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Herb CC, Custer L, Blemker S, Saliba S, Hart J, Hertel J. Gait kinematics and kinetics in patients with chronic ankle instability and healthy controls: A statistical parametric mapping analysis. Foot (Edinb) 2024; 59:102089. [PMID: 38593519 DOI: 10.1016/j.foot.2024.102089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/27/2023] [Accepted: 03/10/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Chronic ankle instability (CAI) is associated with changes in gait biomechanics which may be related to chronic dysfunction. Traditional statistical models may be limited in their ability to assess the complex 3D movement of the lower extremity during gait. Multivariate analysis of the lower extremity kinematics may reveal unique biomechanical differences associated with CAI. RESEARCH QUESTION Do patients with CAI differ from healthy controls in their lower extremity biomechanics and GRF when comparing 3D biomechanics? METHODS Thirty-nine young, active adults participated in this study. Data was collected using a 3D motion analysis system while patients walked and jogged. Statistical parametric mapping (SPM) was used to explore 3D GRF, kinematics and kinetics of the of the lower extremity of CAI and healthy patients. RESULTS During walking, patients with CAI had greater inversion from 68-100% of gait cycle (p < 0.001, mean difference=3.2°). During jogging, patients with CAI had greater inversion from 20-92% (p < 0.001, mean difference=4.6°). Greater plantar flexion moments were found from 65-71% (p = 0.05, mean difference=347.4Nm/kg) and greater eversion moments were found from 95-100% (p = 0.03, mean difference=74.6Nm/kg) in the CAI group. No differences in GRF were found. SIGNIFICANCE Greater inversion may present a potentially injurious position. A faulty position of the rearfoot may require greater muscle function in order to correct the position of the joint resulting in greater eversion moments at the ankle. However, this kinetic change does not appear to correct the ankle position.
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Affiliation(s)
- C C Herb
- Northern Kentucky University, School of Kinesiology, Counseling and Rehabilitative Science, Highland Heights, KY, USA.
| | - L Custer
- Towson University, Department of Kinesiology, Towson, MD, USA
| | - S Blemker
- University of Virginia, School of Engineering and Applied Science, Charlottesville, VA, USA
| | - S Saliba
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hart
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hertel
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
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2
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Devora PV, Motes MA, Hilsabeck RC, Gonzales M, Detoledo J, Maestre G, Hart J. Analyzing direct effects of education level and estimated IQ between cognitively intact Mexican Americans and Non-Hispanic whites on a confrontational naming task. Appl Neuropsychol Adult 2024:1-10. [PMID: 38470863 DOI: 10.1080/23279095.2024.2326587] [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] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Confrontational naming is widely used in diagnosing neurodegenerative disorders like MCI and dementia, and previous research indicates that healthy Non-Hispanic Whites outperform Hispanics in such tasks. However, understanding the factors contributing to score differences among ethnic groups remains limited. This study focuses on cognitively intact Mexican Americans and Non-Hispanic White older adults from the TARCC Hispanic Cohort project. Hierarchical regression analyses reveal that sex, age, ethnicity, education level, and estimated IQ significantly predict performance on the Boston Naming Test (BNT). Notably, education level and estimated IQ more strongly influence BNT performance in Mexican Americans than in Non-Hispanic Whites. When controlling for education level, estimated IQ has a more pronounced impact on BNT performance in aging Mexican Americans compared to Non-Hispanic Whites. Conversely, after controlling for estimated IQ, the influence of education level is weaker for Mexican Americans than Non-Hispanic Whites. These findings emphasize the need for careful evaluation of confrontational naming task scores in diverse ethnic groups, emphasizing the critical role of education and estimated IQ in understanding performance disparities.
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Affiliation(s)
- Paulina Vanessa Devora
- The University of Texas at Dallas School of Behavioral and Brain Sciences, Richardson, TX, USA
| | - Michael A Motes
- The University of Texas at Dallas School of Behavioral and Brain Sciences, Richardson, TX, USA
| | - Robin C Hilsabeck
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Mitzi Gonzales
- The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - John Detoledo
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Gladys Maestre
- The University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - John Hart
- The University of Texas at Dallas School of Behavioral and Brain Sciences, Richardson, TX, USA
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3
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Bellamy COC, O'Leary JG, Adeyi O, Baddour N, Batal I, Bucuvalas J, Del Bello A, El Hag M, El-Monayeri M, Farris AB, Feng S, Fiel MI, Fischer SE, Fung J, Grzyb K, Guimei M, Haga H, Hart J, Jackson AM, Jaeckel E, Khurram NA, Knechtle SJ, Lesniak D, Levitsky J, McCaughan G, McKenzie C, Mescoli C, Miquel R, Minervini MI, Nasser IA, Neil D, O'Neil MF, Pappo O, Randhawa P, Ruiz P, Fueyo AS, Schady D, Schiano T, Sebagh M, Smith M, Stevenson HL, Taner T, Taubert R, Thung S, Trunecka P, Wang HL, Wood-Trageser M, Yilmaz F, Zen Y, Zeevi A, Demetris AJ. Banff 2022 Liver Group Meeting report: Monitoring long-term allograft health. Am J Transplant 2024:S1600-6135(24)00204-1. [PMID: 38461883 DOI: 10.1016/j.ajt.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 03/12/2024]
Abstract
The Banff Working Group on Liver Allograft Pathology met in September 2022. Participants included hepatologists, surgeons, pathologists, immunologists, and histocompatibility specialists. Presentations and discussions focused on the evaluation of long-term allograft health, including noninvasive and tissue monitoring, immunosuppression optimization, and long-term structural changes. Potential revision of the rejection classification scheme to better accommodate and communicate late T cell-mediated rejection patterns and related structural changes, such as nodular regenerative hyperplasia, were discussed. Improved stratification of long-term maintenance immunosuppression to match the heterogeneity of patient settings will be central to improving long-term patient survival. Such personalized therapeutics are in turn contingent on a better understanding and monitoring of allograft status within a rational decision-making approach, likely to be facilitated in implementation with emerging decision-support tools. Proposed revisions to rejection classification emerging from the meeting include the incorporation of interface hepatitis and fibrosis staging. These will be opened to online testing, modified accordingly, and subject to consensus discussion leading up to the next Banff conference.
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Affiliation(s)
- Christopher O C Bellamy
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland and Department of Pathology, Edinburgh Royal Infirmary, Edinburgh, Scotland.
| | - Jacqueline G O'Leary
- Dallas VA Medical Center & University of Texas, Southwestern, Department of Medicine, Dallas Texas, USA
| | - Oyedele Adeyi
- University of Minnesota Medical School, Department of Pathology, Minneapolis, Minnesota, USA
| | - Nahed Baddour
- Faculty of Medicine, University of Alexandria, Egypt
| | - Ibrahim Batal
- Pathology, Columbia University Irving Medical Center, New York, New York, USA
| | | | | | | | | | - Alton B Farris
- Pathology, Emory University Hospital, Atlanta, Georgia, USA
| | - Sandy Feng
- UCSF Health, Department of Surgery, San Francisco, California, USA
| | - Maria Isabel Fiel
- Pathology, Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | | | - John Fung
- Uchicago Medicine, Department of Surgery, Chicago, Illinois, USA
| | | | - Maha Guimei
- Armed Forces College of Medicine, Cairo, Egypt
| | | | - John Hart
- Uchicago Medicine, Department of Pathology, Chicago, Illinois, USA
| | | | | | - Nigar A Khurram
- University of Pittsburgh Medical Center, Department of Pathology, Pittsburgh, Pennsylvania, USA
| | | | - Drew Lesniak
- University of Pittsburgh Medical Center, Department of Pathology, Pittsburgh, Pennsylvania, USA
| | | | | | | | | | - Rosa Miquel
- Institute of Liver Studies, King's College Hospital, London, United Kingdom
| | - Marta I Minervini
- University of Pittsburgh Medical Center, Department of Pathology, Pittsburgh, Pennsylvania, USA
| | - Imad Ahmad Nasser
- Beth Israel Deaconess Medical Center, Harvard, Boston, Massachusetts, USA
| | - Desley Neil
- University Hospitals Birmingham NHS Foundation Trust, United Kingdom
| | - Maura F O'Neil
- University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Orit Pappo
- Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Parmjeet Randhawa
- University of Pittsburgh Medical Center, Department of Pathology, Pittsburgh, Pennsylvania, USA
| | - Phillip Ruiz
- University of Miami Hospital, Miami, Florida, USA
| | | | | | - Thomas Schiano
- Recanati/Miller Transplantation Institute, Mount Sinai Medical Center, New York, New York, USA
| | | | - Maxwell Smith
- Pathology, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | | | - Timucin Taner
- Division of Transplantation Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Richard Taubert
- Dept. of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Swan Thung
- Pathology, Icahn School of Medicine, Mount Sinai, New York, New York, USA
| | - Pavel Trunecka
- Institute for Clinical and Experimental Medicine (IKEM), Prague, Czechia
| | - Hanlin L Wang
- Pathology, UCLA Health, Los Angeles, California, USA
| | - Michelle Wood-Trageser
- University of Pittsburgh Medical Center, Department of Pathology, Pittsburgh, Pennsylvania, USA
| | - Funda Yilmaz
- Pathology, University of Ege, Imir, Bornova, Turkey
| | - Yoh Zen
- Institute of Liver Studies, King's College Hospital, London, United Kingdom
| | - Adriana Zeevi
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Testard C, Shergold C, Acevedo-Ithier A, Hart J, Bernau A, Negron-Del Valle JE, Phillips D, Watowich MM, Sanguinetti-Scheck JI, Montague MJ, Snyder-Mackler N, Higham JP, Platt ML, Brent L. Natural disaster alters the adaptive benefits of sociality in a primate. bioRxiv 2024:2023.07.17.549328. [PMID: 37503170 PMCID: PMC10370068 DOI: 10.1101/2023.07.17.549328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Weather-related disasters can radically alter ecosystems. When disaster-driven ecological damage persists, the selective pressures exerted on individuals can change, eventually leading to phenotypic adjustments. For group-living animals, social relationships are believed to help individuals cope with environmental challenges and may be a critical mechanism enabling adaptation to ecosystems degraded by disasters. Yet, whether natural disasters alter selective pressures on patterns of social interactions and whether group-living animals can, as a result, adaptively change their social relationships remains untested. Here, we leveraged unique data collected on rhesus macaques from 5 years before to 5 years after a category 4 hurricane, leading to persistent deforestation which exacerbated monkeys' exposure to intense heat. In response, macaques increased tolerance for and decreased aggression toward other monkeys, facilitating access to scarce shade critical for thermoregulation. Social tolerance predicted individual survival for 5 years after the hurricane, but not before it, revealing a clear shift in the adaptive function of social relationships in this population. We demonstrate that an extreme climatic event altered selection on sociality and triggered substantial and persistent changes in the social structure of a primate species. Our findings unveil the function and adaptive flexibility of social relationships in degraded ecosystems and identify natural disasters as potential evolutionary drivers of sociality. One-Sentence Summary Testard et al. show that a natural disaster altered selection on sociality in group-living primates triggering persistent changes in their social structure.
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Patel N, Leffler DA, Al-Toma A, Mulder CJ, Elli L, Gan G, Patil P, Atsawarungruangkit A, Kuijpers KC, Del Gobbo A, Goldsmith J, Hintze Z, Pacheco MC, Vieth M, Melcher B, Salomao M, Pai R, Hart J, Olivas A, Naini B, Meyerson C, Choi WT, Kakar S, Westerhoff M, Cheng J, Gopal P, Hammer S, Moreno Prats M, Bronner MP, Robert ME. Clinical Data Do Not Reliably Predict Duodenal Histology at Follow-up in Celiac Disease: A 13 Center Correlative Study. Am J Surg Pathol 2024; 48:212-220. [PMID: 37994653 DOI: 10.1097/pas.0000000000002150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Validated nonbiopsy methods to assure duodenal mucosal healing in celiac disease are lacking, yet ongoing mucosal injury is associated with anemia, osteoporosis, and lymphoma. Most providers utilize clinical data as surrogates of mucosal status to avoid additional esophagogastroduodenoscopy. The reliability of such surrogates to predict mucosal recovery has been incompletely evaluated. The aim of this study was to rigorously assess patterns of histologic mucosal recovery at follow-up in celiac disease and to correlate findings with clinical data. Gastrointestinal pathologists from 13 centers evaluated initial and follow-up duodenal biopsies from 181 celiac disease patients. Marsh scores and intraepithelial lymphocytes (IELs)/100 enterocytes were assessed blindly. Histology at follow-up was correlated with symptoms, immunoglobulin A anti-tissue transglutaminase titers and gluten-free diet adherence. Fifty-six/181 (31%) patients had persistent villous blunting and 46/181 (25%) patients had just persistently elevated IELs at follow-up, with only 79/181 (44%) patients having complete histologic remission. IEL normalization (82/181; 45%) lagged villous recovery (125/181;69%). In a minority of patients, villous blunting was limited to proximal duodenal biopsies. No correlation was found between Marsh scores and symptoms, normalization of immunoglobulin A anti-tissue transglutaminase serology, or diet adherence. Children showed greater recovery of Marsh score ( P <0.001) and IELs ( P <0.01) than adults. Persistent mucosal injury is common in celiac disease, with discordant villous/IEL normalization. Pathologist awareness of expected findings in celiac disease follow-up biopsies, including their frequent lack of correlation with clinical data, is important for patient management, and has implications for eligibility criteria for therapeutics currently in development.
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Affiliation(s)
| | | | | | - Chris J Mulder
- Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Luca Elli
- Center for Prevention and Diagnosis of celiac disease, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | | | | | | | | | - Alessandro Del Gobbo
- Division of Pathology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Italy
| | | | | | | | - Michael Vieth
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany
| | - Balint Melcher
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany
| | | | | | - John Hart
- University of Chicago Medical Center, Chicago, IL
| | | | | | | | - Won-Tak Choi
- Department of Pathology, University of California, San Francisco, CA
| | - Sanjay Kakar
- Department of Pathology, University of California, San Francisco, CA
| | | | - Jerome Cheng
- Department of Pathology, University of Michigan, Ann Arbor, MI
| | - Purva Gopal
- University of Texas Southwestern Medical Center, Dallas, TX
| | - Suntrea Hammer
- University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Mary P Bronner
- University of Utah Health Sciences Center and ARUP Labs, Salt Lake City, UT
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Yilmaz O, Westerhoff M, Panarelli N, Hart J, Groisman G, Ruz-Caracuel I, Loughrey M, Matsukuma K, Lee SH, Yilmaz O, Gonzalez RS, Deshpande V. Lymphoglandular Complex-Like Colorectal Carcinoma-A Series of 20 Colorectal Cases, Including Newly Reported Features of Malignant Behavior. Am J Surg Pathol 2024; 48:70-79. [PMID: 38054635 DOI: 10.1097/pas.0000000000002141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Distinguishing colon carcinoma that is surrounded by well-circumscribed lymphoid tissue from adenomas involving lymphoglandular complexes can be difficult. We assessed a multi-institutional international cohort of 20 colorectal carcinomas with associated prominent lymphoid infiltrates, which we referred to as lymphoglandular complex-like carcinoma (LGCC). We collected clinical and endoscopic features, including lesion size, endoscopic appearance, location, procedure, follow-up, AJCC stage, and mismatch repair status. We recorded the presence of the following histologic features: haphazard gland distribution, gland angulation, gland fusion, solid nest formation, single-cell formation, stromal desmoplasia, presence of lymphovascular invasion and perineural invasion, presence of lamina propria, cytologic atypia as low- or high-grade, presence of goblet cells in the invasive component, and the presence of a surface lesion. Most cases (9 of 13) were described endoscopically as sessile polyps with an average size of 1.56 cm. Most cases (90%) were associated with a surface lesion, of which the majority were tubular adenomas, though a subset was associated with sessile serrated lesions with dysplasia (3 of 18). All cases of LGCC demonstrated haphazard gland distribution and either gland angulation, fusion, or solid nest formation. A portion of cases demonstrated single-cell infiltration (35%) and desmoplasia (50%), and rarely lymphovascular invasion was present (5%). A subset (10%) of cases invaded beyond the submucosa. Deficient mismatch repair was present in 22% (2 of 9) of cases for which it was performed. In cases of colectomy or completion colectomy, nodal metastasis was present in 38% (3 of 8). No cases demonstrated disease recurrence or disease-specific mortality. Overall, LGCC represents an enigmatic subset of carcinomas that is important to distinguish from adenomas involving lymphoglandular complexes due to its varying prognostic outcomes.
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Affiliation(s)
- Osman Yilmaz
- Department of Pathology, Beth Israel Deaconess Medical Center
- Harvard Medical School, Boston, MA
| | | | - Nicole Panarelli
- Department of Pathology, Montefiore Albert Einstein College of Medicine, New York, NY
| | - John Hart
- Department of Pathology, University of Chicago, Chicago, IL
| | - Gabriel Groisman
- Department of Pathology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Ignacio Ruz-Caracuel
- Department of Pathology, Hospital Universitario Ramon y Cajal, IRYCIS, CIBERONC, Madrid, Spain
| | - Maurice Loughrey
- Department of Pathology, Royal Victoria Hospital Belfast Trust, Belfast, N. Ireland
| | - Karen Matsukuma
- Department of Pathology, University of California Davis, Sacramento, CA
| | - Soo Hyun Lee
- Department of Pathology, Boston University Medical Center
| | - Omer Yilmaz
- Department of Pathology, Massachusetts General Hospital, Boston, MA
| | | | - Vikram Deshpande
- Department of Pathology, Beth Israel Deaconess Medical Center
- Harvard Medical School, Boston, MA
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7
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Desai N, Kudose S, Remotti HE, Del Portillo A, Fazlollahi L, Lee MJ, Xiong Y, Moreira RK, Salomao M, Fiel MI, Gonzalez RS, Misdraji J, Gill RM, Hart J, Kleiner DE, Drebber U, Bellizzi AM, Lagana SM. Erythrophagocytosis is not a reproducible finding in liver biopsies, and is not associated with clinical diagnosis of hemophagocytic lymphohistiocytosis. Virchows Arch 2024; 484:61-69. [PMID: 37924345 DOI: 10.1007/s00428-023-03683-7] [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: 09/07/2023] [Revised: 10/12/2023] [Accepted: 10/20/2023] [Indexed: 11/06/2023]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare disease with high mortality. Liver involvement is common (based on elevated liver function tests) with most patients demonstrating acute hepatitis. Liver biopsies are frequently obtained in the setting of suspected HLH for the purpose of identification of erythrophagocytosis, and if present, this finding is thought to suggest or support the diagnosis of HLH. However, there are problems with this approach; in particular, we do not know whether this finding is reproducible or whether it is specific to HLH. Therefore, we conducted a multi-institutional study in which experienced liver pathologists reviewed images taken from liver biopsies from patients with normal liver, acute hepatitis, possible HLH, and clinical HLH to determine if there was agreement about the presence or absence of erythrophagocytosis, and to ascertain whether the finding corresponds to a clinical diagnosis of HLH. Twelve liver pathologists reviewed 141 images in isolation (i.e., no clinical information or diagnosis provided). These came from 32 patients (five normal, 17 acute hepatitis, six HLH, four possible HLH). The pathologists classified each image as negative, equivocal, or positive for erythrophagocytosis. Kappa was .08 (no agreement) for case-level and 0.1 for image-level (1.4% agreement, based on two images which were universally considered negative). There was no difference in the proportion of pathologists who diagnosed erythrophagocytosis among those with different diagnoses at case or image-level (p = 0.82 and p = 0.82, respectively). Thus, erythrophagocytosis is an entirely unreliable histologic parameter in liver, as it is irreproducible and not demonstrably associated with a clinical disease (namely, HLH). Unless and until more reliable guidelines can be established, pathologists should refrain from commenting on the presence or absence of erythrophagocytosis in liver biopsy.
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Affiliation(s)
- Niyati Desai
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, 622 W 168th St.VC14-209A, New York, NY, 10032, USA
| | - Satoru Kudose
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, 622 W 168th St.VC14-209A, New York, NY, 10032, USA
| | - Helen E Remotti
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, 622 W 168th St.VC14-209A, New York, NY, 10032, USA
| | - Armando Del Portillo
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, 622 W 168th St.VC14-209A, New York, NY, 10032, USA
| | - Ladan Fazlollahi
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, 622 W 168th St.VC14-209A, New York, NY, 10032, USA
| | - Michael J Lee
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, 622 W 168th St.VC14-209A, New York, NY, 10032, USA
| | - Yuqing Xiong
- Department of Pathology, Mass General Brigham, Boston, MA, USA
| | - Roger K Moreira
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Maria Isabel Fiel
- Department of Pathology, Mount Sinai School of Medicine, New York, NY, USA
| | - Raul S Gonzalez
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta, USA
| | | | - Ryan M Gill
- Department of Pathology, University of California, San Francisco, San Francisco, USA
| | - John Hart
- Department of Pathology, University of Chicago, Chicago, USA
| | - David E Kleiner
- Laboratory of Pathology, National Cancer Institute, Bethesda, USA
| | - Uta Drebber
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | | | - Stephen M Lagana
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, 622 W 168th St.VC14-209A, New York, NY, 10032, USA.
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8
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Setia N, del Gaudio D, Kandikatla P, Arndt K, Tjota M, Wang P, Segal J, Alikhan M, Hart J. A novel telomere biology disease-associated gastritis identified through a whole exome sequencing-driven approach. J Pathol Clin Res 2024; 10:e349. [PMID: 37994393 PMCID: PMC10766041 DOI: 10.1002/cjp2.349] [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: 08/08/2023] [Revised: 09/20/2023] [Accepted: 10/19/2023] [Indexed: 11/24/2023]
Abstract
A whole exome sequencing (WES)-driven approach to uncover the etiology of unexplained inflammatory gastritides has been underutilized by surgical pathologists. Here, we discovered the pathobiology of an unusual chronic atrophic gastritis in two unrelated patients using this approach. The gastric biopsies were notable for an unusual pattern of gastritis with persistent dense inflammation, loss of both parietal and neuroendocrine cells in the oxyntic mucosa, and sparing of the antral mucosa. The patients were found to harbor pathogenic variants in telomeropathic genes (POT1 and DCLRE1B). Clonality testing for one of the patients showed evidence of evolving clonality of TCR-gene rearrangement. Both patients showed significantly decreased numbers of stem/progenitor cells by immunohistochemistry, which appears to be responsible for the development of mucosal atrophy. No such cases of unusual chronic atrophic gastritis in the setting of telomeropathy have been previously reported. The loss of stem/progenitor cells suggests that stem/progenitor cell exhaustion in the setting of telomere dysfunction is the likely mechanism for development of this unusual chronic atrophic gastritis. The results underscore the need for close monitoring of these gastric lesions, with special regard to their neoplastic potential. This combined WES-driven approach has promise to identify the cause and mechanism of other uncharacterized gastrointestinal inflammatory disorders.
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Affiliation(s)
- Namrata Setia
- Department of PathologyUniversity of ChicagoChicagoILUSA
| | | | | | - Kelly Arndt
- Department of PathologyUniversity of ChicagoChicagoILUSA
| | - Melissa Tjota
- Department of PathologyUniversity of ChicagoChicagoILUSA
| | - Peng Wang
- Department of PathologyUniversity of ChicagoChicagoILUSA
| | - Jeremy Segal
- Department of PathologyUniversity of ChicagoChicagoILUSA
| | - Mir Alikhan
- NorthShore University Health SystemEvanstonILUSA
| | - John Hart
- Department of PathologyUniversity of ChicagoChicagoILUSA
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9
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LoBue C, Stopschinski BE, Calveras NS, Douglas PM, Huebinger R, Cullum CM, Hart J, Gonzales MM. Blood Markers in Relation to a History of Traumatic Brain Injury Across Stages of Cognitive Impairment in a Diverse Cohort. J Alzheimers Dis 2024; 97:345-358. [PMID: 38143366 PMCID: PMC10947497 DOI: 10.3233/jad-231027] [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: 12/26/2023]
Abstract
BACKGROUND Traumatic brain injury (TBI) has been linked to multiple pathophysiological processes that could increase risk for Alzheimer's disease and related dementias (ADRD). However, the impact of prior TBI on blood biomarkers for ADRD remains unknown. OBJECTIVE Using cross-sectional data, we assessed whether a history of TBI influences serum biomarkers in a diverse cohort (approximately 50% Hispanic) with normal cognition, mild cognitive impairment, or dementia. METHODS Levels of glial fibrillary acidic protein (GFAP), neurofilament light (NFL), total tau (T-tau), and ubiquitin carboxy-terminal hydrolase-L1 (UCHL1) were measured for participants across the cognitive spectrum. Participants were categorized based on presence and absence of a history of TBI with loss of consciousness, and study samples were derived through case-control matching. Multivariable general linear models compared concentrations of biomarkers in relation to a history of TBI and smoothing splines modelled biomarkers non-linearly in the cognitively impaired groups as a function of time since symptom onset. RESULTS Each biomarker was higher across stages of cognitive impairment, characterized by clinical diagnosis and Mini-Mental State Examination performance, but these associations were not influenced by a history of TBI. However, modelling biomarkers in relation to duration of cognitive symptoms for ADRD showed differences by history of TBI, with only GFAP and UCHL1 being elevated. CONCLUSIONS Serum GFAP, NFL, T-tau, and UCHL1 were higher across stages of cognitive impairment in this diverse clinical cohort, regardless of TBI history, though longitudinal investigation of the timing, order, and trajectory of the biomarkers in relation to prior TBI is warranted.
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Affiliation(s)
- Christian LoBue
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas,TX
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Barbara E. Stopschinski
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX
- Center for Alzheimer’s and Neurodegenerative Diseases, University of Texas Southwestern Medical Center, Dallas, TX
| | - Nil Saez Calveras
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX
- Center for Alzheimer’s and Neurodegenerative Diseases, University of Texas Southwestern Medical Center, Dallas, TX
| | - Peter M. Douglas
- Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Ryan Huebinger
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - C. Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas,TX
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX
| | - John Hart
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas,TX
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Mitzi M. Gonzales
- Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, TX
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Jafari P, Evaristo G, Du XA, Sharma AE, Marcus V, Liu X, Zhao L, Westerhoff M, Hart J. Portosinusoidal Vascular Disorder: A Heretofore Unrecognized Manifestation of Sickle Cell Disease? Mod Pathol 2024; 37:100351. [PMID: 37820763 DOI: 10.1016/j.modpat.2023.100351] [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: 07/09/2023] [Revised: 09/10/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Abstract
Portosinusoidal vascular disorder (PSVD) is a recently proposed histopathologic entity that encompasses a spectrum of often subtle hepatic microvascular lesions and related microarchitectural abnormalities. Clinical manifestations may arise years after histologic diagnosis and include extrahepatic portal vein thrombosis and portal hypertension. While the histopathologic features of PSVD have been associated with numerous clinical conditions, most notably prothrombotic/vasculopathic disorders, PSVD has not yet been described in sickle cell disease. This gap is striking given the central role of microvascular dysfunction in sickle cell disease and well-described patterns of hepatic injury and dysfunction in this population. This case series is the first to explore the prevalence and pathogenesis of PSVD in sickle cell disease. Forty-one diagnostically adequate liver biopsies from patients with sickle cell disease were identified across the archives of 5 tertiary medical centers. All biopsies exhibited at least 1 histopathologic feature associated with PSVD (mean 3.8 features/case). Overall, 90.2% of patients met the criteria for a diagnosis of PSVD based on the presence of specific histopathologic and/or clinical findings. Immunohistochemical stains for von Willebrand factor, CD34, and glutamine synthetase were performed on 36 cases (87.8%). Aberrant (centrilobular sinusoidal) CD34 and von Willebrand factor staining was present in 97.2% and 86.1% of cases, respectively. Glutamine synthetase reactivity was at least mildly decreased in zone 3 hepatocytes in 52.8% of cases. We posit that chronic erythrocyte sickling results in dysfunction and remodeling of the portal microvasculature, culminating in regression of zone 3 hepatocytes. The presence of PSVD may explain, at least in part, the hepatic dysfunction observed in this patient population. These patients may also benefit from extended clinical surveillance for portal hypertension and other complications. While subtle and prone to overdiagnosis, the features of PSVD should be carefully considered when interpreting liver biopsies from patients with sickle cell disease.
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Affiliation(s)
- Pari Jafari
- Department of Pathology, University of Chicago Medicine, The University of Chicago, Chicago, Illinois.
| | - Gertruda Evaristo
- Department of Pathology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Xiaotang Alison Du
- Department of Pathology, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Aarti E Sharma
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Victoria Marcus
- Department of Pathology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Xiuli Liu
- Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Lei Zhao
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Maria Westerhoff
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - John Hart
- Department of Pathology, University of Chicago Medicine, The University of Chicago, Chicago, Illinois
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Evaristo G, Szczepanski J, Farag MS, Rubin DT, Campbell LK, Marcus VA, Lamps LW, Hart J. Crohn's Disease Features in Anastomotic Biopsies from Patients With and Without Crohn's Disease: Diagnostic and Prognostic Value. Mod Pathol 2023; 36:100325. [PMID: 37660927 DOI: 10.1016/j.modpat.2023.100325] [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: 04/30/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
Endoscopic evidence of disease activity is a critical predictor of clinical relapse in patients with Crohn's disease (CD), and histologic disease activity is evolving as a similarly important end point for patient management. However, classical morphologic features of CD may overlap with postoperative inflammatory changes, confounding the evaluation of anastomotic biopsies. There is a clear unmet need for better characterization of diagnostic and clinically significant histologic features of CD in these surgically altered sites. We evaluated ileocolonic and colocolonic/rectal anastomotic biopsies performed at 3 academic institutions in patients with and without CD. The biopsies were blindly assessed for CD histologic features and correlated to clinical and endoscopic characteristics. In CD patients, the presence of each feature was correlated with the subsequent clinical exacerbation or relapse. We obtained anastomotic biopsies from 208 patients, of which 109 were operated on for CD and 99 for another indication (neoplasia [80%], diverticular disease (11%), and other [9%]). Mean time since surgery was 10 years (0-59; 14 years for CD [1-59], 6 years for non-CD [0-33]). Endoscopic inflammation was noted in 52% of cases (68% for CD and 35% for non-CD). Microscopic inflammation was present in 74% of cases (82% for CD and 67% for non-CD). Only discontinuous lymphoplasmacytosis (P < .001) and pyloric gland metaplasia (P = .04) occurred significantly more often in CD patients. However, none of the histologic features predicted clinical disease progression. In subset analysis, the presence of histologic features of CD in nonanastomotic biopsies obtained concurrently in CD patients was significantly associated with relapse (P = .03). Due to extensive morphologic overlap between CD and postoperative changes and the lack of specific histologic features of relapse, biopsies from anastomotic sites are of no value in predicting clinical CD progression. Instead, CD activity in biopsies obtained away from anastomotic sites should be used for guiding endoscopic sampling and clinical management.
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Affiliation(s)
| | | | - Mina S Farag
- Department of Pathology, McGill University, Montreal, Quebec, Canada
| | - David T Rubin
- Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, Ilinois
| | | | - Victoria A Marcus
- Department of Pathology, McGill University, Montreal, Quebec, Canada
| | - Laura W Lamps
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - John Hart
- Department of Pathology, University of Chicago, Chicago, Illinois.
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Schaffert J, Chiang HS, Fatima H, LoBue C, Hart J, Cullum CM. History of traumatic brain injury does not alter course of neurocognitive decline in older adults with and without cognitive impairment. Neuropsychology 2023; 37:923-932. [PMID: 37023289 PMCID: PMC10556197 DOI: 10.1037/neu0000892] [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: 04/08/2023] Open
Abstract
OBJECTIVE Traumatic brain injury (TBI) history is associated with dementia risk, but it is unclear whether TBI history significantly hastens neurocognitive decline in older adults. METHOD Data were derived from the National Alzheimer's Coordinating Center (NACC) data set. Participants with a history of TBI (TBI +; n = 1,467) were matched to individuals without a history of TBI (TBI-; n = 1,467) based on age (50-97, M = 71.61, SD = 8.40), sex, education, race, ethnicity, cognitive diagnosis, functional decline, number of Apolipoprotein ε4 (APOE ε4) alleles, and number of annual visits (3-6). Mixed linear models were used to assess longitudinal neuropsychological test composite scores of executive functioning/attention/speed, language, and memory in TBI + and TBI- participants. Interactions between TBI and demographics, APOE ε4 status, and cognitive diagnosis were also examined. RESULTS Longitudinal neuropsychological functioning did not differ between TBI groups (p's > .001). There was a significant three-way interaction (age, TBI history, time) in language (F[20, 5750.1] = 3.133, p < .001) and memory performance (F[20, 6580.8] = 3.386, p < .001), but post hoc analyses revealed TBI history was not driving this relationship (all p's > .096). No significant interactions were observed between TBI history and sex, education, race/ethnicity, number of APOE ε4 alleles, or cognitive diagnosis (p's > .001). CONCLUSIONS Findings suggest TBI history, regardless of demographic factors, APOE ε4 status, or cognitive diagnosis, does not alter the course of neurocognitive functioning later-in-life in older adults with or without cognitive impairment. Future clinicopathological longitudinal studies that well-characterize head injuries and the associated clinical course are needed to help clarify the mechanism in which TBI may increase dementia risk. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Jeff Schaffert
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, U.S
| | - Hsueh-Sheng Chiang
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, U.S
- Callier Center, School of Behavioral and Brain Sciences, UT Dallas, Dallas, TX, U.S
| | - Hudaisa Fatima
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, U.S
| | - Christian LoBue
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, U.S
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, U.S
| | - John Hart
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, U.S
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, U.S
- Callier Center, School of Behavioral and Brain Sciences, UT Dallas, Dallas, TX, U.S
| | - C. Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, U.S
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, U.S
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, U.S
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13
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Neaves S, Helphrey J, Cabrera H, Lacritz L, Schaffert J, Smernoff E, Logan R, Nguyen T, Khera A, Hart J, Cullum CM, LoBue C. A - 156 History of Mild Traumatic Brain Injury Is Not Associated with worse Neuropsychological Functioning in Amnestic Mild Cognitive Impairment. Arch Clin Neuropsychol 2023; 38:1328. [PMID: 37807302 DOI: 10.1093/arclin/acad067.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE The mechanisms for traumatic brain injury (TBI) being a risk factor for Alzheimer's disease is unclear, and whether mild TBI (mTBI) may relate to decreased neural circuit functioning in the prodromal phase is unknown. This study examined whether a history of mTBI was associated with lower functioning of neural circuits, measured with neuropsychological tasks, in amnestic Mild Cognitive Impairment (aMCI). METHOD Twenty older adults (MAge = 71 years; 70% Male; 90% White) with aMCI were recruited to complete a detailed TBI interview and were classified based on the presence (mTBI+ n = 13) or absence (mTBI- n = 7) of past mTBI. Most mTBI+ participants (n = 11) had multiple mTBIs, and on average were 32 years from last injury. A comprehensive neuropsychological assessment was administered, and composite T-scores were calculated for the domains of attention, executive functioning, memory, and language. One-tailed T-tests were conducted to compare the means between groups. RESULTS No statistically significant differences (p's = 0.06-0.09) were found between the groups in memory (mTBI+ M = 38.11; mTBI- M = 33.19), executive function (mTBI+ M = 48.79; mTBI- M = 43.09), language (mTBI+ M = 48.12; mTBI- M = 43.09), or attention (mTBI+ M = 40.54; mTBI- M = 35.57). Nonetheless, medium effect sizes were seen for the mTBI+ group performing better than the mTBI- group on all composite scores (Cohen's d = 0.45-0.66). CONCLUSIONS A history of mTBI was not associated with poorer neuropsychological performance in aMCI, often a prodromal stage of Alzheimer's disease. While concerns about later-in-life effects from multiple mTBIs is prevalent, repetitive mTBI may not be related to lower neural circuit functioning in aMCI, though further evaluation with larger samples is needed.
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Adhikari A, Brooks J, Watson K, Morris EE, LoBue C, Motes M, Cullum CM, Hart J, Chiang HS. A - 133 Self-Reported Loss of Consciousness Predicts Executive Functions in Veterans with a History of Traumatic Brain Injury. Arch Clin Neuropsychol 2023; 38:1305. [PMID: 37807278 DOI: 10.1093/arclin/acad067.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE The long-term cognitive effects of traumatic brain injury (TBI) in military personnel remain unclear and need to be better understood. We assessed how cognitive performance was related to the remote history of TBI involving loss of consciousness (LOC) and blast injury (regardless of LOC) in veterans. METHOD Veterans (N = 101; age 42.8 ± 10.5 years; 10 Females) with a self-reported history of TBI and persistent cognitive symptoms were recruited. Effects of (1) the presence of LOC, (2) total number of TBIs with LOC (0, 1-2, >2), and (3) the presence of blast injury were examined on composite scores from tests of executive function (Trail-Making Test B, Color Word Interference), word retrieval (Boston Naming, Letter and Category Fluency), processing speed (Trail Making-A, Color Word Naming/Reading), and episodic memory (Rey-Auditory Verbal Learning Test-total learning and delayed recall), while controlling for age, sex, years of education, and total number of TBIs. RESULTS TBI with LOC was a significant predictor of executive function (p = 0.014) and processing speed (p = 0.014), with more episodes of LOC predicting lower functioning, but not of word retrieval or episodic memory (p > 0.1). Additionally, presence of a blast injury, regardless of LOC, did not predict differences in function on any of the composite measures. CONCLUSIONS Self-reported TBI history with LOC was associated with poorer executive function and processing speed. The findings further characterize the relationship between TBI history and long-term cognitive sequelae in veterans, particularly suggesting LOC can affect neural systems underlying executive function and processing speed.
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Helphrey J, Cabrera H, Neaves S, Ahmed D, Chiang HS, Thakkar V, Peters M, McClintock S, Hart J, LoBue C. A - 22 Preliminary Outcomes on Depression Symptoms in a Randomized Controlled Trial of High-Definition Transcranial Direct Current Stimulation in Alzheimer's Dementia. Arch Clin Neuropsychol 2023; 38:1184. [PMID: 37807149 DOI: 10.1093/arclin/acad067.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE New treatments to manage emotional and cognitive symptoms of Alzheimer's Dementia (ad) are needed. High-definition transcranial direct current stimulation (HD-tDCS) is a non-invasive neuromodulation technology with potential as a new treatment for improving neuropsychiatric symptoms. The dorsal anterior cingulate cortex (dACC) is a region found to play an important role in emotional processes and is vulnerable to degeneration in ad. As such, we conducted a pilot study investigating the effect of HD-tDCS applied over the dACC on depression symptoms in ad patients. METHOD Ten participants (M age = 71.50, SD = 9.80) with clinically diagnosed mild-to-moderate ad were randomized to receive sham (0 milliamps [mA]; n = 2), 1 mA (n = 5), or 2 mA (n = 3) HD-tDCS for ten daily 20-minute sessions across two weeks. The Beck Depression Inventory-2 (BDI-2) was administered before and after ten treatments. A one-tailed analysis of covariance (ANCOVA) was conducted to examine differences in post-treatment scores between HD-tDCS groups, adjusting for pre-treatment scores. RESULTS Baseline BDI-2 scores were similar for the groups receiving 1 mA (M = 7.00; SD = 3.10), 2 mA (M = 4.70; SD = 8.10), and sham (M = 9.00; SD = 7.10) Statistically significant differences were found between groups on depression scores after HD-tDCS, F(2) = 3.55, p = 0.048, ηp2 = 0.54), driven by the depression scores in the 1 mA group being lower than the sham group. CONCLUSIONS Our pilot results suggest that HD-tDCS may be associated with a reduction in depression symptoms in ad, though determining the minimum clinically important difference for a decrease needs further evaluation. Future research having larger samples with ad and long-term follow up is also warranted to examine clinical efficacy.
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Ahmed D, Helphrey J, Cabrera H, Neaves S, Mcclintock SS, Hart J, Chiang HS, Lacritz L, Cullum MC, LoBue C. A - 17 Preliminary Neuropsychological Outcomes in a Randomized Controlled Trial of High-Definition Transcranial Direct Current Stimulation in Alzheimer's Clinical Syndrome. Arch Clin Neuropsychol 2023; 38:1178. [PMID: 37807130 DOI: 10.1093/arclin/acad067.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE The Alzheimer's Clinical Syndrome (ACS) is marked by global cognitive decline, and neural circuit dysfunction involving the dorsal anterior cingulate cortex (dACC) has been associated with some of the episodic memory and non-memory deficits in ACS. High-definition transcranial direct current stimulation (HD-tDCS) is a promising noninvasive treatment to lessen cognitive deficits in ACS, and this preliminary double-blinded trial examined whether HD-tDCS targeting the dACC could improve cognitive performance in ACS. METHODS Ten patients diagnosed with ACS (M age = 71.500; SD = 9.755) were randomized to receive sham (n = 2), 1 mA (n = 5), or 2 mA (n = 3) multi-electrode (4 cathodes x 1 anode) HD-tDCS for 10 daily sessions. Episodic memory, language, attention, and executive function measures were administered pre- and immediately post-treatment, and composite memory and non-memory scores were calculated. Paired samples t-tests examined significant differences (p < 0.05) between pre-treatment and post-treatment scores for each HD-tDCS group. RESULTS For all three HD-tDCS groups, there were no significant improvements between pre-treatment and post-treatment scores for memory or non-memory abilities (p's > 0.05). CONCLUSION This preliminary study showed that HD-tDCS applied over the dACC was unassociated with cognitive improvement in ACS. Future research with a larger sample will be needed to inform if this configuration of HD-tDCS could ameliorate cognitive deficits in ACS. Moreover, evaluation of HD-tDCS applied over other brain regions may yield additional insights, and a critical step will be to identify whether any clinical characteristics such as disease stage may influence the response to stimulation in ACS.
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17
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Cabrera H, Helphrey J, Neaves S, Ahmed D, Chiang HS, McClintock SM, Cullum CM, Hart J, Didehbani N, LoBue C. A - 42 Neuropsychological Improvement in Amnestic Mild Cognitive Impairment Following Noninvasive Transcranial Electrical Stimulation: a Case Report. Arch Clin Neuropsychol 2023; 38:1203. [PMID: 37807158 DOI: 10.1093/arclin/acad067.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE Amnestic Mild Cognitive Impairment (aMCI) is often a prodromal stage for Alzheimer's disease, and the few treatments available have limited efficacy in lessening the neuropsychological deficits. Transcranial direct current stimulation (tDCS) is a noninvasive electrical stimulation method with therapeutic potential found in aMCI, but high-definition tDCS (HD-tDCS) is a recent advancement allowing for improved targeting in stimulation and possibly prolonged treatment effects. We present a case report that investigates HD-tDCS-induced neuropsychological changes in aMCI. METHOD A 78-year-old male with aMCI received 10 HD-tDCS sessions at 1 mA for 20 minutes targeting the dorsal anterior cingulate cortex. He was stable on rivastigmine throughout the trial. Eight neuropsychological tests assessing episodic memory (verbal and visual), attention, executive functioning, and language were completed at baseline, after the 10th session and 3-months later. A change of +/- 10 T-score points from baseline was considered a clinically meaningful difference. RESULTS Significant improvements were observed immediately after HD-tDCS on 4/8 tests, including the Brief Visuospatial Memory Test-Revised (BVMT-R; immediate recall +14; delayed recall +24), semantic fluency (Animals +17), Trail Making Test B (+14), and Stroop Color and Word Interference Trial (+21). At the 3-month follow-up, only the BVMT-R immediate recall remained higher (+16), while the rest were similar to baseline scores. CONCLUSIONS Clinically meaningful improvement in neuropsychological functioning was seen following HD-tDCS in this patient with aMCI. However, nearly all the enhancements were diminished 3-months later, returning to baseline. A randomized sham-controlled trial is warranted to confirm the therapeutic effects of HD- tDCS and examine how long effects may persist.
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18
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Tillman GD, Morris EE, Bass C, Turner M, Watson K, Brooks JT, Rawlinson T, Kozel FA, Kraut MA, Motes MA, Hart J. P3a amplitude to trauma-related stimuli reduced after successful trauma-focused PTSD treatment. Biol Psychol 2023; 182:108648. [PMID: 37482132 DOI: 10.1016/j.biopsycho.2023.108648] [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: 02/24/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/25/2023]
Abstract
An elevated P3a amplitude to trauma-related stimuli is strongly associated with posttraumatic stress disorder (PTSD), yet little is known about whether this response to trauma-related stimuli is affected by treatment that decreases PTSD symptoms. As an analysis of secondary outcome measures from a randomized controlled trial, we investigated the latency and amplitude changes of the P3a in responses in a three-condition oddball visual task that included trauma-related (combat scenes) and trauma-unrelated (threatening animals) distractors. Fifty-five U.S. veterans diagnosed with combat-related PTSD were randomized to receive either active or sham repetitive transcranial magnetic stimulation (rTMS). All received cognitive processing therapy, CPT+A, which requires a written account of the index trauma. They were tested before and 6 months after protocol completion. P3a amplitude and response time decreases were driven largely by the changes in the responses to the trauma-related stimuli, and this decrease correlated to the decrease in PTSD symptoms. The amplitude changes were greater in those who received rTMS + CPT than in those who received sham rTMS + CPT, suggesting that rTMS plays beneficial role in reducing arousal and threat bias, which may allow for more effective engagement in trauma-focused PTSD treatment.
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Affiliation(s)
- Gail D Tillman
- Callier Center, University of Texas at Dallas, Dallas, TX, USA.
| | | | - Christina Bass
- Callier Center, University of Texas at Dallas, Dallas, TX, USA
| | - Mary Turner
- Departments of Psychiatry University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kelsey Watson
- Callier Center, University of Texas at Dallas, Dallas, TX, USA
| | - Jared T Brooks
- Callier Center, University of Texas at Dallas, Dallas, TX, USA
| | - Tyler Rawlinson
- Callier Center, University of Texas at Dallas, Dallas, TX, USA
| | - F Andrew Kozel
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA
| | - Michael A Kraut
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael A Motes
- Callier Center, University of Texas at Dallas, Dallas, TX, USA
| | - John Hart
- Callier Center, University of Texas at Dallas, Dallas, TX, USA; Departments of Psychiatry University of Texas Southwestern Medical Center, Dallas, TX, USA; Departments of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Harris M, Hart J, Bhattacharya O, Russell FM. Risk factors for SARS-CoV-2 infection during the early stages of the COVID-19 pandemic: a systematic literature review. Front Public Health 2023; 11:1178167. [PMID: 37583888 PMCID: PMC10424847 DOI: 10.3389/fpubh.2023.1178167] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/10/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction Identifying SARS-CoV-2 infection risk factors allows targeted public health and social measures (PHSM). As new, more transmissible variants of concern (VoC) emerge, vaccination rates increase and PHSM are eased, it is important to understand any potential change to infection risk factors. The aim of this systematic literature review is to describe the risk factors for SARS-CoV-2 infection by VoC. Methods A literature search was performed in MEDLINE, PubMed and Embase databases on 5 May 2022. Eligibility included: observational studies published in English after 1 January 2020; any age group; the outcome of SARS-CoV-2 infection; and any potential risk factors investigated in the study. Results were synthesized into a narrative summary with respect to measures of association, by VoC. ROBINS-E tool was utilized for risk of bias assessment. Results Of 6,197 studies retrieved, 43 studies were included after screening. Common risk factors included older age, minority ethnic group, low socioeconomic status, male gender, increased household size, occupation/lower income level, inability to work from home, public transport use, and lower education level. Most studies were undertaken when the ancestral strain was predominant. Many studies had some selection bias due to testing criteria and limited laboratory capacity. Conclusion Understanding who is at risk enables the development of strategies that target priority groups at each of the different stages of a pandemic and helps inform vaccination strategies and other interventions which may also inform public health responses to future respiratory infection outbreaks. While it was not possible to determine changes to infection risk by recent VoC in this review, the risk factors identified will add to the overall understanding of the groups who are at greatest risk of infection in the early stages of a respiratory virus outbreak. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022330706, PROSPERO [CRD42022330706].
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Affiliation(s)
- Matthew Harris
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- Asia-Pacific Health Group, Infection, Immunity and Global Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - John Hart
- Asia-Pacific Health Group, Infection, Immunity and Global Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Oashe Bhattacharya
- Asia-Pacific Health Group, Infection, Immunity and Global Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Fiona M. Russell
- Asia-Pacific Health Group, Infection, Immunity and Global Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
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Chiang HS, Lydon EA, Kraut MA, Hart J, Mudar RA. Differences in electroencephalography oscillations between normal aging and mild cognitive impairment during semantic memory retrieval. Eur J Neurosci 2023; 58:2278-2296. [PMID: 37122187 PMCID: PMC10531984 DOI: 10.1111/ejn.16001] [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: 11/28/2022] [Revised: 04/16/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
Semantic memory remains relatively stable with normal cognitive aging and declines in early stages of neurodegenerative disease. We measured electroencephalography (EEG) oscillatory correlates of semantic memory retrieval to examine the effects of normal and pathological aging. Twenty-nine cognitively healthy young adults (YA), 22 cognitively healthy aging adults (HA) and 20 patients with mild cognitive impairment (MCI) completed a semantic memory retrieval task with concurrent EEG recording in which they judged whether two words (features of objects) led to retrieval of an object (retrieval) or not (non-retrieval). Event-related power changes contrasting the two conditions (retrieval vs. non-retrieval) within theta, alpha, low-beta and high-beta EEG frequency bands were examined for normal aging (YA vs. HA) and pathological aging effects (HA vs. MCI). With no behavioural differences between the two normal age groups, we found later theta and alpha event-related power differences between conditions only in YA and a high-beta event-related power difference only in HA. For pathological aging effects, with reduced accuracy in MCI, we found different EEG patterns of early event-related beta power differences between conditions in MCI compared with HA and an event-related low-beta power difference only in HA. Beta oscillations were correlated with behavioural performance only in HA. We conclude that the aging brain relies on faster (beta) oscillations during the semantic memory task. With pathological aging, retrieval accuracy declines and pattern of beta oscillation changes. The findings provide insights about age-related neural mechanisms underlying semantic memory and have implications for early detection of pathological aging.
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Affiliation(s)
- Hsueh-Sheng Chiang
- School of Behavioral and Brain Sciences, The University of Texas at Dallas. 800 W Campbell Rd, Richardson, TX 75080, USA
- Department of Neurology, University of Texas Southwestern Medical Center. 5303 Harry Hines Blvd 8th floor, Dallas, TX 75390, USA
| | - Elizabeth A. Lydon
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign. 901 S 6th St, Champaign, IL 61820, USA
| | - Michael A. Kraut
- Department of Radiology and Radiological Science, Johns Hopkins University. 1800 Orleans St. Baltimore, MD 21287, USA
| | - John Hart
- School of Behavioral and Brain Sciences, The University of Texas at Dallas. 800 W Campbell Rd, Richardson, TX 75080, USA
- Department of Neurology, University of Texas Southwestern Medical Center. 5303 Harry Hines Blvd 8th floor, Dallas, TX 75390, USA
| | - Raksha A. Mudar
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign. 901 S 6th St, Champaign, IL 61820, USA
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21
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Berglund-Barraza A, Carey S, Hart J, Vanneste S, Evans JL. Modulating Phonological Working Memory With Anodal High-Definition Transcranial Direct Current Stimulation to the Anterior Portion of the Supplementary Motor Area. J Speech Lang Hear Res 2023; 66:2079-2094. [PMID: 37227790 PMCID: PMC10465152 DOI: 10.1044/2023_jslhr-21-00098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/27/2021] [Accepted: 02/28/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Phonological working memory is key to vocabulary acquisition, spoken word recognition, real-time language processing, and reading. Transcranial direct current stimulation, when coupled with behavioral training, has been shown to facilitate speech motor output processes, a key component of nonword repetition, the primary task used to assess phonological working memory. In this study, we examined the efficacy of combining overt nonword repetition training with anodal high-definition transcranial direct current stimulation (HD tDCS) to the presupplementary motor area (preSMA) to enhance nonword repetition. OBJECTIVE This study investigated whether 20 min of active or sham anodal HD tDCS targeting preSMA concurrently with a nonword repetition task differentially impacted nonword repetition ability. METHOD Twenty-eight neurotypical college-age adults (18-25 years; 19 females, eight males, one nonbinary) completed a 20-min nonword repetition training task where they received either active or sham 1-mA anodal HD tDCS to the preSMA while overtly repeating a list of four-, five-, six-, and seven-syllable English-like nonwords presented in a random order. Whole nonword accuracy and error patterns (phoneme and syllable) were measured prior to and following training. RESULTS Following training, both groups showed a decrease in nonword repetition accuracy. The drop in performance was significantly greater for the active stimulation group compared to the sham stimulation group at the four-syllable nonword length. DISCUSSION The findings suggest that targeting the speech motor component of nonword repetition through overt training and HD tDCS to the preSMA does not enhance phonological working memory ability.
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Affiliation(s)
- Amy Berglund-Barraza
- Child Language and Cognitive Processes Laboratory, The University of Texas at Dallas
| | - Sarah Carey
- Child Language and Cognitive Processes Laboratory, The University of Texas at Dallas
| | - John Hart
- Cognitive Neuroscience Laboratory of Memory and Language, The University of Texas at Dallas
| | - Sven Vanneste
- Lab for Clinical & Integrative Neuroscience, Trinity College Institute for Neuroscience, Trinity College Dublin, Ireland
| | - Julia L. Evans
- Child Language and Cognitive Processes Laboratory, The University of Texas at Dallas
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22
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Schaffert J, Didehbani N, LoBue C, Hart J, Wilmoth K, Cullum CM. No association between age beginning tackle football, or years played and neurocognitive performance later-in-life among older National Football League retirees. Arch Clin Neuropsychol 2023; 38:644-649. [PMID: 36533487 PMCID: PMC10202547 DOI: 10.1093/arclin/acac101] [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] [Accepted: 11/15/2022] [Indexed: 12/20/2023] Open
Abstract
OBJECTIVE In a retrospective cohort, we evaluated whether age beginning tackle football (ABTF) and more total years of playing football (TYPF) were associated with worse later-in-life neuropsychological change among older retired National Football League (NFL) players. METHOD Participants were 19 older NFL retirees aged 54-79, including 12 who returned for follow-up evaluation 15-51 months later. Mixed-linear models evaluated the association between ABTF/TYFP and baseline neuropsychological composite scores (executive functioning/attention/speed, language, memory), and neuropsychological composites over time. RESULTS ABTF and TYPF were not significantly associated with neuropsychological composites at baseline or over time (all p's > .05). There were no significant differences in neuropsychological performance between those ABTF <12 and ≥ 12 years old (all p's ≥ .475) or between those with TYPF <19 or ≥ 19 years played (median split; all p's ≥ .208). CONCLUSIONS Preliminary findings suggest that ABTF and TYPF does not worsen neurocognitive decline later-in-life among older NFL retirees.
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Affiliation(s)
- Jeff Schaffert
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nyaz Didehbani
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Christian LoBue
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John Hart
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Callier Center, School of Behavioral and Brain Sciences, UT Dallas, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kristin Wilmoth
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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23
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Gordon SF, Lam J, Vasquez JT, Cercone R, Tenneti N, Hart J, Chisholm M, Heland M, Hoq M, Kaufman J, Danchin M. A tailored COVID-19 vaccination pathway for children 5-11 years in Victoria, Australia. Vaccine 2023; 41:3436-3445. [PMID: 37120401 PMCID: PMC10106821 DOI: 10.1016/j.vaccine.2023.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Procedural anxiety was anticipated in children 5-11 years during the COVID-19 vaccine rollout in Victoria, Australia, as children in this age group receive few routine vaccines. Therefore, the Victorian state government designed a tailored, child-friendly vaccine program. This study aimed to assess parental satisfaction with elements of the bespoke vaccination pathway. METHODS The Victorian government and state-run vaccination hubs in Victoria facilitated an online immunisation plan to help parents identify their child's support needs, and utilised experienced paediatric staff and additional supports for children with severe needle distress and/or disability. All parents/guardians of children 5-11 years who received a COVID-19 vaccine in a vaccination hub were sent a 16-item feedback survey via text message. RESULTS Between 9 February and 31 May 2022 there were 9203 responses; 865 children (9.4%) had a first language other than English, 499 (5.4%) had a disability or special needs, and 142 (1.5%) were Aboriginal or Torres Strait Islander. Most parents (94.4%; 8687/9203) rated their satisfaction with the program as very good or excellent. The immunisation plan was used by 13.5% (1244/9203) of respondents, with usage more common for Aboriginal or Torres Strait Islander children (26.1%; 23/88) or families with a first language other than English (23.5%; 42/179). The child-friendly staff (88.5%, 255/288) and themed environment (66.3%, 191/288) were the most valued measures for vaccination. Additional support measures were required by 1.6% (150/9203) of children in the general population and 7.9%, (17/261) of children with a disability and/or special needs. CONCLUSION A tailored COVID-19 vaccination program for children 5-11 years, with additional support for children with severe needle distress and/or disability, had high parental satisfaction. This model could be utilised for COVID-19 vaccination in pre-school children and for routine childhood vaccination programs to provide optimal support to children and their families.
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Affiliation(s)
- S F Gordon
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
| | - J Lam
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J T Vasquez
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - R Cercone
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - N Tenneti
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J Hart
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Chisholm
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Heland
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - J Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - M Danchin
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia; Department of General Medicine, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia
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24
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Chiang HS, Shakal S, Vanneste S, Kraut M, Hart J. Corrigendum: Case report: Improving verbal retrieval deficits with high definition transcranial direct current stimulation targeting the pre-supplementary motor area in a patient with chronic traumatic brain injury. Front Neurol 2023; 14:1177589. [PMID: 36998776 PMCID: PMC10043463 DOI: 10.3389/fneur.2023.1177589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/16/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fneur.2021.678518.].
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Affiliation(s)
- Hsueh-Sheng Chiang
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, United States
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Scott Shakal
- Texas College of Osteopathic Medicine, The University of North Texas Health Science Center, Fort Worth, TX, United States
| | | | - Michael Kraut
- Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - John Hart
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, United States
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25
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Mikolajczyk AE, Cohen NA, Watson S, Ackerman M, Goeppinger SR, Hart J, Turner JR, Rubin DT. Assessment of the Degree of Variation of Histologic Inflammation in Ulcerative Colitis. Inflamm Bowel Dis 2023; 29:222-227. [PMID: 35436339 PMCID: PMC10686247 DOI: 10.1093/ibd/izac070] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Treatment of ulcerative colitis (UC) now includes mucosal healing. Adoption of histologic end points is hindered by a lack of evidence guiding optimal sampling, interpretation, and reproducibility of results. METHODS We analyzed biopsy fragments from colonoscopies in 92 patients with UC. Fragments were scored using 6-point histologic inflammatory activity (HIA) scale. Variability was determined using ordinal representations of HIA scores. The most frequently observed score and percentage of biopsy fragments with that score were determined for each biopsy, each segment, and across all 3 segments for each colonoscopy. Mean percentages and 95% confidence intervals (CIs) were calculated. RESULTS We reviewed 1802 biopsy fragments. The mean percentages of intrasegment biopsy fragments with the same HIA score were 85.5% (95% CI, 80.9% to 92.9%), 79.6% (95% CI, 76.0% to 87.3%), and 82.7% (95% CI, 79.1% to 90.0%) for the rectum, left colon, and right colon, respectively. The mean percentage of intersegment biopsy fragments with the same HIA score was 70.2% (95% CI, 65.7% to 82.5%). The mean percentages of intrabiopsy fragments with the same HIA score were 83.3% (95% CI, 77.6% to 93.5%), 83.6% (95% CI, 80.1% to 89.7%), and 90.2% (95% CI, 87.6% to 94.7%) for the rectum, left colon, and right colon, respectively. All 3 analyses revealed increased variation when a greater degree of histologic inflammation was present in the biopsies (mean HIA score ≥2). CONCLUSIONS We found minimal variability between degree of inflammation among biopsy fragments within and among different colorectal segments in UC, suggesting that even a single biopsy would adequately reflect the inflammation of the entire colorectum. These findings have significant implications for the use of histology as a clinical target and trial end point in UC.
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Affiliation(s)
- Adam E Mikolajczyk
- University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, United States
| | - Nathaniel A Cohen
- University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, United States
| | - Sydeaka Watson
- University of Chicago Medicine, Department of Health Studies, Chicago, IL, United States
| | - Max Ackerman
- University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, United States
| | - Sarah R Goeppinger
- University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, United States
| | - John Hart
- University of Chicago Medicine, Department of Pathology, Chicago, IL, United States
| | - Jerrold R Turner
- Brigham and Women’s Hospital, Department of Pathology, Chicago, IL, United States
| | - David T Rubin
- University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, United States
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26
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Miyatani Y, Choi D, Du X, Hart J, Rubin DT. Medically Refractory Lymphocytic Colitis Successfully Treated With Upadacitinib. ACG Case Rep J 2023; 10:e00979. [PMID: 36788789 PMCID: PMC9916037 DOI: 10.14309/crj.0000000000000979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/09/2023] [Indexed: 02/11/2023] Open
Abstract
Lymphocytic colitis is a microscopic colitis characterized endoscopically by nearly normal-appearing colonic mucosa and histology demonstrating intraepithelial lymphocytosis. Microscopic colitis that is refractory to conventional therapies, including budesonide, is rare but challenging and with scarce evidence. Upadacitinib is a novel Janus kinase 1 selective inhibitor approved by the US Food and Drug Administration for atopic dermatitis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and moderately to severely active ulcerative colitis. We present the first case of lymphocytic colitis refractory to conventional and immunosuppressive therapies, which responded promptly to upadacitinib.
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Affiliation(s)
- Yusuke Miyatani
- Department of Medicine, Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL
| | - David Choi
- Department of Medicine, Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL
| | - Xiaotang Du
- Department of Pathology, University of Chicago Medicine, Chicago, IL
| | - John Hart
- Department of Pathology, University of Chicago Medicine, Chicago, IL
| | - David T. Rubin
- Department of Medicine, Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL
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27
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Omari A, Jeong D, Alkhouri F, Duvall E, Hart J. Utilizing perioperative patient positioning to correct intraocular lens implant subluxation. Am J Ophthalmol Case Rep 2023; 29:101799. [PMID: 36699112 PMCID: PMC9869407 DOI: 10.1016/j.ajoc.2023.101799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 12/22/2022] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
Purpose to describe how preoperative and intraoperative positioning techniques can be used to manage subluxed intraocular lenses (IOL) whilst saving patients from pars plana vitrectomy. Observations An 88-year-old man with a complex past medical history including mild cognitive decline from early Alzheimer's dementia and pertinent ocular history of pseudoexfoliation syndrome and previous cataract surgery with IOL presented with decreased vision secondary to an inferiorly subluxed IOL/bag complex. The IOL was not visible in the operating room when he was supine but was visible in clinic the next day after he had slept in the prone position the night before. The patient was returned to the operating room the next day and a fixation suture was used to capture the IOL while he was upright. The IOL was then fixated to the sclera in standard position. Conclusions and Importance Both pre and intraoperative positioning techniques can help anterior segment surgeons fixate subluxed IOLs that otherwise seem inaccessible from an anterior approach and thus avoiding the inherent risks associated with vitrectomy.
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Affiliation(s)
- Amro Omari
- Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA,Beaumont Eye Institute, Royal Oak, MI, USA,Corresponding author. Beaumont Eye Institute 3535 West 13 Mile Road Suite #555, Royal Oak, MI, 48073, USA.
| | - Daeun Jeong
- Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Faris Alkhouri
- Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Elizabeth Duvall
- Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA,Beaumont Eye Institute, Royal Oak, MI, USA
| | - John Hart
- Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA,Beaumont Eye Institute, Royal Oak, MI, USA
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28
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Fei N, Miyoshi S, Hermanson JB, Miyoshi J, Xie B, DeLeon O, Hawkins M, Charlton W, D’Souza M, Hart J, Sulakhe D, Martinez-Guryn KB, Chang EB, Charlton MR, Leone VA. Imbalanced gut microbiota predicts and drives the progression of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in a fast-food diet mouse model. bioRxiv 2023:2023.01.09.523249. [PMID: 36712061 PMCID: PMC9882021 DOI: 10.1101/2023.01.09.523249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is multifactorial in nature, affecting over a billion people worldwide. The gut microbiome has emerged as an associative factor in NAFLD, yet mechanistic contributions are unclear. Here, we show fast food (FF) diets containing high fat, added cholesterol, and fructose/glucose drinking water differentially impact short- vs. long-term NAFLD severity and progression in conventionally-raised, but not germ-free mice. Correlation and machine learning analyses independently demonstrate FF diets induce early and specific gut microbiota changes that are predictive of NAFLD indicators, with corresponding microbial community instability relative to control-fed mice. Shotgun metagenomics showed FF diets containing high cholesterol elevate fecal pro-inflammatory effectors over time, relating to a reshaping of host hepatic metabolic and inflammatory transcriptomes. FF diet-induced gut dysbiosis precedes onset and is highly predictive of NAFLD outcomes, providing potential insights into microbially-based pathogenesis and therapeutics.
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Affiliation(s)
- Na Fei
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Sawako Miyoshi
- Department of General Medicine, Kyorin University School of Medicine, Tokyo 1818611, Japan
| | - Jake B. Hermanson
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Jun Miyoshi
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo 1818611, Japan
| | - Bingqing Xie
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Orlando DeLeon
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Maximilian Hawkins
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - William Charlton
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Mark D’Souza
- Duchossois Family Institute, University of Chicago, Chicago, IL, 60637, USA
| | - John Hart
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Dinanath Sulakhe
- Duchossois Family Institute, University of Chicago, Chicago, IL, 60637, USA
| | | | - Eugene B. Chang
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Michael R. Charlton
- Department of Medicine, University of Chicago Medical Center, University of Chicago, Chicago, IL, 60637, USA
| | - Vanessa A. Leone
- Department of Animal & Dairy Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
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29
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Schaffert J, Didehbani N, LoBue C, Hart J, Motes M, Rossetti H, Wilmoth K, Goette W, Lacritz L, Cullum CM. Neurocognitive outcomes of older National Football League retirees. Brain Inj 2022; 36:1364-1371. [PMID: 36437496 DOI: 10.1080/02699052.2022.2143567] [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: 11/29/2022]
Abstract
OBJECTIVE Determine if head-injury exposure relates to later-in-life cognitive decline in older National Football League (NFL) retirees. METHOD NFL retirees (aged 50+) with or without cognitive impairment underwent baseline (n = 53) and follow-up (n = 29; 13-59 months later) neuropsychological evaluations. Cognitively normal (CN) retirees (n = 26) were age- and education-matched to healthy controls (n = 26). Cognitively impaired (CI) retirees with mild cognitive impairment or dementia (n = 27) were matched to a clinical sample (CS) by age, sex, education, and diagnosis (n = 83). ANOVAs compared neuropsychological composites at baseline and over time between retirees and their matched groups. Regression models evaluated whether concussions, concussions with loss of consciousness (LOC), or games played predicted neuropsychological functioning. RESULTS At baseline, CN retirees had slightly worse memory than controls (MCN retirees = 50.69, SECN retirees = 1.320; MHealthy controls = 57.08, SEHealthy controls = 1.345; p = 0.005). No other group diferences were observed, and head-injury exposure did not predict neurocognitive performance at baseline or over time. CONCLUSIONS Head-injury exposure was not associated with later-in-life cognition, regardless of cognitive diagnosis. Some retirees may exhibit lower memory scores compared to age-matched peers, though this is of unclear clinical significance.
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Affiliation(s)
- Jeff Schaffert
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nyaz Didehbani
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Christian LoBue
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - John Hart
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA.,Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael Motes
- Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Heidi Rossetti
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kristin Wilmoth
- Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Will Goette
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Laura Lacritz
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - C Munro Cullum
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Hume-Nixon M, Ratu T, Clark S, Nguyen CD, Neal EFG, Pell CL, Bright K, Watts E, Hart J, Mulholland K, Fong J, Rafai E, Sakumeni K, Tuibeqa I, Satzke C, Steer A, Russell FM. Prevention of young infant infections using oral azithromycin in labour in Fiji (Bulabula MaPei): study protocol of a randomised control trial. BMJ Open 2022; 12:e061157. [PMID: 36456016 PMCID: PMC9716885 DOI: 10.1136/bmjopen-2022-061157] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Infections are a leading cause of neonatal mortality globally and can be transmitted from mother-to-child vertically or horizontally. Fiji has higher rates of serious neonatal infections and infant skin and soft tissue infections (SSTIs) than high-income countries. Research from the Gambia found that a single dose of oral azithromycin in labour decreased bacterial carriage and infections in mothers and infants, particularly infant skin infections. The Bulabula MaPei clinical trial evaluates the safety and efficacy of a single dose of azithromycin in labour in reducing the incidence of maternal and infant SSTIs and other infections and the impact on bacterial carriage. It will also describe the effect of azithromycin on antimicrobial (AMR) resistance, the maternal and infant microbiome, and infant dysbiosis. METHODS AND ANALYSIS We are conducting a blinded, placebo-controlled randomised clinical trial administering 2 g of oral azithromycin, or placebo, given to healthy, pregnant women (≥18 years) in labour in Suva, Fiji. The primary outcome is the cumulative incidence of SSTIs in infants by 3 months of age. Secondary outcomes include the incidence of other infant and maternal infections, and safety and tolerability of azithromycin in mother and infant. Following informed consent, 2110 pregnant women will be randomised in a 1:1 ratio, with all study staff and participants masked to group allocation. Mother/infant pairs will be followed up for 12 months over six visits collecting clinical data on infections, antimicrobial use, safety and anthropometrics, in addition to nasopharyngeal, oropharyngeal, rectovaginal and vaginal swabs, maternal breastmilk and infant stool samples, in order to compare bacterial carriage, AMR rates and microbiome. Recruitment for Bulabula MaPei started in June 2019. ETHICS AND DISSEMINATION This trial was approved and is being conducted according to the protocol approved by The Royal Children's Hospital Human Research Ethics Committee, Australia, and the Fiji National Health Research and Ethics Review Committee. The findings of this study will be disseminated in peer-reviewed journals and presented at conferences. TRIAL REGISTRATION NUMBER NCT03925480.
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Affiliation(s)
- Maeve Hume-Nixon
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Tupou Ratu
- Asia-Pacific Health, Murdoch Children's Research Institute, Suva, Fiji
| | - Stephanie Clark
- Department of Paediatrics, Colonial War Memorial Hospital, Suva, Fiji
| | - Cattram Duong Nguyen
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Eleanor F G Neal
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Casey L Pell
- Translational Microbiology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kathryn Bright
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Emma Watts
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - John Hart
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kim Mulholland
- New Vaccines, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - James Fong
- Ministry of Health and Medical Services, Suva, Fiji
| | - Eric Rafai
- Ministry of Health and Medical Services, Suva, Fiji
| | | | - Ilisapeci Tuibeqa
- Department of Paediatrics, Colonial War Memorial Hospital, Suva, Fiji
| | - Catherine Satzke
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Translational Microbiology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Steer
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Fiona M Russell
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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Storozuk T, Brown I, Lagana S, Westerhoff M, Setia N, Hart J, Alpert L. The histological spectrum of ARB-induced gastritis. Histopathology 2022; 81:653-660. [PMID: 35945664 PMCID: PMC9804261 DOI: 10.1111/his.14766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 04/04/2022] [Revised: 07/29/2022] [Accepted: 08/05/2022] [Indexed: 01/05/2023]
Abstract
AIMS Olmesartan, an angiotensin receptor blocker (ARB) used for hypertension management, is known to cause a sprue-like enteropathy in a subset of patients. Rare cases of gastritis occurring with ARB use have also been reported, but the histological features of ARB-induced gastritis and the response to drug cessation have not been examined in a dedicated case-series. METHODS AND RESULTS Cases of suspected ARB-induced gastritis were identified from the pathology archives of four institutions. Haematoxylin and eosin (H&E) slides from gastric biopsies were reviewed. Fifteen patients (14 female, one male) were identified. The most common presenting symptoms were diarrhoea (10) and weight loss (six). Gastric biopsies commonly showed a full-thickness active chronic gastritis with surface epithelial injury involving the antrum and body. Glandular atrophy, intra-epithelial lymphocytosis and/or subepithelial collagen thickening were also present in some cases. Duodenal involvement, including villous atrophy, intra-epithelial lymphocytosis and/or collagenous sprue, was identified in 11 of 13 cases with concurrent duodenal biopsies. Following drug cessation, symptomatic improvement occurred in all 11 cases for which follow-up data were available. Histological resolution occurred in five of eight cases with follow-up gastric biopsies, with improvement seen in the remaining three biopsies. CONCLUSION ARB-induced gastritis typically presents as active chronic gastritis, frequently with associated surface epithelial injury. Glandular atrophy, intra-epithelial lymphocytosis and/or subepithelial collagen thickening may also be present. These gastric changes can be seen without associated duodenal injury in rare cases, and they should alert the pathologist to the possibility of ARB-induced injury. Drug cessation results in marked symptomatic and histological improvement.
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Affiliation(s)
| | - Ian Brown
- Envoi PathologyKelvin GroveQLDAustralia
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Chiang HS, Motes M, Kraut M, Vanneste S, Hart J. High-definition transcranial direct current stimulation modulates theta response during a Go-NoGo task in traumatic brain injury. Clin Neurophysiol 2022; 143:36-47. [PMID: 36108520 PMCID: PMC10545365 DOI: 10.1016/j.clinph.2022.08.015] [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: 12/06/2021] [Revised: 08/08/2022] [Accepted: 08/24/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE High Definition transcranial Direct Current Stimulation (HD-tDCS) has been shown to improve cognitive performance in individuals with chronic traumatic brain injury (TBI), although electrophysiological mechanisms remain unclear. METHODS Veterans with TBI underwent active anodal (N = 15) vs sham (N = 10) HD-tDCS targeting the pre-supplementary motor area (pre-SMA). A Go-NoGo task was conducted simultaneously with electroencephalography (EEG) at baseline and after intervention completion. RESULTS We found increased theta event-related spectral perturbation (ERSP) and inter-trial phase coherence (ITPC) during Go in the frontal midline electrodes overlying the pre-SMA after active HD-tDCS intervention, but not after sham. We also found increased theta phase coherence during Go between the frontal midline and left posterior regions after active HD-tDCS. A late increase in alpha-theta ERSP was found in the left central region after active HD-tDCS. Notably, lower baseline theta ERSP/ITPC in the frontal midline region predicted more post-intervention improvement in Go performance only in the active group. CONCLUSIONS There are local and interregional oscillatory changes in response to HD-tDCS modulation in chronic TBI. SIGNIFICANCE These findings may guide future research in utilizing EEG time-frequency metrics not only to measure interventional effects, but also in selecting candidates who may optimally respond to treatment.
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Affiliation(s)
- Hsueh-Sheng Chiang
- Department of Neurology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W Campbell Rd, Richardson, TX 75080, USA.
| | - Michael Motes
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W Campbell Rd, Richardson, TX 75080, USA.
| | - Michael Kraut
- Department of Radiology, The Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21205, USA.
| | - Sven Vanneste
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W Campbell Rd, Richardson, TX 75080, USA; Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland.
| | - John Hart
- Department of Neurology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W Campbell Rd, Richardson, TX 75080, USA.
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Taylor AS, Setia N, Alpert L, Zhao L, Lamps LW, Hart J, Waxman I, Hissong E, Choi EYK, Shi J, Owens S, Westerhoff M. Measuring the Submucosal Depth of Invasion in Endoscopic Mucosal Resections for Barrett-associated Adenocarcinoma: Practical Issues and Relevance for the Decision for Esophagectomy. Arch Pathol Lab Med 2022; 146:1338-1344. [PMID: 35213893 PMCID: PMC9402809 DOI: 10.5858/arpa.2021-0072-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Endoscopic mucosal resection (EMR) has made it possible for Barrett esophagus patients with superficial cancers to be treated without esophagectomy. Recent guidelines recommend measuring depth of invasion (DOI) in submucosal cancers based on reports that in low-risk cancers, submucosal invasion 500 μm or less is associated with low nodal metastasis rates. However, pathologists face challenges in reproducibly measuring DOI. OBJECTIVE.— To determine how often DOI measurements could impact treatment and to evaluate reproducibility in measuring submucosal DOI in EMR specimens. DESIGN.— Consecutive adenocarcinoma EMR cases were identified, including cases of "low histologic risk" submucosal cancer, as follows: those with negative deep margins, no high-grade histology (G3), and no lymphovascular invasion. Submucosal DOI was measured by 7 pathologists according to guidelines. RESULTS.— Of 213 cancer EMR cases, 46 were submucosa invasive and 6 cases were low histologic risk submucosal cancers for which measurement could impact decision-making. Of these low histologic risk cases, 3 were categorized as superficial, indicating that measurement would be a clinically actionable decision point in only 1.4% of adenocarcinoma EMRs. Interobserver agreement for in-depth categorization between 7 pathologists was moderate (κ = 0.42), and the range of measurements spanned the 500-μm relevant threshold in 40 of 55 measured samples (72.7%). CONCLUSIONS.— While therapeutic decisions would rarely have depended on DOI measurements alone in our cohort, interobserver variability raises concerns about their use as a sole factor on which to offer patients conservative therapy. Responsibly reporting and clinically using submucosal DOI measurements will require practical experience troubleshooting common histologic artifacts, as well as multidisciplinary awareness of the impact of variable specimen-handling practices.
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Affiliation(s)
- Alexander S Taylor
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor, (Taylor, Lamps, Hissong, Choi, Shi, Owens, Westerhoff)
| | - Namrata Setia
- Department of Pathology (Setia, Alpert, Hart), University of Chicago, Chicago, Illinois
| | - Lindsay Alpert
- Department of Pathology (Setia, Alpert, Hart), University of Chicago, Chicago, Illinois
| | - Lili Zhao
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor (Zhao)
| | - Laura W Lamps
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor, (Taylor, Lamps, Hissong, Choi, Shi, Owens, Westerhoff)
| | - John Hart
- Department of Pathology (Setia, Alpert, Hart), University of Chicago, Chicago, Illinois
| | - Irving Waxman
- Department of Gastroenterology (Waxman), University of Chicago, Chicago, Illinois
- Center for Endoscopic Research and Therapeutics (Waxman), University of Chicago, Chicago, Illinois
| | - Erika Hissong
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor, (Taylor, Lamps, Hissong, Choi, Shi, Owens, Westerhoff)
| | - Eun-Young Karen Choi
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor, (Taylor, Lamps, Hissong, Choi, Shi, Owens, Westerhoff)
| | - Jiaqi Shi
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor, (Taylor, Lamps, Hissong, Choi, Shi, Owens, Westerhoff)
| | - Scott Owens
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor, (Taylor, Lamps, Hissong, Choi, Shi, Owens, Westerhoff)
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Fasbender D, Yamba U, Keuk K, Hart T, Hart J, Furuichi T. Bonobo social organization at the seasonal forest‐savanna ecotone of the Lomami national park. Am J Primatol 2022; 84:e23448. [DOI: 10.1002/ajp.23448] [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] [Received: 05/29/2022] [Revised: 08/11/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022]
Affiliation(s)
- David Fasbender
- Department of Primatology and Wildlife Science, Graduate School of Science Kyoto University Inuyama Japan
| | - Uyulu Yamba
- Institut Congolais pour la Conservation de la Nature Kinshasa Democratic Republic of Congo
| | - Kenneth Keuk
- Department of Primatology and Wildlife Science, Graduate School of Science Kyoto University Inuyama Japan
| | - Terese Hart
- TL2 Project of the Frankfurt Zoological Society Kinshasa Democratic Republic of Congo
| | - John Hart
- TL2 Project of the Frankfurt Zoological Society Kinshasa Democratic Republic of Congo
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Schaffert J, Bue CL, Hynan LS, Hart J, Rossetti H, Carlew AR, Lacritz L, White CL, Cullum CM. Erratum to: Predictors of Life Expectancy in Autopsy-Confirmed Alzheimer’s Disease. J Alzheimers Dis 2022; 90:929. [DOI: 10.3233/jad-229015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hart J, Okoro U, Mohr N, Ahmed A. 84 Bystander CPR Rates for Out-of-Hospital Cardiac Arrest Higher in Rural Areas Versus Urban Areas. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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LoBue C, Cullum CM, Hart J. Examination of the Proposed Criteria for Traumatic Encephalopathy Syndrome: Case Report of a Former Professional Football Player. J Neuropsychiatry Clin Neurosci 2022; 34:268-274. [PMID: 35272492 DOI: 10.1176/appi.neuropsych.21090225] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Christian LoBue
- Department of Psychiatry (all authors), Department of Neurological Surgery (LoBue, Cullum), and Department of Neurology (Cullum, Hart), University of Texas Southwestern Medical Center, Dallas; School of Behavioral and Brain Sciences, University of Texas at Dallas (Hart)
| | - C Munro Cullum
- Department of Psychiatry (all authors), Department of Neurological Surgery (LoBue, Cullum), and Department of Neurology (Cullum, Hart), University of Texas Southwestern Medical Center, Dallas; School of Behavioral and Brain Sciences, University of Texas at Dallas (Hart)
| | - John Hart
- Department of Psychiatry (all authors), Department of Neurological Surgery (LoBue, Cullum), and Department of Neurology (Cullum, Hart), University of Texas Southwestern Medical Center, Dallas; School of Behavioral and Brain Sciences, University of Texas at Dallas (Hart)
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Dugas CS, Keltner-Dorman E, Hart J. Differential effects from cognitive rehabilitation and high-definition tDCS in posterior cortical atrophy: A single-case experimental design. Neuropsychol Rehabil 2022; 32:1620-1642. [PMID: 34037503 DOI: 10.1080/09602011.2021.1927761] [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: 09/21/2020] [Accepted: 05/04/2021] [Indexed: 02/08/2023]
Abstract
Posterior cortical atrophy (PCA) is a progressive neurodegenerative syndrome characterized by visual-perceptual deficits, which impact daily life. Recent research has focused on non-pharmacological techniques to ameliorate these deficits, with the most common being cognitive rehabilitation. The present study investigates the differential effects of high definition-transcranial direct current stimulation (HD-tDCS) and cognitive rehabilitation in a single-case experimental design with two separate experimental phases in a patient with PCA. Experimental Phase 1 consisted of 10 sessions of HD-tDCS targeting the pre-SMA/dACC and Phase 2 consisted of 10 sessions of cognitive rehabilitation. Normed and standardized scores from figure copy and recall tests served as the primary outcome measures for visuospatial processing. The participant showed no immediate or long-term changes in visuospatial measures following HD-tDCS intervention. However, cognitive rehabilitation showed immediate improvement in visuospatial memory (figure recall) and clinically significant improvement in visuospatial construction (figure copy). Visuospatial construction gains remained in the low average range in the 10-week follow-up while visuospatial memory returned to baseline. Results indicated differential effects between HD-tDCS and cognitive rehabilitation with cognitive rehabilitation showing clinically significant improvement in primary outcome measures with sustained improvement in the long-term follow-up measure. Additional research is warranted to confirm these effects.
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Affiliation(s)
- Christine Sofka Dugas
- Department of Speech, Language and Hearing Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Elena Keltner-Dorman
- Department of Speech, Language and Hearing Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - John Hart
- Department of Speech, Language and Hearing Sciences, University of Texas at Dallas, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Akiyama S, Ollech JE, Traboulsi C, Rai V, Glick LR, Yi Y, Runde J, Olivas AD, Weber CR, Cohen RD, Olortegui KBS, Hurst RD, Umanskiy K, Shogan BD, Rubin MA, Dalal SR, Sakuraba A, Pekow J, Chang EB, Hart J, Hyman NH, Rubin DT. Histopathology of Colectomy Specimens Predicts Endoscopic Pouch Phenotype in Patients with Ulcerative Colitis. Dig Dis Sci 2022; 67:4020-4031. [PMID: 35288827 PMCID: PMC10966959 DOI: 10.1007/s10620-022-07405-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/29/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The endoscopic appearance in patients with "pouchitis" after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) can be quite heterogenous. Patients with an endoscopic phenotype resembling Crohn's disease (CD) are at high risk of pouch loss. AIMS We aimed to assess how the histopathology of colectomy specimens predicts endoscopic pouch phenotypes in UC. METHODS We retrospectively assessed pouchoscopies from patients with UC who underwent IPAA and classified pouch findings into 7 main phenotypes: (1) normal, (2) afferent limb involvement, (3) inlet involvement, (4) diffuse, (5) focal inflammation of the pouch body, (6) cuffitis, and (7) pouch with fistulas noted ≥ 6 months from ileostomy takedown. We assessed the clinical and pathological data including deep, focal inflammation, granulomas, and terminal ileal involvement in the colectomy specimens. Logistic regression analysis was performed to identify contributing factors to each phenotype. RESULTS This study included 1,203 pouchoscopies from 382 patients with UC. On multivariable analysis, deep inflammation was significantly associated with pouch fistulas (Odds ratio 3.27; 95% confidence interval 1.65-6.47; P = 0.0007). Of the 75 patients with deep inflammation, only two patients (2.7%) were diagnosed with CD based on pathology review. Terminal ileal involvement significantly increased the risk of afferent limb involvement (Odds ratio 2.96; 95% confidence interval 1.04-8.47; P = 0.04). There were no significant associations between other microscopic features and phenotypes. CONCLUSIONS We identify histologic features of colectomy specimens in UC that predict subsequent pouch phenotypes. Particularly, deep inflammation in the resected colon was significantly associated with pouch fistulas, a pouch phenotype with poor prognosis.
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Affiliation(s)
- Shintaro Akiyama
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Jacob E Ollech
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Cindy Traboulsi
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Victoria Rai
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Laura R Glick
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Yangtian Yi
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Joseph Runde
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Andrea D Olivas
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Christopher R Weber
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Russell D Cohen
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Kinga B Skowron Olortegui
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Roger D Hurst
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Konstantin Umanskiy
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Benjamin D Shogan
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Michele A Rubin
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Sushila R Dalal
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Atsushi Sakuraba
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Joel Pekow
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Eugene B Chang
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - John Hart
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - Neil H Hyman
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA
| | - David T Rubin
- University of Chicago Medicine Inflammatory Bowel Disease Center, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA.
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Chaima D, Hart J, Pickering H, Burr S, Maleta K, Kalua K, Bailey R, Holland M. Association between intestinal bacterial carriage, biomarkers of environmental enteric dysfunction, and stunting in rural Malawian children. Gates Open Res 2022. [DOI: 10.12688/gatesopenres.13671.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. Available data from murine studies suggest that intestinal bacteria may have a role in modulating growth phenotypes in the host. We investigated the prevalence of four gut bacteria known in murine models to impair growth (Bifidobacterium longum, Faecalibacterium prausnitzii, Dorea formicigenerans, and Akkermansia muciniphila), the level of fecal biomarkers of environmental enteric dysfunction (EED) and stunting in rural Malawian children. Methods. DNA and protein were extracted from fecal samples of rural Malawian children (aged 1-59 months) at a baseline cross-sectional survey in the Mangochi district of Malawi conducted within the framework of the Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) trial. Intestinal carriage of bacteria was measured by PCR. Neopterin (NEO), myeloperoxidase (MPO), and alpha-1 antitrypsin (AAT), biomarkers of EED, were measured by an enzyme-linked immunosorbent assay (ELISA) test. Height-for-age Z (HAZ) score <-2 defined stunting. Tests of proportions and regression models were used to explore the relationship between bacterial carriage, EED, and stunting. Results. Fecal samples from 613 children were available for laboratory analyses. F. prausnitzii and D. formicigenerans were prevalent in over 70% of children while B. longum was the least prevalent. B. longum carriage in younger children was associated with elevated EED biomarkers. Two thirds of children had elevated NEO, 33% had elevated MPO, and 16% had elevated AAT. Stunting was found in 38%. No significant associations were found between EED biomarkers or intestinal bacteria carriage and stunting. Conclusion. Intestinal carriage of these four bacteria was not associated with stunting in Malawian children. Carriage was also not associated with EED, nor EED biomarker levels associated with stunting. Further factors acting in concert are necessary to impact EED, perturb growth, and alter gut bacterial carriage.
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Conley M, Schaffert J, Cullum CM, Hart J, Didehbani N. A-10 Influence of Different Normative Reference Standards among Cognitively Normal Former NFL Players. Arch Clin Neuropsychol 2022. [DOI: 10.1093/arclin/acac32.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose: Demographic adjustments (e.g., age, sex, race/ethnicity) to neuropsychological tests can assist clinical interpretation and avoid false-positive diagnoses of cognitive impairment. The issue of “race” as a criterion for normative adjustment has been highlighted in recent cases among former NFL players. We examined the impact of different normative reference comparisons on neuropsychological scores among cognitively normal Black and White NFL retirees. Methods: Cognitively normal Black (n = 20) and White (n = 20) retirees were age- and education-matched. Measures of attention (Digit Span), processing speed (Coding, TMTA), memory (ROCFT, CVLT), language (FAS, Animals, BNT), and executive function (TMTB) were examined. Independent samples t-tests (using p < 0.01) were conducted between raw and normative scores of Black and White retirees that adjusted for 1) age/education (Mitrushina); 2) age/education/sex (NACC); and 3) age/education/sex/race (Heaton, MOANS/MOAANS). An additional ANCOVA evaluated group differences controlling for baseline estimated IQ. Results: Raw scores differed between groups on TMTB, Coding, and BNT. Mitrushina normative data showed differences on TMTB (p = 0.007) and BNT (p < 0.001). NACC normative data showed differences on the BNT (p < 0.001). ANCOVA (controlling for IQ) of raw scores between groups differed on the BNT (p = 0.002). Heaton and MOANS/MOAANS normative scores did not reveal differences between groups on any test. Conclusions: As expected, the use of different neuropsychological norms influences findings across different sociodemographic groups to various degrees, depending on the test. The underlying contributors to group differences using “race” as a proxy need to be disentangled and understood. Cautious use of demographically-adjusted norms as interpretive guidelines is warranted until these factors are identified.
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Lee ACH, Edobor A, Lysandrou M, Mirle V, Sadek A, Johnston L, Piech R, Rose R, Hart J, Amundsen B, Jendrisak M, Millis JM, Donington J, Madariaga ML, Barth RN, di Sabato D, Shanmugarajah K, Fung J. The Effect of Normothermic Machine Perfusion on the Immune Profile of Donor Liver. Front Immunol 2022; 13:788935. [PMID: 35720395 PMCID: PMC9201055 DOI: 10.3389/fimmu.2022.788935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 10/03/2021] [Accepted: 05/02/2022] [Indexed: 12/29/2022] Open
Abstract
Background Normothermic machine perfusion (NMP) allows viability assessment and potential resuscitation of donor livers prior to transplantation. The immunological effect of NMP on liver allografts is undetermined, with potential implications on allograft function, rejection outcomes and overall survival. In this study we define the changes in immune profile of human livers during NMP. Methods Six human livers were placed on a NMP device. Tissue and perfusate samples were obtained during cold storage prior to perfusion and at 1, 3, and 6 hours of perfusion. Flow cytometry, immunohistochemistry, and bead-based immunoassays were used to measure leukocyte composition and cytokines in the perfusate and within the liver tissue. Mean values between baseline and time points were compared by Student’s t-test. Results Within circulating perfusate, significantly increased frequencies of CD4 T cells, B cells and eosinophils were detectable by 1 hour of NMP and continued to increase at 6 hours of perfusion. On the other hand, NK cell frequency significantly decreased by 1 hour of NMP and remained decreased for the duration of perfusion. Within the liver tissue there was significantly increased B cell frequency but decreased neutrophils detectable at 6 hours of NMP. A transient decrease in intermediate monocyte frequency was detectable in liver tissue during the middle of the perfusion run. Overall, no significant differences were detectable in tissue resident T regulatory cells during NMP. Significantly increased levels of pro-inflammatory and anti-inflammatory cytokines were seen following initiation of NMP that continued to rise throughout duration of perfusion. Conclusions Time-dependent dynamic changes are seen in individual leukocyte cell-types within both perfusate and tissue compartments of donor livers during NMP. This suggests a potential role of NMP in altering the immunogenicity of donor livers prior to transplant. These data also provide insights for future work to recondition the intrinsic immune profile of donor livers during NMP prior to transplantation.
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Affiliation(s)
| | - Arianna Edobor
- Department of Surgery, University of Chicago, Chicago, IL, United States
| | - Maria Lysandrou
- Biological Sciences Division, University of Chicago, Chicago, IL, United States
| | - Vikranth Mirle
- Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
| | - Amir Sadek
- Department of Surgery, University of Chicago, Chicago, IL, United States
| | - Laura Johnston
- Biological Sciences Division, University of Chicago, Chicago, IL, United States
| | - Ryan Piech
- Department of Surgery, University of Chicago, Chicago, IL, United States
| | - Rebecca Rose
- Department of Surgery, University of Chicago, Chicago, IL, United States
| | - John Hart
- Department of Pathology, University of Chicago, Chicago, IL, United States
| | - Beth Amundsen
- Gift of Hope Tissue and Donor Network, Itasca, IL, United States
| | - Martin Jendrisak
- Gift of Hope Tissue and Donor Network, Itasca, IL, United States
| | | | - Jessica Donington
- Section of Transplant Surgery, Department of Surgery, University of Chicago, Chicago, IL, United States
| | - Maria Lucia Madariaga
- Section of Transplant Surgery, Department of Surgery, University of Chicago, Chicago, IL, United States
| | - Rolf N Barth
- Section of Thoracic Surgery, Department of Surgery, University of Chicago, Chicago, IL, United States
| | - Diego di Sabato
- Section of Thoracic Surgery, Department of Surgery, University of Chicago, Chicago, IL, United States
| | | | - John Fung
- Section of Thoracic Surgery, Department of Surgery, University of Chicago, Chicago, IL, United States
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Hermanson JB, Fei N, Miyoshi S, Miyoshi J, Hawkins M, Xie B, Sulakhe D, Hart J, Chang EB, Leone VA, Charlton M. Dietary Cholesterol‐Induced Gut Microbes Drive Nonalcoholic Fatty Liver Disease Pathogenesis in a Murine Model. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.0r748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Na Fei
- Department of MedicineUniversity of ChicagoChicagoIL
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44
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Thelwell M, Bullas A, Kühnapfel A, Hart J, Ahnert P, Wheat J, Loeffler M, Scholz M, Choppin S. Modelling of human torso shape variation inferred by geometric morphometrics. PLoS One 2022; 17:e0265255. [PMID: 35271672 PMCID: PMC8912174 DOI: 10.1371/journal.pone.0265255] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 09/25/2021] [Accepted: 02/26/2022] [Indexed: 02/06/2023] Open
Abstract
Traditional body measurement techniques are commonly used to assess physical health; however, these approaches do not fully represent the complex shape of the human body. Three-dimensional (3D) imaging systems capture rich point cloud data that provides a representation of the surface of 3D objects and have been shown to be a potential anthropometric tool for use within health applications. Previous studies utilising 3D imaging have only assessed body shape based on combinations and relative proportions of traditional body measures, such as lengths, widths and girths. Geometric morphometrics (GM) is an established framework used for the statistical analysis of biological shape variation. These methods quantify biological shape variation after the effects of non-shape variation-location, rotation and scale-have been mathematically held constant, otherwise known as the Procrustes paradigm. The aim of this study was to determine whether shape measures, identified using geometric morphometrics, can provide additional information about the complexity of human morphology and underlying mass distribution compared to traditional body measures. Scale-invariant features of torso shape were extracted from 3D imaging data of 9,209 participants form the LIFE-Adult study. Partial least squares regression (PLSR) models were created to determine the extent to which variations in human torso shape are explained by existing techniques. The results of this investigation suggest that linear combinations of body measures can explain 49.92% and 47.46% of the total variation in male and female body shape features, respectively. However, there are also significant amounts of variation in human morphology which cannot be identified by current methods. These results indicate that Geometric morphometric methods can identify measures of human body shape which provide complementary information about the human body. The aim of future studies will be to investigate the utility of these measures in clinical epidemiology and the assessment of health risk.
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Affiliation(s)
- Michael Thelwell
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
- * E-mail:
| | - Alice Bullas
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
| | - Andreas Kühnapfel
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - John Hart
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
| | - Peter Ahnert
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Jon Wheat
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
| | - Markus Loeffler
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Markus Scholz
- LIFE Research Center for Civilisation Diseases, Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
- IFB Adiposity Diseases, Leipzig University, Leipzig, Germany
| | - Simon Choppin
- Advanced Wellbeing Research Centre, Health Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
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45
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Chiang HS, Shakal S, Strain JF, Womack K, Kraut M, Vanneste S, Hart J. Reversal of unilateral hand movement dysfunction by high definition transcranial direct current stimulation in a patient with chronic traumatic brain injury. Brain Stimul 2022; 15:283-285. [PMID: 35066190 DOI: 10.1016/j.brs.2022.01.010] [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] [Received: 01/04/2022] [Accepted: 01/16/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Hsueh-Sheng Chiang
- Department of Neurology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard Dallas, Texas, 75390, USA; The University of Texas Southwestern Medical Center, Dallas, TX, USA; The University of Texas at Dallas, Richardson, TX, USA.
| | - Scott Shakal
- The University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
| | - Jeremy F Strain
- Department of Neurology, Washington University in St. Louis, 660 S Euclid Ave, St. Louis, MO, 63108, USA.
| | - Kyle Womack
- Department of Neurology, Washington University in St. Louis, Campus Box 8111, 4488 Forest Park, Suite 200, St. Louis, MO, 63108, USA.
| | - Michael Kraut
- Department of Radiology, The Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD, 21205, USA.
| | - Sven Vanneste
- Trinity College Dublin, The University of Dublin, College Green Dublin 2, Ireland.
| | - John Hart
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W Campbell Rd, Richardson, TX, 75080, USA; Department of Neurology and Psychiatry, The University of Texas Southwestern Medical Center, USA.
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46
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Sharma AE, Olivas A, Parilla M, Yassan L, Wang H, Zhang SS, Weber C, Keutgen XM, Hart J, Krausz T, Setia N. Epigenetic Dysregulation of 5-hydroxymethylcytosine in Well-Differentiated Pancreatic Neuroendocrine Tumors. Appl Immunohistochem Mol Morphol 2022; 30:e11-e15. [PMID: 34711739 DOI: 10.1097/pai.0000000000000982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/14/2021] [Indexed: 10/20/2022]
Abstract
Dysregulation of epigenetic mechanisms, reflected by loss of expression of 5-hydroxymethylcytosine (5-hmC) is being increasingly recognized as a marker of aggressive behavior in several neoplasms; however, the role of such epigenetic modifiers in pancreatic neuroendocrine tumors (PanNETs) has not been studied. Annotated cohort of 60 PanNETs was evaluated for 5-hmC expression using immunohistochemistry. Univariable and multivariable analyses were performed. To determine intratumor heterogeneity of 5-hmC expression, 26 additional synchronous metastatic deposits of PanNETs from 8 patients were evaluated for 5-hmC expression. 5-hmC level showed significant association with the presence of distant metastases (P=0.02), female sex (P=0.04), and Ki-67 proliferation index (P=0.002). A multivariate model created using the stepwise logistic regression analysis showed the presence of nodal metastases (odds ratio=6.15), lymphovascular invasion (odds ratio=4.07) and lack of 5-hmC expression (odds ratio=5.34) were predictive of the risk of distant metastasis in PanNETs with a c-statistic of 0.845. Epigenetic intratumoral heterogeneity of 5-hmC expression was seen in 37.5% cases (3/8). Our work provides evidence that epigenetic regulators are involved in the pathobiology of PanNETs and immunohistochemical analysis of 5-hmC may be able to refine prognostic evaluation of these tumors.
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Affiliation(s)
| | | | - Megan Parilla
- Department of Pathology, Loyola University, Chicago, IL
| | | | - Hanlin Wang
- Department of Pathology and Laboratory Medicine, UCLA, Los Angeles
| | | | | | - Xavier M Keutgen
- Division of General Surgery and Surgical Oncology, Endocrine and Neuroendocrine Surgery Research Program, Department of Surgery, University of Chicago Medical Center
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47
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Tillman GD, Motes MA, Bass CM, Morris EE, Jones P, Kozel FA, Hart J, Kraut MA. Auditory N2 Correlates of Treatment Response in Posttraumatic Stress Disorder. J Trauma Stress 2022; 35:90-100. [PMID: 33960006 DOI: 10.1002/jts.22684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/18/2021] [Accepted: 03/21/2021] [Indexed: 11/06/2022]
Abstract
Emotional processing and cognitive control are implicated as being dysfunctional in posttraumatic stress disorder (PTSD) and targeted in cognitive processing therapy (CPT), a trauma-focused treatment for PTSD. The N2 event-related potential has been interpreted in the context of emotional processing and cognitive control. In this analysis of secondary outcome measures from a randomized controlled trial, we investigated the latency and amplitude changes of the N2 in responses to task-relevant target tones and task-irrelevant distractor sounds (e.g., a trauma-related gunshot and a trauma-unrelated lion's roar) and the associations between these responses and PTSD symptom changes. United States military veterans (N = 60) diagnosed with combat-related PTSD were randomized to either active or sham repetitive transcranial magnetic stimulation (rTMS) and received a CPT intervention that included a written trauma account element (CPT+A). Participants were tested before and 6 months after protocol completion. Reduction in N2 amplitude to the gunshot stimulus was correlated with reductions in reexperiencing, |r| = .445, and hyperarousal measures, |r| = .364. In addition, in both groups, the latency of the N2 event-related potential to the distractors became longer with treatment and the N2 latency to the task-relevant stimulus became shorter, ηp 2 = .064, both of which are consistent with improved cognitive control. There were no between-group differences in N2 amplitude and latency. Normalized N2 latencies, reduced N2 amplitude to threatening distractors, and the correlation between N2 amplitude reduction and PTSD symptom reduction reflect improved cognitive control, consistent with the CPT+A objective of addressing patients' abilities to respond more appropriately to trauma triggers.
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Affiliation(s)
- Gail D Tillman
- Callier Center, University of Texas at Dallas, Dallas, Texas, USA
| | - Michael A Motes
- Callier Center, University of Texas at Dallas, Dallas, Texas, USA
| | - Christina M Bass
- Callier Center, University of Texas at Dallas, Dallas, Texas, USA
| | | | - Penelope Jones
- Callier Center, University of Texas at Dallas, Dallas, Texas, USA
| | - F Andrew Kozel
- Mental Health and Behavioral Sciences, James A. Haley Veterans Administration Hospital and Clinics, Tampa, Florida, USA.,Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - John Hart
- Callier Center, University of Texas at Dallas, Dallas, Texas, USA.,Departments of Neurology & Neurotherapeutics and Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael A Kraut
- Departments of Neurology & Neurotherapeutics and Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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48
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Schaffert J, LoBue C, Hynan LS, Hart J, Rossetti H, Carlew AR, Lacritz L, White CL, Cullum CM. Predictors of Life Expectancy in Autopsy-Confirmed Alzheimer's Disease. J Alzheimers Dis 2022; 86:271-281. [PMID: 35034898 PMCID: PMC8966055 DOI: 10.3233/jad-215200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/25/2023]
Abstract
BACKGROUND Life expectancy (LE) following Alzheimer's disease (AD) is highly variable. The literature to date is limited by smaller sample sizes and clinical diagnoses. OBJECTIVE No study to date has evaluated predictors of AD LE in a retrospective large autopsy-confirmed sample, which was the primary objective of this study. METHODS Participants (≥50 years old) clinically and neuropathologically diagnosed with AD were evaluated using National Alzheimer's Coordinating Center (N = 1,401) data. Analyses focused on 21 demographic, medical, neuropsychiatric, neurological, functional, and global cognitive predictors of LE at AD dementia diagnosis. These 21 predictors were evaluated in univariate analyses. Variables found to be significant were then entered into a forward multiple regression. LE was defined as months between AD diagnosis and death. RESULTS Fourteen predictors were significant in univariate analyses and entered into the regression. Seven predictors explained 27% of LE variance in 764 total participants. Mini-Mental State Examination (MMSE) score was the strongest predictor of LE, followed by sex, age, race/ethnicity, neuropsychiatric symptoms, abnormal neurological exam results, and functional impairment ratings. Post-hoc analyses revealed correlations of LE were strongest with MMSE ≤12. CONCLUSION Global cognitive functioning was the strongest predictor of LE following diagnosis, and AD patients with severe impairment had the shortest LE. AD patients who are older, male, white, and have more motor symptoms, functional impairment, and neuropsychiatric symptoms were also more likely have shorter LE. While this model cannot provide individual prognoses, additional studies may focus on these variables to enhance predictions of LE in patients with AD.
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Affiliation(s)
- Jeff Schaffert
- Department of Psychiatry, University of Texas Southwestern
Medical Center, Dallas, TX, USA
| | - Christian LoBue
- Department of Psychiatry, University of Texas Southwestern
Medical Center, Dallas, TX, USA,Department of Neurological Surgery, University of Texas
Southwestern Medical Center, Dallas, TX, USA
| | - Linda S. Hynan
- Department of Psychiatry, University of Texas Southwestern
Medical Center, Dallas, TX, USA,Department of Population and Data Sciences, University of
Texas Southwestern Medical Center, Dallas, TX, USA
| | - John Hart
- Department of Psychiatry, University of Texas Southwestern
Medical Center, Dallas, TX, USA,Callier Center, School of Behavioral and Brain Sciences, UT
Dallas, Dallas, TX, USA,Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, TX, USA
| | - Heidi Rossetti
- Department of Psychiatry, University of Texas Southwestern
Medical Center, Dallas, TX, USA
| | - Anne R. Carlew
- Department of Psychiatry, University of Texas Southwestern
Medical Center, Dallas, TX, USA
| | - Laura Lacritz
- Department of Psychiatry, University of Texas Southwestern
Medical Center, Dallas, TX, USA,Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, TX, USA
| | - Charles L. White
- Department of Pathology, University of Texas Southwestern
Medical Center, Dallas, TX, USA
| | - C. Munro Cullum
- Department of Psychiatry, University of Texas Southwestern
Medical Center, Dallas, TX, USA,Department of Neurological Surgery, University of Texas
Southwestern Medical Center, Dallas, TX, USA,Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, TX, USA,Correspondence to: C. Munro Cullum, ABPP/CN,
University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., MC9044,
Dallas, TX 75390, USA. Tel.: +1 214 648 5277;
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49
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Gupta N, Rodríguez-Ruiz G, Siddiqui UD, Chapman CG, Donboli K, Hart J, Xiao SY, Waxman I. Endoscopic submucosal dissection for colorectal lesions: outcomes from a United States experience. Surg Endosc 2022; 36:236-243. [PMID: 33523276 DOI: 10.1007/s00464-020-08262-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 08/11/2020] [Accepted: 12/22/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND STUDY AIMS Endoscopic submucosal dissection (ESD) is commonly used in Asia for resection of large non-pedunculated colorectal polyps (LNPCPs) and early (T1) colorectal cancers. It allows for en bloc removal and is often curative. We describe outcomes of colorectal ESD from a United States (US) academic medical center and compare this to international experiences. METHODS Retrospective review was performed of colonic lesions referred to the University of Chicago Medical Center for ESD from 2012 to 2020. Clinical and procedural data were collected. RESULTS The study included 78 lesions with mean size of 29.7 mm (range 10-100 mm). The overall en bloc resection rate was 73.1% (n = 57). Between the first and second half of the study, it improved from 61.5 to 84.6% (p = 0.02). Histology showed adenocarcinoma in fifteen lesions (19.2%). Of all neoplastic lesions (n = 68), resection with negative margins (R0) was achieved in 54 cases (79.4%). Adverse events occurred in 9 cases (11.5%), but most (n = 6, 66.7%) were successfully treated endoscopically. Follow-up endoscopy was performed in 46 patients (59.0%) at a mean interval of 6.8 months (SD ± 5.0 months) with two case of recurrent lesion (4.3%). CONCLUSIONS This study shows successful colorectal ESD outcomes at a US tertiary center. The en bloc resection rate was lower than other cohorts, but a learning curve was demonstrated. The R0 resection, lesion recurrence, and adverse event rates were similar to other non-Asian experiences, but not as favorable as in Asia [Fuccio et al. in Gastrointest Endosc 86:74-86.e17, 2017]. Increased ESD training in the US can help optimize utilization and outcomes.
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Affiliation(s)
- Nina Gupta
- Center for Endoscopic Research and Therapeutics (CERT), The University of Chicago Medicine, Chicago, IL, USA.
| | | | - Uzma D Siddiqui
- Center for Endoscopic Research and Therapeutics (CERT), The University of Chicago Medicine, Chicago, IL, USA
| | - Christopher G Chapman
- Center for Endoscopic Research and Therapeutics (CERT), The University of Chicago Medicine, Chicago, IL, USA
| | - Kianoush Donboli
- Center for Endoscopic Research and Therapeutics (CERT), The University of Chicago Medicine, Chicago, IL, USA
| | - John Hart
- Department of Pathology, The University of Chicago Medicine, Chicago, IL, USA
| | - Shu-Yuan Xiao
- Department of Pathology, The University of Chicago Medicine, Chicago, IL, USA
| | - Irving Waxman
- Center for Endoscopic Research and Therapeutics (CERT), The University of Chicago Medicine, Chicago, IL, USA
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50
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LoBue C, Kelley BJ, Hart J, Helphrey J, Schaffert J, Cullum CM, Peters ME, Douglas PM. Mild Traumatic Brain Injury Is Related to Elevated Cerebrospinal Fluid Tau in Alzheimer's Disease Dementia. J Alzheimers Dis 2022; 87:1491-1496. [PMID: 35491792 PMCID: PMC9241585 DOI: 10.3233/jad-220112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/03/2023]
Abstract
Few studies have examined an association between mild traumatic brain injury (mTBI) and Alzheimer's disease (AD). For this reason, we compared an AD dementia group with an mTBI history (n = 10) to a matched AD control group (n = 20) on measures of cognitive function, cerebral glucose metabolism, and markers of amyloid and tau deposition. Only a trend and medium-to-large effect size for higher phosphorylated and total tau was identified for the mTBI group. A history of mTBI may be associated with greater tau in AD, indicating a potential pathway for increasing risk for AD, though further evaluation with larger samples is needed.
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Affiliation(s)
- Christian LoBue
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX,Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Brendan J. Kelley
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX
| | - John Hart
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX,School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX
| | - Jessica Helphrey
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jeff Schaffert
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | - C. Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX,Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Matthew E. Peters
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Peter M. Douglas
- Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX
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