSE) from rCBF were performed. RESULTS Compared to the stable-NC group: 1) the stable-MCI group exhibited rCBF decreases in the right temporoparietal (p = 0.00010) and right inferior frontal and insula (p = 0.0094) regions; and 2) the MCI/AD-to-AD group exhibited rCBF decreases in the bilateral temporoparietal regions (p = 0.00062 and 0.0035). Compared to the NC-to-MCI group, the stable-MCI group exhibited a rCBF decrease in the right hippocampus region (p = 0.0053). The baseline rCBF values in the posterior cingulate cortex (PCC) (p = 0.0043), bilateral superior medial frontal regions (BSMF) (p = 0.012), and left inferior frontal (p = 0.010) regions predicted the 3MSE scores for all the participants at follow-up. The baseline rCBF in the PCC and BSMF regions predicted the conversion and time to conversion from MCI to AD (p < 0.05; not significant after multiple corrections). CONCLUSION We demonstrated the feasibility of ASL in detecting rCBF changes in the typical AD-affected regions and the predictive value of baseline rCBF on AD conversion and cognitive decline.
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Affiliation(s)
- Wenna Duan
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Grace D Zhou
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | | | - Ashish B Bhumkar
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Paresh B Boraste
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - James T Becker
- Psychiatry, Psychology, and Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Oscar L Lopez
- Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - H Michael Gach
- Radiation Oncology, Radiology, and Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, USA
| | - Weiying Dai
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
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20
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Oliveira NL, Kennedy EH, Tibshirani R, Levine A, Martin E, Munro C, Ragin AB, Rubin LH, Sacktor N, Seaberg EC, Weinstein A, Becker JT. Longitudinal 5-year prediction of cognitive impairment among men with HIV disease. AIDS 2021; 35:889-898. [PMID: 33534203 PMCID: PMC8881797 DOI: 10.1097/qad.0000000000002827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although combination antiretroviral therapy reduced the prevalence of HIV-associated dementia, milder syndromes persist. Our goals were to predict cognitive impairment of the Multicenter AIDS Cohort Study (MACS) participants 5 years ahead and from a large pool of factors, select the ones that mostly contributed to our predictions. DESIGN Longitudinal, natural and treated history of HIV infection among MSM. METHODS The MACS is a longitudinal study of the natural and treated history of HIV disease in MSM; the neuropsychological substudy aims to characterize cognitive disorders in men with HIV disease. RESULTS We modeled on an annual basis the risk of cognitive impairment 5 years in the future. We were able to predict cognitive impairment at individual level with high precision and overperform default methods. We found that while a diagnosis of AIDS is a critical risk factor, HIV infection per se does not necessarily convey additional risk. Other infectious processes, most notably hepatitis B and C, are independently associated with increased risk of impairment. The relative importance of an AIDS diagnosis diminished across calendar time. CONCLUSION Our prediction models are a powerful tool to help clinicians address dementia in early stages for MACS paticipants. The strongest predictors of future cognitive impairment included the presence of clinical AIDS and hepatitis B or C infection. The fact that the pattern of predictive power differs by calendar year suggests a clinically critical change to the face of the epidemic.
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Affiliation(s)
- Natalia L. Oliveira
- Department of Statistics and Data Science, Carnegie Mellon University
- Department of Machine Learning Department, Carnegie Mellon University
| | - Edward H. Kennedy
- Department of Statistics and Data Science, Carnegie Mellon University
| | - Ryan Tibshirani
- Department of Statistics and Data Science, Carnegie Mellon University
- Department of Machine Learning Department, Carnegie Mellon University
| | - Andrew Levine
- Department of Neurology, David Geffen School of Medicine, UCLA
| | - Eileen Martin
- Department of Psychiatry, Rush University School of Medicine
| | - Cynthia Munro
- Departments of Psychiatry, The Johns Hopkins University School of Medicine
| | - Ann B. Ragin
- Department of Radiology, Northwestern University
| | - Leah H. Rubin
- Departments of Psychiatry, The Johns Hopkins University School of Medicine
- Departments of Neurology, The Johns Hopkins University School of Medicine
| | - Ned Sacktor
- Departments of Neurology, The Johns Hopkins University School of Medicine
| | - Eric C. Seaberg
- Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University
| | | | - James T. Becker
- Departments of Psychiatry, University of Pittsburgh
- Departments of Neurology, University of Pittsburgh
- Departments of Psychology, University of Pittsburgh
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21
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Wang Z, Cheng Y, Seaberg EC, Rubin LH, Levine AJ, Becker JT. Longitudinal multivariate normative comparisons. Stat Med 2021; 40:1440-1452. [PMID: 33296952 PMCID: PMC9157690 DOI: 10.1002/sim.8850] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Received: 11/02/2019] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 11/06/2022]
Abstract
Motivated by the Multicenter AIDS Cohort Study (MACS), we develop classification procedures for cognitive impairment based on longitudinal measures. To control family-wise error, we adapt the cross-sectional multivariate normative comparisons (MNC) method to the longitudinal setting. The cross-sectional MNC was proposed to control family-wise error by measuring the distance between multiple domain scores of a participant and the norms of healthy controls and specifically accounting for intercorrelations among all domain scores. However, in a longitudinal setting where domain scores are recorded multiple times, applying the cross-sectional MNC at each visit will still have inflated family-wise error rate due to multiple testing over repeated visits. Thus, we propose longitudinal MNC procedures that are constructed based on multivariate mixed effects models. A χ 2 test procedure is adapted from the cross-sectional MNC to classify impairment on longitudinal multivariate normal data. Meanwhile, a permutation procedure is proposed to handle skewed data. Through simulations we show that our methods can effectively control family-wise error at a predetermined level. A dataset from a neuropsychological substudy of the MACS is used to illustrate the applications of our proposed classification procedures.
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Affiliation(s)
- Zheng Wang
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yu Cheng
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Eric C. Seaberg
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland
| | - Leah H. Rubin
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland
| | - Andrew J. Levine
- Department of Neurology, University of California Los Angeles, Los Angeles, California
| | - James T. Becker
- Departments of Psychiatry, Neurology, and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
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22
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Kim T, Kim SY, Agarwal V, Cohen A, Roush R, Chang YF, Cheng Y, Snitz B, Huppert TJ, Bagic A, Kamboh MI, Doman J, Becker JT. Cardiac-induced cerebral pulsatility, brain structure, and cognition in middle and older-aged adults. Neuroimage 2021; 233:117956. [PMID: 33716158 PMCID: PMC8145789 DOI: 10.1016/j.neuroimage.2021.117956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 12/11/2022] Open
Abstract
Changes of cardiac-induced regional pulsatility can be associated with specific regions of brain volumetric changes, and these are related with cognitive alterations. Thus, mapping of cardiac pulsatility over the entire brain can be helpful to assess these relationships. A total of 108 subjects (age: 66.5 ± 8.4 years, 68 females, 52 healthy controls, 11 subjective cognitive decline, 17 impaired without complaints, 19 MCI and 9 AD) participated. The pulsatility map was obtained directly from resting-state functional MRI time-series data at 3T. Regional brain volumes were segmented from anatomical MRI. Multidomain neuropsychological battery was performed to test memory, language, attention and visuospatial construction. The Montreal Cognitive Assessment (MoCA) was also administered. The sparse partial least square (SPLS) method, which is desirable for better interpreting high-dimensional variables, was applied for the relationship between the entire brain voxels of pulsatility and 45 segmented brain volumes. A multiple holdout SPLS framework was used to optimize sparsity for assessing the pulsatility-volume relationship model and to test the reliability by fitting the models to 9 different splits of the data. We found statistically significant associations between subsets of pulsatility voxels and subsets of segmented brain volumes by rejecting the omnibus null hypothesis (any of 9 splits has p < 0.0056 (=0.05/9) with the Bonferroni correction). The pulsatility was positively associated with the lateral ventricle, choroid plexus, inferior lateral ventricle, and 3rd ventricle and negatively associated with hippocampus, ventral DC, and thalamus volumes for the first pulsatility-volume relationship. The pulsatility had an additional negative relationship with the amygdala and brain stem volumes for the second pulsatility-volume relationship. The spatial distribution of correlated pulsatility was observed in major feeding arteries to the brain regions, ventricles, and sagittal sinus. The indirect mediating pathways through the volumetric changes were statistically significant between the pulsatility and multiple cognitive measures (p < 0.01). Thus, the cerebral pulsatility, along with volumetric measurements, could be a potential marker for better understanding of pathophysiology and monitoring disease progression in age-related neurodegenerative disorders.
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Affiliation(s)
- Tae Kim
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, USA.
| | - Sang-Young Kim
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Vikas Agarwal
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Annie Cohen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Rebecca Roush
- Department of Neurology, University of Pittsburgh, Pittsburgh, USA
| | - Yue-Fang Chang
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, USA
| | - Yu Cheng
- Departments of Statistics and Biostatistics, University of Pittsburgh, Pittsburgh, USA
| | - Beth Snitz
- Department of Neurology, University of Pittsburgh, Pittsburgh, USA
| | - Theodore J Huppert
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, USA; Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, USA
| | - Anto Bagic
- Department of Neurology, University of Pittsburgh, Pittsburgh, USA
| | - M Ilyas Kamboh
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, USA
| | - Jack Doman
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
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23
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Boyle CP, Raji CA, Erickson KI, Lopez OL, Becker JT, Gach HM, Kuller LH, Longstreth W, Carmichael OT, Riedel BC, Thompson PM. Estrogen, brain structure, and cognition in postmenopausal women. Hum Brain Mapp 2021; 42:24-35. [PMID: 32910516 PMCID: PMC7721237 DOI: 10.1002/hbm.25200] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 04/10/2020] [Revised: 07/28/2020] [Accepted: 08/02/2020] [Indexed: 12/17/2022] Open
Abstract
Declining estrogen levels before, during, and after menopause can affect memory and risk for Alzheimer's disease. Undesirable side effects of hormone variations emphasize a role for hormone therapy (HT) where possible benefits include a delay in the onset of dementia-yet findings are inconsistent. Effects of HT may be mediated by estrogen receptors found throughout the brain. Effects may also depend on lifestyle factors, timing of use, and genetic risk. We studied the impact of self-reported HT use on brain volume in 562 elderly women (71-94 years) with mixed cognitive status while adjusting for aforementioned factors. Covariate-adjusted voxelwise linear regression analyses using a model with 16 predictors showed HT use as positively associated with regional brain volumes, regardless of cognitive status. Examinations of other factors related to menopause, oophorectomy and hysterectomy status independently yielded positive effects on brain volume when added to our model. One interaction term, HTxBMI, out of several examined, revealed significant negative association with overall brain volume, suggesting a greater reduction in brain volume than BMI alone. Our main findings relating HT to regional brain volume were as hypothesized, but some exploratory analyses were not in line with existing hypotheses. Studies suggest lower levels of estrogen resulting from oophorectomy and hysterectomy affect brain volume negatively, and the addition of HT modifies the relation between BMI and brain volume positively. Effects of HT may depend on the age range assessed, motivating studies with a wider age range as well as a randomized design.
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Affiliation(s)
- Christina P. Boyle
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging & Informatics, Keck School of MedicineUniversity of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Cyrus A. Raji
- Mallinckrodt Institute of RadiologyWashington UniversitySt. LouisMissouriUSA
| | - Kirk I. Erickson
- Department of PsychologyUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - Oscar L. Lopez
- Department of NeurologyUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - James T. Becker
- Department of PsychologyUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
- Department of NeurologyUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
- Department of PsychiatryUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - H. Michael Gach
- Departments of Radiation Oncology, Radiology, and Biomedical EngineeringWashington UniversitySt. LouisMissouriUSA
| | - Lewis H. Kuller
- Department of EpidemiologyUniversity of Pittsburgh, Graduate School of Public HealthPittsburghPennsylvaniaUSA
| | - William Longstreth
- Departments of Neurology and EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | | | - Brandalyn C. Riedel
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging & Informatics, Keck School of MedicineUniversity of Southern CaliforniaMarina del ReyCaliforniaUSA
- Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisIndianaUSA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging & Informatics, Keck School of MedicineUniversity of Southern CaliforniaMarina del ReyCaliforniaUSA
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24
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Basil RC, Brown TT, Haberlen S, Rubin LH, Plankey M, Becker JT, Lake JE, Palella FJ, Sarkar S. The relationship between diabetes and depressive symptoms in men with or at risk of HIV infection. HIV Med 2021; 22:37-46. [PMID: 32975014 PMCID: PMC8211402 DOI: 10.1111/hiv.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 08/06/2020] [Accepted: 08/12/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to compare the prevalence of comorbid diabetes and depressive symptoms in men living with HIV (MLWH) with that in men without HIV infection and to determine associations between glycaemic control and depressive symptoms. METHODS Participants included 920 MLWH and 840 men without HIV infection from the Multicenter AIDS Cohort Study (MACS) with available data regarding glycaemic status [categorized as normal for fasting blood glucose (FBG) < 100 mg/dL, prediabetes for FBG 100-125 mg/dL, and diabetes, defined by self-report, diabetes medication use or FBG ≥ 126 mg/dL on at least two consecutive visits, with diabetes classified as controlled if Hemoglobin A1c (HbA1C) < 7.5% and uncontrolled if HbA1C ≥ 7.5%]. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) score, with CES-D ≥ 16 scores classified as elevated depressive symptoms. A modified Poisson regression model with robust variance was used and adjusted for covariates including HIV serostatus. RESULTS Compared to men without HIV infection, MLWH had a higher mean CES-D score, but a similar prevalence of diabetes (11.3% versus 12.8%, respectively; P = 0.33). The concomitant prevalence of diabetes and elevated depressive symptoms did not differ by HIV serostatus (P = 0.215). In an adjusted analysis, men with uncontrolled diabetes had a greater prevalence of depressive symptoms compared to men with normoglycaemia (prevalence ratio = 1.43; 95% confidence interval 1.11, 1.84). The association between glycaemic status and depressive symptoms did not differ by HIV serostatus (P = 0.22 for interaction). CONCLUSIONS Both controlled and uncontrolled diabetes were independently associated with a greater prevalence of depressive symptoms, regardless of HIV serostatus. These results highlight the importance of identifying depression in people with diabetes.
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Affiliation(s)
| | | | | | | | | | | | | | - Frank J. Palella
- Northwestern University Feinberg School of Medicine, Chicago, IL
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25
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Hofer E, Roshchupkin GV, Adams HHH, Knol MJ, Lin H, Li S, Zare H, Ahmad S, Armstrong NJ, Satizabal CL, Bernard M, Bis JC, Gillespie NA, Luciano M, Mishra A, Scholz M, Teumer A, Xia R, Jian X, Mosley TH, Saba Y, Pirpamer L, Seiler S, Becker JT, Carmichael O, Rotter JI, Psaty BM, Lopez OL, Amin N, van der Lee SJ, Yang Q, Himali JJ, Maillard P, Beiser AS, DeCarli C, Karama S, Lewis L, Harris M, Bastin ME, Deary IJ, Veronica Witte A, Beyer F, Loeffler M, Mather KA, Schofield PR, Thalamuthu A, Kwok JB, Wright MJ, Ames D, Trollor J, Jiang J, Brodaty H, Wen W, Vernooij MW, Hofman A, Uitterlinden AG, Niessen WJ, Wittfeld K, Bülow R, Völker U, Pausova Z, Bruce Pike G, Maingault S, Crivello F, Tzourio C, Amouyel P, Mazoyer B, Neale MC, Franz CE, Lyons MJ, Panizzon MS, Andreassen OA, Dale AM, Logue M, Grasby KL, Jahanshad N, Painter JN, Colodro-Conde L, Bralten J, Hibar DP, Lind PA, Pizzagalli F, Stein JL, Thompson PM, Medland SE, Sachdev PS, Kremen WS, Wardlaw JM, Villringer A, van Duijn CM, Grabe HJ, Longstreth WT, Fornage M, Paus T, Debette S, Ikram MA, Schmidt H, Schmidt R, Seshadri S. Genetic correlations and genome-wide associations of cortical structure in general population samples of 22,824 adults. Nat Commun 2020; 11:4796. [PMID: 32963231 PMCID: PMC7508833 DOI: 10.1038/s41467-020-18367-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/20/2020] [Indexed: 12/22/2022] Open
Abstract
Cortical thickness, surface area and volumes vary with age and cognitive function, and in neurological and psychiatric diseases. Here we report heritability, genetic correlations and genome-wide associations of these cortical measures across the whole cortex, and in 34 anatomically predefined regions. Our discovery sample comprises 22,824 individuals from 20 cohorts within the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium and the UK Biobank. We identify genetic heterogeneity between cortical measures and brain regions, and 160 genome-wide significant associations pointing to wnt/β-catenin, TGF-β and sonic hedgehog pathways. There is enrichment for genes involved in anthropometric traits, hindbrain development, vascular and neurodegenerative disease and psychiatric conditions. These data are a rich resource for studies of the biological mechanisms behind cortical development and aging. Cortex morphology varies with age, cognitive function, and in neurological and psychiatric diseases. Here the authors report 160 genome-wide significant associations with thickness, surface area and volume of the total cortex and 34 cortical regions from a GWAS meta-analysis in 22,824 adults.
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Affiliation(s)
- Edith Hofer
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria.,Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Gennady V Roshchupkin
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Medical Informatics, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Hieab H H Adams
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Maria J Knol
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Shuo Li
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Habil Zare
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, USA.,Department of Cell Systems & Anatomy, The University of Texas Health Science Center, San Antonio, TX, USA
| | - Shahzad Ahmad
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Claudia L Satizabal
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | | | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, Epidemiology and Health Services, University of Washington, Seattle, WA, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA.,QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Michelle Luciano
- Centre for Cognitive Epidemiology and Cognitive Ageing, University of Edinburgh, Edinburgh, UK.,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Aniket Mishra
- University of Bordeaux, Bordeaux Population Health Research Center, INSERM UMR 1219, Bordeaux, France
| | - Markus Scholz
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.,LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Rui Xia
- Institute of Molecular Medicine and Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Xueqiu Jian
- Institute of Molecular Medicine and Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Yasaman Saba
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Graz, Austria
| | - Lukas Pirpamer
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
| | - Stephan Seiler
- Imaging of Dementia and Aging (IDeA) Laboratory, Department of Neurology, University of California-Davis, Davis, CA, USA.,Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento, CA, USA
| | - James T Becker
- Departments of Psychiatry, Neurology, and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, Epidemiology and Health Services, University of Washington, Seattle, WA, USA
| | - Oscar L Lopez
- Departments of Psychiatry, Neurology, and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Najaf Amin
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jayandra J Himali
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Pauline Maillard
- Imaging of Dementia and Aging (IDeA) Laboratory, Department of Neurology, University of California-Davis, Davis, CA, USA.,Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento, CA, USA
| | - Alexa S Beiser
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Charles DeCarli
- Imaging of Dementia and Aging (IDeA) Laboratory, Department of Neurology, University of California-Davis, Davis, CA, USA.,Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento, CA, USA
| | - Sherif Karama
- McGill University, Montreal Neurological Institute, Montreal, QC, Canada
| | - Lindsay Lewis
- McGill University, Montreal Neurological Institute, Montreal, QC, Canada
| | - Mat Harris
- Centre for Cognitive Epidemiology and Cognitive Ageing, University of Edinburgh, Edinburgh, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Brain Research Imaging Centre, University of Edinburgh, Edinburgh, UK.,Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Department of Neuroimaging Sciences, The University of Edinburgh, Edinburgh, UK
| | - Mark E Bastin
- Centre for Cognitive Epidemiology and Cognitive Ageing, University of Edinburgh, Edinburgh, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Brain Research Imaging Centre, University of Edinburgh, Edinburgh, UK.,Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Department of Neuroimaging Sciences, The University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Centre for Cognitive Epidemiology and Cognitive Ageing, University of Edinburgh, Edinburgh, UK.,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - A Veronica Witte
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Faculty of Medicine, CRC 1052 Obesity Mechanisms, University of Leipzig, Leipzig, Germany
| | - Frauke Beyer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Faculty of Medicine, CRC 1052 Obesity Mechanisms, University of Leipzig, Leipzig, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.,LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Karen A Mather
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.,Neuroscience Research Australia, Sydney, Australia
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, Australia.,School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - John B Kwok
- School of Medical Sciences, University of New South Wales, Sydney, Australia.,Brain and Mind Centre - The University of Sydney, Camperdown, NSW, Australia
| | - Margaret J Wright
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia.,Centre for Advanced Imaging, The University of Queensland, St Lucia, QLD, Australia
| | - David Ames
- National Ageing Research Institute, Royal Melbourne Hospital, Parkvill, VIC, Australia.,Academic Unit for Psychiatry of Old Age, University of Melbourne, St George's Hospital, Kew, VIC, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.,Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.,Dementia Centre for Research Collaboration, University of New South Wales, Sydney, NSW, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Meike W Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Wiro J Niessen
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.,Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany.,Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Robin Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Zdenka Pausova
- Hospital for Sick Children, Toronto, ON, Canada.,Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - G Bruce Pike
- Departments of Radiology and Clinial Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Sophie Maingault
- Institut des Maladies Neurodégénratives UMR5293, CEA, CNRS, University of Bordeaux, Bordeaux, France
| | - Fabrice Crivello
- Institut des Maladies Neurodégénratives UMR5293, CEA, CNRS, University of Bordeaux, Bordeaux, France
| | - Christophe Tzourio
- University of Bordeaux, Bordeaux Population Health Research Center, INSERM UMR 1219, Bordeaux, France.,Pole de santé publique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Philippe Amouyel
- Centre Hospitalier Universitaire de Bordeaux, France; Inserm U1167, Lille, France.,Department of Epidemiology and Public Health, Pasteur Institute of Lille, Lille, France.,Department of Public Health, Lille University Hospital, Lille, France
| | - Bernard Mazoyer
- Institut des Maladies Neurodégénratives UMR5293, CEA, CNRS, University of Bordeaux, Bordeaux, France
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Carol E Franz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Matthew S Panizzon
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anders M Dale
- Departments of Radiology and Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Mark Logue
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.,National Center for PTSD at Boston VA Healthcare System, Boston, MA, USA.,Department of Psychiatry and Department of Medicine-Biomedical Genetics Section, Boston University School of Medicine, Boston, MA, USA
| | - Katrina L Grasby
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Jodie N Painter
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Lucía Colodro-Conde
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Janita Bralten
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Derrek P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA.,Neuroscience Biomarkers, Janssen Research and Development, LLC, San Diego, CA, USA
| | - Penelope A Lind
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Fabrizio Pizzagalli
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Jason L Stein
- Department of Genetics & UNC Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Sarah E Medland
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | | | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - William S Kremen
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Joanna M Wardlaw
- Centre for Cognitive Epidemiology and Cognitive Ageing, University of Edinburgh, Edinburgh, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Brain Research Imaging Centre, University of Edinburgh, Edinburgh, UK.,Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Department of Neuroimaging Sciences, The University of Edinburgh, Edinburgh, UK
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Day Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Hans J Grabe
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany.,Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - William T Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, USA
| | - Myriam Fornage
- Institute of Molecular Medicine and Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Tomas Paus
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Stephanie Debette
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,University of Bordeaux, Bordeaux Population Health Research Center, INSERM UMR 1219, Bordeaux, France.,CHU de Bordeaux, Department of Neurology, F-33000, Bordeaux, France
| | - M Arfan Ikram
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Helena Schmidt
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Graz, Austria
| | - Reinhold Schmidt
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria.
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, USA. .,Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
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26
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Lopez OL, Kofler J, Chang Y, Berman SB, Becker JT, Sweet RA, Nadkarni N, Patira R, Kamboh MI, Cohen AD, Snitz BE, Kuller LH, Klunk WE. Hippocampal sclerosis, TDP-43, and the duration of the symptoms of dementia of AD patients. Ann Clin Transl Neurol 2020; 7:1546-1556. [PMID: 32735084 PMCID: PMC7480925 DOI: 10.1002/acn3.51135] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To examine the relationship between duration of the cognitive symptoms, from the earliest reported symptom to death, and hippocampal sclerosis (HS) and TAR-DNA binding protein of 43kDA (TDP-43) in Alzheimer's disease (AD) patients. METHODS The study was conducted in 359 cognitively impaired patients who met the pathological criteria for AD (NIA-Reagan intermediate or high). The mean age at onset was 69.5 ± 8.8 years (range 37-95) and the mean duration of the symptoms was 10.5 ± 4.2 years. The association between symptoms duration and HS and TDP-43 was examined with logistic regression analyses controlling for age at death, atherosclerosis in the Circle of Willis (CW), cerebral infarcts, gender, baseline Mini Mental State Examination scores, APOE-4 allele, and presence of Lewy bodies (LB). RESULTS HS was present in 18% (n = 64) and TDP-43 in 51.5% (n = 185) of the patients. HS and TDP-43 were more frequent in patients whose symptoms lasted more than 10 years. LBs were present in 72% of the patients with HS and in 64% of the patients with TDP-43. Age at onset was not associated with TDP-43 or HS. HS was associated with duration of symptoms and LB, TDP-43, and atherosclerosis in the CW. TDP-43 was associated with duration of symptoms, LB, and HS. INTERPRETATION HS and TDP-43 are present in early and late onset AD. However, their presence is mainly driven by the duration of symptoms and the presence of LB. This suggests that HS and TDP-43 are part of the later neuropathological changes in AD.
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Affiliation(s)
- Oscar L. Lopez
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Julia Kofler
- Department of PathologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - YueFang Chang
- Department of NeurosurgeryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Sarah B. Berman
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - James T. Becker
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
- Department of PsychologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Robert A. Sweet
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Neelesh Nadkarni
- Department of MedicineUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Riddhi Patira
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - M. Ilyas Kamboh
- Department of Human GeneticsUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Ann D. Cohen
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Beth E. Snitz
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Lewis H. Kuller
- Department of EpidemiologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - William E. Klunk
- Department of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
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27
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Thirumala PD, Reddy RP, Lopez OL, Chang YF, Becker JT, Kuller LH. Long-term cognitive decline and mortality after carotid endarterectomy. Clin Neurol Neurosurg 2020; 194:105823. [PMID: 32283472 PMCID: PMC7871212 DOI: 10.1016/j.clineuro.2020.105823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 03/28/2020] [Accepted: 03/30/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To date no studies have evaluated long term cognitive decline after carotid endarterectomy (CEA). We evaluated whether participants who had CEA were at increased risk of cognitive decline over participants who didn't undergo CEA. PATIENTS AND METHODS The patients in the study were participants in the Cardiovascular Health Study (CHS), a study of 5201 men and women over the age of 65 who were recruited from four communities (Pittsburgh, Pennsylvania; Sacramento, California; Winston-Salem, North Carolina; Hagerstown, Maryland) in 1988-89. The outcomes measured were 1) Decline in 3MSE and digit symbol substitution test (DSST) scores after CEA compared to before CEA. 2) All-cause mortality in CHS cohort among participants who did and did not have CEA. RESULTS CEA patients had significantly greater annual decrease in the DSST scores -2.43 (SD 4.21) compared to those who did not have a CEA -1.1 (SD 2.57) (p < 0.001) but this was not seen in the 3MSE scores. CEA patients had increased the risk of decline in DSST (OR 2.41, 95 % CI 1.49, 3.88) and 3MSE (OR 2.17, 95 % CI 1.35, 3.48) scores after adjusting for age, gender, race and educational status. CEA was associated with all-cause mortality in the long term with a HR of 2.72 (95 % CI 2.22, 3.34) after adjusting for covariates. Participants with lower baseline 3MSE scores HR 1.39 (1.27, 1.51), lower DSST scores <34 HR 1.69(1.54, 1.85) were more likely deceased. CONCLUSIONS CEA patients are at increased risk of lower scores on 3MSE and DSST testing in the long term. Mortality in the CHS cohort was higher in participants who underwent CEA. Further, lower 3MSE and DSST scores increased the risk of mortality.
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Affiliation(s)
| | - Rajiv P Reddy
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Oscar L Lopez
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Yue-Fang Chang
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - James T Becker
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Lewis H Kuller
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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28
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Popov M, Molsberry SA, Lecci F, Junker B, Kingsley LA, Levine A, Martin E, Miller E, Munro CA, Ragin A, Seaberg E, Sacktor N, Becker JT. Brain structural correlates of trajectories to cognitive impairment in men with and without HIV disease. Brain Imaging Behav 2020; 14:821-829. [PMID: 30623289 PMCID: PMC6616021 DOI: 10.1007/s11682-018-0026-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
There are distinct trajectories to cognitive impairment among participants in the Multicenter AIDS Cohort Study (MACS). Here we analyzed the relationship between regional brain volumes and the individual trajectories to impairment in a subsample (n = 302) of the cohort. 302 (167 HIV-infected; mean age = 55.7 yrs.; mean education: 16.2 yrs.) of the men enrolled in the MACS MRI study contributed data to this analysis. We used voxel-based morphometry (VBM) to segment the brain images to analyze gray and white matter volume at the voxel-level. A Mixed Membership Trajectory Model had previously identified three distinct profiles, and each study participant had a membership weight for each of these three trajectories. We estimated VBM model parameters for 100 imputations, manually performed the post-hoc contrasts, and pooled the results. We examined the associations between brain volume at the voxel level and the MMTM membership weights for two profiles: one considered "unhealthy" and the other considered "Premature aging." The unhealthy profile was linked to the volume of the posterior cingulate gyrus/precuneus, the inferior frontal cortex, and the insula, whereas the premature aging profile was independently associated with the integrity of a portion of the precuneus. Trajectories to cognitive impairment are the result, in part, of atrophy in cortical regions linked to normal and pathological aging. These data suggest the possibility of predicting cognitive morbidity based on patterns of CNS atrophy.
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Affiliation(s)
- Mikhail Popov
- Department of Psychiatry, University of Pittsburgh, Suite 830, 3501 Forbes Avenue, Pittsburgh, PA, 15213, USA
- Wikimedia Foundation, San Francisco, CA, USA
| | - Samantha A Molsberry
- Department of Psychiatry, University of Pittsburgh, Suite 830, 3501 Forbes Avenue, Pittsburgh, PA, 15213, USA
- Population Health Sciences, Harvard University, Cambridge, MA, USA
| | - Fabrizio Lecci
- Department of Statistics, Carnegie Mellon University, Pittsburgh, PA, USA
- Uber, New York, NY, USA
| | - Brian Junker
- Department of Statistics, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Lawrence A Kingsley
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrew Levine
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Eileen Martin
- Department of Psychiatry, Rush Medical School, Chicago, IL, USA
| | - Eric Miller
- Department of Psychiatry, University of California Los Angeles, Los Angeles, CA, USA
| | - Cynthia A Munro
- Department of Psychiatry, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ann Ragin
- Department of Radiology, Northwestern University, Evanston, IL, USA
| | - Eric Seaberg
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ned Sacktor
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh, Suite 830, 3501 Forbes Avenue, Pittsburgh, PA, 15213, USA.
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
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29
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Wang Z, Cheng Y, Seaberg EC, Becker JT. Quantifying diagnostic accuracy improvement of new biomarkers for competing risk outcomes. Biostatistics 2020; 23:kxaa048. [PMID: 33324980 PMCID: PMC9017290 DOI: 10.1093/biostatistics/kxaa048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/27/2020] [Accepted: 10/03/2020] [Indexed: 11/13/2022] Open
Abstract
The net reclassification improvement (NRI) and the integrated discrimination improvement (IDI) were originally proposed to characterize accuracy improvement in predicting a binary outcome, when new biomarkers are added to regression models. These two indices have been extended from binary outcomes to multi-categorical and survival outcomes. Working on an AIDS study where the onset of cognitive impairment is competing risk censored by death, we extend the NRI and the IDI to competing risk outcomes, by using cumulative incidence functions to quantify cumulative risks of competing events, and adopting the definitions of the two indices for multi-category outcomes. The "missing" category due to independent censoring is handled through inverse probability weighting. Various competing risk models are considered, such as the Fine and Gray, multistate, and multinomial logistic models. Estimation methods for the NRI and the IDI from competing risk data are presented. The inference for the NRI is constructed based on asymptotic normality of its estimator, and the bias-corrected and accelerated bootstrap procedure is used for the IDI. Simulations demonstrate that the proposed inferential procedures perform very well. The Multicenter AIDS Cohort Study is used to illustrate the practical utility of the extended NRI and IDI for competing risk outcomes.
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Affiliation(s)
- Zheng Wang
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Yu Cheng
- Departments of Statistics and Biostatistics, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Eric C Seaberg
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21202, USA
| | - James T Becker
- Departments of Psychiatry, Neurology, and Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
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30
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Levine A, Sacktor N, Becker JT. Studying the neuropsychological sequelae of SARS-CoV-2: lessons learned from 35 years of neuroHIV research. J Neurovirol 2020; 26:809-823. [PMID: 32880873 PMCID: PMC7471564 DOI: 10.1007/s13365-020-00897-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/11/2020] [Accepted: 08/18/2020] [Indexed: 01/14/2023]
Abstract
The virology of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and the human immune response to the virus are under vigorous investigation. There are now several reports describing neurological symptoms in individuals who develop coronavirus disease 2019 (COVID-19), the syndrome associated with SARS-CoV-2 infection. The prevalence, incidence, and clinical course of these symptoms will become clearer in the coming months and years through epidemiological studies. However, the long-term neurological and cognitive consequence of SARS-CoV-2 infection will remain conjectural for some time and will likely require the creation of cohort studies that include uninfected individuals. Considering the early evidence for neurological involvement in COVID-19 it may prove helpful to compare SARS-CoV-2 with another endemic and neurovirulent virus, human immunodeficiency virus-1 (HIV-1), when designing such cohort studies and when making predictions about neuropsychological outcomes. In this paper, similarities and differences between SARS-CoV-2 and HIV-1 are reviewed, including routes of neuroinvasion, putative mechanisms of neurovirulence, and factors involved in possible long-term neuropsychological sequelae. Application of the knowledge gained from over three decades of neuroHIV research is discussed, with a focus on alerting researchers and clinicians to the challenges in determining the cause of neurocognitive deficits among long-term survivors.
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Affiliation(s)
- Andrew Levine
- grid.19006.3e0000 0000 9632 6718Department of Neurology David Geffen School of Medicine, University of California, Los Angeles, CA 90095 USA
| | - Ned Sacktor
- grid.21107.350000 0001 2171 9311Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - James T. Becker
- grid.21925.3d0000 0004 1936 9000Departments of Psychiatry, Neurology, and Psychology, University of Pittsburgh, Pittsburgh, PA 15260 USA
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31
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Wang Z, Molsberry SA, Cheng Y, Kingsley L, Levine AJ, Martin E, Munro CA, Ragin A, Rubin LH, Sacktor N, Seaberg EC, Becker JT. Cross-sectional analysis of cognitive function using multivariate normative comparisons in men with HIV disease. AIDS 2019; 33:2115-2124. [PMID: 31335803 PMCID: PMC6832818 DOI: 10.1097/qad.0000000000002312] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Prevalence estimates of cognitive impairment in HIV disease vary widely. Here we used multivariate normative comparison (MNC) with identify individuals with impaired cognition, and to compare the results with those using the Frascati and Gisslén criteria. METHODS The current project used data collected before October 2014 from bisexual/gay men from the Multicenter AIDS Cohort Study. A total of 2904 men (mean age 39.7 years, 52.7% seropositive) had complete data in six cognitive domains at their first neuropsychological evaluation. T-scores were computed for each domain and the MNC was applied to detect impairment among seronegative and seropositive groups. RESULTS The MNC classified 6.26% of seronegative men as being impaired using a predetermined 5% false discovery rate. By contrast, the Frascati and the Gisslén criteria identified 24.54 and 11.36% of seronegative men as impaired. For seropositive men, the percentage impairment was 7.45, 25.73, and 11.69%, respectively, by the MNC, Frascati and Gisslén criteria. When we used seronegative men without medical comorbidities as the control group, the MNC, the Frascati and the Gisslén criteria identified 5.05, 27.07, and 4.21% of the seronegative men, and 4.34, 30.95, and 4.48% of the seropositive men as having cognitive impairment. For each method, serostatus was not associated with cognitive impairment. CONCLUSION The MNC controls the false discovery rate and therefore avoids the low specificity that characterizes the Frascati and Gisslén criteria. More research is needed to evaluate the sensitivity of the MNC method in a seropositive population that may be sicker and older than the current study sample and that includes women.
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Affiliation(s)
- Zheng Wang
- aDepartment of Statistics bDepartment of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania cPopulation Health Sciences, Harvard University, Cambridge, Massachusetts dDepartment of Epidemiology eDepartment of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania fDepartment of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, California gDepartment of Psychiatry, Rush University School of Medicine, Chicago, Illinois hDepartment of Psychiatry iDepartment of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland jDepartment of Radiology, Northwestern University, Evanston, Illinois kDepartment of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland lDepartment of Psychiatry mDepartment of Neurology nDepartment of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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32
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Erickson KI, Grove GA, Burns JM, Hillman CH, Kramer AF, McAuley E, Vidoni ED, Becker JT, Butters MA, Gray K, Huang H, Jakicic JM, Kamboh MI, Kang C, Klunk WE, Lee P, Marsland AL, Mettenburg J, Rogers RJ, Stillman CM, Sutton BP, Szabo-Reed A, Verstynen TD, Watt JC, Weinstein AM, Wollam ME. Investigating Gains in Neurocognition in an Intervention Trial of Exercise (IGNITE): Protocol. Contemp Clin Trials 2019; 85:105832. [PMID: 31465859 PMCID: PMC6815730 DOI: 10.1016/j.cct.2019.105832] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 12/16/2022]
Abstract
Despite the ubiquity of normal age-related cognitive decline there is an absence of effective approaches for improving neurocognitive health. Fortunately, moderate intensity exercise is a promising method for improving brain and cognitive health in late life, but its effectiveness remains a matter of skepticism and debate because of the absence of large, comprehensive, Phase III clinical trials. Here we describe the protocol for such a randomized clinical trial called IGNITE (Investigating Gains in Neurocognition in an Intervention Trial of Exercise), a study capable of more definitively addressing whether exercise influences cognitive and brain health in cognitively normal older adults. We are conducting a 12-month, multi-site, randomized dose-response exercise trial in 639 cognitively normal adults between 65 and 80 years of age. Participants are randomized to (1) a moderate intensity aerobic exercise condition of 150 min/week (N = 213), (2) a moderate intensity aerobic exercise condition at 225 min/week (N = 213), or (3) a light intensity stretching-and-toning control condition for 150 min/week (N = 213). Participants are engaging in 3 days/week of supervised exercise and two more days per week of unsupervised exercise for 12 months. A comprehensive cognitive battery, blood biomarkers and battery of psychosocial questionnaires is assessed at baseline, 6 and 12-months. In addition, brain magnetic resonance imaging, physiological biomarkers, cardiorespiratory fitness, physical function, and positron emission tomography of amyloid deposition are assessed at baseline and at the 12-month follow-up. The results from this trial could transform scientific-based policy and health care recommendations for approaches to improve cognitive function in cognitively normal older adults.
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Affiliation(s)
- Kirk I Erickson
- Department of Psychology, University of Pittsburgh, USA.; Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, Australia.
| | | | - Jeffrey M Burns
- Department of Neurology, University of Kansas Medical Center, USA
| | - Charles H Hillman
- Department of Psychology, Northeastern University, USA; Department of Physical Therapy, Movement, & Rehabilitation Sciences, Northeastern University, USA
| | - Arthur F Kramer
- Department of Psychology, Northeastern University, USA; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, USA
| | - Eric D Vidoni
- Department of Neurology, University of Kansas Medical Center, USA
| | - James T Becker
- Department of Psychology, University of Pittsburgh, USA.; Department of Psychiatry, University of Pittsburgh, USA; Department of Neurology, University of Pittsburgh, USA
| | | | - Katerina Gray
- Department of Psychology, University of Pittsburgh, USA
| | - Haiqing Huang
- Department of Psychology, University of Pittsburgh, USA
| | - John M Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, USA
| | - M Ilyas Kamboh
- Department of Human Genetics, University of Pittsburgh, USA
| | - Chaeryon Kang
- Department of Biostatistics, University of Pittsburgh, USA
| | | | - Phil Lee
- Department of Radiology, University of Kansas Medical Center, USA
| | | | | | - Renee J Rogers
- Department of Health and Physical Activity, University of Pittsburgh, USA
| | | | - Bradley P Sutton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, USA
| | - Amanda Szabo-Reed
- Department of Internal Medicine, University of Kansas Medical Center, USA
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O'Connor EE, Zeffiro T, Lopez OL, Becker JT, Zeffiro T. HIV infection and age effects on striatal structure are additive. J Neurovirol 2019; 25:480-495. [PMID: 31028692 PMCID: PMC10488234 DOI: 10.1007/s13365-019-00747-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/04/2019] [Accepted: 04/01/2019] [Indexed: 12/17/2022]
Abstract
The age of the HIV-infected population is increasing. Although many studies document gray matter volume (GMV) changes following HIV infection, GMV also declines with age. Findings have been inconsistent concerning interactions between HIV infection and age on brain structure. Effects of age, substance use, and inadequate viral suppression may confound identification of GMV serostatus effects using quantitative structural measures. In a cross-sectional study of HIV infection, including 97 seropositive and 84 seronegative, demographically matched participants, ages 30-70, we examined serostatus and age effects on GMV and neuropsychological measures. Ninety-eight percent of seropositive participants were currently treated with anti-retroviral therapies and all were virally suppressed. Gray, white, and CSF volumes were estimated using high-resolution T1-weighted MRI. Linear regression modeled effects of serostatus, age, education, comorbidities, and magnetic field strength on brain structure, using both a priori regions and voxel-based morphometry. Although seropositive participants exhibited significant bilateral decreases in striatal GMV, no serostatus effects were detected in the thalamus, hippocampus, or cerebellum. Age was associated with cortical, striatal, thalamic, hippocampal, and cerebellar GMV reductions. Effects of age and serostatus on striatal GMV were additive. Although no main effects of serostatus on neuropsychological performance were observed, serostatus moderated the relationship between pegboard performance and striatal volume. Both HIV infection and age were associated with reduced striatal volume. The lack of interaction of these two predictors suggests that HIV infection is associated with premature, but not accelerated, brain age. In serostatus groups matched on demographic and clinical variables, there were no observed differences in neuropsychological performance. Striatal GMV measures may be promising biomarker for use in studies of treated HIV infection.
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Affiliation(s)
- Erin E O'Connor
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, MD, USA.
| | | | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - James T Becker
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Thomas Zeffiro
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, MD, USA
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Rubin LH, Gustafson D, Hawkins KL, Zhang L, Jacobson LP, Becker JT, Munro CA, Lake JE, Martin E, Levine A, Brown TT, Sacktor N, Erlandson KM. Midlife adiposity predicts cognitive decline in the prospective Multicenter AIDS Cohort Study. Neurology 2019; 93:e261-e271. [PMID: 31201294 PMCID: PMC6656644 DOI: 10.1212/wnl.0000000000007779] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/11/2019] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Obesity is a common, modifiable cardiovascular and cerebrovascular risk factor. Among people with HIV, obesity may contribute to multisystem dysregulation including cognitive impairment. We examined body mass index (BMI) and central obesity (waist circumference [WC]) in association with domain-specific cognitive function and 10-year cognitive decline in men with HIV infection (MWH) vs HIV-uninfected (HIV-) men. METHODS A total of 316 MWH and 656 HIV- Multicenter AIDS Cohort Study participants ≥40 years at baseline, with neuropsychological testing every 2 years and concurrent BMI and WC measurements, were included. MWH were included if taking ≥2 antiretroviral agents and had HIV-1 RNA <400 copies/mL at >80% of visits. Mixed-effects models included all visits from 1996 to 2015, stratified by HIV serostatus, and adjusted for sociodemographic, behavioral, and clinical characteristics. At baseline and follow-up, 8% of MWH and 15% of HIV- men and 41% of MWH and 56% of HIV- men were ≥60 years, respectively. RESULTS Cross-sectionally, higher BMI was inversely associated with motor function in MWH and HIV- men, and attention/working memory in HIV- men. WC was inversely associated with motor function in MWH and HIV- men. Longitudinal associations indicated an obese BMI was associated with a less steep decline in motor function in MWH whereas in HIV- men, obesity was associated with a greater decline in motor function, learning, and memory. WC, or central obesity, showed similar patterns of associations. CONCLUSION Higher adiposity is associated with lower cognition cross-sectionally and greater cognitive decline, particularly in HIV- men. Overweight and obesity may be important predictors of neurologic outcomes and avenues for prevention and intervention.
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Affiliation(s)
- Leah H Rubin
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles.
| | - Deborah Gustafson
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - Kellie L Hawkins
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - Long Zhang
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - Lisa P Jacobson
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - James T Becker
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - Cynthia A Munro
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - Jordan E Lake
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - Eileen Martin
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - Andrew Levine
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - Todd T Brown
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - Ned Sacktor
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
| | - Kristine M Erlandson
- From the Departments of Neurology (L.H.R., C.A.M., N.S.), Psychiatry (C.A.M.), and Medicine (T.T.B.), Johns Hopkins University School of Medicine; Department of Epidemiology (L.H.R., L.Z., L.P.J.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (D.G.), State University of New York Downstate Medical Center, Brooklyn; University of Colorado (K.L.H., K.M.E.), Aurora; Denver Public Health (K.L.H.), CO; Department of Neurology (J.T.B.), University of Pittsburgh, PA; Department of Medicine (J.E.L.), University of Texas Health Science Center at Houston; Department of Psychiatry (E.M.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), David Geffen School of Medicine at the University of California, Los Angeles
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Abstract
BACKGROUND Efavirenz is associated with side effects involving the central nervous system. However, it remains largely unknown whether switching off EFV improves neuropsychological performance. METHODS We utilized data from the Multicenter AIDS Cohort Study (MACS). Participants were categorized by their use of EFV: never on EFV (No EFV), continuously on EFV (No Switch-OFF) and on EFV and then switched off (Switch-OFF). Baseline time points were defined as visits when first neuropsychological data were available. In Analysis 1, we compared neuropsychological and Center for Epidemiological Studies-Depression Scale (CES-D) scores before and after EFV switch in Switch-OFF group, aligning participants at the time of switch. Analysis 2 evaluated trajectory of neuropsychological/CES-D score among the three groups. RESULTS This analysis included 1989 HIV-seropositive participants with neuropsychological data (1675 in No EFV, 44 in No Switch-OFF, and 270 in Switch-OFF group). At baseline, participants had a median age of 37 years, median CD4 cell count 442 cells/μl, and 22.9% viral suppression rate. In Analysis 1, neuropsychological and CES-D scores did not show clinically significant changes over 2 years prior to and 4 years after switch in Switch-OFF group. In Analysis 2, trends in neuropsychological and CES-D scores in the three different groups did not show significant differences during a median of 3.2 years of follow-up. CONCLUSION Discontinuation of EFV is not associated with changes in neuropsychological performance or severity of depression in men. Furthermore, we did not observe differences among participants who were never on EFV, continuously on EFV, and on EFV and then switched off.
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Affiliation(s)
- Yijia Li
- University of Pittsburgh School of Medicine
| | | | - Yu Cheng
- Department of Statistics
- Department of Psychiatry, University of Pittsburgh, Pittsburgh
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh, Pittsburgh
| | | | - Andrew Levine
- Department of Neurology, UCLA - David Geffen School of Medicine, Los Angeles
| | - Leah H Rubin
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore
| | - Ned Sacktor
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore
| | - Ann Ragin
- Feinberg School of Medicine, Northwestern University, Chicago
| | - Ken Ho
- University of Pittsburgh School of Medicine
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, USA
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Gustafson DR, Rubin LH, Hawkins KL, Zhang L, Jacobson LP, Becker JT, Munro CA, Lake JE, Martin E, Levine A, Brown TT, Saktor N, Erlandson KM. P2-574: MIDLIFE ADIPOSITY PREDICTS COGNITIVE DECLINE IN THE PROSPECTIVE MULTICENTER AIDS COHORT STUDY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2983] [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: 11/24/2022]
Affiliation(s)
- Deborah R. Gustafson
- University of Skövde; Skövde Sweden
- University of Gothenburg; Gothenburg Sweden
- State University of New York Downstate Medical Center; Brooklyn NY USA
| | | | | | - Long Zhang
- Johns Hopkins University; Baltimore MD USA
| | | | | | | | - Jordan E. Lake
- University of Texas Health Science Center; Houston TX USA
| | | | - Andrew Levine
- University of California Los Angeles; Los Angeles CA USA
| | | | - Ned Saktor
- Johns Hopkins University; Baltimore MD USA
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Rubin LH, Springer G, Martin EM, Seaberg EC, Sacktor NC, Levine A, Valcour VG, Young MA, Becker JT, Maki PM. Elevated Depressive Symptoms Are a Stronger Predictor of Executive Dysfunction in HIV-Infected Women Than in Men. J Acquir Immune Defic Syndr 2019; 81:274-283. [PMID: 30893126 PMCID: PMC7254882 DOI: 10.1097/qai.0000000000002029] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND HIV-infected (HIV+) women seem to be more vulnerable to neurocognitive impairment (NCI) than HIV+ men, perhaps in part due to mental health factors. We assessed the association between elevated depressive symptoms and NCI among HIV+ and HIV-uninfected (HIV-) women and men. SETTING Women's Interagency HIV Study and Multicenter AIDS Cohort Study. METHODS Eight hundred fifty-eight HIV+ (429 women; 429 men) and 562 HIV- (281 women; 281 men) completed the Center for Epidemiologic Studies Depression (16 cutoff) Scale and measures of psychomotor speed/attention, executive, and motor function over multiple visits (or time points). Women's Interagency HIV Study and Multicenter AIDS Cohort Study participants were matched according to HIV status, age, race/ethnicity, and education. Generalized linear mixed models were used to examine interactions between biological sex, HIV serostatus, and depression on impairment (T-scores <40) after covariate adjustment. RESULTS Despite a higher frequency of depression among men, the association between depression and executive function differed by sex and HIV serostatus. HIV+ women with depression had 5 times the odds of impairment on a measure of executive control and inhibition versus HIV- depressed women and 3 times the odds of impairment on that measure versus HIV+ depressed men. Regardless of group status, depression was associated with greater impairment on processing speed, executive (mental flexibility), and motor function (P's < 0.05). CONCLUSIONS Depression contributes to NCI across a broad range of cognitive domains in HIV+ and HIV- individuals, but HIV+ depressed women show greater vulnerabilities in executive function. Treating depression may help to improve cognition in patients with HIV infection.
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Affiliation(s)
- Leah H. Rubin
- Department of Neurology, Johns Hopkins University School of Medicine
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | - Gayle Springer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | | | - Eric C. Seaberg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | - Ned C. Sacktor
- Department of Neurology, Johns Hopkins University School of Medicine
| | - Andrew Levine
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles
| | | | | | | | - Pauline M. Maki
- Departments of Psychiatry and Psychology, University of Illinois at Chicago College of Medicine
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Kunkle BW, Grenier-Boley B, Sims R, Bis JC, Damotte V, Naj AC, Boland A, Vronskaya M, van der Lee SJ, Amlie-Wolf A, Bellenguez C, Frizatti A, Chouraki V, Martin ER, Sleegers K, Badarinarayan N, Jakobsdottir J, Hamilton-Nelson KL, Moreno-Grau S, Olaso R, Raybould R, Chen Y, Kuzma AB, Hiltunen M, Morgan T, Ahmad S, Vardarajan BN, Epelbaum J, Hoffmann P, Boada M, Beecham GW, Garnier JG, Harold D, Fitzpatrick AL, Valladares O, Moutet ML, Gerrish A, Smith AV, Qu L, Bacq D, Denning N, Jian X, Zhao Y, Del Zompo M, Fox NC, Choi SH, Mateo I, Hughes JT, Adams HH, Malamon J, Sanchez-Garcia F, Patel Y, Brody JA, Dombroski BA, Naranjo MCD, Daniilidou M, Eiriksdottir G, Mukherjee S, Wallon D, Uphill J, Aspelund T, Cantwell LB, Garzia F, Galimberti D, Hofer E, Butkiewicz M, Fin B, Scarpini E, Sarnowski C, Bush WS, Meslage S, Kornhuber J, White CC, Song Y, Barber RC, Engelborghs S, Sordon S, Voijnovic D, Adams PM, Vandenberghe R, Mayhaus M, Cupples LA, Albert MS, De Deyn PP, Gu W, Himali JJ, Beekly D, Squassina A, Hartmann AM, Orellana A, Blacker D, Rodriguez-Rodriguez E, Lovestone S, Garcia ME, Doody RS, Munoz-Fernadez C, Sussams R, Lin H, Fairchild TJ, Benito YA, Holmes C, Karamujić-Čomić H, Frosch MP, Thonberg H, Maier W, Roshchupkin G, Ghetti B, Giedraitis V, Kawalia A, Li S, Huebinger RM, Kilander L, Moebus S, Hernández I, Kamboh MI, Brundin R, Turton J, Yang Q, Katz MJ, Concari L, Lord J, Beiser AS, Keene CD, Helisalmi S, Kloszewska I, Kukull WA, Koivisto AM, Lynch A, Tarraga L, Larson EB, Haapasalo A, Lawlor B, Mosley TH, Lipton RB, Solfrizzi V, Gill M, Longstreth WT, Montine TJ, Frisardi V, Diez-Fairen M, Rivadeneira F, Petersen RC, Deramecourt V, Alvarez I, Salani F, Ciaramella A, Boerwinkle E, Reiman EM, Fievet N, Rotter JI, Reisch JS, Hanon O, Cupidi C, Andre Uitterlinden AG, Royall DR, Dufouil C, Maletta RG, de Rojas I, Sano M, Brice A, Cecchetti R, George-Hyslop PS, Ritchie K, Tsolaki M, Tsuang DW, Dubois B, Craig D, Wu CK, Soininen H, Avramidou D, Albin RL, Fratiglioni L, Germanou A, Apostolova LG, Keller L, Koutroumani M, Arnold SE, Panza F, Gkatzima O, Asthana S, Hannequin D, Whitehead P, Atwood CS, Caffarra P, Hampel H, Quintela I, Carracedo Á, Lannfelt L, Rubinsztein DC, Barnes LL, Pasquier F, Frölich L, Barral S, McGuinness B, Beach TG, Johnston JA, Becker JT, Passmore P, Bigio EH, Schott JM, Bird TD, Warren JD, Boeve BF, Lupton MK, Bowen JD, Proitsi P, Boxer A, Powell JF, Burke JR, Kauwe JSK, Burns JM, Mancuso M, Buxbaum JD, Bonuccelli U, Cairns NJ, McQuillin A, Cao C, Livingston G, Carlson CS, Bass NJ, Carlsson CM, Hardy J, Carney RM, Bras J, Carrasquillo MM, Guerreiro R, Allen M, Chui HC, Fisher E, Masullo C, Crocco EA, DeCarli C, Bisceglio G, Dick M, Ma L, Duara R, Graff-Radford NR, Evans DA, Hodges A, Faber KM, Scherer M, Fallon KB, Riemenschneider M, Fardo DW, Heun R, Farlow MR, Kölsch H, Ferris S, Leber M, Foroud TM, Heuser I, Galasko DR, Giegling I, Gearing M, Hüll M, Geschwind DH, Gilbert JR, Morris J, Green RC, Mayo K, Growdon JH, Feulner T, Hamilton RL, Harrell LE, Drichel D, Honig LS, Cushion TD, Huentelman MJ, Hollingworth P, Hulette CM, Hyman BT, Marshall R, Jarvik GP, Meggy A, Abner E, Menzies GE, Jin LW, Leonenko G, Real LM, Jun GR, Baldwin CT, Grozeva D, Karydas A, Russo G, Kaye JA, Kim R, Jessen F, Kowall NW, Vellas B, Kramer JH, Vardy E, LaFerla FM, Jöckel KH, Lah JJ, Dichgans M, Leverenz JB, Mann D, Levey AI, Pickering-Brown S, Lieberman AP, Klopp N, Lunetta KL, Wichmann HE, Lyketsos CG, Morgan K, Marson DC, Brown K, Martiniuk F, Medway C, Mash DC, Nöthen MM, Masliah E, Hooper NM, McCormick WC, Daniele A, McCurry SM, Bayer A, McDavid AN, Gallacher J, McKee AC, van den Bussche H, Mesulam M, Brayne C, Miller BL, Riedel-Heller S, Miller CA, Miller JW, Al-Chalabi A, Morris JC, Shaw CE, Myers AJ, Wiltfang J, O'Bryant S, Olichney JM, Alvarez V, Parisi JE, Singleton AB, Paulson HL, Collinge J, Perry WR, Mead S, Peskind E, Cribbs DH, Rossor M, Pierce A, Ryan NS, Poon WW, Nacmias B, Potter H, Sorbi S, Quinn JF, 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Genetic meta-analysis of diagnosed Alzheimer's disease identifies new risk loci and implicates Aβ, tau, immunity and lipid processing. Nat Genet 2019; 51:414-430. [PMID: 30820047 PMCID: PMC6463297 DOI: 10.1038/s41588-019-0358-2] [Citation(s) in RCA: 1518] [Impact Index Per Article: 303.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 01/22/2019] [Indexed: 02/08/2023]
Abstract
Risk for late-onset Alzheimer's disease (LOAD), the most prevalent dementia, is partially driven by genetics. To identify LOAD risk loci, we performed a large genome-wide association meta-analysis of clinically diagnosed LOAD (94,437 individuals). We confirm 20 previous LOAD risk loci and identify five new genome-wide loci (IQCK, ACE, ADAM10, ADAMTS1, and WWOX), two of which (ADAM10, ACE) were identified in a recent genome-wide association (GWAS)-by-familial-proxy of Alzheimer's or dementia. Fine-mapping of the human leukocyte antigen (HLA) region confirms the neurological and immune-mediated disease haplotype HLA-DR15 as a risk factor for LOAD. Pathway analysis implicates immunity, lipid metabolism, tau binding proteins, and amyloid precursor protein (APP) metabolism, showing that genetic variants affecting APP and Aβ processing are associated not only with early-onset autosomal dominant Alzheimer's disease but also with LOAD. Analyses of risk genes and pathways show enrichment for rare variants (P = 1.32 × 10-7), indicating that additional rare variants remain to be identified. We also identify important genetic correlations between LOAD and traits such as family history of dementia and education.
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Affiliation(s)
- Brian W Kunkle
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Benjamin Grenier-Boley
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Rebecca Sims
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Vincent Damotte
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Adam C Naj
- Department of Biostatistics and Epidemiology/Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Maria Vronskaya
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Sven J van der Lee
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Alexandre Amlie-Wolf
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Céline Bellenguez
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Aura Frizatti
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Vincent Chouraki
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Eden R Martin
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kristel Sleegers
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Antwerp, Belgium
- Laboratory for Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Nandini Badarinarayan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | - Kara L Hamilton-Nelson
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sonia Moreno-Grau
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Robert Olaso
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Rachel Raybould
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Yuning Chen
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Amanda B Kuzma
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Mikko Hiltunen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Taniesha Morgan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Shahzad Ahmad
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Badri N Vardarajan
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Jacques Epelbaum
- UMR 894, Center for Psychiatry and Neuroscience, Inserm, Université Paris Descartes, Paris, France
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Division of Medical Genetics, University Hospital and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Merce Boada
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Gary W Beecham
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jean-Guillaume Garnier
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Denise Harold
- School of Biotechnology, Dublin City University, Dublin, Ireland
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Otto Valladares
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marie-Laure Moutet
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Amy Gerrish
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Albert V Smith
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Liming Qu
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Delphine Bacq
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Nicola Denning
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Xueqiu Jian
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Yi Zhao
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Maria Del Zompo
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Seung-Hoan Choi
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ignacio Mateo
- Neurology Service and CIBERNED, 'Marqués de Valdecilla' University Hospital (University of Cantabria and IDIVAL), Santander, Spain
| | - Joseph T Hughes
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Hieab H Adams
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - John Malamon
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Yogen Patel
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Beth A Dombroski
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Makrina Daniilidou
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - David Wallon
- Normandie University, UNIROUEN, Inserm U1245, and Rouen University Hospital, Department of Neurology, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - James Uphill
- Department of Neurodegenerative Disease, MRC Prion Unit at UCL, Institute of Prion Diseases, London, UK
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland
- Centre for Public Health, University of Iceland, Reykjavik, Iceland
| | - Laura B Cantwell
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Fabienne Garzia
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Daniela Galimberti
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy
- University of Milan, Centro Dino Ferrari, Milan, Italy
| | - Edith Hofer
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Mariusz Butkiewicz
- Institute for Computational Biology, Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Bertrand Fin
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Elio Scarpini
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy
- University of Milan, Centro Dino Ferrari, Milan, Italy
| | - Chloe Sarnowski
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Will S Bush
- Institute for Computational Biology, Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Stéphane Meslage
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Charles C White
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Yuenjoo Song
- Institute for Computational Biology, Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Robert C Barber
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Sebastiaan Engelborghs
- Laboratory for Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp, Antwerp, Belgium
| | - Sabrina Sordon
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - Dina Voijnovic
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Perrie M Adams
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurology, University Hospital and University of Leuven, Leuven, Belgium
| | - Manuel Mayhaus
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - L Adrienne Cupples
- Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Peter P De Deyn
- Laboratory for Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp, Antwerp, Belgium
| | - Wei Gu
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - Jayanadra J Himali
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Duane Beekly
- National Alzheimer's Coordinating Center, University of Washington, Seattle, WA, USA
| | - Alessio Squassina
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Annette M Hartmann
- Department of Psychiatry, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Adelina Orellana
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
| | - Deborah Blacker
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Eloy Rodriguez-Rodriguez
- Neurology Service and CIBERNED, 'Marqués de Valdecilla' University Hospital (University of Cantabria and IDIVAL), Santander, Spain
| | | | - Melissa E Garcia
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Rachelle S Doody
- Alzheimer's Disease and Memory Disorders Center, Baylor College of Medicine, Houston, TX, USA
| | - Carmen Munoz-Fernadez
- Department of Immunology, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Rebecca Sussams
- Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK
| | - Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Thomas J Fairchild
- Office of Strategy and Measurement, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Yolanda A Benito
- Department of Immunology, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Clive Holmes
- Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK
| | | | - Matthew P Frosch
- C.S. Kubik Laboratory for Neuropathology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Hakan Thonberg
- Theme Aging, Unit for Hereditary Dementias, Karolinska University Hospital-Solna, Stockholm, Sweden
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Alzheimer Research Center, Division of Neurogeriatrics, Solna, Sweden
| | - Wolfgang Maier
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Gennady Roshchupkin
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bernardino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Vilmantas Giedraitis
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Amit Kawalia
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Shuo Li
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Ryan M Huebinger
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lena Kilander
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Isabel Hernández
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - M Ilyas Kamboh
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - RoseMarie Brundin
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - James Turton
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Mindy J Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Letizia Concari
- Section of Neuroscience, DIMEC-University of Parma, Parma, Italy
- FERB-Alzheimer Center, Gazzaniga (Bergamo), Italy
| | - Jenny Lord
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Alexa S Beiser
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - C Dirk Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Seppo Helisalmi
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Iwona Kloszewska
- Elderly and Psychiatric Disorders Department, Medical University of Lodz, Lodz, Poland
| | - Walter A Kukull
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Anne Maria Koivisto
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Aoibhinn Lynch
- Mercer's Institute for Research on Aging, St. James's Hospital and Trinity College, Dublin, Ireland
- St. James's Hospital and Trinity College, Dublin, Ireland
| | - Lluís Tarraga
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Annakaisa Haapasalo
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Brian Lawlor
- Mercer's Institute for Research on Aging, St. James's Hospital and Trinity College, Dublin, Ireland
- St. James's Hospital and Trinity College, Dublin, Ireland
| | - Thomas H Mosley
- Departments of Medicine, Geriatrics, Gerontology and Neurology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Vincenzo Solfrizzi
- Interdisciplinary Department of Medicine, Geriatric Medicine and Memory Unity, University of Bari, Bari, Italy
| | - Michael Gill
- Mercer's Institute for Research on Aging, St. James's Hospital and Trinity College, Dublin, Ireland
- St. James's Hospital and Trinity College, Dublin, Ireland
| | - W T Longstreth
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Thomas J Montine
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Vincenza Frisardi
- Department of Geriatrics, Center for Aging Brain, University of Bari, Bari, Italy
| | - Monica Diez-Fairen
- Fundació per la Recerca Biomèdica i Social Mútua Terrassa, Terrassa, Barcelona, Spain
- Memory Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdamt, the Netherlands
- Netherlands Consortium on Health Aging and National Genomics Initiative, Leiden, the Netherlands
| | | | - Vincent Deramecourt
- CHU Lille, Memory Center of Lille (Centre Mémoire de Ressources et de Recherche), Lille, France
| | - Ignacio Alvarez
- Fundació per la Recerca Biomèdica i Social Mútua Terrassa, Terrassa, Barcelona, Spain
- Memory Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | - Francesca Salani
- Department of Clinical and Behavioral Neurology, Experimental Neuropsychobiology Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Antonio Ciaramella
- Department of Clinical and Behavioral Neurology, Experimental Neuropsychobiology Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Eric Boerwinkle
- School of Public Health, Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Eric M Reiman
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
- Banner Alzheimer's Institute, Phoenix, AZ, USA
- Department of Psychiatry, University of Arizona, Phoenix, AZ, USA
| | - Nathalie Fievet
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Joan S Reisch
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Olivier Hanon
- University Paris Descartes, EA 4468, AP-HP, Geriatrics Department, Hôpital Broca, Paris, France
| | - Chiara Cupidi
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | - A G Andre Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdamt, the Netherlands
- Netherlands Consortium on Health Aging and National Genomics Initiative, Leiden, the Netherlands
| | - Donald R Royall
- Departments of Psychiatry, Medicine, Family & Community Medicine, South Texas Veterans Health Administration Geriatric Research Education & Clinical Center (GRECC), UT Health Science Center at San Antonio, San Antonio, TX, USA
| | - Carole Dufouil
- University of Bordeaux, Inserm 1219, Bordeaux, France
- Department of Neurology, Bordeaux University Hospital / CHU de Bordeaux, Bordeaux, France
| | | | - Itziar de Rojas
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Mary Sano
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexis Brice
- Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Université Paris 06, UMRS 1127, Institut du Cerveau et de la Moelle Épinière, Paris, France
- AP-HP, Department of Genetics, Pitié-Salpêtrière Hospital, Paris, France
| | - Roberta Cecchetti
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Peter St George-Hyslop
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
| | - Karen Ritchie
- Inserm U1061 Neuropsychiatry, La Colombière Hospital, Montpellier, France
- Montpellier University, Montpellier, France
- Department of Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Magda Tsolaki
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Debby W Tsuang
- VA Puget Sound Health Care System/>GRECC, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Bruno Dubois
- Institut de la Mémoire et de la Maladie d'Alzheimer and Institut du Cerveau et de la Moelle Épinière, Département de Neurologie, Hôpital de la Pitié-Salpêtrière, Paris, France
- Institut des Neurosciences Translationnelles de Paris, Institut du Cerveau et de la Moelle Épinière, Paris, France
- Inserm, CNRS, UMR-S975, Institut du Cerveau et de la Moelle Epinière, Paris, France
- Sorbonne Universités, Université Pierre et Marie Curie, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
| | - David Craig
- Ageing Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Chuang-Kuo Wu
- Departments of Neurology, Pharmacology & Neuroscience, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Hilkka Soininen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Despoina Avramidou
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Roger L Albin
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Geriatric Research, Education and Clinical Center (GRECC), VA Ann Arbor Healthcare System (VAAAHS), Ann Arbor, MI, USA
- Michigan Alzheimer Disease Center, Ann Arbor, MI, USA
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Antonia Germanou
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Liana G Apostolova
- Indiana Alzheimer's Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA
- Department of Neurology, Indiana University, Indianapolis, IN, USA
- Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN, USA
| | - Lina Keller
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Maria Koutroumani
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Steven E Arnold
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Francesco Panza
- Department of Geriatrics, Center for Aging Brain, University of Bari, Bari, Italy
| | - Olymbia Gkatzima
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sanjay Asthana
- Geriatric Research, Education and Clinical Center (GRECC), University of Wisconsin, Madison, WI, USA
- Department of Medicine, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Didier Hannequin
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Patrice Whitehead
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Craig S Atwood
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA
- Department of Neurology, Indiana University, Indianapolis, IN, USA
- Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN, USA
| | - Paolo Caffarra
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Harald Hampel
- AXA Research Fund & Sorbonne University Chair, Paris, France
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- Brain & Spine Institute, Inserm U 1127, CNRS UMR 7225, Paris, France
- Institute of Memory and Alzheimer's Disease, Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Inés Quintela
- Grupo de Medicina Xenomica, Universidade de Santiago de Compostela, Centro Nacional de Genotipado, Centro de Investigación Biomédica en Red de Enfermedades Raras, Santiago de Compostela, Spain
| | - Ángel Carracedo
- Grupo de Medicina Xenomica, Universidade de Santiago de Compostela, Centro Nacional de Genotipado, Centro de Investigación Biomédica en Red de Enfermedades Raras, Santiago de Compostela, Spain
| | - Lars Lannfelt
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - David C Rubinsztein
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
- UK Dementia Research Institute, University of Cambridge, Cambridge, UK
| | - Lisa L Barnes
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Florence Pasquier
- CHU Lille, Memory Center of Lille (Centre Mémoire de Ressources et de Recherche), Lille, France
| | - Lutz Frölich
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Sandra Barral
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Bernadette McGuinness
- Ageing Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Thomas G Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, AZ, USA
| | - Janet A Johnston
- Ageing Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Peter Passmore
- Ageing Group, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Eileen H Bigio
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jonathan M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Thomas D Bird
- Department of Neurology, University of Washington, Seattle, WA, USA
- VA Puget Sound Health Care System/>GRECC, Seattle, WA, USA
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | | | - Michelle K Lupton
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | | | - Petra Proitsi
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Adam Boxer
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - John F Powell
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James R Burke
- Department of Neurology, Duke University, Durham, NC, USA
| | - John S K Kauwe
- Departments of Biology, Brigham Young University, Provo, UT, USA
| | - Jeffrey M Burns
- University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Michelangelo Mancuso
- Department of Experimental and Clinical Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ubaldo Bonuccelli
- Department of Experimental and Clinical Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - Nigel J Cairns
- Department of Pathology and Immunology, Washington University, St. Louis, MO, USA
| | | | - Chuanhai Cao
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, USA
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
| | - Chris S Carlson
- Department of Medicine, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Nicholas J Bass
- Division of Psychiatry, University College London, London, UK
| | | | - John Hardy
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
| | - Regina M Carney
- Mental Health & Behavioral Science Service, Bruce W. Carter VA Medical Center, Miami, FL, USA
| | - Jose Bras
- UK Dementia Research Institute at UCL, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | | | - Rita Guerreiro
- UK Dementia Research Institute at UCL, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Mariet Allen
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Helena C Chui
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
| | - Elizabeth Fisher
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Carlo Masullo
- Department of Neurology, Catholic University of Rome, Rome, Italy
| | - Elizabeth A Crocco
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Charles DeCarli
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Gina Bisceglio
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Malcolm Dick
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Li Ma
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Ranjan Duara
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | | | - Denis A Evans
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Angela Hodges
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kelley M Faber
- Indiana Alzheimer's Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Kenneth B Fallon
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - David W Fardo
- Sanders-Brown Center on Aging, Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - Reinhard Heun
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Martin R Farlow
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - Heike Kölsch
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Steven Ferris
- Department of Psychiatry, New York University, New York, NY, USA
| | - Markus Leber
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Tatiana M Foroud
- Indiana Alzheimer's Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Isabella Heuser
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany
| | - Douglas R Galasko
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Ina Giegling
- Department of Psychiatry, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Marla Gearing
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
- Emory Alzheimer's Disease Center, Emory University, Atlanta, GA, USA
| | - Michael Hüll
- Department of Psychiatry, University of Freiburg, Freiburg, Germany
| | - Daniel H Geschwind
- Neurogenetics Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - John R Gilbert
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - John Morris
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center Program on Protein Aggregation and Neurodegeneration, Washington University School of Medicine, St. Louis, MO, USA
| | - Robert C Green
- Division of Genetics, Department of Medicine and Partners Center for Personalized Genetic Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kevin Mayo
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University, St. Louis, MO, USA
- Department of Genetics, Washington University, St. Louis, MO, USA
| | - John H Growdon
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Thomas Feulner
- Department of Psychiatry and Psychotherapy, University Hospital, Saarland, Germany
| | - Ronald L Hamilton
- Department of Pathology (Neuropathology), University of Pittsburgh, Pittsburgh, PA, USA
| | - Lindy E Harrell
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dmitriy Drichel
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Lawrence S Honig
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
| | - Thomas D Cushion
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Matthew J Huentelman
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Paul Hollingworth
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Rachel Marshall
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Gail P Jarvik
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
- Department of Medicine (Medical Genetics), University of Washington, Seattle, WA, USA
| | - Alun Meggy
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Erin Abner
- Sanders-Brown Center on Aging, College of Public Health, Department of Epidemiology, University of Kentucky, Lexington, KY, USA
| | - Georgina E Menzies
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Lee-Way Jin
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain
| | - Ganna Leonenko
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Luis M Real
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain
| | - Gyungah R Jun
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Clinton T Baldwin
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Detelina Grozeva
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | - Giancarlo Russo
- Functional Genomics Center Zurich, ETH/University of Zurich, Zurich, Switzerland
| | - Jeffrey A Kaye
- Department of Neurology, Oregon Health &Science University, Portland, OR, USA
- Department of Neurology, Portland Veterans Affairs Medical Center, Portland, OR, USA
| | - Ronald Kim
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, USA
| | - Frank Jessen
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Neil W Kowall
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Pathology, Boston University School of Medicine, Boston University, Boston, MA, USA
| | - Bruno Vellas
- Inserm U558, University of Toulouse, Toulouse, France
| | - Joel H Kramer
- Department of Neuropsychology, University of California San Francisco, San Francisco, CA, USA
| | - Emma Vardy
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
| | - Frank M LaFerla
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - James J Lah
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases, Munich, Germany
| | - James B Leverenz
- Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA
| | - David Mann
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Allan I Levey
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - Stuart Pickering-Brown
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Norman Klopp
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Munich, Germany
| | - Kathryn L Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - H-Erich Wichmann
- Helmholtz Center Munich, Institute of Epidemiology, Neuherberg, Munich, Germany
- Ludwig-Maximilians University Chair of Epidemiology, Munich, Germany
- Joint Biobank Munich and KORA Biobank, Baltimore, MD, USA
| | | | - Kevin Morgan
- Human Genetics, Schools of Life Sciences and Medicine, University of Nottingham, Nottingham, UK
| | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristelle Brown
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Frank Martiniuk
- Department of Medicine-Pulmonary, New York University, New York, NY, USA
| | - Christopher Medway
- Institute of Genetics, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Deborah C Mash
- Department of Neurology, University of Miami, Miami, FL, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Eliezer Masliah
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
- Department of Pathology, University of California, San Diego, La Jolla, CA, USA
| | - Nigel M Hooper
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Hearth, Rome, Italy
| | - Susan M McCurry
- School of Nursing Northwest Research Group on Aging, University of Washington, Seattle, WA, USA
| | - Anthony Bayer
- Institute of Primary Care and Public Health, Cardiff University, University Hospital of Wales, Cardiff, UK
| | - Andrew N McDavid
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, USA
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ann C McKee
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Pathology, Boston University School of Medicine, Boston University, Boston, MA, USA
| | - Hendrik van den Bussche
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Carol Brayne
- Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Bruce L Miller
- Weill Institute for Neurosciences, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Carol A Miller
- Department of Pathology, University of Southern California, Los Angeles, CA, USA
| | - Joshua W Miller
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA, USA
| | - Ammar Al-Chalabi
- Institute of Psychiatry, Psychology and Neuroscienceó, King's College London, London, UK
| | - John C Morris
- Department of Pathology and Immunology, Washington University, St. Louis, MO, USA
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Christopher E Shaw
- Institute of Psychiatry, Psychology and Neuroscienceó, King's College London, London, UK
- UK Dementia Research Institute, King's College London, London, UK
| | - Amanda J Myers
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany
- German Center for Neurodegenerative Diseases, Goettingen, Germany
- IBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Sid O'Bryant
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - John M Olichney
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Victoria Alvarez
- Molecular Genetics Laboratory-Hospital, University of Central Asturias, Oviedo, Spain
| | - Joseph E Parisi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Andrew B Singleton
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Henry L Paulson
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer Disease Center, Ann Arbor, MI, USA
| | - John Collinge
- Department of Neurodegenerative Disease, MRC Prion Unit at UCL, Institute of Prion Diseases, London, UK
| | - William R Perry
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Simon Mead
- Department of Neurodegenerative Disease, MRC Prion Unit at UCL, Institute of Prion Diseases, London, UK
| | - Elaine Peskind
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - David H Cribbs
- Department of Neurology, University of California, Irvine, Irvine, CA, USA
| | - Martin Rossor
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Aimee Pierce
- Department of Neurology, University of California, Irvine, Irvine, CA, USA
| | - Natalie S Ryan
- Department of Neurodegenerative Disease, MRC Prion Unit at UCL, Institute of Prion Diseases, London, UK
| | - Wayne W Poon
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- Centro di Ricerca, Trasferimento e Alta Formazione DENOTHE, University of Florence, Florence, Italy
| | - Huntington Potter
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Joseph F Quinn
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eleonora Sacchinelli
- Department of Clinical and Behavioral Neurology, Experimental Neuropsychobiology Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ashok Raj
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, USA
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
- Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Murray Raskind
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Carlo Caltagirone
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Paola Bossù
- Department of Clinical and Behavioral Neurology, Experimental Neuropsychobiology Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Maria Donata Orfei
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Barry Reisberg
- Department of Psychiatry, New York University, New York, NY, USA
- Alzheimer's Disease Center, New York University, New York, NY, USA
| | - Robert Clarke
- Oxford Healthy Aging Project, Clinical Trial Service Unit, University of Oxford, Oxford, UK
| | - Christiane Reitz
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - A David Smith
- Oxford Project to Investigate Memory and Ageing, University of Oxford, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - John M Ringman
- Department of Neurology, Keck School of Medicine at the University of Southern California, Los Angeles, Los Angeles, CA, USA
| | - Donald Warden
- Oxford Project to Investigate Memory and Ageing, University of Oxford, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gordon Wilcock
- Oxford Project to Investigate Memory and Ageing, University of Oxford, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
| | | | - Howard J Rosen
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Maura Gallo
- Regional Neurogenetic Centre (CRN), ASP Catanzaro, Lamezia Terme, Italy
| | - Roger N Rosenberg
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mark A Sager
- Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Patrizia Mecocci
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Andrew J Saykin
- Indiana Alzheimer's Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - Pau Pastor
- Fundació per la Recerca Biomèdica i Social Mútua Terrassa, Terrassa, Barcelona, Spain
- Memory Disorders Unit, Department of Neurology, Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | - Michael L Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jeffery M Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Julie A Schneider
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Pathology (Neuropathology), Rush University Medical Center, Chicago, IL, USA
| | - Lori S Schneider
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
- Department of Psychiatry, University of Southern California, Los Angeles, CA, USA
| | - Susan Slifer
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Amanda G Smith
- USF Health Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, USA
| | - Joshua A Sonnen
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Salvatore Spina
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Robert A Stern
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Russell H Swerdlow
- University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Mitchell Tang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rudolph E Tanzi
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Juan C Troncoso
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Linda J Van Eldik
- Sanders-Brown Center on Aging, Department of Neuroscience, University of Kentucky, Lexington, KY, USA
| | - Harry V Vinters
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jean Paul Vonsattel
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Pathology, Columbia University, New York, NY, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kathleen A Welsh-Bohmer
- Department of Neurology, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Kirk C Wilhelmsen
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer Williamson
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
| | - Thomas S Wingo
- Department of Neurology, Emory University, Atlanta, GA, USA
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Randall L Woltjer
- Department of Pathology, Oregon Health & Science University, Portland, OR, USA
| | - Clinton B Wright
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Chang-En Yu
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Lei Yu
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Yasaman Saba
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Division of Molecular Biology and Biochemistry, Medical University Graz, Graz, Austria
| | - Alberto Pilotto
- Gerontology and Geriatrics Research Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
- Department Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genova, Italy
| | - Maria J Bullido
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
- IdiPAZ, Instituto de Investigación Sanitaria la Paz, Madrid, Spain
- Centro de Biologia Molecular Severo Ochoa (CSIC-UAM), Madrid, Spain
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany
- German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - David Bennett
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Paola Bosco
- Instituto di Ricovero e Cura a Carattere Scientifico, Associazione Oasi Maria Santissima Srl, Troina, Italy
| | - Eliecer Coto
- Molecular Genetics Laboratory-Hospital, University of Central Asturias, Oviedo, Spain
| | - Virginia Boccardi
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Phil L De Jager
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Alberto Lleo
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Autonomous University Barcelona, Barcelona, Spain
| | - Nick Warner
- Somerset Partnership NHS Trust, Somerset, UK
| | - Oscar L Lopez
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Martin Ingelsson
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | | | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center Program on Protein Aggregation and Neurodegeneration, Washington University School of Medicine, St. Louis, MO, USA
| | - Caroline Graff
- Theme Aging, Unit for Hereditary Dementias, Karolinska University Hospital-Solna, Stockholm, Sweden
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Alzheimer Research Center, Division of Neurogeriatrics, Solna, Sweden
| | - Rhian Gwilliam
- The Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Alison M Goate
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer's Disease, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pascual Sanchez-Juan
- Neurology Service and CIBERNED, 'Marqués de Valdecilla' University Hospital (University of Cantabria and IDIVAL), Santander, Spain
| | - Patrick G Kehoe
- University of Bristol Medical School, Learning & Research level 2, Southmead Hospital, Bristol, UK
| | - Najaf Amin
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Nilifur Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Claudine Berr
- Inserm U1061 Neuropsychiatry, La Colombière Hospital, Montpellier, France
- Montpellier University, Montpellier, France
| | - Stéphanie Debette
- Inserm U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Université Paris 06, UMRS 1127, Institut du Cerveau et de la Moelle Épinière, Paris, France
- AP-HP, Department of Genetics, Pitié-Salpêtrière Hospital, Paris, France
| | - Seth Love
- University of Bristol Medical School, Learning & Research level 2, Southmead Hospital, Bristol, UK
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Steven G Younkin
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Departments of Radiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | | | - Gael Nicolas
- Normandie University, UNIROUEN, Inserm U1245, and Rouen University Hospital, Department of Neurology, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - Dominique Campion
- Normandie University, UNIROUEN, Inserm U1245, and Rouen University Hospital, Department of Neurology, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
- Department of Research Rouvray Psychiatric Hospital, Sotteville-lès-Rouen, France
| | | | - Helena Schmidt
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Division of Molecular Biology and Biochemistry, Medical University Graz, Graz, Austria
- Department of Neurology, Medical University Graz, Graz, Austria
| | - Hakon Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Human Genetics, Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jordi Clarimon
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
- Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Autonomous University Barcelona, Barcelona, Spain
| | | | - Reinhold Schmidt
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University Graz, Graz, Austria
| | - Lindsay A Farrer
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
- Department of Ophthalmology, Boston University School of Medicine, Boston University, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Christine Van Broeckhoven
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Antwerp, Belgium
- Laboratory for Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Michael C O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Anita L DeStefano
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Lesley Jones
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Jonathan L Haines
- Institute for Computational Biology, Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Jean-Francois Deleuze
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Université Paris-Saclay, and LabEx GENMED, Evry, France
| | - Michael J Owen
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Richard Mayeux
- Taub Institute on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Valentina Escott-Price
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
- Kaiser Permanente, Washington Health Research Institute, Seattle, WA, USA
| | - Alfredo Ramirez
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Li-San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Agustin Ruiz
- Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Peter A Holmans
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
| | - Julie Williams
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- UK Dementia Research Institute at Cardiff, Cardiff University, Cardiff, UK
| | - Phillippe Amouyel
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Institut Pasteur de Lille, Lille, France
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France
- Centre Hospitalier Universitaire de Lille, Lille, France
| | - Gerard D Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jean-Charles Lambert
- Inserm, U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France.
- Institut Pasteur de Lille, Lille, France.
- Univ. Lille, U1167-Excellence Laboratory LabEx DISTALZ, Lille, France.
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.
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Jones JD, Kuhn T, Levine A, Sacktor N, Munro CA, Teplin LA, D'Souza G, Martin EM, Becker JT, Miller EN, Hinkin CH. Changes in cognition precede changes in HRQoL among HIV+ males: Longitudinal analysis of the multicenter AIDS cohort study. Neuropsychology 2019; 33:370-378. [PMID: 30816783 PMCID: PMC6666308 DOI: 10.1037/neu0000530] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Despite treatment-related improvements in morbidity and mortality, HIV-1-infected (HIV+) individuals continue to face a wide range of HIV-associated medical and HIV-associated neurocognitive disorders. Little is known about the impact of cognitive impairment on patients' health-related quality of life (HRQoL). To address this, the current study examined the longitudinal relationship between cognitive functioning and HRQoL among HIV+ individuals. METHOD The sample consisted of 1,306 HIV+ men enrolled in the Multicenter AIDS Cohort Study. Participants received biannual assessments of cognitive functioning (including tests of processing speed, executive functioning, attention/working memory, motor functioning, learning, and memory) and completed questionnaires assessing HRQoL and depression. Multilevel models were used to examine the longitudinal and cross-lagged relationship between HRQoL and cognition, independent of depression and HIV disease severity. RESULTS There was a significant relationship between HRQoL and cognitive functioning both between and within subjects. Specifically, individuals who reported better HRQoL reported better cognitive functioning, and longitudinal change in cognition was positively related to change in HRQoL. There was a significant unidirectional-lagged relationship; cognition predicted HRQoL at subsequent visits, but HRQoL did not predict cognitive functioning at subsequent visits. Furthermore, analyses of severity of neurocognitive impairment revealed that transition to a more severe stage of cognitive impairment was associated with a decline in HRQoL. CONCLUSIONS Overall, the current study suggests that changes in HRQoL are partially driven by changes in cognitive functioning. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Adhikari S, Lecci F, Becker JT, Junker BW, Kuller LH, Lopez OL, Tibshirani RJ. High-dimensional longitudinal classification with the multinomial fused lasso. Stat Med 2019; 38:2184-2205. [PMID: 30701586 DOI: 10.1002/sim.8100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 12/10/2018] [Accepted: 01/02/2019] [Indexed: 01/03/2023]
Abstract
We study regularized estimation in high-dimensional longitudinal classification problems, using the lasso and fused lasso regularizers. The constructed coefficient estimates are piecewise constant across the time dimension in the longitudinal problem, with adaptively selected change points (break points). We present an efficient algorithm for computing such estimates, based on proximal gradient descent. We apply our proposed technique to a longitudinal data set on Alzheimer's disease from the Cardiovascular Health Study Cognition Study. Using data analysis and a simulation study, we motivate and demonstrate several practical considerations such as the selection of tuning parameters and the assessment of model stability. While race, gender, vascular and heart disease, lack of caregivers, and deterioration of learning and memory are all important predictors of dementia, we also find that these risk factors become more relevant in the later stages of life.
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Affiliation(s)
- Samrachana Adhikari
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Fabrizio Lecci
- Department of Statistics, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - James T Becker
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brian W Junker
- Department of Statistics, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ryan J Tibshirani
- Department of Statistics, Carnegie Mellon University, Pittsburgh, Pennsylvania
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Maki PM, Rubin LH, Springer G, Seaberg EC, Sacktor N, Miller EN, Valcour V, Young MA, Becker JT, Martin EM. Differences in Cognitive Function Between Women and Men With HIV. J Acquir Immune Defic Syndr 2018; 79:101-107. [PMID: 29847476 PMCID: PMC6092201 DOI: 10.1097/qai.0000000000001764] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Women may be more vulnerable to HIV-related cognitive dysfunction compared with men because of sociodemographic, lifestyle, mental health, and biological factors. However, studies to date have yielded inconsistent findings on the existence, magnitude, and pattern of sex differences. We examined these issues using longitudinal data from 2 large, prospective, multisite, observational studies of US women and men with and without HIV. SETTING The Women's Interagency HIV Study (WIHS) and Multicenter AIDS Cohort Study (MACS). METHODS HIV-infected (HIV+) and uninfected (HIV-) participants in the Women's Interagency HIV Study and Multicenter AIDS Cohort Study completed tests of psychomotor speed, executive function, and fine motor skills. Groups were matched on HIV status, sex, age, education, and black race. Generalized linear mixed models were used to examine group differences on continuous and categorical demographically corrected T-scores. Results were adjusted for other confounding factors. RESULTS The sample (n = 1420) included 710 women (429 HIV+) and 710 men (429 HIV+) (67% non-Hispanic black; 53% high school or less). For continuous T-scores, sex by HIV serostatus interactions were observed on the Trail Making Test parts A & B, Grooved Pegboard, and Symbol Digit Modalities Test. For these tests, HIV+ women scored lower than HIV+ men, with no sex differences in HIV- individuals. In analyses of categorical scores, particularly the Trail Making Test part A and Grooved Pegboard nondominant, HIV+ women also had a higher odds of impairment compared with HIV+ men. Sex differences were constant over time. CONCLUSIONS Although sex differences are generally understudied, HIV+ women vs men show cognitive disadvantages. Elucidating the mechanisms underlying these differences is critical for tailoring cognitive interventions.
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Affiliation(s)
- Pauline M. Maki
- Department of Psychiatry, University of Illinois at Chicago College of Medicine
- Department of Psychology, University of Illinois at Chicago College of Medicine
| | - Leah H. Rubin
- Department of Psychiatry, University of Illinois at Chicago College of Medicine
- Department of Neurology, Johns Hopkins University School of Medicine
- Johns Hopkins Bloomberg School of Public Health
| | | | | | - Ned Sacktor
- Department of Neurology, Johns Hopkins University School of Medicine
| | - Eric N. Miller
- Departments of Psychiatry & Behavioral Sciences, University of California Los Angeles
| | - Victor Valcour
- Department of Neurology, University of California San Francisco
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Wu M, Fatukasi O, Yang S, Alger J, Barker PB, Hetherington H, Kim T, Levine A, Martin E, Munro CA, Parrish T, Ragin A, Sacktor N, Seaberg E, Becker JT. HIV disease and diabetes interact to affect brain white matter hyperintensities and cognition. AIDS 2018; 32:1803-1810. [PMID: 29794829 PMCID: PMC6082131 DOI: 10.1097/qad.0000000000001891] [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: 12/17/2022]
Abstract
BACKGROUND Since the onset of combination antiretroviral therapy use, the incidence of HIV-associated dementia and of HIV encephalitis has fallen dramatically. The present study investigates the extent of white matter hyperintensities (WMHs) among individuals with HIV disease, and factors that predict their presence and their impact on psychomotor speed. METHODS A total of 322 men participating in the Multicenter AIDS Cohort Study (185 HIV-infected, age: 57.5 ± 6.0) underwent MRI scans of the brain. T1-weighted magnetization-prepared rapid gradient-echo (MP-RAGE) and T2-weighted Fluid Attenuated Inversion Recovery (FLAIR) images were obtained and processed using an automated method for identifying and measuring WMHs. WMH burden was expressed as the log10 transformed percentage of total white matter. RESULTS There were no significant associations between WMHs and HIV disease. However, the extent of WMHs was predicted by age more than 60 (β = 0.17), non-white race (β = 0.14), glomerular filtration rate (β = -0.11), and the presence of diabetes (β = 0.12). There were no interactions between HIV status and age (β = -0.03) or between age and diabetes (β = 0.07). However, the interaction between HIV infection and diabetes was significant (β = 0.26). The extent of WMHs was significantly associated with performance on measures of psychomotor speed (β = 0.15). CONCLUSION In today's therapeutic environment, in HIV-infected and HIV seronegative individuals, those factors which affect the cerebrovasculature are the best predictors of WMHs. Diabetes has a specific impact among HIV-infected, but not uninfected, men, suggesting the need for more aggressive treatment even in the prediabetes state, especially as WMHs affect cognitive functions.
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Affiliation(s)
- Minjie Wu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Omalara Fatukasi
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Shaolin Yang
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Jeffery Alger
- Department of Radiology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - Peter B Barker
- Departments of Radiology, The Johns Hopkins University, Baltimore, Maryland
| | - Hoby Hetherington
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tae Kim
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Andrew Levine
- Department of Neurology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - Eileen Martin
- Department of Psychiatry, Rush University Medical School, Chicago, Illinois
| | - Cynthia A Munro
- Department of Neurology, The Johns Hopkins University, Baltimore, Maryland
| | - Todd Parrish
- Department of Radiology, Northwestern University, Evanston, Illinois
| | - Ann Ragin
- Department of Radiology, Northwestern University, Evanston, Illinois
| | - Ned Sacktor
- Department of Neurology, The Johns Hopkins University, Baltimore, Maryland
| | - Eric Seaberg
- Department of Epidemiology, The Johns Hopkins University, Baltimore, Maryland
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Neurology
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Levine AJ, Martin E, Munro CA, Sacktor N, Horvath S, Becker JT. Intraindividual variability in neurocognitive performance: No influence due to HIV status or self-reported effort. J Clin Exp Neuropsychol 2018; 40:1044-1049. [PMID: 30124355 DOI: 10.1080/13803395.2018.1508554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION HIV-associated neurocognitive disorders (HAND) are estimated to affect approximately 50% of infected individuals at any one time. Dispersion, a type of intraindividual variability in neurocognitive test performance, has been identified as a potential behavioral marker of HAND; however, the specificity of dispersion to HAND and how it is influenced by participant effort when taking neurocognitive tests remain unclear. METHOD Data were analyzed from 996 (474 HIV-, 522 HIV+) men enrolled in the Multicenter AIDS Cohort Study (MACS). Dispersion was calculated based on the standard deviation of an individual's test scores within a single assessment. Effort was determined using the Visual Analogue Effort Scale. Predictors of dispersion were determined using stepwise linear regression. Dispersion was compared between the HIV serostatus groups using analysis of covariance (ANCOVA), considering demographic and psychosocial variables that differed between the groups. RESULTS Contrary to our hypothesis, dispersion was not influenced by effort. Instead, poorer neurocognitive ability and race were the sole predictors of dispersion. Dispersion did not differ between the serostatus groups. CONCLUSIONS Our results indicate that dispersion is a valid indicator of neurocognitive dysfunction that is not due to suboptimal effort; however, it is not specific to HIV and is therefore of limited utility as a behavioral marker of HIV-related neurocognitive impairment.
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Affiliation(s)
- Andrew J Levine
- a Department of Neurology , David Geffen School of Medicine at the University of California Los Angeles , Los Angeles , CA , USA
| | - Eileen Martin
- b Department of Psychiatry , Rush University Medical Center , Chicago , IL , USA
| | - Cynthia A Munro
- c Departments of Psychiatry and Neurology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Ned Sacktor
- d Department of Neurology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Steve Horvath
- e Departments of Human Genetics and Biostatistics , David Geffen School of Medicine at the University of California Los Angeles , Los Angeles , CA , USA
| | - James T Becker
- f Departments of Psychiatry, Neurology, and Psychology , University of Pittsburgh , Pittsburgh , PA , USA
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Molsberry SA, Cheng Y, Kingsley L, Jacobson L, Levine AJ, Martin E, Miller EN, Munro CA, Ragin A, Sacktor N, Becker JT. Neuropsychological phenotypes among men with and without HIV disease in the multicenter AIDS cohort study. AIDS 2018; 32:1679-1688. [PMID: 29762177 PMCID: PMC6082155 DOI: 10.1097/qad.0000000000001865] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 11/26/2022]
Abstract
OBJECTIVE Mild forms of HIV-associated neurocognitive disorder (HAND) remain prevalent in the combination antiretroviral therapy (cART) era. This study's objective was to identify neuropsychological subgroups within the Multicenter AIDS Cohort Study (MACS) based on the participant-based latent structure of cognitive function and to identify factors associated with subgroups. DESIGN The MACS is a four-site longitudinal study of the natural and treated history of HIV disease among gay and bisexual men. METHODS Using neuropsychological domain scores, we used a cluster variable selection algorithm to identify the optimal subset of domains with cluster information. Latent profile analysis was applied using scores from identified domains. Exploratory and posthoc analyses were conducted to identify factors associated with cluster membership and the drivers of the observed associations. RESULTS Cluster variable selection identified all domains as containing cluster information except for Working Memory. A three-profile solution produced the best fit for the data. Profile 1 performed below average on all domains, Profile 2 performed average on executive functioning, motor, and speed and below average on learning and memory, Profile 3 performed at or above average across all domains. Several demographic, cognitive, and social factors were associated with profile membership; these associations were driven by differences between Profile 1 and the other profiles. CONCLUSION There is an identifiable pattern of neuropsychological performance among MACS members determined by all domains except Working Memory. Neither HIV nor HIV-related biomarkers were related with cluster membership, consistent with other findings that cognitive performance patterns do not map directly onto HIV serostatus.
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Affiliation(s)
- Samantha A Molsberry
- Population Health Sciences Program, Graduate School of Arts and Sciences, Harvard University, Cambridge, Massachusetts
| | - Yu Cheng
- Department of Statistics
- Department of Psychiatry, University of Pittsburgh
| | - Lawrence Kingsley
- Department of Epidemiology
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lisa Jacobson
- Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
| | - Andrew J Levine
- Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Eileen Martin
- Department of Psychiatry, Rush University School of Medicine, Chicago, Illinois
| | - Eric N Miller
- Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Cynthia A Munro
- Department of Psychiatry
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ann Ragin
- Department of Radiology, Northwestern University, Evanston, Illinois
| | - Ned Sacktor
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh
- Department of Psychology
- Department of Neurology , University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Yousef S, Kuller LH, Chang Y, Barinas-Mitchell E, Becker JT, Klunk WE, Aizenstein HJ, Cohen A, Snitz BE, Lopez OL. P1‐437: PULSE WAVE VELOCITY IS ASSOCIATED WITH INCIDENT DEMENTIA AND AMYLOID DEPOSITION IN THE BRAINS OF ELDERLY ADULTS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.446] [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: 11/30/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Annie Cohen
- University of Pittsburgh School of MedicinePittsburghPAUSA
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Corlier F, Hafzalla G, Faskowitz J, Kuller LH, Becker JT, Lopez OL, Thompson PM, Braskie MN. Systemic inflammation as a predictor of brain aging: Contributions of physical activity, metabolic risk, and genetic risk. Neuroimage 2018; 172:118-129. [PMID: 29357308 PMCID: PMC5954991 DOI: 10.1016/j.neuroimage.2017.12.027] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 12/01/2017] [Accepted: 12/11/2017] [Indexed: 12/17/2022] Open
Abstract
Inflammatory processes may contribute to risk for Alzheimer's disease (AD) and age-related brain degeneration. Metabolic and genetic risk factors, and physical activity may, in turn, influence these inflammatory processes. Some of these risk factors are modifiable, and interact with each other. Understanding how these processes together relate to brain aging will help to inform future interventions to treat or prevent cognitive decline. We used brain magnetic resonance imaging (MRI) to scan 335 older adult humans (mean age 77.3 ± 3.4 years) who remained non-demented for the duration of the 9-year longitudinal study. We used structural equation modeling (SEM) in a subset of 226 adults to evaluate whether measures of baseline peripheral inflammation (serum C-reactive protein levels; CRP), mediated the baseline contributions of genetic and metabolic risk, and physical activity, to regional cortical thickness in AD-relevant brain regions at study year 9. We found that both baseline metabolic risk and AD risk variant apolipoprotein E ε4 (APOE4), modulated baseline serum CRP. Higher baseline CRP levels, in turn, predicted thinner regional cortex at year 9, and mediated an effect between higher metabolic risk and thinner cortex in those regions. A higher polygenic risk score composed of variants in immune-associated AD risk genes (other than APOE) was associated with thinner regional cortex. However, CRP levels did not mediate this effect, suggesting that other mechanisms may be responsible for the elevated AD risk. We found interactions between genetic and environmental factors and structural brain health. Our findings support the role of metabolic risk and peripheral inflammation in age-related brain decline.
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Affiliation(s)
- Fabian Corlier
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA
| | - George Hafzalla
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA
| | - Joshua Faskowitz
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA
| | - Lewis H Kuller
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - James T Becker
- Departments of Neurology, Psychiatry, and Psychology, University of Pittsburgh, Pittsburgh, PA 15139, USA
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA; Depts. of Neurology, Psychiatry, Engineering, Radiology, & Ophthalmology, Keck/USC School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Meredith N Braskie
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA.
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Lopez OL, Becker JT, Chang Y, Klunk WE, Mathis C, Price J, Aizenstein HJ, Snitz B, Cohen AD, DeKosky ST, Ikonomovic M, Kamboh MI, Kuller LH. Amyloid deposition and brain structure as long-term predictors of MCI, dementia, and mortality. Neurology 2018; 90:e1920-e1928. [PMID: 29695596 DOI: 10.1212/wnl.0000000000005549] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 03/14/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To test the hypothesis that brain structural integrity (i.e., hippocampal [HIP] volume), white matter lesions (WMLs), and β-amyloid deposition are associated with long-term increased risk of incident dementia and mortality in 183 cognitively normal individuals and patients with mild cognitive impairment (MCI) aged 80 years and older. METHODS All participants had a brain structural MRI scan and PET scan with 11C-labeled Pittsburgh compound B in 2009 and were reexamined yearly through 2015 (mean follow-up time 5.2 ± 1.3 years). RESULTS In the last evaluation through 2010-2015, 56 (31%) participants were cognitively normal, 67 (37%) had MCI, and 60 (33%) had dementia. Fifty-seven (31%) died during follow-up, and 20 (35%) developed dementia before their death. All 3 biomarkers were independent predictors of incident dementia in all participants. After adjusting for the risk of dying, amyloid deposition and WMLs remained strong predictors. Of the 60 participants with incident dementia, 54 (90%) had at least one imaging abnormality. Participants with no biomarker positivity had a very low risk of dementia (16%), while 75% of the participants with the 3 biomarkers progressed to dementia. HIP volume and β-amyloid deposition were associated with death only in participants with MCI. CONCLUSIONS This study showed the presence of more than one biomarker was a stronger long-term predictor of incident dementia than any biomarker alone. After adjusting for the risk of dying, amyloid deposition and WMLs were stronger predictors of dementia than HIP volume. The risk of dying during follow-up was associated with both neurodegeneration and amyloid deposition, especially in individuals with MCI.
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Affiliation(s)
- Oscar L Lopez
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville.
| | - James T Becker
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - YueFang Chang
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - William E Klunk
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - Chester Mathis
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - Julia Price
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - Howard J Aizenstein
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - Beth Snitz
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - Ann D Cohen
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - Steven T DeKosky
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - Milos Ikonomovic
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - M Ilyas Kamboh
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
| | - Lewis H Kuller
- From the Departments of Neurology (O.L.L., J.T.B., B.S., M.I.), Psychiatry (O.L.L., J.T.B., W.E.K., H.J.A., A.D.C.), Psychology (J.T.B.), Neurosurgery (Y.C.), Epidemiology, Graduate School of Public Health (Y.C., L.H.K.), Radiology (C.M., J.P.), Pharmaceutical Sciences (C.M.), and Genetics (M.I.K.), University of Pittsburgh, School of Medicine, PA; and Department of Neurology (S.T.D.), University of Florida, Gainesville
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Espinosa A, Alegret M, Pesini P, Valero S, Lafuente A, Buendía M, San José I, Ibarria M, Tejero MA, Giménez J, Ruiz S, Hernández I, Pujadas F, Martínez-Lage P, Munuera J, Arbizu J, Tárraga L, Hendrix SB, Ruiz A, Becker JT, Landau SM, Sotolongo-Grau O, Sarasa M, Boada M. Cognitive Composites Domain Scores Related to Neuroimaging Biomarkers within Probable-Amnestic Mild Cognitive Impairment-Storage Subtype. J Alzheimers Dis 2018; 57:447-459. [PMID: 28269787 PMCID: PMC5366247 DOI: 10.3233/jad-161223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The probable-amnestic (Pr-a) mild cognitive impairment (MCI)-storage subtype is a phenotype with 8.5 times more risk of conversion to dementia, mainly Alzheimer's disease (AD), than the possible non-amnestic (Pss-na) MCI. The aim of this study was to find the optimized cognitive composites (CCs) domain scores most related to neuroimaging biomarkers within Pr-aMCI-storage subtype patients. The Fundació ACE (ACE) study with 20 Pr-aMCI-storage subtype subjects (MCI) were analyzed. All subjects underwent a neuropsychological assessment, a structural MRI, FDG-PET, and PIB-PET. The adjusted hippocampal volume (aHV) on MRI, the standard uptake value ratio (SUVR) on FDG-PET and PIB-PET SUVR measures were analyzed. The construction of the CCs domain scores, and the aHV on MRI and FDG-PET SUVR measures, were replicated in the parental AB255 study database (n = 133 MCI). Partial correlations adjusted by age, gender, and education were calculated with the associated p-value among every CC domain score and the neuroimaging biomarkers. The results were replicated in the "MCI due to AD" with memory storage impairments from ADNI. Delayed Recall CC domain score was significantly correlated with PIB-PET SUVR (β= -0.61, p = 0.003) in the ACE study and also with aHV on MRI (β= 0.27, p = 0.01) and FDG-PET SUVR (β= 0.27, p = 0.01) in the AB255 study. After a median survival time of 20.6 months, 85% from the ACE MCI converted to AD. The replication of our results in the ADNI dataset also confirmed our findings. Delayed Recall is the CC domain score best correlated with neuroimaging biomarkers associated with prodromal AD diagnosis.
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Affiliation(s)
- Ana Espinosa
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
| | - Montserrat Alegret
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
| | | | - Sergi Valero
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain.,Deparment of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Asunción Lafuente
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
| | - Mar Buendía
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
| | | | - Marta Ibarria
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
| | | | | | - Susana Ruiz
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
| | - Isabel Hernández
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
| | - Francesc Pujadas
- Department of Neurology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pablo Martínez-Lage
- Fundación CITA, Centro de Investigación y Terapias Avanzadas, Alzheimer, San Sebastián, Spain
| | - Josep Munuera
- Hospital Universitari Germans Trias i Pujol, Unitat RM Badalona, Institut de diagnòstic per la imatge, Badalona, Spain
| | | | - Lluis Tárraga
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
| | | | - Agustín Ruiz
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
| | - James T Becker
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Oscar Sotolongo-Grau
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
| | | | - Mercè Boada
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Alzheimer Barcelona, Spain
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Slachevsky A, Guzmán-Martínez L, Delgado C, Reyes P, Farías GA, Muñoz-Neira C, Bravo E, Farías M, Flores P, Garrido C, Becker JT, López OL, Maccioni RB. Tau Platelets Correlate with Regional Brain Atrophy in Patients with Alzheimer's Disease. J Alzheimers Dis 2018; 55:1595-1603. [PMID: 27911301 DOI: 10.3233/jad-160652] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Intracellular neurofibrillary tangles are part of the core pathology of Alzheimer's disease (AD), which are mainly composed of hyperphosphorylated tau protein. OBJECTIVES The purpose of this study is to determine whether high molecular weight (HMW) or low molecular weight (LMW) tau protein levels, as well as the ratio HMW/LMW, present in platelets correlates with brain magnetic resonance imaging (MRI) structural changes in normal and cognitively impaired subjects. METHODS We examined 53 AD patients and 37 cognitively normal subjects recruited from two Memory Clinics at the Universidad de Chile. Tau levels in platelets were determined by immunoreactivity and the MRI scans were analyzed using voxel-based morphometry in 41 AD patients. RESULTS The HMW/LMW tau ratio was statistically different between controls and AD patients, and no associations were noted between HMW or LMW tau and MRI structures. In a multivariate analysis controlled for age and education level, the HMW/LMW tau ratio was associated with reduced volume in the left medial and right anterior cingulate gyri, right cerebellum, right thalamus (pulvinar), left frontal cortex, and right parahippocampal region. CONCLUSIONS This exploratory study showed that HMW/LMW tau ratio is significantly higher in AD patients than control subjects, and that it is associated with specific brain regions atrophy. Determination of peripheral markers of AD pathology can help understanding the pathophysiology of neurodegeneration in AD.
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Affiliation(s)
- Andrea Slachevsky
- Physiopathology Department, ICBM and East Neuroscience Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Cognitive Neurology and Dementia Unit, Neurological Sciences Department, Faculty of Medicine, Universidad de Chile and Neurology Department, Hospital del Salvador, Santiago, Chile.,Gerosciences Center for Brain Health and Metabolism, Santiago, Chile.,CIAE, Center for Advanced Research in Education, Universidad de Chile, Santiago, Chile
| | | | - Carolina Delgado
- Neurology and Neurosurgery Department, Clinical Hospital, Universidad de Chile, Santiago, Chile
| | - Pablo Reyes
- Physiopathology Department, ICBM and East Neuroscience Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Gonzalo A Farías
- International Center for Biomedicine, Santiago, Chile.,Neurology and Neurosurgery Department, Clinical Hospital, Universidad de Chile, Santiago, Chile
| | - Carlos Muñoz-Neira
- Cognitive Neurology and Dementia Unit, Neurological Sciences Department, Faculty of Medicine, Universidad de Chile and Neurology Department, Hospital del Salvador, Santiago, Chile
| | - Eduardo Bravo
- Neuroradiology Department, Institute of Neurosurgery Asenjo, Santiago, Chile
| | - Mauricio Farías
- Neuroradiology Department, Institute of Neurosurgery Asenjo, Santiago, Chile
| | - Patricia Flores
- Cognitive Neurology and Dementia Unit, Neurological Sciences Department, Faculty of Medicine, Universidad de Chile and Neurology Department, Hospital del Salvador, Santiago, Chile.,Neurology Unit, Department of Medicine, Clínica Alemana-Universidad del Desarollo, Santiago, Chile
| | - Cristian Garrido
- Neurology and Neurosurgery Department, Clinical Hospital, Universidad de Chile, Santiago, Chile
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.,Department of Neurology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.,Department of Psychology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Oscar L López
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.,Department of Neurology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Ricardo B Maccioni
- International Center for Biomedicine, Santiago, Chile.,Faculty of Sciences, University of Chile, Santiago, Chile
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Hines LJ, Miller EN, Hinkin CH, Alger JR, Barker P, Goodkin K, Martin EM, Maruca V, Ragin A, Sacktor N, Sanders J, Selnes O, Becker JT. Cortical brain atrophy and intra-individual variability in neuropsychological test performance in HIV disease. Brain Imaging Behav 2017; 10:640-51. [PMID: 26303224 DOI: 10.1007/s11682-015-9441-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
To characterize the relationship between dispersion-based intra-individual variability (IIVd) in neuropsychological test performance and brain volume among HIV seropositive and seronegative men and to determine the effects of cardiovascular risk and HIV infection on this relationship. Magnetic Resonance Imaging (MRI) was used to acquire high-resolution neuroanatomic data from 147 men age 50 and over, including 80 HIV seropositive (HIV+) and 67 seronegative controls (HIV-) in this cross-sectional cohort study. Voxel Based Morphometry was used to derive volumetric measurements at the level of the individual voxel. These brain structure maps were analyzed using Statistical Parametric Mapping (SPM2). IIVd was measured by computing intra-individual standard deviations (ISD's) from the standardized performance scores of five neuropsychological tests: Wechsler Memory Scale-III Visual Reproduction I and II, Logical Memory I and II, Wechsler Adult Intelligence Scale-III Letter Number Sequencing. Total gray matter (GM) volume was inversely associated with IIVd. Among all subjects, IIVd -related GM atrophy was observed primarily in: 1) the inferior frontal gyrus bilaterally, the left inferior temporal gyrus extending to the supramarginal gyrus, spanning the lateral sulcus; 2) the right superior parietal lobule and intraparietal sulcus; and, 3) dorsal/ventral regions of the posterior section of the transverse temporal gyrus. HIV status, biological, and cardiovascular disease (CVD) variables were not linked to IIVd -related GM atrophy. IIVd in neuropsychological test performance may be a sensitive marker of cortical integrity in older adults, regardless of HIV infection status or CVD risk factors, and degree of intra-individual variability links with volume loss in specific cortical regions; independent of mean-level performance on neuropsychological tests.
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Affiliation(s)
- Lindsay J Hines
- Semel Institute for Neurosciences, University of California Los Angeles, Los Angeles, CA, USA. .,Sanford Brain and Spine Center, Sanford Health, Fargo, ND, USA. .,Department of Psychology, University of North Dakota, Fargo, ND, USA.
| | - Eric N Miller
- Semel Institute for Neurosciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Charles H Hinkin
- Semel Institute for Neurosciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Jeffery R Alger
- The Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Peter Barker
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karl Goodkin
- Department of Psychiatry and Behavioral Sciences, East Tennessee State University, Johnson City, TN, USA
| | | | - Victoria Maruca
- Department of Psychology, Spalding University, Louisville, KY, USA
| | - Ann Ragin
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - Ned Sacktor
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joanne Sanders
- Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA
| | - Ola Selnes
- Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Psychology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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